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初级保健护士从业者的 DNP 准备和慢性病患者的临床结果。

DNP preparation of primary care nurse practitioners and clinical outcomes for patients with chronic conditions.

机构信息

School of Nursing, University of Pittsburgh, Pittsburgh, PA.

School of Nursing, Columbia University, New York, NY.

出版信息

Nurs Outlook. 2023 May-Jun;71(3):101951. doi: 10.1016/j.outlook.2023.101951. Epub 2023 Mar 20.

Abstract

BACKGROUND

Many professional nursing organizations have proposed that the Doctor of Nursing Practice (DNP) is the most appropriate entry-level degree for nurse practitioners (NPs). There have been no studies to date examining the impact of DNP preparation on quality of care or patient outcomes.

PURPOSE

To examine differences in emergency department utilization and hospitalizations among patients with chronic conditions cared for by Master of Science in Nursing (MSN)- and DNP-prepared primary care NPs.

METHODS

We use survey data from over 1,000 primary care NPs in 6 states linked to Medicare claims data. Using regression models, we controlled for various patient, NP, and practice characteristics that might confound the relationship.

RESULS

We find that patient outcomes are not statistically different between patients attributed to MSN- and DNP-prepared primary care NPs.

DISCUSSION

These findings suggest that there remains little evidence that DNP education has led to significant improvements in patient outcomes.

CONCLUSIONS

Further empirical analysis related to the clinical outcomes other than health care utilization of the DNP degree is warranted. Future studies might consider examining (a) NPs in settings other than primary care, (b) practice-wide or system-wide outcomes, (c) other measures of care quality, and (d) impact of DNP program content.

摘要

背景

许多专业护理组织提出,护理实践博士(DNP)是护士从业者(NP)的最合适的入门级学位。迄今为止,还没有研究考察 DNP 准备对护理质量或患者结果的影响。

目的

检查由护理科学硕士(MSN)和 DNP 准备的初级保健 NP 护理的慢性病患者在急诊部门的使用情况和住院率方面的差异。

方法

我们使用来自 6 个州的 1000 多名初级保健 NP 的调查数据,并与医疗保险索赔数据相关联。使用回归模型,我们控制了可能使关系复杂化的各种患者、NP 和实践特征。

结果

我们发现,归因于 MSN 和 DNP 准备的初级保健 NP 的患者的结果在统计学上没有差异。

讨论

这些发现表明,几乎没有证据表明 DNP 教育导致患者结果的显著改善。

结论

需要进一步进行与 DNP 学位的除医疗保健利用之外的临床结果相关的实证分析。未来的研究可能会考虑(a)初级保健以外的其他环境中的 NPs,(b)实践范围或系统范围的结果,(c)其他护理质量指标,以及(d)DNP 课程内容的影响。

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