Dr. Alisha Johnson and Dr. Amy Vogelsmeier from the University of Missouri School of Nursing received a $208,000 grant from the Donaghue Foundation to investigate the impact of full-time, embedded advanced practice registered nurses (APRNs) on resident outcomes in nursing homes. This cross-case analysis study aims to answer 1) How does the practice of full-time, embedded APRNs in the NH influence outcomes through altered NH structures and processes? and 2) What full-time embedded APRN direct and indirect care activities influence the NHs’ response to the COVID-19 pandemic?

Data collected from 8 years (2012-2020) of the Missouri Quality Initiative project (which achieved its goal of reducing resident hospitalizations by employing full-time APRNs working on-site in 16 nursing homes in the St. Louis MO area) will be used to understand APRN activities. In collaboration with our community stakeholder VOYCE, the long-term care ombudsman for the St. Louis area, we will compare high- versus low-performing nursing homes to better understand how APRN practice activities change nursing home operations to deliver better resident care. Study findings will be valuable to stakeholders interested in effective systems of care for nursing home residents, including administrators, advocacy groups, and educators. Findings will be shared via training and care conferences hosted by our community stakeholder. Policy and APRN education recommendations will be put forward to enhance quality of life for nursing home residents and their families.