September 12, 2011

Study: Advanced practice nurse care comparable to physician care

Today’s primary care physicians in the U.S. are too few in number to meet the health care needs of a burgeoning population, and health care reform will only amplify the problem. That’s where nurse practitioners, nurse midwives and other advanced practice nurses enter the picture. 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,” an assessment of the quality of care provided by advanced practice nurses in the United States.

Writing in Nursing Economics, Johns Hopkins School of Nursing associate professors Julie Stanik-Hutt and Kathleen M. White 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 found care by advanced practice nurses to be of comparable quality, safety and effectiveness to that by 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 that 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; advanced practice nurses see patients not pathology. Both provide effective interventions, but for different reasons.

“The study isn’t about who is a better health provider,” she said. “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.”