Patient Satisfaction With a Nurse Practitioner in a University Emergency Service,☆☆,

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Abstract

Study objective: To compare the overall satisfaction with emergency department care of patients seen by a nurse practitioner (NP) with that of patients seen in the usual fashion.

Design: A case-control study comparing responses by means of a five-point scale from a prospectively designed telephone survey. Setting: Midwestern urban university hospital ED in which most patients are seen mainly by fourth-year medical students or house staff and all patients are seen and evaluated by the attending staff. Participants: Patients or, for children and incompetent adults, the person who accompanied the patient to the ED. Results: Overall satisfaction was good for both groups of patients and was not significantly different: 3.9 (SD, 1.1) for the NP group versus 4.0 (SD, 1.3) for the control group (P=.66 [NS]). Conclusion: This study supports data from earlier studies suggesting that patients are satisfied with ambulatory care delivered by NPs. [Rhee KJ, Dermyer AL: Patient satisfaction with a nurse practitioner in a university emergency service. Ann Emerg Med August 1995;26:130-132.]

Section snippets

INTRODUCTION

In the late 1960s, the 1970s, and the early 1980s, the use of nurse practitioners (NPs) and physician assistants in several practice environments demonstrated that they could provide care equal in quality to that provided by physicians.1, 2

Some emergency departments reported that NPs and physician assistants could provide service for patients with nonurgent problems.3, 4Only one report from a US hospital specifically examined patient satisfaction. This report was from an inner-city hospital 10

MATERIALS AND METHODS

We carried out the study at the University of Nebraska Medical Center in Omaha, a city with a population of approximately 400,000. The ED census is about 22,000 patients a year and represents a socioeconomically diverse group. Patients are usually seen by residents or fourth-year medical students and then examined by the attending staff. Occasionally, patients are seen directly by the attending staff. From the beginning of March through May 1994, a trained and licensed NP worked in the ED and

RESULTS

Thirty patients who were seen by the NP were contacted by telephone and agreed to participate in the study. An equal number of other patients seen during the period was also contacted. The groups were not significantly different in age or sex.

Overall satisfaction was good for both groups of patients: 3.9 (SD, 1.1) for the group who saw the NP and 4.0 (SD, 1.3) for the control group (P=.66 [NS]). Three patients said they would have preferred to have been seen primarily by a physician, 3 patients

DISCUSSION

Our results suggest that ED patients are as satisfied with the care provided by an NP as with that provided by a physician.

It is important to point out the limitations of these data. First, there may have been a socioeconomic bias because this was a telephone survey. Second, only one NP was involved in this trial, and she may not have represented a typical practitioner. Third, most patients were seen by a medical student or resident and then by an attending physician. Patients might feel

CONCLUSION

This study supports data from earlier studies suggesting that patients are satisfied with ambulatory care delivered by NPs.

References (8)

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From the Section of Emergency Medicine, Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska.

☆☆

Address for reprints: Erica L Liebelt, MD, Pediatric Emergency Medicine, Room WP 143, YaleNew Haven Hospital, 20 York Street, New Haven, Connecticut 06504, 203-785-7970, Fax 203-785-4809

Reprint no. 47/1/64583

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