title: Nurse practitioner perceptions of the impact of physician oversight on quality and safety of nurse practitioner practice.
abstract: OBJECTIVE
  Nurse practitioner (NP) regulation and physician oversight (PO) of NP practice are inextricably intertwined. A flexible, well-prepared workforce is needed to meet consumer healthcare needs. All outcome studies have revealed that NPs provide safe, effective, quality care with outcomes equal to or better than that of physicians or physician assistants. Variability in state regulation of NP practice limits the full deployment of these proven healthcare providers, threatens the quality and safety of NP-delivered care, and limits consumer choice in healthcare access. The purpose of this study was to document NP perceptions of the impact of PO on the safety and quality of NP practice.
  
  
  METHODS
  A total of 1139 NP respondents completed an exploratory survey, Impact of Regulatory Requirements for Physician Oversight on Nurse Practitioner Practice. Participants were asked their perceptions of the impact of PO on patient care and NP practice. Descriptive statistics on the state of residence regulatory requirements and personal demographics were also collected.
  
  
  CONCLUSIONS
  NP perceptions of the impact of PO on the safety and quality of NP practice were predicted by NP experience and state regulatory environment ranking.
  
  
  CONCLUSIONS
  The results of this study have implications for educators, policy makers, and nursing advocacy groups seeking to increase access to care in U.S.
  
  
  METHODS
  Study participants perceived that requirements for PO impacted their practice and may jeopardize patient safety. An understanding of the impact of influences on regulatory processes is critical to ensuring full deployment of NPs as interprofessional leaders to meet current and future healthcare access.
authors.affiliation: North Carolina Board of Nursing, Raleigh, North Carolina.
authors.forename: Bobby
authors.initials: B
authors.lastname: Lowery
authors.affiliation: College of Nursing, East Carolina University, Greenville, North Carolina.
authors.forename: Elaine
authors.initials: E
authors.lastname: Scott
authors.affiliation: Office of Research and Creative Activity, College of Nursing, East Carolina University, Greenville, North Carolina.
authors.forename: Mel
authors.initials: M
authors.lastname: Swanson
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D009722:Nurse Practitioners / Q000523:psychology* / Q000592:standards / Q000706:statistics & numerical data; D061214:Patient Safety / Q000592:standards; D010465:Perception; D019555:Physician-Nurse Relations; D017009:Professional Autonomy; D011787:Quality of Health Care / Q000592:standards*; D011795:Surveys and Questionnaires
keywords: Nurse practitioners; physicians; quality; regulation; safety