Pilot of Nurse Practitioners in Aged Care

A collaborative pilot project investigating a new model of care in residential aged care facilities (RACFs) is providing valuable insights into innovative ways to improve health care for residents.

Hunter Primary Care, in partnership with the PHN, has researched, developed, and implemented a pilot Aged Care Nurse Practitioner (NP) service to increase access to and the effectiveness of primary care services for people living in RACFs.

The recent Royal Commission into Aged Care Quality and Safety highlighted the difficulty experienced by many people living in residential aged care facilities in accessing health care. Older frail residents cannot always travel to health practitioners and health practitioners cannot always leave their busy practices to provide timely medical consultations in RACFs.

The Nurse Practitioner does not replace the GP but works with the resident’s GP in conducting regular health assessments and consulting when changes in the clinical management of the person is required.

The NP model is designed to provide residents with both a proactive and responsive person-centred model of care to provide timely clinical assessment and management. A NP provides a regular outreach service to residents with whom they have an established and ongoing relationship and is familiar with the resident’s baseline health status and care goals.

The NP model of care builds on work undertaken within the Aged Care Emergency (ACE) service. The ACE service is a reactive response for acutely unwell residents that provides triage, consultancy, clinical support, and advice for staff, so that care for residents can be delivered in the facility where appropriate and transfer to hospital is avoided.

The pilot NP program was conducted in six RACFs in the Hunter region with proactive weekly visits and built-in capacity to respond to unexpected health events. One RACF General Manager involved in the pilot noted “the model is ideal, by sitting outside the RACF the NP remains wholly focused on clinical management of the residents’ conditions.”

Similarly, a GP working with two NPs at two different facilities stated they were “very happy with the two Nurse Practitioners, their work has reduced my workload significantly” and they “would like the service to extend to other facilities where my patients reside in the future.”

The research undertaken in this pilot program will be utilised to contribute to the body of knowledge underpinning Nurse Practitioners in Aged Care and Primary care. It will also contribute to changes in government policies that would enhance the cost effectiveness of the model of care.