To evaluate primary care activities affecting quality, safety, and care coordination among VHA nurses.
Approach:
Survey Methodology: A nationwide survey was conducted among VHA PC nurses to assess nursing activities and time allocation.
Statistical Analysis: Categorical variables were evaluated with the χ2 test, and ordinal variables were assessed using the Wilcoxon rank sum test.
Key Findings:
3284 nurses responded to the survey, including 1940 RNs and 1363 LPN/LVNs.
RNs reported higher involvement in care coordination (93.6% vs 58.5%), postdischarge outreach (94.4% vs 48.9%), and patient assessment (96.0% vs 53.6%) compared to LPN/LVNs.
LPN/LVNs reported more frequently performing immunizations (97.0% vs 88.5%) and health care screenings (96.8% vs 82.6%).
Both RNs and LPN/LVNs spent considerable time on health care education and counseling.
Interpretation:
VHA PACT RNs and LPN/LVNs share responsibilities, but their activity patterns differ significantly.
Limitations:
No adjustment for respondent bias or covariates.
Limited generalizability beyond VHA.
Possibility of unreported activities by PC nurses.
Conclusion:
Nursing activities align with the VHA PACT handbook, but optimization of PC team composition and function requires better measurement of nursing work.
Investigators compared cardiovascular outcomes with tirzepatide and a placebo proxy in patients with type 2 diabetes and established atherosclerotic cardiovascular disease.
