Experts recommend strategies for strengthening the use of advanced practice nurses in nursing homes.
In 2003, The John A. Hartford Foundation Institute for Geriatric Nursing, New York University Division of Nursing, convened an expert panel to explore the potential for developing recommendations for the caseloads of advanced practice nurses (APNs) in nursing homes and to provide substantive and detailed strategies to strengthen the use of APNs in nursing homes. The panel, consisting of nationally recognized experts in geriatric practice, education, research, public policy, and long-term care, developed six recommendations related to caseloads for APNs in nursing homes. The recommendations address educational preparation of APNs; average reimbursable APN visits per day; factors affecting APNs caseload parameters, including provider characteristics, practice models, resident acuity, and facility factors; changes in Medicare reimbursement to acknowledge nonbillable time spent in resident care; and technical assistance to promote a climate conducive to APN practice in nursing homes. Detailed research findings and clinical expertise underpin each recommendation. These recommendations provide practitioners, payers, regulators, and consumers with a rationale and details of current advanced practice nursing models and caseload parameters, preferred geriatric education, reimbursement strategies, and a range of technical assistance necessary to strengthen, enhance, and increase APNs' participation in the care of nursing home residents.
Mezey
Mathy
M
John A. Hartford Foundation Institute for Geriatric Nursing, New York University, Steinhardt School of Education, Division of Nursing, NY, NY 10003, USA. mathy.mezey@nyu.edu
Burger
Sarah Greene
SG
Bloom
Harrison G
HG
Bonner
Alice
A
Bourbonniere
Mary
M
Bowers
Barbara
B
Burl
Jeffrey B
JB
Capezuti
Elizabeth
E
Carter
Diane
D
Dimant
Jacob
J
Jerro
Sarah A
SA
Reinhard
Susan C
SC
Ter Maat
Marilyn
M
D000368:Aged; D004511:Education, Nursing, Graduate; D005851:Geriatric Nursing / Q000193:education; D006707:Homes for the Aged / Q000191:economics; D006801:Humans; D006278:Medicare / Q000191:economics; D009720:Nurse Clinicians / Q000191:economics / Q000706:statistics & numerical data*; D009722:Nurse Practitioners / Q000191:economics / Q000706:statistics & numerical data*; D009735:Nursing Homes / Q000191:economics; D010560:Personnel Selection / Q000706:statistics & numerical data; D011361:Professional Competence; D012051:Reimbursement Mechanisms / Q000191:economics; D013038:Specialization; D014481:United States; D000078329:Workforce