Do nurse practitioners make a difference in provision of health counseling in hospital outpatient departments?
OBJECTIVE
This study examined whether nurse practitioners (NPs) had any impact on the type and amount of health counseling provided during patient visits to hospital outpatient departments (OPDs).


METHODS
This is a secondary data analysis of the National Hospital Ambulatory Medical Care Survey from 1997 to 2000. Only patient visits to hospital OPDs were included. Rates of health counseling provided at patient visits involving an NP were compared with those without an NP. Adjusted odds ratio was reported separately for each type of health counseling provided at patient visits for nonillness care, for chronic problems, and for acute problems.


CONCLUSIONS
Health counseling for diet, exercise, human immunodeficiency virus (HIV) and sexually transmitted disease (STD) prevention, tobacco use, and injury prevention are more likely to be provided at nonillness care visits involving an NP than at those not involving an NP. The presence of an NP is associated not only with higher rates of counseling for diet, exercise, and tobacco use provided at patient visits for chronic problems but also with higher rates of counseling for diet and HIV/STD prevention provided at patient visits for acute problems.


CONCLUSIONS
This study indicates an important role NPs can play in providing preventive services in outpatient hospital departments. The findings reflect the emphasis of the NP education on health counseling and patient education in clinical practice.
Lin
Susan X
SX
Columbia University School of Nursing, New York, NY, USA. XL18@columbia.edu
Gebbie
Kristine M
KM
Fullilove
Robert E
RE
Arons
Raymond R
RR
D000208:Acute Disease / Q000451:nursing; D002908:Chronic Disease / Q000451:nursing; D003376:Counseling / Q000458:organization & administration*; D003430:Cross-Sectional Studies; D004032:Diet; D019317:Evidence-Based Medicine; D015444:Exercise; D019538:Health Care Surveys; D006801:Humans; D016015:Logistic Models; D009722:Nurse Practitioners / Q000458:organization & administration*; D024802:Nurse's Role; D015403:Nursing Evaluation Research; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration*; D011314:Preventive Health Services / Q000592:standards; D012749:Sexually Transmitted Diseases / Q000517:prevention & control; D000074606:Smoking Prevention; D017749:Total Quality Management; D014947:Wounds and Injuries / Q000517:prevention & control