Role of Nurse Practitioners in Reinventing Primary Care

The Quality and Effectiveness of Care Provided by Nurse Practitioners

Expanding the Role of Advanced Nurse Practitioners — Risks and Rewards

• Glaiza Lanuza

The Role of Nurse Practitioners in Reinventing Primary Care (Mary D. Naylor and Ellen T. Kurtzman. 2010)

The authors in this study acknowledge that Nurse Practitioners are the fundamental category of advanced practice nurses yielding immediate care in the United States in the primary setting. Out of the 2.9 million nurses that the country produces substantially in the past decades, eight percent of which are APRNs, and roughly 70-80 percent work in the primary care setting (Mary D. Naylor and Ellen T. Kurtzman, 2010).

They reconsidered the current and projected nurse practitioner workforce. There is a proportionate surge of NPs in the populace which they projected to flourish by an average of 9 percent per annum.

Also, they considered the critical points of the available indication of NPs significant addition in ameliorating primary care and decreased utilization of health resources through two methodologies- literature review and study findings (Mary D. Naylor and Ellen T. Kurtzman, 2010).

Literature Review

They distinguished a policy review that was conveyed by the RAND Corporation. The said inquiry hypothesized that the usual expenditure of nurse practitioner or physician assistant visit is 20–35 percent less than the regular cost of a physician appointment. With that data, they predict aggregate savings of up to $8.4 billion between years 2010 to 2020 (Mary D. Naylor and Ellen T. Kurtzman. 2010).

Study Findings

The congressional Office of Technology Assessment (OTA) pioneered two autonomous scrutinies of non-physician providers in the United States (Mary D. Naylor and Ellen T. Kurtzman. 2010). The OTA recapitulated that, within their scope of practice, NPs deliver quality of care same of that contributed by physicians.

In conclusion, with the remarkable affirmations of NPs augmentation of high-value primary care, they proposed that nurse practice acts or state laws- be institutionalized and be less restrictive, to equalize payments and to increase nurse’s accountability.

This article speaks highly of Nurse Practitioners in their cognizance of the pivotal role NPs play in the future of health care as primary care providers; thus, putting them in the vanguard of administering preventative care to the public.

Research Article 2

The Quality and Effectiveness of Care Provided by Nurse Practitioners (Stanik-Hutt et al., 2013)

The study put scrutiny on evidences regarding the repercussion of nurse practitioners (NPs) in comparison with physicians (MDs) on three key points: health care condition, safety, and efficacy (Stanik-Hutt et al., 2013).

Health Care Quality

In the analytic inquiry of patient care in three settings such as, primary, outpatient surgical and inpatient environment, they ascertained that the patient satisfaction with care of NPs was similar to that associated with care from MDs. Moreover, in some reports, they discovered that patients were more satisfied with the care rendered by NPs.

Safety

Patient safety is affected by a myriad of factors such patient, healthcare setting and practitioner. They claimed that the mortality was the only safety outcome they can consider as a probable composite in this study.

Effectiveness

NP care effectiveness was linked to similar MD care effect though not better blood pressure and blood glucose regulation. Additionally, they correlated NP care with better serum lipid control.

The authors used four methodologies in this research such as data sources and searches, study selection, data retrieval and quality assurance and data organization and inquiry.

In the end, results for NPs compared to MDs (or teams without NPs) are proportionate or more sophisticated for all the sequelae recognized. In the primary care context, they laid evidences suggesting superior lipid control in patients cared for by NPs. Furthermore, noteworthy studies demonstrated that optimum well-being, physical function, count of patients’ emergency stays and hospital encounters; blood sugar, vital signs, and mortality have been positively linked to NPs and MDs (Stanik-Hutt et al., 2013).

Nurse Practitioners play an integral part in the nation’s dynamic healthcare system. Apart from being one of the most lucrative and beneficial option that the populace can elicit, their patient care, yield impressive outcomes in terms of quality, safety, and effectiveness.

Expert Opinion Article

Expanding the Role of Advanced Nurse Practitioners — Risks and Rewards (Iglehart, 2013)

This article discusses the 2014 extension of coverage decreed by The Patient Protection and Affordable Care Act (PPACA). Furthermore, it also chronicles as to how health professionals, lawmakers, and consumers will grapple with an expected intensification of patient claim for benefits and assistance (State of Rhode Island: Health Care Reform Commission).

Also, the author presented its’ risks, rewards and solutions.

Risks

According to the report of The Association of American Medical Colleges (Iglehart, 2013), by year 2015 the country might have to address a deficit of an estimated 33,000 care providers and around 30,000 other consultants.

Also, the Institute of Medicine (IOM) identified that the rigorous nurse practice state laws serve as impediments to accessible care.

Rewards

The author cited myriad of evidences in the nursing discourses that render support for the scientific achievement of NPs. One is the recent systematic study that bestowed NPs distinction for delivering safe, efficient, exceptional care. He, also emphasized, APRNs, in conjunction with physicians and other caregivers will need to progress with best current evidences and major synergistic frameworks of care strategies.

Solutions

Economist, David Auerbach, conferred that growth in nurse practitioner statistics is one answer to alleviating the inadequacy of primary care providers.

IOM reiterated that the federal government should find a way to have profound interest and action in the standardization of reforms for health care pursuit especially that of Advanced Practice Nurses.

He also made into account the Agreement between Nurse Leaders and Physician Officers on collaboration between professionals, in which they were empathic on eradicating the shipmaster notion, rather, regarding clienteles as champions of their care (Iglehart, 2013).

The methodologies that he used in this article are study findings and systematic review.

In summary, despite the hurdles that the healthcare system might face, the author was positive about the theme of this research article for he is optimistic about situational leadership.

In my viewpoint, nursing leaders and health policymakers need to be mindful in designing a health care system that delivers high-quality care at reasonable cost to improve results, effectiveness, efficacy, and costs. Ultimately, the patients and their families are the be-all and end-all of primary care. They deserve an unparalleled provision of care.

References

Mary D. Naylor and Ellen T. Kurtzman. 2010. The Role of Nurse Practitioners in Reinventing

Primary Care. Health Affairs, 29, no.5 893-899. Retrieved from

http://content.healthaffairs.org/content/29/5/893.full

Julie Stanik-Hutt, Robin P. Newhouse, Kathleen M. White, Meg Johantgen, Eric B. Bass, George Zangaro… Jonathan P. Weiner. (2013, September). The Quality and Effectiveness of Care Provided by Nurse Practitioners. The Journal for Nurse Practitioners, 9(8), 492-500.E13. Retrieved from: http://dx.doi.org/10.1016/j.nurpra.2013.07.004

John K. Iglehart. (2013, May). Expanding the Role of Advanced Nurse Practitioners — Risks and Rewards. The New England Journal of Medicine 368:1935-1941. doi: 10.1056/NEJMhpr1301084

State of Rhode Island: Health Care Reform Commission. Retrieved from http://www.healthcare.ri.gov/faq/answers.php