Nurse Practitioner Survey
Collaboration with the Physician in Long-Term Care
March 2006
Throughout this survey, we are using the terms “Nurse Practitioner” and “NP” for those nurses who have obtained their extended class (EC) certificate (certification by the College of Nurses of Ontario to function as an NP). The term “MD” refers to physicians who are general practitioners or family physicians.
Collaborative Practice by Nurse Practitioners and
Physicians in Long-Term Care Facilities:
A Mixed-Methods Study
Faith Donald and Alba DiCenso
McMaster University
Part A – Demographics and Experience
1a. What is your educationalbackground?
(Check ALL that apply)
Nursing Diploma
BScN
Non-nursing Baccalaureate (please specify) __________________________
Master of Nursing
Non-nursing Masters Degree (please specify) ________________________
PhD (please specify) ____________________________________________
1b. How did you obtain your Nurse Practitioner education?
(Check ALL that apply)
COUPN certificate program
Non-COUPN certificate program
COUPN integrated BScN/NPprogram
Non-COUPN degree program
COUPN transition program
Acute Care NP Program
Other (please specify) ___________________________________________
1c. How did you become licensed as an RN (EC)?
(Check ALL that apply)
Completed COUPN program
Wrote CNO registration exam
Completed Non-COUPN program
Completed the CNO three step process (Portfolio, OSCE, registration exam)
Other (please specify) ___________________________________________
2. What is your age in years? ____ years
3a. In total, how long have you practiced as a registered
nurse [including as an RN(EC)]? ____ years ____ months
3b. How many years did you practice as an RN in
long-term care (LTC), prior to becoming an RN(EC)? ____ years as an RN in LTC 3c. In total, how many months have you practiced as an
RN(EC)? ____ months
3d. How many months have you worked in LTC as an
RN(EC)? ____ months
3e. How many months have you worked in this LTC
setting as an RN(EC)? ____ months
3f. Have you worked in this LTC setting in another
4a. Are you currently practicing Full-time
Casual
Part-time
Contract (specify length of contract) ____ years
4b. Please describe your work experience since becoming an NP, other than your current long-term care
position? (e.g., 13 months in a CHC, 22 months in a regional geriatric program, etc.)
________________________________________ ________________________________________ ________________________________________ ________________________________________
5a. Would you classify your work location as Remote Rural Urban
5b. In what area of Ontario is your work setting located? Northern Southern Central
5c. Within how many long-term care facilities do you
currently work? ____ Long-term care facilities
5d. How many GPs or family MDs do you work with on a frequent basis, taking into consideration all the LTC facilities in which you work?
____ MDs
6. What percentage of your time is spent in each activity?
___% Clinical in long-term care ___% Clinical outside of LTC
___% Management/leadership in long-term care ___% Research
___% Education/Training provision ___% Professional development
___% Other (please specify) __________________ __________________________________________
7a.Have you had previous experience with MD-NP collaboration?
Yes, proceed to 7b No, proceed to Part B
7b. If yes, please describe the type of practice setting and duration of the MD-NP collaboration immediately prior to your current MD-NPcollaboration.
7c. Practice setting(s) for previous collaboration (e.g.,
community health centre, nursing home): _______________________________________ 7d. Duration of previous collaboration: ____ months
7e. How satisfied were you with the past collaborative relationship with the MD? (please circle one number)
1 2 3 4 5 6 Not Extremely satisfied satisfied
Part B – Collaborative Experience with the LTC Physician
Please complete the following information for each long-term care facility in which you work.
1a. Name of long-term care facility: 1b. Number of beds:
1c. Type of facility: Nursing Home
Home-for-the-aged
Other: ___________________________________
2. Were you involved in developing the proposal for your NP position in this LTC facility?
Yes
No
3. How many hours per month do you work at this
facility? ____ hours
4. Please identify the one physician (GP or Family Physician) with whom you work most frequently at this facility.
MD’s Name: ____________________________________
5. How long have you worked with this MD at this
facility? ____ months
6. How would you describe the extent of collaboration with this MD? (please circle one number)
1 2 3 4 5 6 No Total collaboration collaboration
7. How satisfied are you with the collaborative relationship with this MD? (please circle one number)
1 2 3 4 5 6 Not Extremely satisfied satisfied
8. How much time per month is currently spent collaborating with this MD on specific resident issues?
____ hours
9. Please briefly describe the collaborative structure (i.e., how collaboration occurs) at this facility. _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________
10. Please describe the ways you communicate/interact with this MD in your practice setting (check ALL that apply).
Discussions on the telephone
Unplanned communication (e.g. meeting in the hallway)
As needed – e.g. we seek each other out when there are questions about a resident Regular meetings
Work side by side with the MD
Review charts/orders
Written messages (not in the residents’ charts)
Messages via staff
Other (please describe) ________________________________________________________
11. List the three most important contributions that you make, as an NP, to resident and/or family care at this facility.
