Nurse‐practitioners (NPs) are increasingly utilized in the acute care setting. Prior qualitative studies suggest physician knowledge and attitude deficits create barriers to effective NP/physician collaboration. Little is known about hospitalists' knowledge and attitudes about NP collaboration. Effective methods to overcome these barriers have not been reported.
Baseline knowledge and attitudes were assessed using a 30‐item instrument addressing knowledge and attitudes in 4 areas: scope of practice, supervision, collaboration, and patient outcomes. Respondents rated their agreement using a 5‐point Likert‐type scale. Constructed response items addressed specific knowledge questions of NP practice requirements and physician demographics. A 1‐hour educational lecture was administered immediately following the initial survey. This intervention primarily focused on the intersection of collaboration, supervision, and scope of practice. A posteducational intervention survey was completed immediately following the lecture. Descriptive statistics and paired 2‐sided t tests were used to evaluate changes in hospitalists' knowledge and attitudes following the educational session.
Eleven of the 13 eligible hospitalists (85%) completed the preeducational and immediate posteducational surveys. The respondents had a mean of 1.9 years of attending experience, 6 of 11 (55%) were female, and 6 of 11 (55%) had no or minimal experience working with NPs. Responses to preeducation knowledge questions indicated hospitalists have limited knowledge of the NP role and scope of practice. Of the 15 knowledge‐based questions, responses to the following showed statistically significant changes immediately following the educational lecture intervention: physician authorization for subspecialty consultation (P = .03), NP supervision for inpatient management of service (P = .03), and supervision requirements for procedures (P = .04). In addition, significant differences were detected in physician understanding of supervision in NP collaboration (P = .001), knowledge of NP required training hours (P< .001), and prescriptive rights of NPs (P = .004). Responses to 2 of the 11 (18%) attitudinal questions — comfort with NPs independently admitting new patients (P = .03) and the scholarship of nursing research (P = .03) — were significantly different following the educational intervention.
Baseline knowledge and attitudes of hospitalists are consistent with patterns that have led to barriers to effective collaboration in other settings. A simple 1‐hour educational program describing the NP role, scope of practice, and impact of care on patient outcomes in the acute care setting significantly affected hospitalists' knowledge and attitudes. Future work aims to assess the impact of time and experience on hospitalists' attitudes toward NPs in acute care.
T. E. Cardin, None; M. M. Forbes, None; C. Whelan, Society of Hospital Medicine, research grants; Pfizer, research grants; TAP, research grants.
To cite this abstract:Cardin T, Forbes M, Whelan C. Impact of Educational Intervention on Hospitalists' Knowledge and Attitudes Regarding Nurse‐Practitioner Scope of Practice and Collaboration. Abstract published at Hospital Medicine 2007, May 23-25, Dallas, Texas Abstract 14. Journal of Hospital Medicine. 2007; 2 (suppl 2). https://www.shmabstracts.com/abstract/impact-of-educational-intervention-on-hospitalists-knowledge-and-attitudes-regarding-nursepractitioner-scope-of-practice-and-collaboration/. Accessed April 10, 2020.