TY - JOUR
T1 - Home-based primary care visits by nurse practitioners
AU - Sun, Chun An
AU - Parslow, Chad
AU - Gray, Ja'Lynn
AU - Koyfman, Irina
AU - Hladek, Melissa Decardi
AU - Han, Hae Ra
N1 - Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.
PY - 2022/6/19
Y1 - 2022/6/19
N2 - Background:With rapidly growing numbers of homebound older adults, the need for effective home-based health interventions is increasingly recognized. Advanced practice registered nurses (NPs) are one of the most common providers of home-based primary care. Limited information is available to address the scope and nature of NP-led home-based primary care and associated outcomes.Objective:To synthesize research evidence of NP visits in home-based primary care.Data Sources:Six electronic databases-PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, Cochrane, Web of Science, and Scopus-were searched to identify peer-reviewed research articles addressing home-based primary care interventions led by NPs. Independent screening resulted in 17 relevant articles from 14 unique studies to include in the review.Conclusions:Nurse practitioners provided health assessments, education, care planning and coordination primarily by face-To-face home visits. Despite a variability in terms of study design, setting, and sample, NP-led home-based primary care was in general associated with less hospitalization and fewer emergency department visits. Evidence was mixed in relation to patient-reported outcomes such as subjective health, functional status, and symptoms. Costs and patient or caregiver satisfaction were additional outcomes addressed, but the findings were inconsistent.Implications for Practice:Recent policy changes to authorize NPs to independently assess, diagnose, and order home care services directly affect how NPs approach home-based primary care programs. Our findings support NP-led home-based primary care to decrease consequential health utilization and suggest the need for further evaluating the care models in diverse populations with more patient-reported and caregiver outcomes.
AB - Background:With rapidly growing numbers of homebound older adults, the need for effective home-based health interventions is increasingly recognized. Advanced practice registered nurses (NPs) are one of the most common providers of home-based primary care. Limited information is available to address the scope and nature of NP-led home-based primary care and associated outcomes.Objective:To synthesize research evidence of NP visits in home-based primary care.Data Sources:Six electronic databases-PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, Cochrane, Web of Science, and Scopus-were searched to identify peer-reviewed research articles addressing home-based primary care interventions led by NPs. Independent screening resulted in 17 relevant articles from 14 unique studies to include in the review.Conclusions:Nurse practitioners provided health assessments, education, care planning and coordination primarily by face-To-face home visits. Despite a variability in terms of study design, setting, and sample, NP-led home-based primary care was in general associated with less hospitalization and fewer emergency department visits. Evidence was mixed in relation to patient-reported outcomes such as subjective health, functional status, and symptoms. Costs and patient or caregiver satisfaction were additional outcomes addressed, but the findings were inconsistent.Implications for Practice:Recent policy changes to authorize NPs to independently assess, diagnose, and order home care services directly affect how NPs approach home-based primary care programs. Our findings support NP-led home-based primary care to decrease consequential health utilization and suggest the need for further evaluating the care models in diverse populations with more patient-reported and caregiver outcomes.
KW - Home-based primary care
KW - nurse practitioner
KW - systematic review
UR - http://www.scopus.com/inward/record.url?scp=85131701882&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85131701882&partnerID=8YFLogxK
U2 - 10.1097/JXX.0000000000000706
DO - 10.1097/JXX.0000000000000706
M3 - Review article
C2 - 35439205
AN - SCOPUS:85131701882
SN - 2327-6886
VL - 34
SP - 802
EP - 812
JO - Journal of the American Association of Nurse Practitioners
JF - Journal of the American Association of Nurse Practitioners
IS - 6
ER -