Cover: Effects of a Geriatric Nurse Practitioner on Process and Outcome of Nursing Home Care

Effects of a Geriatric Nurse Practitioner on Process and Outcome of Nursing Home Care

Published in: American Journal of Public Health, v. 79, no. 9, Sep. 1989, p. 1271-1277

Posted on 1989

by Robert L. Kane, Judith Garrard, Carol Skay, David M. Radosevich, Joan L. Buchanan, Susan McDermott, Sharon B. Arnold, Loyd Kepferle

The authors compared measures of quality of care and health services utilization in 30 nursing homes employing geriatric nurse practitioners with those in 30 matched control homes. Information for this analysis came from reviews of samples of patient records drawn at comparable periods before and after the geriatric NPs were employed. The measures of geriatric nurse practitioner impact were based on comparisons of changes from pre-NP to post-NP periods. Separate analyses were done for newly admitted and long-stay residents; a subgroup of homes judged to be best case examples was analyzed separately as well as the whole sample. Favorable changes were seen in two out of eight activity of daily living (ADL) measures: five of 18 nursing therapies; two of six drug therapies; six of eight tracers. There was some reduction in hospital admissions and total days in geriatric NP homes. Overall measures of medical attention showed a mixed pattern with some evidence of geriatric NP care substituted for physician care. These findings suggest that the geriatric NP has a useful role in nursing home care.

This report is part of the RAND external publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

RAND is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.