How EverCare nurse practitioners spend their time

OBJECTIVES: To describe how nurse practitioners (NPs) employed by EverCare, a Medicare HMO serving exclusively nursing home residents, spend their wor king days. DESIGN: A descriptive study based on structured self-reports. SETTING: Nursing homes. PARTICIPANTS: Seventeen NPs employed by EverCare in five sites. MEASUREMENTS: Self-reports of time spent over a 2-week period and specific reports of how time was spent on selected cases. RESULTS: NPs spend about 35% of their working day on direct patient care an d another 26% in indirect care activities. Of the latter, 46% of the time w as spent interacting with nursing home staff, 26% with family, and 15% with the physicians. The mean time spent on a given patient per day was 42 minu tes (median 30); of this time 20 minutes was direct care (median 15). CONCLUSIONS: NPs' activities are varied. Much of their time is spent commun icating with vital parties, an important function that supports the physici ans' primary care role and should enhance families' satisfaction with care.