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Implications of the Patient-Centered Medical Home for Nursing Practice.
Stewart KR, Stewart GL, Lampman M, Wakefield B, Rosenthal G, Solimeo SL. Implications of the Patient-Centered Medical Home for Nursing Practice. The Journal of nursing administration. 2015 Nov 1; 45(11):569-74.
The experiences of RNs and licensed practical nurses (LPNs) implementing a patient-centered medical home (PCMH) in the Department of Veterans Affairs (VA) primary care clinics were examined to understand model implications for nursing practice and professional identity.
National implementation of the PCMH model, called patient-aligned care teams (PACTs) in VA, emphasizes areas of nursing expertise, yet little is known about the effect of medical homes on the day-to-day work of nurses.
As part of a formative evaluation to identify barriers and facilitators to PACT implementation, we interviewed 18 nurses implementing PACT.
Challenges to nurse's organizational and professional roles were experienced differently by RNs and LPNs in the following areas: (1) diversified modes of care and expanded clinical duties, (2) division of labor among PACT nurses, and (3) interprofessional status in the team.
Healthcare managers implementing PCMH should consider its inherent cultural and practice transformations.