Primary Care Organizational Support for Nurse Practitioner Practice and Emotional Health Care Delivery.

Objectives: Nurse practitioners (NPs) are key to delivery of primary care services. However, poor organizational support for independent NP practice, such as lack of access to clinic resources, may lead to prioritizing patient physical health over emotional health. We investigated the relationship between organizational support for independent NP practice and emotional health care delivery.
Methods: This was a secondary analysis of cross-sectional survey data collected from 397 NPs in 2017. We measured organizational support for independent NP practice using the independent practice and support subscale of the NP Primary Care Organizational Climate Questionnaire. Emotional health care delivery was measured by asking NPs how frequently they addressed emotional concerns of patients. We utilized multilevel mixed effects linear regression models, adjusting for NP and practice covariates.
Results: Controlling for NP age, gender, marital status, race, and ethnicity, along with practice setting and size, as the independent practice and support score increased, NPs reported addressing emotional concerns of patients more frequently (beta = 0.34, 95% confidence interval = 0.02-0.66, P = 0.04). This indicates that as organizations provided more support for independent NP practice, NPs were able to more frequently address emotional concerns of patients.
Conclusions: Organizational support for independent NP practice is associated with addressing emotional concerns of patients. To support NP practice, primary care organizations should ensure that NPs manage patients independently and have access to ancillary staff and support for care management.
Competing Interests: Conflicts of interest and source of funding: At the time of original submission, E.T., A.S., & S.C. efforts were supported by a National Institutes of Health, National Institute of Nursing Research T32 training grant (T32NR014205). E.T. was also supported by a Jonas Scholarship. This work was supported by the Agency for Healthcare Research and Quality, R03HS024758. E.T. is now funded by T32MH109433 and the National Clinician Scholars Program. The authors have no conflicts of interest.
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