Nurse practitioner and physician adherence to standing orders criteria for consultation or referral

L.O. Watkins and E.H. Wagner

American Journal of Public Health, 1982, vol. 72, issue 1, 22-29

Abstract: The degree to which nurse-practitioners (NPs) and physicians (MDs) follow the mutually agreed-upon rules for their practice and the effects of any deviations are unknown. This study assessed whether NPs adhered to consultation/referral (C/R) criteria in NP standing orders for hypertension, whether MDs adhered to the task-delegation intent expressed in standing orders, and the relationship between adherence and blood-pressure (BP) control. A sample of 161 patients from a practice of five MDs and four NPs in a rural primary care clinic was studied over 16 months. Patient characteristics associated with provider non-adherence were identified by discriminant analysis. NPs failed to obtain consultation or referral for 22 of 66 patients (33 per cent) with conditions requiring C/R. MDs retained 17 of the 43 patients (40 per cent) without C/R conditions. NP nonadherence was associated with care by a single NP, presence of few non-hypertension problems, and need for dietary alteration (p

Date: 1982
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.72.1.22_5

DOI: 10.2105/AJPH.72.1.22

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