Recent Research About Nursing, August 2011

    • August 29, 2011

Physician Shortages Will Lead to Expanded Roles for APRNs, Says Study

A newly published study concludes that the growth in the demand for health care in the United States, coupled with the mounting physician shortage, will inevitably lead to a larger role for advanced practiced registered nurses and physician assistants.

The study, published in the Journal of the American College of Surgeons, relied on models projecting the size of the health care workforce for the next 15 years. Researchers concluded that all three professions will face shortages. "The most likely scenario is one of flat supply in the face of rising demand, leading to long-term shortages of advanced clinicians of approximately 15 percent [by 2025], double the current level."

As a result, the researchers conclude, meeting future demand for health care will require redesigning medical practice, so that some health care professionals take on new tasks. “It means giving up some old models and accepting the reality that we're going to have a continuing shortage of physicians and [asking] how do we deploy them," says study co-author Richard Cooper, M.D., emeritus professor at the University of Pennsylvania School of Medicine and senior fellow in the University's Leonard Davis Institute of Health Economics in Philadelphia.

The authors conclude that, “Efforts must be made to expand the output of clinicians in all three disciplines, while also strengthening the infrastructure of clinical practice and facilitating the delegation of tasks to a broadened spectrum of caregivers in new models of care.”

Study: Registered Nurses Achieve Similar or Superior Patient Outcomes

A new study in the journal Nursing Economics concludes that advanced practice registered nurses (APRNs) achieve similar or superior patient outcomes as do physicians or teams that do not include an APRN.

Researchers conducted a systematic review of 69 relevant studies published between 1990 and 2008, examining care provided by APRNs and midwives in collaboration with physicians. They found that patient outcomes were “similar to and in some ways better than care provided by physicians alone for the populations in the settings included.” The authors, led by Robin P. Newhouse, Ph.D., R.N., N.E.A.-B.C., of the University of Maryland School of Nursing, conclude that “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.”

Four New Studies Show Nurses’ Impact

A series of unrelated studies published in recent weeks demonstrate the many ways that expanded roles for nurses produce superior results for patients and institutions alike.

In brief:

  • A study in Diabetes Care, published by the American Diabetes Association, finds that nurse case managers can increase the share of diabetes patients who achieve control of hypertension, hyperglycemia and hyperlipidemia.
  • A study in the AORN Journal, published by the Association of periOperative Registered Nurses, finds that having nurses at a North Carolina ambulatory surgery center call patients three business days prior to a scheduled surgery decreases the daily cancellation rate by 53 percent.
  • A study in the online issue of Neurology, published by the American Academy of Neurology, finds that patients with psychogenic pain symptoms – pain not explained by underlying disease – can achieve improved physical symptoms and emotional state if they receive a newly developed cognitive behavioral therapy approach that relies on nurses to guide the therapy.
  • A study in the Archives of Internal Medicine finds that a transitional care program led by advanced practice registered nurses (APRNs) and targeting heart patients over 65 decreased hospital readmission rates by 48 percent. APRNs in the study met with patients before being discharged and then conducted at least eight house calls per patient after they left the hospital.