RESUMO
BACKGROUND: Responding to National Academy of Medicine and National Council of State Boards of Nursing recommendations, the Department of Veterans Health Affairs (VHA) implemented full practice authority (FPA) for Advanced Practice Registered Nurses in VHA medical centers (VAMCs) in 2017. PURPOSE: To evaluate FPA policy implementation's impact on quality indicators including access to care as measured by new patient appointments in primary, specialty and mental health services. METHODS: Linear growth models compared early (n = 85) vs. late (n = 55) FPA implementing VAMCs on the trajectories of each of the three quality indicators. FINDINGS: Early FPA implementing VAMCs showed greater rates of improvement over time in new patient appointments completed within 30 days of preferred date for primary care (p = .003), specialty care (p = 0.05), and mental health (p = 0.001). DISCUSSION: VAMCs that started implementation of FPA policy early showed greater improvement in access to care for Veterans over time than VAMCs that did not.
Assuntos
Prática Avançada de Enfermagem/métodos , Enfermeiras e Enfermeiros/normas , Âmbito da Prática/tendências , Prática Avançada de Enfermagem/estatística & dados numéricos , Humanos , Papel do Profissional de Enfermagem , Enfermeiras e Enfermeiros/estatística & dados numéricos , Enfermeiras e Enfermeiros/tendências , Avaliação de Programas e Projetos de Saúde/métodos , Avaliação de Programas e Projetos de Saúde/estatística & dados numéricos , Estados Unidos , United States Department of Veterans Affairs/organização & administração , United States Department of Veterans Affairs/estatística & dados numéricosRESUMO
Approximately 20% of veterans suffer from posttraumatic stress disorder (PTSD). NPs are well positioned to provide early detection and assist veterans with access to life-saving treatment. The PTSD Toolkit for Nurses helps nurses improve their skills in assessing PTSD and provides a specialized intervention and referral procedure that promotes help-seeking behavior among veterans.