Structural capabilities in primary care practices where nurse practitioners care for persons living with dementia

Int J Older People Nurs. 2023 Sep;18(5):e12556. doi: 10.1111/opn.12556. Epub 2023 Jul 11.

Abstract

Background: Primary care structural capabilities (i.e., electronic health records, care coordination, community integration, and reminder systems) can address the multiple needs of persons living with dementia (PLWD).

Objectives: This study describes structural capabilities in primary care practices where nurse practitioners (NPs) provide care to PLWD and compares the presence of structural capabilities in practices with a high and low volume of PLWD.

Methods: We conducted a secondary analysis of cross-sectional data from 293 NPs in 259 practices in California. Logistic regression models were used to determine the association between the volume of PLWD and the presence of structural capabilities.

Results: NPs reported that 96% of practices had electronic health records, 61% had community integration, 55% had reminder systems and 35% had care coordination capabilities. Practices with a high volume of PLWD were less likely to have community integration compared to practices with a low volume of PLWD.

Conclusion: Many PLWD-serving practices do not have the essential infrastructure for providing optimal dementia care. Practice managers should focus on implementing the essential structural capabilities to address the complex needs of PLWD.

Implications for practice: Clinicians and practice administrations can use the findings of this study to improve the delivery of care in practices that provide care to PLWD.

Keywords: nurse practitioners; persons living with dementia; primary care; structural capabilities.

MeSH terms

  • Caregivers
  • Cross-Sectional Studies
  • Dementia*
  • Humans
  • Nurse Practitioners*
  • Primary Health Care