Review finds APRNs may outperform physicians

Patients of advanced practice registered nurses have similar or better results in many outcome measurements compared with physicians and other healthcare teams without APRNs, according to a new study.

Published in Nursing Economics, the report “reinforces that APRNs provide effective, high-quality patient care and play an important role in improving the quality of care in the United States,” according to a news release.

Robin P. Newhouse, RN, PhD, NEA-BC, associate professor at the University of Maryland School of Nursing and assistant dean for the Doctor of Nursing Practice Program, and co-authors conducted a systematic review comparing APRN processes and outcomes to those of physician providers. They analyzed 69 studies published between 1990 and 2008 and summarized 28 outcomes for nurses in APRN roles.

The authors described patient outcomes for each of three patient groups — nurse practitioners, certified nurse-midwives and clinical nurse specialists. Outcomes with similar or better grades than those of physician comparison groups included:

• 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 authors wrote 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.”

The complete article is available as a PDF at

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