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When it comes to caring for patients suffering from COVID-19, nurse practitioners (NPs), as you might expect, are making a major contribution.

Some 61% of NPs are treating patients who have been diagnosed with COVID-19, according to a recent survey from the American Association of Nurse Practitioners (AANP).  Almost as many (58%) are offering COVID-19 testing at their practices.

“It was somewhat surprising to see how many nurse practitioners are literally on the frontlines of this pandemic,” said Stephen Ferrara, DNP, FNP, of ColumbiaDoctors Nurse Practitioner Group and Associate Dean of Clinical Affairs at Columbia University School of Nursing. He is also Executive Director of the Nurse Practitioner Association of New York State and the Editor-in-Chief of the Journal of Doctoral Nursing Practice.

Barriers to Treatment

Caring for COVID-19 patients does not come without obstacles, however. NPs identified lack of testing (47%) and lack of personal protective equipment (PPE) (24%) as the top barriers to treating patients with COVID-19, according to an executive summary of the survey.  The survey was conducted from May 8 to May 17, 2020 and garnered over 4,800 responses from across the country. In many locations, COVID-19 testing is limited to patients who meet a narrow set of criteria (69%).

Of note, over three-quarters of the survey respondents (79%) said they reused PPE. And more than one out of two (53%) were exposed to SARS-CoV-2 in their practice or elsewhere.

At ColumbiaDoctors, Ferrara notes that he has had to reuse PPE. Specifically, he has reused an N95 mask and changed an outer surgical mask.

The use of PPE is “probably forever changed,” said Sophia L. Thomas, DNP, APRN, FNP-BC, PPCNP-BC, FNAP, FAANP, president of AANP in an interview with DailyNurse. She notes that the CDC has provided guidance on safely reusing PPE, and that a variety of mask shapes and sizes have been approved. 

Long-Term Changes

As in many areas of health care, COVID-19 may lead to significant structural changes. For one thing, notes Thomas, “the expansion of the use of telehealth is going to change the landscape in which we provide health care in this country and will definitely improve access to care for all patients.” NPs, she noted, “are big utilizers of telehealth because we feel it’s important to provide access to patients wherever they are.”

Ferrara’s Manhattan-based primary care practice rapidly adopted telehealth/virtual visits for non-COVID patients, he said. The practice restricted in-person visits only to those patients with COVID-19 symptoms.

Another change involves lowering regulatory obstacles. The AANP and the general NP community, Thomas said, “call on the nation’s governors to suspend all legislative and regulatory barriers that prevent NPs from providing patients with full and direct access to all the health care services that NPs are educated and prepared to provide.”

Five governors, she said, have issued executive orders to allow NPs to practice at the top of their education and training.  She hopes that these five governors “will make those executive orders permanent to change that regulatory language, and I hope that we modernize health care delivery in all the other states and allow nurse practitioners to practice at the top of their education and training.”

“Beacon of Light”

As the pandemic continues, NPs need to educate patients, said Thomas, on the importance of  wearing masks to prevent the spread of COVID-19. In a July 14 statement, the  AANP called on the American public to wear masks, socially distance, and wash hands. NPs, said Thomas, need to be the “beacon of light to their patients.”

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