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Evidence Brief: The Quality of Care Provided by Advanced Practice Nurses

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Evidence Brief: The Quality of Care Provided by Advanced Practice Nurses

Investigators: Ellen McCleery, MPH; Vivian Christensen, PHD; Kimberly Peterson, MS; Linda Humphrey, MD, MPH; Mark Helfand, MD, MPH, MS

Evidence-based Synthesis Program (ESP) Center, Portland VA Medical Center, Portland, OR

Washington (DC): Department of Veterans Affairs; September 2014

Download PDF: Brief, Supplemental Materials


Summary

The objective of this evidence brief is to assess the strength and relevance of studies comparing autonomous APRNs with physicians in primary care, urgent care, and anesthesia settings for 4 important outcomes: health status, quality of life, hospitalizations, and mortality. We did not include process of care measures (such as access to care or resource use), performance measures (eg, blood pressure or glucose control), or patient satisfaction. We did not include studies of the work of APRNs (primarily CNSs) in team-based care or in interventions designed to augment usual care, nor care provided by nurse midwives.

Key Question #1: Do independent advanced practice nurses and physicians provide comparable quality of care?

Key Question #2: Does the quality of care provided by advanced practice nurses vary by the type of care (eg, primary or specialized care) being provided or by the setting of practice?

Key Question #3: Does the quality of care provided by advanced practice nurses vary by their degree of autonomy?