Xue Ying, Ye Zhiqiu, Brewer Carol, Spetz Joanne
University of Rochester, School of Nursing, Rochester, NY.
Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY.
Nurs Outlook. 2016 Jan-Feb;64(1):71-85. doi: 10.1016/j.outlook.2015.08.005. Epub 2015 Sep 9.
One proposed strategy to expand primary care capacity is to use nurse practitioners (NPs) more effectively in health care delivery. However, the ability of NPs to provide care to the fullest extent of their education is moderated by state scope-of-practice (SOP) regulations.
The purpose of this study was to examine the impact of state SOP regulations on the following three key issues: (a) NP workforce, (b) access to care and health care utilization, and (c) health care costs.
Systematic review.
RESULTS/DISCUSSION: States granting NPs greater SOP authority tend to exhibit an increase in the number and growth of NPs, greater care provision by NPs, and expanded health care utilization, especially among rural and vulnerable populations. Our review indicates that expanded NP practice regulation can impact health care delivery by increasing the number of NPs in combination with easing restrictions on their SOP.
Findings show promise that removing restrictions on NP SOP regulations could be a viable and effective strategy to increase primary care capacity.
一种扩大初级保健能力的提议策略是在医疗服务中更有效地利用执业护士（NP）。然而，执业护士根据其所学知识提供充分护理的能力受到州执业范围（SOP）法规的限制。
本研究的目的是考察州SOP法规对以下三个关键问题的影响：（a）执业护士劳动力，（b）医疗服务可及性和医疗保健利用，以及（c）医疗保健成本。
系统评价。
结果/讨论：给予执业护士更大SOP权限的州往往会出现执业护士数量增加且增长加快、执业护士提供的护理更多以及医疗保健利用增加的情况，尤其是在农村和弱势群体中。我们的评价表明，扩大执业护士执业法规可通过增加执业护士数量并放宽对其执业范围的限制来影响医疗服务提供。
研究结果显示，取消对执业护士SOP法规的限制可能是增加初级保健能力的可行且有效策略。
