Nurse Practitioner Profession

The emergency nurse practitioner (ENP) role has developed significantly over the past two decades. Although the role has been evaluated in respect of outcomes, patient satisfaction and safety, there is no research exploring what motivates senior nurses to undertake a role with greater clinical responsibility and exposure to greater legal risk, but little financial reward.

OBJECTIVE: This study is designed to assess the cost of services provided to Medicare beneficiaries by nurse practitioners (NPs) billing under their own National Provider Identification number as compared to primary care physicians (PCMDs). DATA SOURCE: Medicare Part A (inpatient) and Part B (office visit) claims for 2009-2010. STUDY DESIGN: Retrospective cohort design using propensity score weighted regression. DATA EXTRACTION METHODS: Beneficiaries cared for by a random sample of NPs and primary care physicians...

OBJECTIVES: The employment of more nurse practitioners (NPs) is one of the most promising ways to expand the capacity of medical group practices. The objective of this study was to determine the association of NPs with patient-level cost and quality of care. STUDY DESIGN: Eighty-five primary care medical group practices were matched with 315,000 Medicare patients. Per beneficiary per year total costs and quality of care were calculated from Medicare claims data...

PURPOSE: This integrative review of the existing literature was conducted to identify dimensions related to nurse practitioner (NP) autonomy and to recommend future areas of research related to the important topic of NP autonomy in this era of cost-conscious healthcare reform. DATA SOURCES: Articles were identified from the following databases: CINAHL, MEDLINE, PubMed, Ovid, Scopus, Google Scholar, and EBSCO. CONCLUSION: Over 24 articles were found; 12 peer-reviewed articles met the inclusion criteria of research conducted with NPs, physicians, and patients...

PURPOSE: Community health centers (CHCs) fill a vital role in providing health care to underserved populations. This project compares characteristics of patient visits to nurse practitioners (NPs), physician assistants (PAs), and physicians in CHCs. METHODS: This study analyzes 2006-2010 annual survey data from the National Ambulatory Medical Care Survey CHC sample, a representative national sample of CHC providers and patient visits. We examine trends in provider mix in CHCs and compare NPs, PAs, and physicians with regard to patient and visit attributes...

INTRODUCTION: The Emergency Nurse Practitioner (ENP) role has become established over the last two decades within emergency care. This role has developed to meet the rising demands of healthcare, combat the continuing medical workforce shortfall and address targets around healthcare delivery within emergency care. The ENP role has been widely evaluated in terms of patient satisfaction, safety and outcome. To date there is no published literature exploring what drives senior nurses to undertake this role which involves additional clinical responsibility and educational preparation for no increase in pay...

This article describes the context and development of the new Nurse Practitioner Standards for Practice in Australia, which went into effect in January 2014. The researchers used a mixed-methods design to engage a broad range of stakeholders who brought both political and practice knowledge to the development of the new standards. Methods included interviews, focus groups, surveys, and work-based observation of nurse practitioner practice. Stakeholders varied in terms of their need for detail in the standards...

PROBLEM: Thousands of people die annually in hospitals because of poor communication and teamwork between health care team members. Standardized tools and strategies help increase the amount and quality of communication. Two structured communication methods include implementing huddles and the use of the situation, background, assessment, and recommendation (SBAR) communication framework. METHODS: To improve communication among nurse practitioners and registered nurses within a pediatric emergency department, a performance-improvement project with the structured processes of a joint patient evaluation and huddle was implemented...

OBJECTIVES: Access block refers to the delay caused for patients in gaining access to in-patient beds after being admitted. It is almost always associated with emergency department overcrowding. This study aimed to identify evidence-based strategies that can be followed in emergency departments and hospital settings to alleviate the problem of access block and emergency department overcrowding; and to explore the applicability of these solutions in Hong Kong. DATA SOURCES: A systematic literature review was performed by searching the following databases: CINAHL, Cochrane Database of Systematic Reviews, EMBASE, MEDLINE (OVID), NHS Evidence, Scopus, and PubMed...

No abstract text is available yet for this article.

BACKGROUND: Nurse practitioners perform a diagnostic role previously delivered by doctors. Multiple studies demonstrate nurse practitioners are as effective as doctors when managing chronic conditions and minor illnesses and injuries. No studies have focused on how nurse practitioners compare to doctors in their management of complex cases presenting for the first time. OBJECTIVE: This study assessed how nurse practitioners' diagnostic reasoning abilities when managing a complex case compared to those of doctors'? DESIGN: A comparative research design...

The role of nurse practitioners (NPs) in emergency care continues to evolve. A new and exciting role is the provider-in-triage (PIT) role. This innovative role has been implemented in many emergency departments (EDs) across the country. It was developed primarily as a front-end strategy to improve throughput of patients receiving emergency care. The PIT process uses a provider, physician, NP, or physician assistant in the triage area. Patient satisfaction, quality measures, and financial improvements have been attributed to using a PIT...

BACKGROUND: The U.S. health care system is at a critical juncture in health care workforce planning. The nation has a shortage of primary care physicians. Policy analysts have proposed expanding the supply and scope of practice of nurse practitioners to address increased demand for primary care providers. These proposals are controversial. METHODS: From November 23, 2011, to April 9, 2012, we conducted a national postal-mail survey of 972 clinicians (505 physicians and 467 nurse practitioners) in primary care practice...

OBJECTIVES: With nationwide resident shortages and decreasing resident shifts, and legislation decreasing resident work hours, the nurse practitioners (NPs) have been called upon to expand their scope of practice to encompass patients with immediate and critical conditions and to perform quick procedures. Most pediatric NP (PNP) programs do not have formal training for NP students to work in a pediatric emergency department (ED). METHODS: Senior ED NPs in collaboration with an NP educator developed a comprehensive clinical program to prepare a general PNP student to practice in an ED...