The effect of nurse practitioner practice in home care on emergency department visits for homebound older adult patients: An exploratory pilot study

The impact of nurse practitioners (NPs) in home care on emergency department (ED) usage in Canada has not been documented in the literature. This article discusses the potential impact of care provided by NPs on ED use for home care patients in Canada. The authors used a 2-group prospective design for this pilot study to compare the number of ED visits in home care patients followed by NPs (intervention group, n = 30) with those receiving usual care and not followed by NPs (control group, n = 9). Data were collected by accessing provincial electronic medical records at the time of recruitment and at 3 additional time points: 2 weeks, 4 weeks, and 8 weeks. Descriptive statistics and the z-test of 2 proportions were used to compare the 2 groups. The authors found more ED visits were documented in the control group than in the intervention group at 2 and 4 weeks, but not at 8 weeks. Six subjects dropped out in the intervention group and 1 in the control group during the study due to death. The number of ED visits was reduced at 2 and 4 weeks in the intervention group, but there was no significant difference in the death rates between the 2 groups. This study serves as a springboard for future studies of NPs in home care in Canada.