Using NIC to Describe the Role of the Nurse Practitioner

PURPOSE

To have nurse practitioners (NPs) identify the 20 most prevalent NIC interventions describing their nursing practice; to determine if the NIC is applicable to the NP role.

METHODS

The study used a descriptive survey design. NPs with prescriptive privileges in the state of Minnesota received a cover letter and survey that included a description of NIC and a list of the 486 intervention labels and their definitions from the NIC (3rd ed.). Each participant was asked to identify all interventions performed at least once per month in their practice and to provide basic demographic data, including identification of NP specialty.

FINDINGS

A total of 1,190 surveys were mailed with a return rate of 37%. NPs' average age was 45 years; the average number of years of NP practice was 9. Employment in a clinic represented the work setting of 72% of respondents followed by hospital practice (11%) and long-term care (10%). Specialty (certified) areas were family practice (27%), pediatrics (21%), adult (19%), women's health (16%), geriatrics (11%), psychiatric (5%), and oncology (1%). The educational level was primarily master's degree (73%).

NPs identified an average of 120 interventions they performed at least once per month. These interventions reflected areas of patient education and support, as well as documentation and physician collaboration. The 20 most frequently selected interventions were reported by 71%– 90% of respondents. Four core interventions —“documentation,”“telephone consultation,”“teaching: prescribed medication,” and “emotional support”— were used at least once per month by all specialties.

DISCUSSION

The level of consistency (70%) among responses validates the strong foundation that professional nursing, as described by NIC, provides NPs in their role. Four core interventions and the remaining 16 most frequently selected interventions that are more specific to each specialty practice indicates that NIC is comprehensive enough to meet the needs of a variety of NP practices.

CONCLUSIONS

NIC encompasses key areas of interventions (health screening, treatment and management, health promotion and education, psychosocial support, indirect activities) central to the role of NPs, but qualitative comments described the need for more language within NIC to characterize the NP role related to the prescribing of medications and treatments. Some respondents found the definitions to be unclear as to whether they were performing or ordering/prescribing the intervention. This lack of clarity could be addressed by further development of the NIC definitions and activities so the advanced role of the NP is more fully described.

Development of documentation systems using the core interventions identified by the various NP specialties is needed. Using standardized nursing language for documentation will enable NPs to build clinical databases that reflect and describe the role. Future research needs to be focused by NP specialty and to go beyond the NIC definition and include analysis at the activity level.