APRN care by NP, CNS, Nurse Midwives, CRNA similar + better than physicans alone

advanced practice registered nurses
have assumed an increasing
role as providers in the health care
system, particularly for underserved
populations.
the aim of this systematic review
was to answer the following question:
compared to other providers
(physicians or teams without
aprns) are aprn patient outcomes
of care similar?

this systematic review of published
literature between 1990 and 2008
on care provided by aprns indicates
patient outcomes of care provided
by nurse practitioners and
certified nurse midwives in collaboration
with physicians are similar to
and in some ways better than care
provided by physicians alone for the
populations and in the settings
included.

use of clinical nurse specialists in
acute care settings can reduce
length of stay and cost of care for
hospitalized patients.

these results extend what is known
about aprn outcomes from previous
reviews by assessing all types
of aprns over a span of 18 years,
using a systematic process with
intentionally broad inclusion of outcomes,
patient populations, and
settings.

the results indicate aprns provide
effective and high-quality patient
care, have an important role in
improving the quality of patient care
in the united states, and could help
to address concerns about whether
care provided by aprns can safely
augment the physician supply to
support reform efforts aimed at
expanding access to care.