The level of quality care nurse practitioners provide compared with their physician colleagues in the primary care setting: A systematic review

Abstract

Background: There is an increasing demand for high-quality primary care providers without adequate supply to meet the need. Nurse practitioners (NPs) are uniquely positioned to fill this demand but influence on regulatory practice authority from concerned groups regarding patient safety and quality of care has delayed this as an effective solution.Objectives: The objective was to address concerns abovt NP-led care by examining evidence regarding patient safety, clinical outcomes, cost, and patient satisfaction that reflect on the ability of NPs to provide high-quality care within the primary care setting and to compare their ability with standard models of care led by physicians.Data sources: A systematic review was completed using PubMed, CINHAL Complete, and Scopus. Using PRISMA guidelines to critique literature and the John's Hopkins Research Evidence Appraisal tool, articles were analyzed comparing the quality of care between NP and physician providers in the primary care setting.Conclusions: A total of 11 articles met the criteria and reveal that NPs provide equal or better quality of care for all outcomes outcomes when compared with their physician colleagues.Implications for practice: Quality patient care provided by NPs in the primary care setting is equal to, and in several cases superior to, that of physicians. Concerns for patient safety and quality care outcomes seem unsupported by data, and state legislatures should continue to grant full practice authority. as an effective source of providing highquality primary health care.

Impacto de la formación y aspectos legales en la aplicación de la gestión enfermera de la demanda por parte de las enfermeras de atención primaria de Cataluña

“…Otro estudio demostró que no existían diferencias entre un diagnóstico emitido entre una enfermera y un médico cuando se trataba de enfermedades agudas leves 16 . Una de las revisiones sistemáticas más recientes 17 concluye que la calidad de la atención al paciente proporcionada por las enfermeras en el ámbito de la atención primaria es igual o superior, a la de los médicos.…”

CPD providers can positively impact practice by better understanding how APNs are educated, licenced, and certified

“…One study that confirmed comparable care quality between NPs and physicians also found that hospitals with NPs who complied with guidelines for treating ICU patients with septic shock had lower mortality rates [ 7 ]. In addition, a systematic review noted that in the primary care setting, NPs provide care that is not only equal to that of physicians but in some cases is superior [ 8 ]. For example, NPs are associated with higher patient satisfaction.…”

Advocating, implementing, and supporting the journey to full-practice authority in a large healthcare system

“…The FPA steering committee was comprised of APRN leadership, a physician executive sponsor, operational champions, representatives from public affairs/marketing, human resources, risk, compliance, credentialing practitioner verifi cation department, provider contracting, and leaders from hospital medical staff offi ces. The goal of the FPA steering committee included: (1) defi ning the current state including numbers of potential APRNs qualifying for FPA and departments that would be affected by the change; (2) defi ning workfl ows and processes for all departments affected by the change; (3) clarifying relationships between APRNs with FPA and their physician consultants, including reenvisioning the requirements for WCA; (4) creating a pathway identifying and encouraging those APRNs who qualify to apply; (5) developing and providing encouraging and consistent messaging to APRNs, physicians, and other key stakeholders via a communication plan to acculturate the concept and garner support for change; and (6) identifying and amending internal policies that would be affected by these sweeping changes.…”