Need and Readiness for a Nurse Practitioner-Paramedic Unit in Rural Yuma, Arizona

Abstract

Background: The expansion of health care coverage, overuse, misuse, and overcrowding of emergency departments, inappropriate use of emergency medical services, and issues pertaining to rural dwelling, call for the development of new models of care to improve patient outcomes, bridge care gaps, and meet community needs. One such model that may be instrumental in overcoming these issues it that of the Nurse Practitioner-Paramedic Unit (NPPU). Purpose: This doctor of nursing practice project comprises a needs and readiness assessment with input from key stakeholders regarding resources required and the need for a NPPU in Yuma, Arizona. The ultimate goal of this needs and readiness assessment is to inform the future development of a new model of care, the NPPU for Yuma, Arizona. Methods: Surveys were distributed via Qualtrics to 86 individuals to include local physicians, nurse practitioners, and paramedics, amongst others. The survey contained nine open-ended questions to inform the future development of a NPPU. A total of 17 completed surveys were submitted between 9/11/16 to 10/9/16. Response were grouped by question number and analyzed for themes. Results: Eighty-two percent of respondents felt that a NPPU was needed in Yuma, Arizona. Respondents identified more benefits than negatives of an NPPU. Resources needed were identified to include hospital buy-in, provider trust and buy-in, coordination between the hospital and fire departments, medical equipment, transport vehicle, funding, scheduling, and education. The most common care situations considered appropriate for a NPPU were identified as low acuity (47%), transitional care and/or chronic health issues (35%), and behavioral health (29%). The importance of protocols was noted by 65% of respondents. 94% of respondents expressed that an NPPU would increase patient satisfaction. Improved patient outcomes due to an NPPU was identified by 24% of respondents. Overall, 94% of respondents stated that they would support an NPPU and were interested in being part of a working group. Conclusions: The results of this project support the need for a NPPU by stakeholders in the community and will guide the future development of an NPPU for Yuma.