title: Advanced practice nurse outcomes 1990-2008: a systematic review.
abstract: 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.
authors.affiliation: University of Maryland School of Nursing, Baltimore, MD, USA.
authors.forename: Robin P
authors.initials: RP
authors.lastname: Newhouse
authors.forename: Julie
authors.initials: J
authors.lastname: Stanik-Hutt
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: White
authors.forename: Meg
authors.initials: M
authors.lastname: Johantgen
authors.forename: Eric B
authors.initials: EB
authors.lastname: Bass
authors.forename: George
authors.initials: G
authors.lastname: Zangaro
authors.forename: Renee F
authors.initials: RF
authors.lastname: Wilson
authors.forename: Lily
authors.initials: L
authors.lastname: Fountain
authors.forename: Donald M
authors.initials: DM
authors.lastname: Steinwachs
authors.forename: Lou
authors.initials: L
authors.lastname: Heindel
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Weiner
mesh_terms: D057179:Advanced Practice Nursing; D003695:Delivery of Health Care; D017048:Health Care Costs; D006801:Humans; D007902:Length of Stay; D010043:Outcome and Process Assessment, Health Care; D017060:Patient Satisfaction; D016896:Treatment Outcome; D014481:United States; D000078329:Workforce