Courtney R, Rice C
Partnership Action for Healthy Communities, Arlington, TX, USA.
Nurse Pract. 1997 Feb;22(2):46-8, 54-7, 60 passim.
Primary care has become a major focus of health care reform. To create the most effective delivery of primary care services by nurse practitioners (NPs), researchers, clinicians, and administrators must continue to develop knowledge about the structure, process, and outcomes of NP primary care patient encounters. Few measures of NP-patient care encounters exist. This exploratory study examines a method of investigating NP practice and a description of the process of NP primary care. The Nurse Practitioner Rating Form (NPRF) was used to analyze 20 videotaped NP visits with Latino clients in a primary care setting. Major findings are that NPs spent visit time engaged in assessment (61%), management (29%), and charting, consultation, and other (10%). The content or focus of the majority of NP time during visits (90%) was directed to existing physical problems. NPs received high scores for communication style and degree of client participation. Problems with using the NPRF are noted and key recommendations are made to enhance NP care and improve investigation of primary care practice.
初级保健已成为医疗保健改革的主要重点。为了让执业护士（NPs）提供最有效的初级保健服务，研究人员、临床医生和管理人员必须继续深入了解NP初级保健患者诊疗过程的结构、流程和结果。目前几乎没有衡量NP与患者诊疗过程的指标。这项探索性研究考察了一种调查NP执业情况的方法，并描述了NP初级保健的过程。使用护士执业者评级表（NPRF）对在初级保健机构中20次NP为拉丁裔客户进行诊疗的录像进行了分析。主要研究结果是，NP在诊疗过程中用于评估的时间占61%，管理占29%，记录、会诊及其他占10%。诊疗期间NP大部分时间（90%）的内容或重点都针对现有的身体问题。NP在沟通方式和患者参与度方面得分较高。文中指出了使用NPRF存在的问题，并提出了关键建议，以加强NP护理并改进对初级保健实践的调查。
