Potential Crisis in Nurse Practitioner Preparation in the United States.

The Doctor of Nursing Practice (DNP) degree was established to expand nurse practitioner education by adding new competencies. In 2004, the American Association of Colleges of Nursing released a position statement that redefined practice from only clinical care of patients to include nonclinical care. This policy position likely contributed to the rapid growth of DNP programs.

The ABCs of the doctor of nursing practice: assessing resources, building a culture of clinical scholarship, curricular models.

The Doctor of Nursing Practice (DNP) degree prepares nurses to provide comprehensive care across sites and over time. It is absolutely crucial-for both patient care and the nursing profession-that broadly recognized standards of competency for these new practitioners be established. The Council for the Advancement of Comprehensive Care has met since 2000 to build consensus on competency standards and a process for certifying these graduates.

Who's who in nursing: bringing clarity to the doctor of nursing practice.

Advanced practice nurses across the country are informally learning expanded skills and are assuming significant autonomy. The growing complexity and acuity of care, the aging of the US population, and the dwindling number of primary care physicians all contribute to the need for increased knowledge and practice competency. A formal and standardized educational process leading to a doctoral degree is essential for quality assurance, to clarify and validate authority/responsibility, and to recognize and identify these practitioners.

Context of care or provider training: the impact on preventive screening practices.

Background: While MD adherence to U.S. Preventive Services Task Force guidelines has been found to be uneven, nurse practitioners (NPs) and their adherence to guidelines have not been closely examined.

Essential health care: affordable for all?

Access to affordable health care has become a national crisis. The uninsured have many faces and many reasons for being uninsured. The nation cannot afford to sustain this broken system; not in terms of resources, nor in terms of the deteriorating health of the public.

Primary care outcomes in patients treated by nurse practitioners or physicians: two-year follow-up.

This study reports results of the 2-year follow-up phase of a randomized study comparing outcomes of patients assigned to a nurse practitioner or a physician primary care practice. In the sample of 406 adults, no differences were found between the groups in health status, disease-specific physiologic measures, satisfaction or use of specialist, emergency room or inpatient services. Physician patients averaged more primary care visits than nurse practitioner patients.

Diabetes care processes and outcomes in patients treated by nurse practitioners or physicians.

Purpose: The purpose of this study was to compare selected diabetes care processes and outcomes of nurse practitioners (NPs) and physicians (MDs) in the primary care of adults with type 2 diabetes.

Methods: Adults with type 2 diabetes and no regular source of primary care were enrolled from the emergency room and randomized to an NP or MD practice. Chart reviews were conducted to assess processes of care; patient interviews and hemoglobin A1C (A1C) testing were performed to measure patient outcomes.

Twenty-first-century primary care: new partnerships between nurses and doctors.

What role will advanced practice nurses (APNs) play in tomorrow's health care system? The author shares her answer to this question by first looking at the history of APNs and nurse practitioners (APNs whose focus is primary care), explaining what they do, and tracing their increasing success in overcoming long-standing barriers to full acceptance as providers of care. The author emphasizes that while APNs' advancement has usually been based on demonstrating sameness of practice processes and outcomes with those of physicians, in actuality, APNs-whose advanced primary care is delivered with full accountability and is indistinguishable from such care delivered by physicians-offer a different style of practice, which involves caring, nurturing, support, engagement with patients, attention to illness prevention and health promotion, and patient education. It is this difference on which APNs' survival rests.