Expanding nurse practitioner’s scope of practice could help meet primary care demands without diminishing quality of care, a literature review found.
The National Governors Association compared NP-provided and physician-provided care in 22 studies to assess the affect of expanding scope-of-practice laws for NPs and other advanced practice registered nurses (APRNs).
“Most studies showed that NP-provided care is comparable to physician-provided care on several process and outcome measures,” the report, The Role of Nurse Practitioners in Meeting Increasing Demand for Primary Care, stated. “Moreover, the studies suggest that NPs may provide improved access to care.”
Specifically, the review found that NP care was comparable to physician care in terms of patient satisfaction, time spent with patients, prescribing accuracy and preventive education.
Other findings showed:
- NPs were capable of successfully managing chronic conditions in patients suffering from hypertension, diabetes and obesity
- NPs rated favorably in achieving patients’ compliance with recommendations and reductions in blood pressure and blood sugar
- NPs were more likely to work in underserved urban populations and rural areas
None of the studies included in the review assessed differences in quality, access or costs between states with more and less restrictive scope-of-practice laws, the authors noted.
By 2016 an additional 30,000 Americans are expected to gain health coverage under the Affordable Care Act, with the demand for primary care projected to increase between 15 million and 25 million visits per year by the end of the decade. This will require an estimated 4,000 and 7,000 more primary care clinicians to meet healthcare demands.
“To better meet the nation’s current and growing need for primary care providers, states may want to consider easing their scope of practice restrictions and modifying their reimbursement policies to encourage greater NP involvement in the provision of primary care,” the authors wrote.