Nurse practitioner

Last updated

Nurse practitioner
US Navy 031027-N-0000W-001 Family Nurse Practitioner Lt. Cmdr. Michael Service cares for a young girl at the U.S. Naval Hospital (USNH) Yokosuka.jpg
A Navy nurse practitioner assessing a patient
Occupation
Occupation type
Professional
Activity sectors
Nursing
Description
Education required
Depends on the country, but generally includes at least a post-graduate nursing degree
Fields of
employment
Healthcare
Related jobs
Registered nurse

A nurse practitioner (NP) is an advanced practice registered nurse and a type of mid-level practitioner. [1] [2] NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, formulate and prescribe medications and treatment plans. NP training covers basic disease prevention, coordination of care, and health promotion, but does not provide the depth of expertise needed to recognize more complex conditions. [3]

Contents

The scope of practice for a NP is defined by legal jurisdiction. [4] [5] In 26 states of the US, NPs have full practice authority, while in the remaining 24 states, NPs are required to work under the supervision of a physician. [6] In Australia, the scope of practice is guided by health organisation policy and the individual's competency, while their right to access Medicare rebates requires a Collaborative Practice Aranagement with a medical practitioner. [7]

History

United States

The present-day concept of advanced practice nursing as a primary care provider was created in the mid-1960s, spurred on by a national shortage of physicians. [8] The first formal graduate certificate program for NPs was created by Henry Silver, a physician, and Loretta Ford, a nurse, in 1965. [8] In 1971, The U.S. Secretary of Health, Education and Welfare, Elliot Richardson, made a formal recommendation in expanding the scope of nursing practice to be able to serve as primary care providers. [9] In 2012, discussions arose between accreditation agencies, national certifying bodies, and state boards of nursing about the possibility of making the Doctor of Nursing Practice (DNP) degree the new minimum standard of education for NP certification and licensure by 2015. [10]

Canada

Advanced practice nursing first appeared in the 1990s in Ontario. [11] These nurses practiced in neonatal intensive care units within tertiary care hospitals in collaboration with pediatricians and neonatologists. [11] Although the role of these nurses initially resembled a blended version of clinical nurse specialists and NPs, today the distinction has been more formally established. [11]

Nurse practitioners in the United States

Education requirements

Becoming a nurse practitioner in the United States requires either a Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP). [12] During their studies, nurse practitioners are required to receive a minimum of 500 hours of clinical training in addition to the clinical hours required to obtain their RN. Upon completion of the graduate program, they must pass the National NP Certification Board Exam, specific to their specialization. After passing this exam, candidates must apply for NP licensure which varies by state regulations. [13] [14] [15]

Although nurse practitioners are required to be licensed as registered nurses prior to obtaining their advanced practice registered nurse certification, there are several programs that combine a nursing undergraduate degree with nurse practitioner training. Other nurse practitioner programs have 100% acceptance rates. [16]

Training pathways

There are many types of nurse practitioner programs in the United States with the vast majority being in the specialty of a family nurse practitioner (FNP). [17] There are also psychiatric, adult geriatric acute care, adult geriatric primary care, pediatric, cardiac, women's health, oncology and neonatal nurse practitioner programs.[ citation needed ] Many of these programs have their pre-clinical or didactic courses taught online with proctored examinations.[ citation needed ] Once the students start their clinical courses they have online material, but are required to perform clinical hours at an approved facility under the guidance of an NP or physician.[ citation needed ] Each clinical course has specific requirements that vary on their program's degree/eligibility for certification. For instance FNPs are required to see patients across the lifespan whereas Adult Geriatric NPs do not see anyone below the age of 13. [18]

