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August 12, 2011

Review Suggests that APRNs Achieve Comparable or Better Outcomes than Physicians

A systematic review to be published in the September/October 2011 issue of Nursing Economic$ suggests APRNs garner similar and in some ways better outcomes than their physician counterparts. The report, “Advanced Practice Nurse Outcomes 1990-2008: A Systematic Review,” reinforces that APRNs provide effective, high-quality patient care and play an important role in improving the quality of care in the United States.

In the review, led by Robin P. Newhouse, PhD, RN, NEA-BC, associate professor and chair, Department of Organizational Systems and Adult Health at the University of Maryland School of Nursing, Newhouse and her co-authors* compare APRN processes and outcomes to those of physician providers. Sixty-nine studies published between 1990 and 2008 were analyzed and 28 outcomes were summarized for nurses practicing in APRN roles.

The review describes patient outcomes for three groups – nurse practitioners, certified nurse-midwives, and clinical nurse specialists. Outcomes with similar or better grades than those of physician comparison groups include:

  • Nurse practitioners: Glucose control, lipid control, patient satisfaction, functional status, mortality
  • Certified nurse-midwives: Cesarean, low APGAR score, episiotomy, labor analgesia, perineal lacerations
  • Clinical nurse specialists: Satisfaction, length of stay, cost.

The results indicate that APRNs provide safe, effective, quality care and play a significant role in promoting health and health care. The report states that the results “could help address concerns about whether care provided by APRNs can safely augment the physician supply to support reform efforts aimed at expanding access to care.”

Read the complete article on the Nursing Economic$ website. This article will appear in the print version of Nursing Economic$, September/October 2011 (Vol. 29, No. 5). Readers may access the article online.

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*Co-authors include: Meg Johantgen, PhD, RN and Lily Fountain, MS, CNM, University of Maryland School of Nursing; Julie Stanik-Hutt, PhD, ACNP, CCNS and Kathleen M. White, PhD, RN, CNAA, BC, Johns Hopkins University School of Nursing; George Zangaro, PhD, RN, Catholic University School of Nursing; Lou Heindel, DNP, CRNA; Donald M. Steinwachs, PhD and Jonathan P. Weiner, DrPH, Johns Hopkins Bloomberg School of Public Health; and Eric B. Bass, MD, MPH, and Renee Wilson, MS, Johns Hopkins University School of Medicine.

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