Home Health Visits With Paramedicine in Rural Montana

Abstract

Purpose: The purpose of this Doctor of Nursing Practice project was to implement a quality improvement project to evaluate whether patients value home-health checks by community paramedics in Montana. Background: Rural areas are vulnerable to ED overutilization because of the lack of health care services. Research has shown that community paramedicine programs help fill the primary care gap. Community paramedicine can expand primary care’s reach by performing patient assessments and procedures within their skillset. However, there is a lack of research on paramedicine program enrollees’ perception of programs and programs are finding difficulty in funding such programs. Methods. This project used quantitative and qualitative analysis to examine a convenience sample of (n=15). Participants were enrolled in the Community Care program in Carbon County who participated in the questionnaire. After concluding the visit, the participant would voluntarily complete a questionnaire. Data analysis was conducted using descriptive statistics and a qualitative response was scanned for emerging themes. Results: A total of (n=15) participants completed the questionnaire. The results showed a use rate of 76.9% of enrollees that had used the community care team previously and 23.1% had not and was receiving a home health visit from the Community Care team for the first time. 60% of participants have gone to the emergency room before to seek care due to their primary care provider not being available. 93.3% of participants answered they would seek care at the emergency room if this program was not available. Illness knowledge was assessed using the Likert scale. Out of the 15 responses 9 responses had a score of 3 or less. Necessity, funding, communication, and improving advertisement, as well as security were commonly presented themes within the 15 questionnaires. Conclusion: This project shows encouraging results for the effectiveness of this program preventing unnecessary hospital visits in Carbon County, Montana, and the value it has. The project was able to identify areas of success and identify areas of improvement. Last, there is a need for the nurse practitioner in the field of community paramedicine with the ability to enhance patient care, outcomes, and provide patient education.