Quality of care

A review of studies comparing outcomes of care by NPs and physicians in primary care and urgent care settings were generally comparable, although the strength of the evidence was generally low, with virtually all of the studies sponsored by nursing organizations. [19] A recent study showed nurse practitioners practicing in states with independent prescription authority were more than twenty times more likely to overprescribe opioids than nurse practitioners in prescription-restricted states, the same study identified that both nurse practitioners and Physician Associates were more likely to over-prescribe opioids compared to physicians. [20] Nurse practitioners and physician assistants were also associated with more unnecessary imaging services than primary care physicians, which may have ramifications on care and overall costs. [21]

One systematic review suggests "that the implementation of advanced practice nursing roles in the emergency and critical care settings improves patient outcomes in emergency and critical care settings". [22]

Job setting

Nurse practitioners are currently employed in a wide variety of practice settings. These settings include the ambulatory, inpatient, or emergency room of hospitals, health clinics, and office practices whether private or nurse-run. In addition, they serve in schools and college campuses delivering care as well as nursing homes and assisted living facilities. NPs can work alone or under the supervision of a physician in a wide variety of specializations. [14] [23]

Scope of practice

Australia

In Australia, a nurse practitioner-endorsed registered nurse has an expanded scope of practice, allowing them to practice certain advanced clinical skills within their endorsed field. As a nurse practitioner, they can complete advanced health assessments, diagnose and treat diseases, order diagnostic testing such as imaging and pathology, and prescribe medications and therapeutics. [24]

Nurse practitioners can access Medicare (universal healthcare system) rebates for the services they provide to patients, excluding services provided in public facilities (such as a Queensland Health hospital). [25] Nurse practitioner items on the Medicare Benefits Schedule, however, provide significantly smaller rebates than equivalent items for General Practitioners, leading to a higher out-of-pocket cost to patients. [26] To claim Medicare rebates, the NP must also be in a documented "Collaborative Practice Arrangement" with a medical practitioner and the episode of care approved by a doctor. [7] Prescriptions issued by NPs must also be verified by a medical practitioner to be eligible to be subsidised under the Pharmaceutical Benefits Scheme. [26]

Canada

In Canada, an NP is a registered nurse (RN) with a graduate degree in nursing.[ citation needed ] Canada recognizes them in primary care and acute care practice. NPs diagnose illnesses and medical conditions, prescribe Schedule 1 medications, order and interpret diagnostic tests, and perform procedures, within their scope of practice, and may build their own panel of patients at the same level as physicians. [27] Primary care NPs work in places like primary care and community healthcare centers, as well as long-term care institutions. The main focus of primary care NPs includes health promotion, preventative care, diagnosis and treatment of acute and chronic diseases and conditions. Acute care NPs serve a specific population of patients. They generally work in in-patient facilities that include neonatology, nephrology, and cardiology units. [28] There are currently three specialties for nurse practitioners in Canada: family practice, pediatrics, and adult care. NPs who specialize in family practice work at the same level and offer the same services as family physicians with the exclusion of Quebec, where only physicians are allowed to formulate a medical diagnosis. [29]

Ireland

Ireland's publicly funded healthcare system, the Health Service Executive has the advanced nurse practitioner (ANP) grade. [30] ANPs may prescribe medications. [31]

United Kingdom

In the United Kingdom nurse practitioners carry out care at an advanced practice level. They commonly work in primary care (e.g. GP surgeries) or A&E departments, although they are increasingly being seen in other areas of practice.[ citation needed ]

United States

Because the profession is state-regulated, the scope of practice varies by state. Some states allow NPs to have full practice authority, however, in other states, a written collaborative or supervisory agreement with a physician is legally required for practice. [32] Autonomous practice was introduced in the 1980s, mostly in states facing a physician shortage or that struggled to find enough healthcare providers to work in rural areas. [33] The extent of this collaborative agreement, and the role, duties, responsibilities, nursing treatments, and pharmacologic recommendations again varies widely between states. [34] [35] [36]

