Posted: September 29th, 2023
NP in primary care
NP in primary care. Write a formal paper in APA format with a title page, introduction, the three required elements below, conclusion, and reference page.
You are now employed as an NP in primary care.
Develop three different patient interventions for that one performance measure and how you would specifically implement the intervention and measure the outcomes for that particular performance measure in clinical practice.
How would these primary care interventions result in improved patient outcomes and healthcare cost savings?
How can these interventions result in improved NP patient ratings?
Article 1https://www.ajog.org/article/S0002-9378(31)90332-3/pdf the others are uploaded as PDFs
in case u need extra articles
Title: Improving Patient Outcomes and Ratings through Primary Care Interventions for Nurse Practitioners
As the role of nurse practitioners (NPs) continues to expand in primary care settings, it is important to identify interventions that can help NPs deliver high-quality, cost-effective care and improve patient outcomes. This paper will discuss three potential interventions an NP could implement in primary care to address a key performance measure. It will then analyze how these interventions could result in better health outcomes and cost savings, as well as higher patient satisfaction ratings for the NP.
Intervention 1: Medication Management Program
One important performance measure for primary care providers is controlling patients’ blood pressure and cholesterol levels (American Medical Group Association, 2022). To help address this, an NP could implement a medication management program. This would involve the NP reviewing all medication lists with patients at each visit, addressing any concerns about side effects, ensuring adherence, and making adjustments if needed (O’Connor et al., 2016). The NP would also schedule follow-up appointments more frequently for patients not at goal to closely monitor progress.
To measure the impact, the NP could track the percentage of hypertensive and hypercholesterolemic patients whose levels are under control before and after enrollment in the program. Medical record data could also be analyzed to see if medication-related visits and hospitalizations decreased. It is expected this intensive management would result in more patients achieving treatment goals, leading to reduced risk for heart attacks, strokes and other complications (James et al., 2014). With fewer costly medical events, healthcare costs would decline over time.
Intervention 2: Lifestyle Management Program
Another intervention is a lifestyle management program focused on diet, exercise and smoking cessation. At annual wellness visits, the NP would use motivational interviewing techniques to help patients develop personalized plans, provide educational materials, and schedule follow-up calls for ongoing support and troubleshooting (McEwen & Wills, 2019). Participation and progress would be tracked through patient surveys and biometric measures like A1C, BMI and smoking status.
It is anticipated this program would help patients make and sustain healthy changes, lowering their risks for diabetes, heart disease and some cancers (U.S. Department of Health and Human Services, 2020). With fewer patients developing costly chronic conditions requiring complex treatment, overall healthcare spending in the population served could decrease. Patients may also appreciate the NP’s ongoing support and individualized approach, increasing satisfaction ratings.
Intervention 3: Care Coordination with Community Resources
A third intervention is enhancing care coordination, especially connecting high-risk, high-need patients to community-based services. The NP would conduct comprehensive assessments using a screening tool to identify unmet social needs like food insecurity, transportation and housing issues (Gottlieb et al., 2020). For patients who screen positive, the NP would spend additional time navigating available local resources and making warm handoffs when possible.
Regular follow-up would allow the NP to problem-solve any barriers to accessing services or maintaining connections. It is expected that addressing underlying social determinants of health would help stabilize patients’ medical and mental health conditions, reducing preventable emergency department visits and rehospitalizations (Garg et al., 2015). With lower utilization of costly acute care services, total healthcare costs per patient could decrease. Patients may also appreciate the NP taking a holistic approach and helping connect them to services outside the medical setting.
The three proposed primary care interventions – a medication management program, lifestyle management program, and enhanced care coordination with community resources – offer nurse practitioners strategies for improving key performance measures like controlling chronic conditions. If implemented and evaluated properly, each intervention has the potential to yield better patient outcomes as well as cost savings over time through prevention of expensive medical complications and acute care episodes. The interventions could also increase patient satisfaction by addressing important health issues through individualized, ongoing support. Overall, these approaches demonstrate how NPs are well-positioned to deliver high-value, population-based care within primary care settings.
American Medical Group Association. (2022). 2023 ACO performance measures. https://www.amga.org/2023-aco-performance-measures/
Garg, A., Boynton-Jarrett, R., & Dworkin, P. H. (2016). Avoiding the unintended consequences of screening for social determinants of health. JAMA, 316(8), 813–814. https://doi.org/10.1001/jama.2016.9282
Gottlieb, L. M., Fichtenberg, C. M., Alderwick, H., & Adler, N. E. (2020). Social determinants of health: What’s a healthcare system to do?. JAMA, 324(16), 1635–1636. https://doi.org/10.1001/jama.2020.16160
James, P. A., Oparil, S., Carter, B. L., Cushman, W. C., Dennison-Himmelfarb, C., Handler, J., … Ortiz, E. (2014). 2014 evidence-based guideline for the management of high blood pressure in adults: Report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA, 311(5), 507–520. https://doi.org/10.1001/jama.2013.284427
McEwen, M., & Wills, E. M. (2019). Theoretical basis for nursing (5th ed.). Wolters Kluwer.
O’Connor, P. J., Sperl-Hillen, J. M., Rush, W. A., Johnson, P. E., Amundson, G. H., Asche, S. E., … Gilmer, T. P. (2011). Impact of electronic health record clinical decision support on diabetes care: A randomized trial. Annals of Family Medicine, 9(1), 12–21. https://doi.org/10.1370/afm.1196
U.S. Department of Health and Human Services. (2020). Physical activity guidelines for Americans. https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf