Healthcare in the Shadows

Interprofessional Collaboration: Nurse Practitioners and Dentists

Posted by on Friday, October 30, 2015 in News.

Dr. Lloyd, far right, with student Adrienne Hoving, faculty Leslie Taub, and office manager Aleyda Rizzo

New York University College of Nursing Faculty Practice operates an innovative primary care practice within the College of Dentistry’s clinical practice building in lower Manhattan. This unique practice began in 2005 when the dean of nursing and the dean of dentistry implemented a shared vision of integrated practice and interprofessional education for their students. What makes this practice unique is that it is managed and operated solely by nurse practitioners who leverage the proximity and structural connection to the College of Dentistry to educate nursing and dental students to identify oral-systemic health care issues during their patient care encounters. Today 2,000 unique patients use this nurse-led practice as their primary healthcare home. The patents range from young adults to the elderly. About a third of the patients are uninsured with the remaining having commercial insurance, Medicare or Medicaid.

Madeleine Lloyd, PhD, FNP, PMHNP manages the clinic and is the anchor of the practice. She is the only full time health care provider at the practice and is supplemented by the NYU’s teaching faculty NPs and who spend one or two days per week in the practice as clinical preceptors. The practice also includes a receptionist and an office manager who oversees operations and billing.

Since the practice’s founding 10 years ago, the practice has provided a unique opportunity of inter-professional education for dental hygiene, dentist and nursing students. In addition to providing full scope primary care, Dr. Lloyd serves as a preceptor for advanced practice nursing students from a variety of specialties, as well as for dental students. Dr. Lloyd also gives formal lectures in both nursing and dentistry programs. Illustrating the cooperative nature of the practice’s education APN students and dental students see patients together when assigned to the practice. In addition, the nursing and dental faculties work together on several initiatives including developing a comprehensive tobacco screening and cessation program that gives dental students the knowledge to screen, assist, and prescribe cessation medications to their patients. Advanced practice nursing students have also benefitted from this integrated model. For example, by working closely with dentist students and faculty, these nursing students are developing skills necessary for a thorough oral exam, well beyond what is routinely taught in traditional nursing physical assessment courses. This unique integration of advanced practice nurse-led primary care with dental health care has given all students valuable skills and provided patients with integrated services that they cannot find elsewhere and significantly ahead of most other health professions programs nationally.

The practice has a strong and growing patient base and serves approximately 15 to 20 patients per day in its two exam rooms. Dr Lloyd and her faculty colleagues have no clinical support staff so they must put patients in rooms, take all vital signs, clean rooms in between patients, draw blood and collect other specimens….all functions that a medical assistant or nurse routinely performs in other primary care clinics. Like so many safety net clinics, reimbursement is never enough to cover all of the expenses, hence the lean staffing model. There is a possibility that the practice will move to larger space to accommodate its growing patient base.




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