Program shows advanced practice registered nurses better for nursing homes

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COLUMBIA - Results from the Missouri Quality Initiative for Nursing Homes (MOQI), show that advanced practice registered nurses, or APRNs, in nursing homes might help improve the health of nursing home residents with heart disease. 

MOQI is a partnership between the University of Missouri and the Centers for Medicare & Medicaid Services, and provides full-time APRNs to work in participating nursing homes. 

An APRN is a nurse with advanced qualifications, oftentimes a doctorate, and is good at managing chronic illnesses, according to Dr. Marilyn Rantz, a curators professor at the Sinclair School of Nursing. 

"Anytime you add additional education, one becomes better prepared to learn the skills that are necessary to more advanced practice," Rantz said. "And be able to better manage people with complex chronic illnesses."

Rantz said that in the first three years of the program, potentially avoidable hospitalizations have decreased by over 30 percent. 

"Through early illness recognition we can manage people very well in the nursing homes and help reduce avoidable hospitalizations and those costs." Rantz said. 

Rantz said heart disease is very common among older adults.

"APRNs and the nursing homes staff are particularly good at managing congestive heart failure and managing other heart problems that people in nursing homes have." Rantz said. 

Rantz said ARPNs can also help other staff in nursing homes learn how to detect changes in condition very early.

"Little, subtle things that happen with older adults," Rantz said. "You can detect those things early, and treat those problems when the problems are small."

 Rantz said anytime extra education is added, a person becomes better prepared to learn the skills that are necessary to more advanced practice. 

Rantz said she thinks APRNs should be in every nursing home. 

"It would go a long way to improving the quality of care," Rantz said. "As well as reducing the cost." 

Rantz said APRNs help reduce the number of avoidable hospitalizations, which would cover the cost of the APRN.

Rantz said the program will continue for four more years so the payment methods associated with bringing in APRNs to nursing homes can be studied.