1. _____________________________________________________________
_____________________________________________________________
2. __________________________________________________________________________________________________________________________
3. _____________________________________________________________ _____________________________________________________________PART B1: MEASURE OF CURRENT COLLABORATION
Consider your current experience of collaborative practice between you and the physician you have named above and rate your level ofagreement or disagreement with each statement.
Please check the one best answer for each statement below
The general practitioner or Family physician and you:
1 Strongly Disagree 2 Disagree 3 Slightly Disagree 4 Slightly Agree 5 Agree 6 Strongly Agree 1. Plan together to make decisions about
the care for the residents
2. Communicate openly as decisions are
made about resident care
3. Share responsibility for decisions made
about resident care
4. Co-operate in making decisions about
resident care
5. Consider both nursing and medical concerns in making decisions about resident care
6. Co-ordinate implementation of a shared
plan for resident care
7. Demonstrate trust in the other’s decision making ability in making shared
decisions about resident care
8. Respect the other’s knowledge and skills in making shared decisions about resident care
9. Fully collaborate in making shared
decisions about resident care
[Copyright 2001 by Jones, Way and Associates. All rights reserved. Used with permission from Jones, Way and Associates (Way, Jones, & Baskerville, 2001). Adapted using ‘resident’ instead of ‘patient’ and ‘slightly disagree’ and ‘slightly agree’ instead of ‘neutral’ and ‘not applicable’ by Faith Donald]
PART B2: PROVIDER SATISFACTION IN CURRENT COLLABORATION
Consider your current experience of collaboration with the physician you have named above and rateyour current level ofsatisfaction or dissatisfaction with each statement.
Please check the one best answer for each statement below
What is your current level of satisfaction with:
1 Strongly Dissatisfied 2 Dissatisfied 3 Slightly Dissatisfied 4 Slightly Satisfied 5 Satisfied 6 Strongly Satisfied
1. The shared planning that occurs between you and the physician while making decisions about resident care
2. The open communication between you and the physician that takes place as
decisions are made about resident care
3. The shared responsibility for decisions made between you and the physician about resident care
Please check the one best answer for each statement below
What is your current level of satisfaction with:
1 Strongly Dissatisfied 2 Dissatisfied 3 Slightly Dissatisfied 4 Slightly Satisfied 5 Satisfied 6 Strongly Satisfied
4. The cooperation between you and the physician in making decisions about resident care
5. The consideration of both nursing and medical concerns as decisions are made about resident care
6. The coordination between you and the physician when implementing a shared plan for resident care
7. The trust shown by you and the physician in one another’s decision making ability in making shared decisions about resident care
8. The respect shown by you and the
physician in one another’s knowledge and skills
9. The amount of collaboration between you and the physician that occurs in making decisions about resident care
10. The way that decisions are made between you and the physician about resident care (that is, with the decision making process, not necessarily with the decisions)
11. The decisions that are made between
you and the physician about resident care
12. The amount of time you spend consulting
with the physician
13. The availability of the physician
14. The appropriateness of consultations
initiated by the physician
15. The quality of care provided by the
physician
[Copyright 2001 by Jones, Way and Associates. All rights reserved. Used with permission from Jones, Way and Associates (Way, Jones, & Baskerville, 2001). Adapted using ‘resident’ instead of ‘patient’ and ‘slightly disagree’ and ‘slightly agree’ instead of ‘neutral’ and ‘not applicable’; added questions 12 -15, by Faith Donald and Alba DiCenso.]
Thank you for taking the time to complete this survey.
Please return it in the enclosed self-addressed, stamped envelope or fax to Faith Donald at
(905) 524-5199 by June 15, 2006, or as soon thereafter as possible.
References
Way, D., Jones, L., & Baskerville, N. B. (2001a). Improving the effectiveness of primary health care delivery through nurse practitioner/family physician structured collaborative practice. Joint University of Ottawa Department of Family
Medicine and School of Nursing project funded by Health Canada's Health Transition Fund. Ottawa, ON: University of
Ottawa. http://www2.itssti.hc-sc.gc.ca/B_Pcb/HTF/Projectc.nsf/ExecSum/NA342/$File/NA342.pdf.
Way, D., Jones, L., & Baskerville, N. B. (2001b). Improving the effectiveness of primary health care delivery through nurse practitioner/family physician structured collaborative practice. Joint University of Ottawa Department of Family
Medicine and School of Nursing project funded by Health Canada's Health Transition Fund. Ottawa, ON: University of
