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Good info about APRNs in the US

This article describes the Consensus Model developed in 2008 for the APRN role for licensure, accreditation and certification across the United States. Though the intended goal for adoption was in 2015 (still has not happened yet), there is still much work that needs to be done at the state and national level to get this to approved.

In reproductive endocrinology, there is no clear role for a CNM. I feel like this article has an undertone that doesn't seem to invite the CNM to the table for collaboration, though I still found it interesting.

Here is another brief, yet insightful read on the evolution of midwifery in the US.

This is a brief summary of the history of midwifery and beginnings of nurse-midwifery in the United States.Though the statistics are a bit dated, the article also has some recent data on the positive impact of the recent resurgence of midwifery practice since it began declining in the late 19th and early 20th centuries. It also discusses the profession of nurse-midwifery's close ties with public health and under served communities.

This is an older but fascinating article about a midwife working in Gardener, Massachusetts in the 19th century. Hanna continued to attend births of mostly the immigrant population of the city despite being told by courts to cease. She was convicted of "practicing medicine without a license" and had to pay many fines and spend 3 months in a correctional facility. Note that the charges brought against her were never from clients, but from the physicians working in the area.

This resource goes into details on the role of the NNP and shows the progression of how the profession has come to be established and known as a provider.

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

This article gives a great glimpse into the need for ENP programs in order to support our health system in emergency care. It was written in 2011, so before ENP certification was approved by the ANCC.

This article does a wonderful job of providing the historical background to the pediatric nurse practitioner profession. It touches upon some of the most memorable accomplishments that were achieved both in the specialty itself and the influential role it played on the profession of nurse practitioners in all specialties. This was a very beneficial resource that I utilized for my APRN infographic!

NAPNAP Position Statement on Age Parameters for Pediatric Nurse Practitioner Practice

This article details the age and scope of practice for Pediatric Nurse Practioners based on NAPNAP guidelines. This helps to guide both institutions and practioners with an age related scope of practice.

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).

This article shows a timeline and the evolution of Pediatric Nurse Practitioners and NAPNAP starting in 1964.