Study: Advanced practice nurse care as effective as physicians

Today's primary care physicians in the U.S. are too few in number to meet the healthcare needs of a burgeoning population; healthcare reform will only amplify the problem. That's where nurse practitioners, nurse midwives and other advanced practice nurses enter the picture. But do these master's-trained, board-certified nurses have the skills needed for autonomous practice that can help bridge the expanding gap between need and health care services? The answer is an unequivocal "yes," according to "Advanced Practice Nurse Outcomes 1990-2008: A Systematic Review," a groundbreaking assessment of the quality of care provided by advanced practice nurses in the U.S.

Writing in Nursing Economics, Johns Hopkins School of Nursing associate professors Julie Stanik-Hutt, PhD, ACNP, CCNS, FAAN; Kathleen M. White, PhD, RN, CEA-BC, FAAN, and colleagues present what Stanik-Hutt calls "the stuff of which new health policy is made." The analysis of 18 years of U.S. studies (1990-2008), found care by advanced practice nurses to be of comparable quality, safety, and effectiveness to that of physicians. Stanik-Hutt likens the study to research comparing the relative capacity of two different medications to treat the same illness; here, the study compares advanced practice nurse and physician effectiveness when treating people with the same illnesses. The study, conducted by a multidisciplinary team and funded, in part, by the Tri-Council for Nursing, specifically found care by nurse practitioners and nurse midwives is as good as, and in some ways better than, that of physicians. Clinical nurse specialists not only enhanced the quality of care for hospitalized patients, but also reduced unnecessary hospital days, stays, and readmissions.

According to Stanik-Hutt, the findings reflect the distinct, but complementary prisms through which nurses and physicians view patients. Physicians treat and cure disease; advance practice nurses see patients, not pathology. Both provide effective interventions, but for different reasons. She says, "The study isn't about who is a better health provider. Rather, the study suggests the value of enabling both doctors and advanced practice nurses each to do what they do best in a collaborative, but autonomous environment. When each profession works to its strengths, without the fetters of current regulatory restrictions, the unique contributions of both shine through. And that's what I call a win-win for patient care and for providers alike."