NPs can legally examine patients, diagnose illness, prescribe some medications, and provide treatments.[ citation needed ] As of 2022, twenty-six states granted full practice authority to NPs and do not require the supervision or collaboration with a physician. Twenty-four states require NPs to have a written agreement with a physician in order to provide care. Eleven of those states require NPs to be supervised or delegated by a physician, this physician may not be on site. [37]

Licensing and board certification

Australia

In Australia, nursing registration including endorsement of a RN as a nurse practitioner is overseen by the Nursing and Midwifery Board of Australia (NMBA) and the Australian Health Practitioner Regulation Agency (AHPRA).[ citation needed ] Registered nurses working in rural and isolated communities can apply for scheduled medicine prescriber endorsement if clinically necessary and trained, and instead become a prescribing registered nurse rather than a nurse practitioner to better meet the need of less-resourced communities. [38] Nurse practitioners are professionally represented by the Australian College of Nurse Practitioners, as well as the Australian College of Nursing. Endorsement as a nurse practitioner in either Australia or New Zealand is recognised by both countries as part of the Trans-Tasman Mutual Recognition Scheme.

For a RN to apply to the NMBA for nurse practitioner endorsement, they must be able to demonstrate they have completed at least 5000 hours (three years, full-time equivalent) at an "advanced nursing practice" level.[ citation needed ] Advanced nursing practice is loosely defined, and not a specific role, but rather a recognised process of higher-level clinical practice within a nurse's existing scope of practice. The RN must also complete an approved nurse practitioner postgraduate master's degree, or demonstrate they have gained qualifications to an equivalent level in advanced health assessment, pharmacology, therapeutics, diagnostics, and research. Nurses applying through the latter pathway must also demonstrate the equivalent training is clinically relevant to the field for which they wish to apply for nurse practitioner endorsement in. [39]

Canada

In Canada, the educational standard is a graduate degree in nursing.[ citation needed ] The Canadian Nursing Association (CNA) notes that advanced practice nurses must have a combination of a graduate level education and the clinical experience that prepare them to practice at an advanced level. Their education alone does not give them the ability to practice at an advanced level. Two national frameworks have been developed in order to provide further guidance for the development of educational courses and requirements, research concepts, and government position statements regarding advanced practice nursing: the CNA's Advanced Nursing Practice: A National Framework and the Canadian Nurse Practitioner Core Competency Framework. All educational programs for NPs must achieve formal approval by provincial and territorial regulating nurse agencies due to the fact that the NP is considered a legislated role in Canada. As such, it is common to see differences among approved educational programs between territories and provinces. Specifically, inconsistencies can be found in core graduate courses, clinical experiences, and length of programs. Canada does not have a national curriculum or consistent standards regarding advanced practice nurses. All advanced practice nurses must meet individual requirements set by their provincial or territorial regulatory nursing body.

Israel

As of November 2013, NPs were recognized legally in Israel. [40]

United States

The most common path to becoming a nurse practitioner in the United States begins by earning a Bachelor of Science in Nursing (BSN) and passing the National Council Licensure Examination (NCLEX) to become an RN. One must then be accepted into and complete a Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP) (most of which require at least 1-2 years of RN experience) to gain additional medical training in their specialty area. Finally, one must pass a national NP board certification exam. [12]

Salary

The salary of an NP generally depends on the area of specialization, location, years of experience, and level of education. In 2015, the American Association of Nurse Practitioners (AANP) conducted its fourth annual NP salary survey.[ citation needed ] The results revealed the salary range to be between $98,760 to $108,643 reported income among full-time NPs. According to the U.S. Bureau of Labor Statistics, NPs in the top 10% earned an average salary of $135,800. The median salary was $98,190. According to a report published by Merritt Hawkins, starting salaries for NPs increased in dramatic fashion between 2015 and 2016.[ citation needed ] The highest average starting salary reached $197,000 in 2016. The primary factor in the dramatic increase in starting salaries is skyrocketing demand for NPs, recognizing them as the fifth most highly sought after advanced health professional in 2016. [41]

