Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

High Patient Satisfaction with Nurse Practitioner Delivered Services at Two Health Centres in Urban Jamaica

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

High Patient Satisfaction with Nurse Practitioner Delivered Services at Two Health Centres in Urban Jamaica

Article excerpt

Nurse practitioners have been providing primary care for over 45 years in the United States (American Academy of Nurse Practitioner [AANP], 2010). They are considered competent, safe, cost effective providers of primary care; providing solutions related to cost, quality and access to healthcare (Bauer, 2010; Reid et al., 2010). Nurse practitioner led care in primary healthcare settings has been positively evaluated by service users (Laurant et al., 2007, 2008; Thrasher & Purc- Stephenson, 2008). Therefore, increasing the number of nurse practitioners in primary care is likely to lead to elevated levels of patient satisfaction and quality of care (Horrocks, Anderson, & Salisbury, 2002; Melby, Gillespie, & Martin, 2011).

Satisfaction with services provided by nurse practitioners was reported as high in several practice settings. For example, patients in an Emergency Department in Australia noted consistently higher levels of patient satisfaction with nurse practitioners than doctors and both health professionals and patients studied in the US were supportive of emergency nurse practitioners (Melby et al., 2011; Wilson & Shifaza, 2008). Clients surveyed in a Canadian emergency room setting also reported high levels of satisfaction with the comprehensive care they received from nurse practitioners (Thrasher & Purc- Stephenson, 2008).

High satisfaction with nursing care did not mean that patients always favoured nurses to doctors (Laurant et al., 2007, 2008). Wortans, Happell, and Johnstone (2006) exploratory qualitative analysis of clients in a psychiatric facility in Australia discovered high levels of patient satisfaction, with services offered by mental health nurse practitioners equivalent to services provided by the medical doctors. However, patients at a veterans' hospital in the United States were more satisfied with care by nurse practitioners than with physicians and physician's assistants (Budzi, Lurie, Singh, & Hooker, 2010). Furthermore, a randomised trial of 1316 patients in four United States community-based primary clinics noted comparable patient outcomes among nurse practitioners and doctors but higher levels of satisfaction with nurse practitioners (Lenz, Mundinger, Kane, Hopkins, & Lin, 2004).

Within the Jamaican context, the role of the Nurse Practitioner evolved in the mid 1970s out of an increased demand for accessible curative and preventative healthcare services, which could no longer be provided solely by medical doctors (Cumper, 1986). The 2 year Nurse Practitioner Program is offered by the University of the West Indies, School of Nursing and serves Jamaica and the wider English speaking Caribbean. The programme consists of two tracks: family nurse practitioner; and mental health/psychiatric nurse practitioner. The programme aims to meet the changing health needs and nursing care realities of the Caribbean by providing cost effective healthcare that meets international standards through training for advanced nursing practice in clinical nursing. Currently, the criteria for admission to the Nurse Practitioner Programmes include a Bachelor of Science degree in nursing with midwifery or post basic psychiatric training. Further, candidates must have at least 5 years of clinical practice in an approved recognised agency, institution or organisation where primary, secondary, tertiary or extended healthcare services are offered. Despite the attainment of a Master of Science degree in nursing, nurse practitioners in Jamaica cannot legally prescribe medications independently of a physician.

Patient satisfaction with nurse practitioners in several countries has been evaluated and the evidence has suggested positive outcomes. Nurse practitioners have been instrumental in the delivery of primary health care in Jamaica since 1977 (Seivwright, 1982); however, the level of patient satisfaction with nurse practitioner delivered services in the primary care setting has not been formally investigated. …

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