Problem: The healthcare system in the United States has increased in complexity, resulting in new and expanded opportunities for nurse practitioners. Activities previously performed only by medical doctors are now becoming increasingly within the scope of practice of the nurse practitioner. Little information is known about how patients perceive this healthcare change. Nurse practitioners often manage patients with acute and chronic disorders and numerous studies have shown that patients are satisfied with their delivery of care. Specifically, the question of client satisfaction with nurse practitioners delivery of care following a skills intervention, specifically performing a paracentesis for patients with large volume ascites is examined. Purpose and Scope: The purpose of this capstone project was to describe patient/client satisfaction with nurse practitioner delivery of care following a skilled intervention. The performance of an invasive procedure, usually done by medical doctors, specifically, an abdominal paracentesis for large volume ascites in patients with liver cirrhosis, was examined at two Department of Veterans Affairs Medical Centers, Long Beac California and Portland Oregon. The findings of the project will serve to describe the patient/client population and to examine the results of a twelve item Client Satisfaction Tool (CST) of the procedure performed by nurse practitioners. Goal: The goal of the project was to successfully implement a client satisfaction project in a selected population within two healthcare organizations. Objectives: This project had three overarching objecives. The first was to describe the demographic characteristics of the patients enrolled in the project within the two selected healthcare organizations. Second was to summarize of the Client Satisfaction Tool collected from the two Department of Veterans Affairs Medial Center sites. Third was to formulate conclusions and make recommendations based on the findings. Plan: Phase One: Conduct a needs assessment using a literature review. Phase Two: Design, plan, and develop the evidence-based project. Phase Three: Implement the Client Satisifaction project in Long Beach, California and Portland Oregon. Phase Four: Evaluate the analyzed the collection data. Outcomes and Results: Forty patients completed the CST questionnaire and provided demographic information. Twenty patients/clients were enrolled at each site. Using a triangulated research design, scaled reliability estimates based on internal consistency for the Oregon sample achieved significance while the California sample also achieved significance. On a scale of 1 to 5 with 1 being the lowest and 5 being the highest, the mean scores for the Oregon sample was 4.78 and the mean score for the California sample was 4.64. The findings revealed that patients/clients were very satisfied with nurse practitioner delivery of care following the skilled intervention.
