Newhouse Robin P, Stanik-Hutt Julie, White Kathleen M, Johantgen Meg, Bass Eric B, Zangaro George, Wilson Renee F, Fountain Lily, Steinwachs Donald M, Heindel Lou, Weiner Jonathan P
University of Maryland School of Nursing, Baltimore, MD, USA.
Nurs Econ. 2011 Sep-Oct;29(5):230-50; quiz 251.
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.
高级执业注册护士在医疗保健系统中作为医疗服务提供者所发挥的作用日益增强，尤其是为那些医疗服务不足的人群。本系统综述的目的是回答以下问题：与其他医疗服务提供者（医生或没有高级执业注册护士的团队）相比，高级执业注册护士所提供的患者护理结果是否相似？这项对1990年至2008年间发表的有关高级执业注册护士提供护理的文献的系统综述表明，执业护士和认证助产士与医生协作提供的患者护理结果，对于所纳入的人群和环境而言，与医生单独提供的护理相似，并且在某些方面更好。在急性护理环境中使用临床护理专家可以缩短住院患者的住院时间并降低护理成本。这些结果通过在18年的时间跨度内评估所有类型的高级执业注册护士，采用一种有意广泛纳入结果、患者人群和环境的系统方法，扩展了以往综述中关于高级执业注册护士护理结果的已知信息。结果表明，高级执业注册护士提供有效且高质量的患者护理，在美国改善患者护理质量方面发挥着重要作用，并且有助于解决有关高级执业注册护士提供的护理能否安全地增加医生供给以支持旨在扩大医疗服务可及性的改革努力的担忧。