Importance during the COVID-19 pandemic

Temporarily, the pandemic expanded the scope of practice for nurse practitioners as a result of legislative policy adjustments. [42] Under the Trump administration, many requirements for nurse practitioners were waived, permitting NPs to utilize their abilities to the fullest extent in some cases. [43]

See also

Related Research Articles

<span class="mw-page-title-main">Registered nurse</span> Nurse who has graduated from a nursing program

A registered nurse (RN) is a nurse who has graduated from a nursing program and met the requirements outlined by a country, state, province or similar government-authorized licensing body to obtain a nursing license. An RN's scope of practice is determined by legislation, and is regulated by a professional body or council.

A physician assistant or physician associate (PA) is a type of mid-level health care provider. In North America PAs may diagnose illnesses, develop and manage treatment plans, prescribe medications, and may serve as a principal healthcare provider. PAs are required in many states to have a direct agreement with a physician. PAs typically cost the practice employing them less than half as much as a fully qualified physician.

<span class="mw-page-title-main">Oncology nursing</span>

An oncology nurse is a specialized nurse who cares for cancer patients. These nurses require advanced certifications and clinical experiences in oncology further than the typical baccalaureate nursing program provides. Oncology nursing care can be defined as meeting the various needs of oncology patients during the time of their disease including appropriate screenings and other preventive practices, symptom management, care to retain as much normal functioning as possible, and supportive measures upon end of life.

Pediatric nursing is part of the nursing profession, specifically revolving around the care of neonates and children up to adolescence. The word, pediatrics, comes from the Greek words 'paedia' (child) and 'iatrike' (physician). 'Paediatrics' is the British/Australian spelling, while 'pediatrics' is the American spelling.

A licensed practical nurse (LPN), in much of the United States and Canada, is a nurse who cares for people who are sick, injured, convalescent, or disabled. In the United States, LPNs work under the direction of physicians, mid-level practitioners, and may work under the direction of registered nurses depending on their jurisdiction.

An advanced practice nurse (APN) is a nurse with post-graduate education and training in nursing. Nurses practicing at this level may work in either a specialist or generalist capacity. APNs are prepared with advanced didactic and clinical education, knowledge, skills, and scope of practice in nursing.

The Doctor of Nursing Practice (DNP) is a professional degree in nursing. In the United States, the DNP is one of three doctorate degrees in nursing, the others being the research degrees PhD and the Doctor of Nursing Science. Internationally, since the 1990s, there have been a wide number of doctorate degrees available for nurses, including DProf, PhD and others. Internationally all such doctoral nursing degrees include mandatory research elements and take longer than a single year to complete.

Nursing credentials and certifications are the various credentials and certifications that a person must have to practice nursing legally. Nurses' postnominal letters reflect their credentials—that is, their achievements in nursing education, licensure, certification, and fellowship. The letters usually appear in the following order:

<span class="mw-page-title-main">Nursing in Australia</span> Overview of nursing in Australia

Nursing in Australia has evolved in training and regulation since the 19th century.

In the United States, a psychiatric-mental health nurse practitioner (PMHNP) is an advanced practice registered nurse trained to provide a wide range of mental health services to patients and families in a variety of settings. PMHNPs diagnose, conduct therapy, and prescribe medications for patients who have psychiatric disorders, medical organic brain disorders or substance abuse problems. They are licensed to provide emergency psychiatric services, psychosocial and physical assessment of their patients, treatment plans, and manage patient care. They may also serve as consultants or as educators for families and staff. The PMHNP has a focus on psychiatric diagnosis, including the differential diagnosis of medical disorders with psychiatric symptoms, and on medication treatment for psychiatric disorders.

Mid-level practitioners, also called non-physician practitioners or advanced practice providers, are health care providers who have a defined scope of practice. The term mid-level refers to the complexity of healthcare situations they handle, not the quality of the care provided. This means that they are trained and legally permitted to provide healthcare in fewer situations than physicians but more than other health professionals. For example, a mid-level provider may be trained for and legally permitted to perform minor surgical procedures, but not trained for or legally permitted to perform complex or experimental surgeries.

