Publications (25) View all
-
Article: Nurse practitioners in Ontario primary healthcare: referral patterns and collaboration with other healthcare professionals.
[show abstract] [hide abstract]
ABSTRACT: The purpose of this study is to examine referrals of nurse practitioners providing primary healthcare (PHC NPs) to better understand how PHC NPs collaborate with other healthcare professionals and contribute to interprofessional care. The analysis is based on the data from a survey of 378 PHC NPs registered in Ontario, Canada in 2008. Overall, 69% of PHC NPs made referrals to family physicians (FPs) and 67% of PHC NPs received referrals from FPs. Almost 50% of PHC NPs had bidirectional referrals between them and FPs. Eighty-nine percent of PHC NPs made referrals to specialist physicians. Bidirectional referrals between PHC NPs and social workers and mental health workers were common in family health teams and community health centers. Patterns of referrals (bidirectional, unidirectional and no referrals) between PHC NPs and FPs, social workers, mental and allied health workers in various practice settings indicate development of collaborative relationships between PHC NPs and other healthcare professionals and reflect the influence of practice models on delivery of interprofessional care. These findings are discussed in light of the development of NPs' role and integration of PHC NPs in the Ontario healthcare system. Implications for policy changes and future research are also suggested.Journal of Interprofessional Care 01/2012; 26(3):232-9. · 1.12 Impact Factor -
Article: Therapeutic benefit of preventive telehealth counseling in the Community Outreach Heart Health and Risk Reduction Trial.
[show abstract] [hide abstract]
ABSTRACT: We evaluated whether telehealth counseling augments lifestyle change and risk factor decrease in subjects at high risk for primary or secondary cardiovascular events compared to a recommended guideline for brief preventive counseling. Subjects at high risk or with coronary heart disease (35 to 74 years of age, n = 680) were randomized to active control (risk factor feedback, brief advice, handouts) or telehealth lifestyle counseling (active control plus 6 weekly 1-hour teleconferenced sessions to groups of 4 to 8 subjects). Primary outcome was questionnaire assessment of adherence to daily exercise/physical activity and diet (daily vegetable and fruit intake and restriction of fat and salt) after treatment and at 6-month follow-up. Secondary outcomes were systolic and diastolic blood pressures, ratio of total to high-density lipoprotein cholesterol, and 10-year absolute risk for coronary disease. After treatment and at 6-month follow-up, adherence increased for telehealth versus control in exercise (29.3% and 18.4% vs 2.5% and 9.3%, respectively, odds ratio 1.60, 95% confidence interval 1.2 to 2.1) and diet (37.1% and 38.1% vs 16.7% and 33.3%, respectively, odds ratio 1.41, 95% confidence interval 1.1 to 1.9). Telehealth versus control had greater 6-month decreases in blood pressure (mean ± SE, systolic -4.8 ± 0.8 vs -2.8 ± 0.9 mm Hg, p = 0.04; diastolic -2.7 ± 0.5 vs -1.5 ± 0.6 mm Hg, p = 0.04). Decreases in cholesterol ratio and 10-year absolute risk were significant for the 2 groups. In conclusion, telehealth counseling augments therapeutic lifestyle change in subjects at high risk for cardiovascular events compared to a recommended guideline for brief preventive counseling.The American journal of cardiology 03/2011; 107(5):690-6. · 3.58 Impact Factor -
Article: Integration of nurse practitioners into Ontario's primary health care system: variations across practice settings.
[show abstract] [hide abstract]
ABSTRACT: Annual tracking surveys of nurse practitioners in the Canadian province of Ontario conducted by the Centre for Rural and Northern Health Research for the Ministry of Health and Long-Term Care provide a picture of current employment and practice. The authors present an update on the most recent survey of primary health care nurse practitioners (PHC NPs), conducted in 2008.The study sample consisted of 378 NPs registered in Ontario in 2008 and practising in PHC. Differences in demographic, employment, and practice characteristics in a variety of practice settings are explored. Geographic distribution, education, autonomy of the NP, and the practice profiles varied across settings. The findings document the integration of NPs into Ontario's health-care system and suggest a need to further describe the models of practice and their impact on PHC outcomes.The Canadian journal of nursing research = Revue canadienne de recherche en sciences infirmières 06/2010; 42(2):48-69. -
Article: Integration of Nurse Practitioners Into Ontario's Primary Health Care System: Variations Across Practice Settings L'intégration des infirmières praticiennes dans le système des soins primaires en Ontario : étude des variantes selon les milieux de travail
[show abstract] [hide abstract]
ABSTRACT: Annual tracking surveys of nurse practitioners in the Canadian province of Ontario conducted by the Centre for Rural and Northern Health Research for the Ministry of Health and Long-Term Care provide a picture of current employment and practice. The authors present an update on the most recent survey of primary health care nurse practitioners (PHC NPs), conducted in 2008. The study sample consisted of 378 NPs registered in Ontario in 2008 and practising in PHC. Differences in demographic, employment, and practice characteristics in a variety of practice settings are explored. Geographic distribution, education, autonomy of the NP, and the practice profiles varied across settings. The findings document the integration of NPs into Ontario's health-care system and suggest a need to further describe the models of practice and their impact on PHC outcomes. French Le Centre de recherche en santé dans les milieux ruraux et du Nord mène, pour le compte du ministère ontarien de la Santé et des Soins de longue durée, des enquêtes annuelles de suivi sur les infirmières praticiennes en soins de santé primaires (IP SSP), dans le but de dresser un portrait de la profession et de l'emploi en ce domaine. Les résultats de l'enquête la plus récente, menée en 2008, sont présentés par les auteures. L'échantillon comprenait 378 IP inscrites en Ontario cette année-là et actives dans le secteur des soins primaires. On a analysé les différences entre les milieux de soins sur le plan démographique, de l'emploi et de l'exercice. On a constaté que la répartition géographique, l'éducation, le degré d'autonomie et le profil d'exercice variaient d'un milieu à l'autre. Les données brossent un tableau de l'intégration des IP au sein du système de santé en Ontario et confirment la nécessité de continuer à décrire les modèles d'exercice et leurs effets sur les résultats en matière de soins primaires.The Canadian journal of nursing research = Revue canadienne de recherche en sciences infirmières 05/2010; 42(2):48-69. -
Article: Students' perceptions of interprofessional learning through facilitated online learning modules.
[show abstract] [hide abstract]
ABSTRACT: Asynchronous e-learning is an appealing option for interprofessional education (IPE) as it addresses the geographic and timetabling barriers often encountered when organizing activities across educational programs. This study examined the extent to which pre-licensure students were able to learn with, from, and about each other through completion of innovative online IPE learning modules. Seventy-seven students completed e-learning modules developed through a consortium of educational institutions. Evaluation was primarily qualitative through focus groups, interviews, analyses on off-line discussions and an online feedback form. Qualitative analyses of the discussion fora revealed that students were able to solve problems collaboratively, clarify their professional roles, and provide information from their professional perspective. Focus groups and interviews reinforced that students recognized the importance of working together and implicate clinical education as an important venue to reinforce learning about collaborative practice. Analyses of the online feedback form suggest the need for clear processes related to group assignments and deadlines. Students learned about each other's role, solved problems together and had positive perceptions of the online modules as a venue for interprofessional learning. Results are encouraging to those interested in using e-learning in IPE as part of an overall curriculum.Medical Teacher 01/2010; 32(9):e391-8. · 1.22 Impact Factor
