Dual certified primary care-psychiatric mental health advanced practice registered nurses: Their perceived impact on patient outcomes

Teresa Judge-Ellis; Peter James Abad; Linda Liu Hand; Kathleen Coen Buckwalter

doi:10.1097/JXX.0000000000001345

Dual certified primary care and psychiatric mental health advanced practice registered nurses (PC/PMHNP) are well-positioned to care for high needs/high-cost patients. Although prior work suggests that PC/PMHNP care produces positive patient outcomes the existing evidence was limited and primarily based on case studies and anecdotal reports.BACKGROUNDDual certified primary care and psychiatric mental health advanced practice registered nurses (PC/PMHNP) are well-positioned to care for high needs/high-cost patients. Although prior work suggests that PC/PMHNP care produces positive patient outcomes the existing evidence was limited and primarily based on case studies and anecdotal reports.To conduct a survey of dual certified PC/PMHNPs to identify outcomes providers perceive to be associated with their practice preparation and dual role.PURPOSETo conduct a survey of dual certified PC/PMHNPs to identify outcomes providers perceive to be associated with their practice preparation and dual role.Primary care and psychiatric mental health advanced practice registered nurses across the state of Iowa completed an online survey exploring their perceptions of their impact on patient outcomes.METHODOLOGYPrimary care and psychiatric mental health advanced practice registered nurses across the state of Iowa completed an online survey exploring their perceptions of their impact on patient outcomes.Respondents perceived dual certification to be positively associated with patient satisfaction and associated with decreased health care utilization costs (e.g., hospitalization, ER visits). Yet, respondents felt their dual role was underrecognized by employers both in pay and time allocated for patient visits.RESULTSRespondents perceived dual certification to be positively associated with patient satisfaction and associated with decreased health care utilization costs (e.g., hospitalization, ER visits). Yet, respondents felt their dual role was underrecognized by employers both in pay and time allocated for patient visits.This systematic effort to capture the perceived impact of dual certification confirmed past findings of the benefits to integrated practice by PC/PMHNPs. It also extends prior work by articulating ways in which PC/PMHNPs work to fulfill their dual role, including working in multiple practice settings and providing uncompensated care in their second specialty.CONCLUSIONSThis systematic effort to capture the perceived impact of dual certification confirmed past findings of the benefits to integrated practice by PC/PMHNPs. It also extends prior work by articulating ways in which PC/PMHNPs work to fulfill their dual role, including working in multiple practice settings and providing uncompensated care in their second specialty.Dual certified PC/PMHNPs feel uniquely empowered to improve patient care and decrease health resource utilization. This study supports the feasibility and need to conduct a nationwide survey of the PC/PMHNP role.IMPLICATIONSDual certified PC/PMHNPs feel uniquely empowered to improve patient care and decrease health resource utilization. This study supports the feasibility and need to conduct a nationwide survey of the PC/PMHNP role.

Dual certified primary care-psychiatric mental health advanced practice registered nurses: Their perceived impact on patient outcomes

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