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Regulation of the Nurse Practitioner Workforce: Implications for Care Across Settings

      Introduction

      The current shortage of physicians in the United States has potential to dramatically limit access to healthcare. Nurse practitioners (NPs) can provide a cost-effective solution to the shortage, yet few states allow NPs to practice independently.

      Purpose

      The purpose of this study was to provide an up-to-date description of the NP workforce and to identify the professional and organizational factors associated with NP care quality.

      Methods

      Cross-sectional survey data from a sample of NPs actively employed in four states with reduced or restricted practice (California, Florida, New Jersey, and Pennsylvania) was used. NPs were categorized into acute and primary care. Regression models were fit to estimate the odds of three measures of care quality: overall quality of patient care, NP confidence that patients and their caregivers can manage their care at home, and whether NPs would recommend their practice facility to family and friends.

      Results

      Receiving support from administrative staff and physicians was associated with an increase in the three measures of quality. The greatest effects were seen in primary care settings.

      Conclusion

      It is imperative that legislators and healthcare administrators implement policies that provide NPs with an environment that supports clinical practice and enhances care delivery.

      Keywords

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      Biography

      Jeannie P. Cimiotti, PhD, RN, FAAN, is Associate Professor, Nell Hodgson Woodruff School of Nursing, Emory University.

      Biography

      Yin Li, PhD, is Assistant Professor, Nell Hodgson Woodruff School of Nursing, Emory University.

      Biography

      Douglas M. Sloane, PhD, is Adjunct Professor, School of Nursing, University of Pennsylvania.

      Biography

      Hilary Barnes, PhD, NP-C, is Assistant Professor, School of Nursing, University of Delaware.

      Biography

      Heather M. Brom, PhD, RN, NP-C, is Post-Doctoral Research Fellow, School of Nursing, University of Pennsylvania.

      Biography

      Linda H. Aiken, PhD, RN, FAAN, is Professor, School of Nursing, University of Pennsylvania.

      Linked Article

      • Conflict of Interest Compliance Article 4
        Journal of Nursing Regulation Vol. 12Issue 2
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          As is standard in scholarly publishing, NCSBN’s Journal of Nursing Regulation (JNR) requires its authors to disclose any potential conflicts of interest (COI). Although COI information has always been collected by our staff in order to support editors’ review of the paper, it was not our standard practice to publish COI statements in each article. In this issue, JNR is retrospectively publishing the COI statements, which were collected with the below papers at submission, in order to make potential COI’s transparent to readers, as well as editors.
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