Nurse Practitioner Model

Abstract Advances in medicine have increased the life expectancy from 45 to 78 years of age in the last century. As the population ages, so does the number of chronic illness and the need for specialized end-of-life care. With the current shortage of trained hospice care providers, the push for utilization of nurse practitioners in this area of medicine is being looked at as a possible solution. Efficacy of a nurse practitioner led model of care has been demonstrated in the limited amount of studies done in recent years and shows promise of a solution to the shortage. The hospice model of care focuses on improving quality of life rather than prolonging it, and holistically embraces the principles of dying with comfort and dignity. Removing
Although hospice has been around since the 1960’s it still faces many challenges such as increased work load, a lack of hospice trained healthcare providers, and hospice Medicare requirements. Due to these issues, the role of the nurse practitioner has become increasingly more important to hospice care.
Hospice can be described as a philosophy of care that focuses on the palliation of a terminally ill patient’s symptoms while providing emotional and spiritual support for them and their family (Meirer, McCormick, & Lagman, 2015). The hospice model of care focuses on improving quality of life rather than prolonging it, and holistically embraces the principles of dying with comfort and dignity. This model uses an interdisciplinary team to develop an individualized plan of care that addresses all aspects of care and is based on the patient’s goals and cultural values (Meirer, McCormick, & Lagman,
Information regarding the quality of hospice programs insufficiently show the true potential and benefit of a nurse practitioner led model. One study evaluated the nurse practitioner based model of specialized palliative care in the home environment in an effort to test the sustainability and evaluation of feasibility of nurse practitioner services (Bookbinder, Glajchen, McHugh, Higgins, Budis, Solomon, Homel, Cassin, & Portenoy, 2011). What her team discovered was the nurse practitioner led model generated an approximate 360% increment in hospice admission compared with the two years before the program, and the incremental surplus to the hospice program from these patients was determined to be approximately $1.875 million annually. Not only did the profit margin increase substantially, the comparison of the prevalence of distress at baseline and follow up showed statistically significant decrease in symptoms of pain, shortness of breath, weight loss, and difficulty sleeping (Bookbinder, et al, 2011). It was noted that at the end of the study, the hospice agency hired an additional four nurse