ORCID Identifier(s)

ORCID 0009-0009-0511-983X

Graduation Semester and Year

Summer 2025

Language

English

Document Type

Dissertation

Degree Name

Doctor of Philosophy in Nursing

Department

Nursing

First Advisor

Kristin H. Gigli

Second Advisor

Zhaoli Liu

Third Advisor

Jaquetta M. Reeves

Abstract

Despite initiatives to improve primary care, access to high-quality primary care has yet to achieve anticipated results, negatively impacting health outcomes (NASEM, 2021a). Among developed countries, the United States consistently performs poorly in health outcomes and within the United States, Texas notably underperforms ranking 48th out of 51 states and jurisdictions on 87% of primary care indicators on the State Health System Performance (The Commonwealth Fund, 2019; 2023). Understanding primary care providers’ perspectives on factors that influence the delivery of high-quality primary care can provide insight into barriers and help guide policy to improve primary care. However, research is lacking in this area. To describe factors that influence the delivery of high-quality primary care from the perspective of primary care providers in Texas, a quantitative, cross-sectional, descriptive study was conducted in the Central Texas Region between September 2024 and January 2025. The analysis revealed that most primary care providers work in group settings and workload was an area where they would like to see change. Additionally, despite substantiated benefits of registered nurses and interdisciplinary care teams in supporting and positively influencing patient care, our findings indicate a notable absence of these teams across all primary care settings (NASEM, 2021a). The findings suggest that providers in primary care settings need support to help decrease workload. An incremental approach that supports providers and aligns with initiatives to improve access to high-quality primary care can begin with the expansion of registered nurses in primary care settings.

Keywords

Primary Care, Nursing, Team-based Care, Quality of Primary Care

Disciplines

Family Practice Nursing | Other Nursing

License

Creative Commons Attribution 3.0 License
This work is licensed under a Creative Commons Attribution 3.0 License.

Available for download on Thursday, August 05, 2027

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