Practice environment, independence, and roles among DNP- and MSN-prepared primary care nurse practitioners

Martsolf, Grant R.; Komadino, Amy; Germack, Hayley D.; Harrison, Jordan; Poghosyan, Lusine

doi:10.1016/j.outlook.2021.06.008

Cited by 13 publications

(4 citation statements)

References 17 publications

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Section: Resultsmentioning

confidence: 99%

“…The move to the Doctor of Nursing Practice in the US by 2025 [ 100 ] has implications for the primary care workforce. Early evidence suggest that Doctor of Nursing Practice NPs are likely to move directly into leadership, policy or management instead of direct care roles, impacting NP workforce availability and planning [ 100 – 103 ]. One study identified that only 11% of Doctor of Nursing Practice graduates practice in primary care [ 101 ], while another reported that 85% of Doctor of Nursing Practice programs in 2018 were non-clinical, focusing on leadership and administration [ 103 ].…”

Section: Resultsmentioning

confidence: 99%

“…While it is premature to evaluate the impact of the introduction of the US’s Doctor of Nursing Practice by 2025, on NPs choosing primary care, early data does suggest a larger proportion of Doctor of Nursing Practice graduates take up administrative or leadership positions compared to clinical roles [ 100 , 101 , 103 ]. This is relevant considering US workforce projections indicate an ongoing decline in the primary care NP and physician-to-population ratio [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

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Practice pathways, education, and regulation influencing nurse practitioners’ decision to provide primary care: a rapid scoping review

Elvidge,

Hobbs,

Fox

et al. 2024

BMC Prim. Care

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Background/Objective Initially established to improve access to healthcare, particularly for primary care, the full potential of the nurse practitioner role is yet to be realised in most countries. Despite this, most countries are working to meet an ageing population’s increasing healthcare needs and reduce healthcare costs and access disparities. Achieving these outcomes requires reform at multiple levels, including nurse practitioner practice pathways, education and regulation, and identifying the barriers and facilitators to optimising their primary care role. Methods A rapid scoping review of nurse practitioner practice pathways, education and regulation inclusive of: (1) a systematic search of Medline and CINAHL for peer-reviewed English language articles, including opinion pieces published between January 2015 and February 2022; and (2) a web-based search of nurse practitioner program entry requirements of International Nurse Regulator Collaborative country members with a protected nurse practitioner title and prescribing rights, plus the Netherlands. The individually summarised search data was integrated and synthesised using Popay’s narrative approach. Results Emerging evidence from the included nurse practitioner courses (n = 86) and articles (n = 79) suggests nurse practitioners working in primary care provide safe, effective care and improve healthcare efficiencies. However, different regulatory and educational models are required if the primary care nurse practitioner is to meet growing demand. Conclusions International variations in entry criteria, curriculum, and regulation shape the global profile of the nurse practitioner primary care workforce and their practice setting. For countries to grow their primary care nurse practitioner workforce to meet unmet needs, different entry requirements, program content and accredited post-registration transitional programs must be urgently considered.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Practice pathways, education, and regulation influencing nurse practitioners’ decision to provide primary care: a rapid scoping review

Elvidge,

Hobbs,

Fox

et al. 2024

BMC Prim. Care

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“…Martsolf and colleagues conducted two studies comparing MSN-prepared and DNP-prepared nurse practitioners. The first study 37 examined practice environment, independence, and roles between the two levels of preparation. Compared to MSN-prepared nurse practitioners (n=1,031), DNP-prepared nurse practitioners (n=117) in primary care practices reported non-significantly more favorable relationships with physicians, less direct patient clinical hours, and more practice leadership hours.…”

Section: VIIImentioning

confidence: 99%

The Doctor of Nursing Practice: A Narrative Review of the History and Current Status

Dunbar‐Jacob

Schlenk

Tuite

2023

MRAJ

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Objective: The objective of this narrative review of Doctor of Nursing Practice implementation is to present the background leading to the 2004 American Association of Colleges of Nursing recommendation that the Doctor of Nursing Practice degree be required for advanced practice, discuss the implementation of programs, identify challenges, and provide recommendations for the future. Method: Both publications and organizational documents, such as white papers and position statements, were reviewed to identify the historical antecedents to the Doctor of Nursing Practice degree recommendation. A review of the status of the degree acceptance by professional organizations was conducted to identify current trends and challenges. Summary: In 2004, the American Association of Colleges of Nursing voted to require the Doctor of Nursing Practice degree for advanced practice providers by 2015. This occurred within a broad initiative within health science disciplines to move to a practice doctorate. The need for the degree was supported by the Institute of Medicine 2002 recommendation for additional competencies in health professions education and the National Research Council 2005 recommendation that nursing create a clinical doctorate. The goal of the Doctor of Nursing Practice by 2015 has not been met, although programs are growing across the country with varying models of education. Currently nurse anesthesia requires the Doctor of Nursing Practice, clinical nurse specialists have a target date for the requirement of the Doctor of Nursing Practice, nurse practitioner recommendations are to move from the master’s level to the Doctor of Nursing Practice, but certification bodies have not required it, and nurse midwives will accept but have not endorsed a requirement for the Doctor of Nursing Practice. Nurse executives have recommended the Doctor of Nursing Practice for advanced leadership, but many health systems do not require it. There are multiple challenges to developing a pathway to the Doctor of Nursing Practice, including the multiple organizations influencing educational programs, the certification and licensure of graduates, and the employment practices by health systems. These challenges will have to be addressed to achieve the original goal of doctoral education for advanced practice in nursing.

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The current state of transplant advanced practice providers: results of the advanced practice provider practice survey

Muth

Krieger

Domingo

et al. 2023

American Journal of Transplantation

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Practice environment, independence, and roles among DNP- and MSN-prepared primary care nurse practitioners

Cited by 13 publications

References 17 publications

Practice pathways, education, and regulation influencing nurse practitioners’ decision to provide primary care: a rapid scoping review

Practice pathways, education, and regulation influencing nurse practitioners’ decision to provide primary care: a rapid scoping review

The Doctor of Nursing Practice: A Narrative Review of the History and Current Status

The current state of transplant advanced practice providers: results of the advanced practice provider practice survey

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