Abstract
BACKGROUND: As a result of high demand, outpatient clinics nationwide are pressured to effectively serve more patients.1 Registered nurse (RN) interventions,2 including RN-led visits (LV), have emerged as a strategy to increase quality patient care. RN-LVs encompass a wide range of services, including disease management,3 treatment follow-up,4 patient education,1 and care coordination.2 RN-LVs are not conducted by advanced practice nurses;5 however, RN-LVs demonstrate promising patient outcomes. The impact of these visits on patient access remains underreported within the ambulatory specialty care setting.
PURPOSE: The purpose of this study was to elucidate ambulatory RNs’ experiences with RN-led visits as a response to patient access challenges.
METHODS: This IRB-approved qualitative study used semi-structured, recorded interviews at specialty ambulatory care clinics within an academic health center in the Western United States. Interviews were professionally transcribed and verified for accuracy. Inductive content analysis was used to analyze the transcripts.
RESULTS: A total of 10 RNs were interviewed, 7 providing RN-LVs, and 3 not providing RN-LVs. Both groups expressed a desire for more training and standard operating procedures for RN-LVs (n=8). Themes from RN-LV group included: confidence in RN growth and expertise (n=7), elevating RN scope of practice (n=7), and thorough patient and caregiver communication and education (n=6). Themes from those not participating in RN-LVs included: patient financial impacts (n=3), perception of increased workload (n=3), and voluntary RN participation based on clinic needs (n=3).
IMPLICATIONS: Further education is needed for ambulatory leaders to integrate RN-LVs as a response to care access limitations. Although patient access was not an explicit theme, RN-LVs may be an effective model to increase patient access to specialty ambulatory services without compromising quality care. Future RN-LV research should incorporate standardized practices across ambulatory specialty settings, training for RNs, and provider perspectives about RN-LVs increasing access, with an examined number of provider new patient visits and wait times for appointments pre- and post RN-LV implementation.
Notes
References:
1. Goodman, K. J., Dougan, B. M., Stevens, D. M., Smith, J. R., Mikhail, M. A., & Majka, A. J. (2020). Introducing nurse-led patient education visits. Journal of Nursing Care Quality, 36(1), 43–49. https://doi.org/10.1097/ncq.0000000000000489
2. American Academy of Ambulatory Care Nursing. (2023). Scope and standards of practice for professional ambulatory care nursing (10th ed.). American Academy of Ambulatory Care Nursing.
3. Berardinelli, D., Conti, A., Hasnaoui, A., Casabona, E., Martin, B., Campagna, S., & Dimonte, V. (2024). Nurse-led interventions for improving medication adherence in chronic diseases: A systematic review. Healthcare, 12(23), 2337. https://doi.org/10.3390/healthcare12232337
4. Saltbæk, L., Bidstrup, P. E., Karlsen, R. V., Høeg, B. L., Horsboel, T. A., Belmonte, F., Andersen, E. A., Zoffmann, V., Friberg, A. S., Svendsen, M. N., Christensen, H. G., Glavicic, V., Nielsen, D. L., Dalton, S. O., & Johansen, C. (2024). Nurse-led individualized follow-up versus regular physician-led visits after early breast cancer (MyHealth): A phase III randomized, controlled trial. Journal of Clinical Oncology, 42(17), 2038–2049. https://doi.org/10.1200/jco.23.01447
5. Connolly, C., & Cotter, P. (2021). Effectiveness of nurse-led clinics on healthcare delivery: An umbrella review. Journal of Clinical Nursing, 32(9–10), 1760–1767. https://doi.org/10.1111/jocn.16186
Sigma Membership
Alpha Alpha Lambda at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Qualitative Research
Keywords:
Primary Care, Workforce, Implementation Science, Promoting Clinical Outcomes, RN-led Visits, RN-led Patient Care
Recommended Citation
Platon, Charlene Grace Alforque; Bell-Stephens, Teresa; Cortez, Cynthia Dorantes; Williams, Briana; and Lewis, Chrystal L., "Scheduled Nurse-Led Visits: Responding to Specialty Care Access Limitations in Neuroscience Clinics" (2025). Biennial Convention (CONV). 170.
https://www.sigmarepository.org/convention/2025/presentations_2025/170
Conference Name
48th Biennial Convention
Conference Host
Sigma Theta Tau International
Conference Location
Indianapolis, Indiana, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2025-12-04
Funder(s)
Stanford Nurse Alumnae
Scheduled Nurse-Led Visits: Responding to Specialty Care Access Limitations in Neuroscience Clinics
Indianapolis, Indiana, USA
BACKGROUND: As a result of high demand, outpatient clinics nationwide are pressured to effectively serve more patients.1 Registered nurse (RN) interventions,2 including RN-led visits (LV), have emerged as a strategy to increase quality patient care. RN-LVs encompass a wide range of services, including disease management,3 treatment follow-up,4 patient education,1 and care coordination.2 RN-LVs are not conducted by advanced practice nurses;5 however, RN-LVs demonstrate promising patient outcomes. The impact of these visits on patient access remains underreported within the ambulatory specialty care setting.
PURPOSE: The purpose of this study was to elucidate ambulatory RNs’ experiences with RN-led visits as a response to patient access challenges.
METHODS: This IRB-approved qualitative study used semi-structured, recorded interviews at specialty ambulatory care clinics within an academic health center in the Western United States. Interviews were professionally transcribed and verified for accuracy. Inductive content analysis was used to analyze the transcripts.
RESULTS: A total of 10 RNs were interviewed, 7 providing RN-LVs, and 3 not providing RN-LVs. Both groups expressed a desire for more training and standard operating procedures for RN-LVs (n=8). Themes from RN-LV group included: confidence in RN growth and expertise (n=7), elevating RN scope of practice (n=7), and thorough patient and caregiver communication and education (n=6). Themes from those not participating in RN-LVs included: patient financial impacts (n=3), perception of increased workload (n=3), and voluntary RN participation based on clinic needs (n=3).
IMPLICATIONS: Further education is needed for ambulatory leaders to integrate RN-LVs as a response to care access limitations. Although patient access was not an explicit theme, RN-LVs may be an effective model to increase patient access to specialty ambulatory services without compromising quality care. Future RN-LV research should incorporate standardized practices across ambulatory specialty settings, training for RNs, and provider perspectives about RN-LVs increasing access, with an examined number of provider new patient visits and wait times for appointments pre- and post RN-LV implementation.
Description
Registered Nurse-Led Visits (RN-LV) encompass a wide range of patient care services; however, impact of these visits on patient access remains underreported within ambulatory specialty care settings. The purpose of this qualitative study was to elucidate ambulatory neuroscience RNs’ experiences with RN-LVs as a response to patient access challenges. There were 10 RNs interviewed, with the majority reporting RN-LV impact on elevating nursing practice (n=7), and improving patient education (n=6).