Ministry Reports

The Ontario Nurse Practitioner in Long-Term Care Facilities Pilot Project

February 23, 2002


Background

In March 1999, the provincial government announced a pilot project to introduce primary health care Nurse Practitioners into long-term care facilities, as part of the government's response to the Provincial Nursing Task Force Report Good Nursing, Good Health - An Investment for the 21st Century. Subsequently, in 2000, the Ontario Ministry of Health and Long-Term Care funded 20 full-time Nurse Practitioner positions in long-term care as part of a larger provincial Nurse Practitioner initiative. This initiative has also provided funding for an additional 76 positions for under-serviced areas, five positions for aboriginal health centres, and five positions for primary care networks. The pilot project was scheduled to be two years in duration, from July 1, 2000 to June 30, 2002, but has been extended to March 30, 2003.

The participating projects represent municipal homes, charitable homes, profit, and not-for-profit homes. Each is unique in their partnerships (including Community Care Access Centres, outreach programs, the Alzheimer Society, and other partners), number of facilities involved (ranging from 1 to 18), number of residents (ranging from 65 to 600), and specified focus (e.g., primary health care, management of behavioural and psychogeriatric problems).

This report describes the methods and results of an interim evaluation of the Nurse Practitioner initiative in long-term care.

Evaluation Objectives and Methods

The main objectives of this evaluation were:

  1. to describe the major roles and activities of the Nurse Practitioners involved in the long-term care pilot projects (including their linkages with community agencies;
  2. to identify factors and elements that facilitate, or pose barriers to, the successful implementation of a Nurse Practitioner role in long-term care, with specific attention to the implementation of this role in under-serviced areas as well as Nurse Practitioner preparation for work in long-term care; and
  3. to identify potential positive and negative outcomes of the nurse practitioner pilot projects.

A number of sources of information were used to inform this evaluationĀ :

  1. Document review: A review of background documents and project descriptions, including the project summaries provided in the "Knowledge Bank" on the project website.
  2. Focus group interview with Nurse Practitioners: A focus group interview was conducted, via telephone, with Nurse Practitioners working in the pilot project.
  3. Site visits: Site visits were carried out at three sites purposefully selected to represent varying geographical regions and locations (urban vs rural), facility size, and partnership situations. During these visits, a total of 18 individual interviews were conducted with Administrators, Directors of Care, Medical Directors, physicians, registered nurses, and Nurse Practitioners.
  4. Individual interviews with other key informants: Individual interviews were conducted, via telephone, with key informants including Ministry of Health and Long-Term Care Compliance Advisors and representatives of community organizations and agencies.
  5. A survey of Nurse Practitioner work activities: This survey, suggested by the Nurse Practitioners themselves, was carried out to get a "snap shot" of the Nurse Practitioners' workload over the course of a week.

Information through the focus group, site visit interviews, and other individual key informant interviews was gathered from all seven regions of the province, as defined by the Ministry of Health and Long-Term Care.

The complete Report and Appendices are available for download at the links below.

Document Download

Executive Summary
9 pages | 72 kb | PDF format

Full Report
Ontario Nurse Practitioner in Private Care Report
70 pages | 446 kb | PDF format

Appendices

Appendix A :
Participating Projects
1 pages | 31 kb | PDF format

Appendix B :
"Knowledge Bank" Summary
10 pages | 66 kb | PDF format

Appendix C :
Background Document Summary
5 pages | 55 kb | PDF format

Appendix D :
Focus Group and Interview Guide
2 pages | 21 kb | PDF format

Appendix E :
List of Key Informants
1 pages | 15 kb | PDF format

Appendix F :
Summary of Focus Groups and Key Informant Interviews
101 pages | 19 kb | PDF format

Appendix G :
Work Activity Survey
52 pages | 1 kb | PDF format

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