The Perspectives of Nurse Practitioners and Physicians on Increasing the Number of Registered Nurses in Primary Care

Headnote

Executive Summary

* Team-based care models have increasingly been implemented to increase access to primary care, reduce cost, and improve quality by delivering care through interprofessional teams.

* There is a gap in the literature, however, about the increased staffing of registered nurses (RN) within primary care.

* This study sought to elicit primary care provider (PCP) perspectives about the use of RNs in primary care, including how RNs can optimally be integrated into primary care teams and the perceived impact of increased RN staffing in primary care.

* Findings suggest PCPs perceive RNs to be an integral component of interprofessional primary care teams whose expertise is needed to meet the care management demands in primary care.

* An increase in RN staffing is perceived by PCPs to help transform primary care through high-quality nursing practice that increases patient safety, reduces omission of important care management tasks, and ensures patient-centered primary care.

AS MORE PATIENTS ARE LIVING with chronic disease, which is expected to reach 157 million Americans by 2020, it is crucial to ensure there is an adequate workforce to deliver timely and high-quality primary care to patients who need to manage their conditions (Bauer, Briss, Goodman, & Bowman, 2014; Wu & Green, 2000). Traditional models for delivering primary care, such as use of solo providers, are threatened by increased workload, growing complexity of patient visits due to multimorbidity, and an expected deficit of 52,000 primary care physicians by 2025 (Milani & Lavie, 2015; Petterson et al., 2012). This strain jeopardizes patient safety and quality of care because it is difficult for a solo provider to complete all recommended care management tasks sin gle-handedly (Yarnall et al., 2009). As a result, team-based care models, such as patient-centered medical homes or accountable care organizations, have increasingly been implemented to increase access to care, reduce cost, and improve quality by delivering care through interprofessional teams (Auerbach et al., 2013; Grumbach & Bodenheimer, 2004). Organizations are increasingly expanding interprofessional primary care teams that consist of healthcare professionals from multiple disciplines, such as physicians, nurse practitioners (NPs), pharmacists, and social workers (Auerbach et al., 2013; Ghorob & Bodenheimer, 2015). There is a gap in the literature, however, about the increased staffing of registered nurses (RN) within primary...