Group items tagged

This article asks the question: "Compared to other providers (physicians or teams without APRNs), are APRN patient outcomes of care similar?" The study is specific to USA and includes data regarding NPs, CNRAs, and CNMs. Outcomes were determined by the following: patient satisfaction with provider/care, patient self-assessment of perceived health status, functional status, blood glucose, serum lipids, blood pressure, emergency department visits, hospitalization, duration of ventilation, length of stay, and mortality (p9).

I really liked this article because it focused on crisis resource management in Emergency Medicine. Seven perceived barriers to effective team performance in the ED were listed with the number one barrier being communication between disciplines. Further, of 81 (nurses, physicians, and residents) 100% felt that effective communication and effective leadership were very important team management skills that could effect the outcome of a resuscitation. Additionally, the number one contributing factor to adverse resuscitation outcomes was poor communication (96.2% out of 79 participants). Though other barriers and contributing factors to adverse outcomes were identified, communication was reported as the most contributory. Coming from an emergency room myself, I totally love the aspect of interdisciplinary collaboration. In resuscitation you are working with the physician, the nurses, the techs, pharmacy, the lab, the radiology department--and following a successful resuscitation, you are collaborating with the intensivist/pulmonolgist, cardiologist, and potentially other specialists, as well as the ICU staff members. The patient is relying on effective communication and collaboration to obtain the best outcome possible. And this communication and collaboration is not the sole responsibility of the provider, but EVERYONE on the team!

This article is about the scope of practice of midwives and childbirth outcomes. It discusses the relationship between autonomous practice and better birth outcomes. The article suggests there should be future policies to expand the access to midwifery services.

Birth centers run by midwives lead to better outcomes than hospital births

This article examines the documented positive impact of full practice legislation on patient outcomes. Potentially avoidable hospitalizations, readmission rates after inpatient rehabilitation, and nursing home resident hospitalizations were explored. States with full practice of nurse practitioners have lower hospitalization rates in all examined groups and improved health outcomes in their communities.

This study compares the labor and delivery outcomes of certified nurse-midwives (CNMs) and physicians. For care processes, (e.g., epidural, labor induction, episiotomy), CNMs were found to have lower rates of application/use. For infant outcomes, (e.g., low Apgar, low birth weight, neonatal intensive care unit admission), there were no differences between physicians and CNMs. Perineal lacerations were lower and breastfeeding rates were higher among women cared for by CNMs compared with physicians.

Meant to share this when we did our timelines. This was cited as a pinnacle article for the NP profession. It demonstrates that NPs give just as effective care as physicians in a primary care setting when given equal authority and responsibility. Research from JAMA - Primary Care Outcomes in Patients Treated by Nurse Practitioners or Physicians - A Randomized Trial - ContextStudies have suggested that the quality of primary care delivered by nurse practitioners is equal to that of physicians.

Landmark article showing primary care from NP vs MD was not different.

This article discusses how overall outcomes are better for patients when ACNP are members of a unit or service-based provider team. It also touches on how to hire ACNP for different patient populations.

This systematic review article has shown that the interdisciplinary care in general medical wards has not made any significant improvement to patient's outcome. This article states that it really needs to look more into their outcome criteria, and I, personally based on this article, think that this article needs to look at more into how interdisciplinary team in this review has performed as a team.

The role of APRNs continues to expand when current gaps in patient care management and outcomes are identified. Central Arkansas Veteran Healthcare System created the role of Abnormal Radiology Findings APRN with the aim of improving patient outcomes by decreasing the length of time between abnormal radiology findings and decrease of care for our veterans. During the year of research since the advent of this position, the days until decision dropped on average from 38 to 7 demonstrating the efficacy of the role and the ways APRN are well placed within the health care system to provide patient-centered care.

This article discusses the benefits and pit-falls to autonomous primary care Nurse practitioner practice and advocates for cost effective improvements to our healthcare system. The research suggests that Nurse practitioners who practice independently report greater job satisfaction, improved patient outcomes and provide low cost, high quality services that are equal or superior to primary care physicians. Unfortunately, current healthcare reimbursement models, policies and reluctant physicians have created barriers to autonomous NP practices. The author suggests that autonomous practice requires further research across the U.S, the establishment of a well-defined model and the evaluation of patient outcomes, in order to determine whether the present day Nurse Practitioner requires future collaborative agreements with physicians, in order to provide quality patient care across the United States.

This article explores how restrictions on CNM scope of practice affect health outcomes. Scope of practice laws were found to be neither helpful nor harmful regarding health outcomes. However, states without scope of practice barriers for CNMs had lower rates of induced labor and cesarean deliveries.

BACKGROUND: The trauma service experienced preventable delays caused by an Accreditation Council for Graduate Medical Education work restrictions and a 16% increase in patient census. Furthermore, nurses needed a consistently accessible provider for the coordination of care. We hypothesized that using experienced acute care nurse practitioners (ACNPs) on the stepdown unit would improve throughput and decrease length of stay (LOS) and hospital charges. Moreover, we hypothesized that adding ACNPs would improve staff satisfaction. On December 1, 2011, the Vanderbilt University Medical Center Division of Trauma reassigned ACNPs to the stepdown area 5 days a week for a pilot program. METHODS: LOS data from December 1, 2011 through December 1, 2012 was compared with data from the same months from the previous two years and estimated hospital charges and patient days were extrapolated. Physician and nursing surveys were performed. Data from 2010 (n = 2,559) and 2011 (n= 2,671) were averaged and the mean LOS for the entire trauma service was 7.2 days. After adding an experienced ACNP, the average LOS decreased to 6.4 days, a 0.8 day reduction. Per patient, there was a $ 9,111.50 savings in hospital charges, for a reduction of $27.8 million dollars in hospital charges over the 12 month pilot program. RESULTS: A confidential survey administered to attending physicians showed that 100% agreed that a nurse practitioner in the stepdown area was beneficial and helped throughput. Dayshift nurses were surveyed, and 100% agreed or strongly agreed that the ACNPs were knowledgeable about the patient's plan of care, experienced in the care of trauma patients, and improved patient care overall. CONCLUSION: The addition of experienced ACNPs resulted in the decrease of overall trauma service LOS, saving almost $9 million in hospital charges