The Quality and Effectiveness of Care Provided by Nurse Practitioners

Stanik-Hutt, Julie; Newhouse, Robin; White, Kathleen M.; Johantgen, Meg; Bass, Eric B.; Zangaro, George A.; Wilson, Renée; Fountain, Lily; Steinwachs, Donald M.; Heindel, Lou; Weiner, Jonathan P.

doi:10.1016/j.nurpra.2013.07.004

Cited by 194 publications

(162 citation statements)

References 53 publications

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“…There is abundant evidence that NPs provide care that is of an equal quality to that of medical practitioners. [27][28][29] Collaboration is already an intrinsic component of registered nurse standards for practice. 30 Therefore, mandating collaborative arrangements seems both superfluous and potentially counter-productive to the establishment of much needed community and primary care services.…”

Section: Impact Of Collaborative Arrangements On Patient Access To Carementioning

confidence: 99%

Collaborative arrangements and privately practising nurse practitioners in Australia: results from a national survey

Currie

Chiarella

Buckley

2017

Aust. Health Review

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Objective. Since the introduction of legislative changes in 2010, services provided by privately practising nurse practitioners (PPNPs) in Australia have been eligible for subsidisation through the Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS). To provide eligible services, PPNPs must collaborate formally with a medical practitioner or an entity that employs medical practitioners. This paper provides data from a national survey on these collaborative arrangements in Australia. The aim of the study was to evaluate the impact of PPNP services on patient access to care in Australia.Methods. PPNPs in Australia were invited to complete an electronic survey. Quantitative data were analysed using descriptive statistics, whereas qualitative data were analysed using thematic analysis. Seventy-three surveys were completed.Results. Ninety-three per cent of participants reported having a collaborative arrangement in place. Frequency of communication ranged from daily (27%) to never (1%). Participants reported that collaborative arrangements facilitate learning, patient care and offer support to PPNPs. However, for some PPNPs, organising a formal collaborative arrangement is demanding because it is dependent on the availability and willingness of medical practitioners and the open interpretation of the arrangement. Only 19% of participants believed that collaborative arrangements should be a prerequisite for PPNPs to access the MBS and PBS.Conclusion. Although there are benefits to collaborative arrangements, there is also concern from PPNPs that mandating such arrangements through legislation presents a barrier to establishing PPNP services and potentially reduces patient access to care. Collaboration with medical practitioners is intrinsic to nursing practice. Thus, legislating for collaborative arrangements is unnecessary, because it makes the normal abnormal.What is known about the topic? To access the MBS and PBS, PPNPs are required by law to have a collaborative arrangement with a medical practitioner or entity that employs medical practitioners. To date, the effects of these collaborative arrangements on PPNP services in Australia have not been known. What does the paper add? This paper provides unique data from a national survey on collaborative arrangements between PPNPs and medical practitioners in Australia. What are the implications for practitioners? Although there are benefits to collaborative arrangements, there is also concern that mandating such arrangements presents a barrier to establishing PPNP services and potentially reduces patient access to care.

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Section: Impact Of Collaborative Arrangements On Patient Access To Carementioning

confidence: 99%

Collaborative arrangements and privately practising nurse practitioners in Australia: results from a national survey

Currie

Chiarella

Buckley

2017

Aust. Health Review

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“…Studies showed that these new NPs were well prepared to provide primary care. 11 In the late 1970s and early 1980s, the US saw a rapid proliferation of NP programs at the master's level and the various state laws regulating nursing practice changed quite rapidly. Initially, no state had legislation that allowed for NPs to diagnose or prescribe drugs, but states began to allow for both.…”

Section: The Case Of Us Npsmentioning

confidence: 99%

“…This study revealed that NP practice is equivalent or better than that of physicians on all measures of quality, safety, and effectiveness. 11 This rich history of research regarding the quality, safety, and effectiveness of NP care in the US will not likely put to rest the issue of equivalency of NP practice to that of physicians. The 2 professions use different models of education and have different underlying epistemologies upon which their education is built.…”

Section: Questions Of Quality Safety and Effectiveness Of Np Practicementioning

confidence: 99%

“…There is no evidence from any of the many US studies concerning NP practice that supports this very restrictive policy. 11 The mandate of this collaborative practice agreement implies that, somehow, NPs must subvert their knowledge and ability to another profession. This policy promotes one health care profession's control over another profession.…”

Section: Change Policy To Eliminate Collaborative Requirements With Pmentioning

confidence: 99%

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Meeting Australia’s Emerging Primary Care Needs by Nurse Practitioners

Carter¹,

Owen-Williams²,

Della³

2015

The Journal for Nurse Practitioners

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“…Multiple studies confirm the high quality and safety of NP-delivered care [1][2][3] but suggest a difficult transition for new NPs as they move from the academic to service delivery setting. [4][5][6] Postgraduate training programs such as NP residencies and fellowships have been suggested as a logical next step in providing depth and intensity of clinical training to give new NPs an opportunity to develop greater confidence and competence in their practice as primary care providers (PCPs).…”

Section: Introductionmentioning

confidence: 99%

Thematic elements of the postgraduate NP residency year and transition to the primary care provider role in a Federally Qualified Health Center

Flinter

Hart

2016

JNEP

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Background/Objective: Although the literature supports that nurse practitioners provide quality primary care resulting in excellent outcomes, the transition from nurse pracitioner education to practice is often difficult. Postgraduate residency programs have been suggested to help new nurse practitioners successfully transition, and studies indicate that most new nurse practitioners are interested in postgraduate residencies; however, little is known about how residencies facilitate transitioning. We sought to understand the experience of nurse practitioners in a residency program in the United States and how the program facilitated their transition to the role of primary care provider. Methods: Reflective journals of 24 Residents who completed the first primary care nurse practitioner residency in the United States were analyzed using Content Analysis. Results: Four to nine themes for each month and one theme for each yearly quarter were identified. Residents went from feeling shocked and overwhelmed to becoming confident, competent primary care providers, committed to underserved populations. Transitioning conditions (e.g., on-call experience) and specific facilitators (e.g., engaged preceptors) and stressors (e.g., managing chronic pain and reqests for opioids) that impacted their transition were also identified. Conclusions: The findings are significant as the United States addresses the shortage of primary care providers and models for postgraduate residencies and fellowships for nurse practitioners and other advanced practice registerered nurses emerge. The findings also represent the first qualitative data that reflect the experience of nurse practitioner Residents and provide rich insight into the overall experience of a one year residency, as well as facilitating and stressful factors. Organizations that are developing or refining nurse practitioner residencies or fellowships should consider these findings and discuss ways to address them with both nurse practitioner Residents and preceptors, as well as program and organizational leadership.

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The Quality and Effectiveness of Care Provided by Nurse Practitioners

Cited by 194 publications

References 53 publications

Collaborative arrangements and privately practising nurse practitioners in Australia: results from a national survey

Collaborative arrangements and privately practising nurse practitioners in Australia: results from a national survey

Meeting Australia’s Emerging Primary Care Needs by Nurse Practitioners

Thematic elements of the postgraduate NP residency year and transition to the primary care provider role in a Federally Qualified Health Center

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