Direct care refers to nursing care activities provided at the point of care to patients or working with other healthcare providers that are intended to achieve specific health goals or achieve selected health outcomes. Direct care may be provided in a wide range of settings, including acute and critical care, long term care, home health, community-based settings, and education settings.

Examples of direct care experiences include provision of nursing care directly to patients, which are defined as individuals, families, groups, communities, or populations; but also, may include:

• Working with other providers in any setting where health care is delivered, including the community, to identify gaps in care and implement a quality improvement strategy.

• Collaborating with nursing staff to implement a new procedure or nursing practice that is evidence-based.

• Working with an interprofessional team to evaluate the outcomes of a new practice guideline and implement recommended changes.

• Designing and implementing a coordinated, patient-centered plan of care with an interprofessional team.

Indirect care refers to nursing decisions, actions, or interventions that are provided through or on behalf of patients. These decisions or interventions create the conditions under which nursing care or self-care may occur. Nurses might use administrative decisions, population or aggregate health planning, or policy development to affect health outcomes in this way.

Examples of indirect care experiences include:

• Educating other healthcare providers regarding the safe and effective use of new technology.

• Writing a policy and working with other stakeholders to have the policy approved by the state board of nursing.

• Working with community leaders to develop a disaster/emergency preparedness plan for a specific population in a community.

• Collaborating with the facility information technology staff to design or implement an electronic health record.

• Working with staff to write an administrative policy that will improve communication among the units in the facility.