APRN Practice: Challenges, Empowerment, and Outcomes

In her 2008 article entitled "Advanced Practice Registered Nurses: The Impact of Patient Safety and Quality," Eileen O'Grady reported that the advanced practice registered nurse (APRN) workforce "has been growing exponentially with APRNs employed in every health care sector." 1 The Bureau of Labor Statistics agreed, underscoring the demand for APRNs with the ever-increasing need for access to cost-effective, quality health care. 2 Today, there are more than 267,000 APRNs across the United States, practicing in communities, hospitals, and many other healthcare settings. APRNs are categorized as certified nurse practitioners (NPs), certified nurse midwives (CNM), certified nurse specialists (CNS), and certified registered nurse anesthetists (CRNAs). 3 All groups continue to increase in number and effectiveness as integral members of the healthcare team.

[1]  M. Shea.  Determined persistence: Achieving and sustaining job satisfaction among nurse practitioners , 2015, Journal of the American Association of Nurse Practitioners.

[2]  Renee F Wilson,et al.  Advanced practice nurse outcomes 1990-2008: a systematic review. , 2011, Nursing economic$.

[3]  L. Kohn,et al.  To Err Is Human : Building a Safer Health System , 2007 .

[4]  Optimizing advanced practitioner charge capture in high-acuity surgical intensive care units. , 2011, Archives of surgery.

[5]  Clare Thomson-Smith,et al.  NPs in the ICU: the Vanderbilt initiative. , 2012, The Nurse practitioner.

[6]  J. Norwood,et al.  Occupational outlook handbook , 1990 .

[7]  S. B. Walker,et al.  Resource commitment to improve outcomes and increase value at a level I trauma center. , 2011, The Journal of trauma.

[8]  Robert L Kane,et al.  Primary Care Outcomes in Patients treated by Nurse Practitioners or Physicians: Two-Year Follow-Up , 2004, Medical care research and review : MCRR.

[9]  R. Hughes.  Patient Safety and Quality: An Evidence-Based Handbook for Nurses , 2008 .

[10]  April Kapu,et al.  Outcomes of adding acute care nurse practitioners to a Level I trauma service with the goal of decreased length of stay and improved physician and nursing satisfaction , 2014, The journal of trauma and acute care surgery.

[11]  A. Afifi,et al.  Evaluation of a nurse practitioner-led care management model in reducing inpatient drug utilization and cost. , 2009, Nursing economic$.

[12]  Raquel Pasarón.  Nurse practitioner job satisfaction: looking for successful outcomes. , 2013, Journal of clinical nursing.

[13]  R. Hays,et al.  An Alternative Approach to Reducing the Costs of Patient Care? A Controlled Trial of the Multi-Disciplinary Doctor-Nurse Practitioner (MDNP) Model , 2006, Medical decision making : an international journal of the Society for Medical Decision Making.

[14]  S. Burns,et al.  Effect of an outcomes-managed approach to care of neuroscience patients by acute care nurse practitioners. , 2002, American journal of critical care : an official publication, American Association of Critical-Care Nurses.

[15]  T. Mikhailov,et al.  A national survey of PICU nurse practitioners--opportunities to standardize practices and optimize service delivery. , 2012, Pediatric Nursing.

[16]  Kathryn A. Paez,et al.  Cost‐effectiveness of nurse practitioner management of hypercholesterolemia following coronary revascularization , 2006, Journal of the American Academy of Nurse Practitioners.

[17]  Eileen T. O’Grady,et al.  Advanced Practice Registered Nurses: The Impact on Patient Safety and Quality , 2008 .

[18]  J. Bauer.  Nurse practitioners as an underutilized resource for health reform: evidence-based demonstrations of cost-effectiveness. , 2010, Journal of the American Academy of Nurse Practitioners.

[19]  M. Manojlovich,et al.  Power and empowerment in nursing: looking backward to inform the future. , 2007, Online journal of issues in nursing.

[20]  Abdelmonem Afifi,et al.  The Effect of a Multidisciplinary Hospitalist/Physician and Advanced Practice Nurse Collaboration on Hospital Costs , 2006, The Journal of nursing administration.

[21]  R. Kleinpell,et al.  Physician Assistant and Nurse Practitioner Utilization in Academic Medical Centers , 2011, American journal of medical quality : the official journal of the American College of Medical Quality.

[22]  S. Shortell,et al.  Crossing the quality chasm: implications for health services administration education. , 2004, The Journal of health administration education.

[23]  L. J. Miers,et al.  Cardiovascular surgeon and acute care nurse practitioner: collaboration on postoperative outcomes. , 2005, AACN clinical issues.

[24]  A. Greiner,et al.  Health Professions Education: A Bridge to Quality , 2003 .

[25]  S. Burns,et al.  Improving outcomes for mechanically ventilated medical intensive care unit patients using advanced practice nurses: a 6-year experience. , 2002, Critical care nursing clinics of North America.

[26]  A. DiCenso,et al.  A framework for the introduction and evaluation of advanced practice nursing roles. , 2004, Journal of advanced nursing.

[27]  C. Tanner.  Transforming prelicensure nursing education: preparing the new nurse to meet emerging health care needs. , 2010, Nursing education perspectives.

[28]  R. Kleinpell,et al.  Quality and Financial Impact of Adding Nurse Practitioners to Inpatient Care Teams , 2014, The Journal of nursing administration.

[29]  T. Bleck,et al.  Implementation of an institutional program to improve clinical and financial outcomes of mechanically ventilated patients: One-year outcomes and lessons learned* , 2003, Critical care medicine.

[30]  Allen C. Bluedorn,et al.  Men and Women of the Corporation , 1978 .