<span class="mw-page-title-main">Family nurse practitioner</span> Type of mid-level health provider

A family nurse practitioner (FNP) provides continuing and comprehensive healthcare for the individual and family across all ages, genders, diseases, and body systems. Primary care emphasizes the holistic nature of health and it is based on knowledge of the patient in the context of the family and the community, emphasizing disease prevention and health promotion.

<span class="mw-page-title-main">Nursing</span> Health care profession

Nursing is a profession within the health care sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other health care providers by their approach to patient care, training, and scope of practice. Nurses practice in many specialties with differing levels of prescription authority. Nurses comprise the largest component of most healthcare environments; but there is evidence of international shortages of qualified nurses. Many nurses provide care within the ordering scope of physicians, and this traditional role has shaped the public image of nurses as care providers. Nurse practitioners are nurses with a graduate degree in advanced practice nursing. They are however permitted by most jurisdictions to practice independently in a variety of settings. Since the postwar period, nurse education has undergone a process of diversification towards advanced and specialized credentials, and many of the traditional regulations and provider roles are changing.

A pediatric nurse practitioner (PNP) is a nurse practitioner who specializes in care for newborns, infants, toddlers, pre-schoolers, school-aged children, adolescents, and young adults. Nurse practitioners have an in-depth knowledge and experience in pediatric healthcare including well childcare, and prevention/management of common pediatric acute illnesses and chronic conditions. This care is provided to support optimal health of children within the context of their family, community, and environmental setting. In order to be a pediatric nurse practitioner one must be compassionate, resourceful, good at communicating and have good attention to detail. In the past couple decades, the job of a nurse practitioner has nearly doubled in the United States. Pediatric nurse practitioner numbers have stayed relatively the same. It is expected that the demand for the PNPs will start to increase in our society. This demand comes from children with chronic illnesses which are surviving and having diseases. PNPs are mostly taking over offices over the physicians, but still work side by side.

<span class="mw-page-title-main">Neonatal nurse practitioner</span>

A neonatal nurse practitioner (NNP) is an advanced practice registered nurse (APRN) with at least 2 years experience as a bedside registered nurse in a Level III NICU, who is prepared to practice across the continuum, providing primary, acute, chronic, and critical care to neonates, infants, and toddlers through age 2. Primarily working in neonatal intensive care unit (NICU) settings, NNPs select and perform clinically indicated advanced diagnostic and therapeutic invasive procedures. In the United States, a board certified neonatal nurse practitioner (NNP-BC) is an APRN who has acquired Graduate education at the master’s or doctoral level and has a board certification in neonatology. The National Association of Neonatal Nurse Practitioners (NANNP) is the national association that represents neonatal nurse practitioners in the United States. Certification is governed by the National Certification Corporation for Obstetrics, Gynecologic and Neonatal Nursing Specialties (NCC).

An adult-gerontology nurse practitioner (AGNP) is a nurse practitioner that specializes in continuing and comprehensive healthcare for adults across the lifespan from adolescence to old age.

Advanced practice registered nurses (APRNs) are registered nurses with graduate degrees in nursing. APRN roles include: certified nurse midwife, clinical nurse specialist, certified registered nurse anesthetist, and nurse practitioner. APRNs assess, diagnose, manage patient medical problems, order diagnostic tests, and prescribe medications. Rules, regulations, and credentialing for APRNs vary by state. This page outlines the regulatory processes for nurse practitioners in Wisconsin, including education, certification, licensing, and credentialing. Regulatory and credentialing processes are continuously changing, and the information contained on this page is current as of November 2015.

Nursing is the largest healthcare profession in the United States, with more than 3.1 million registered nurses. Between 2012 and 2022, employment for nurses is projected to grow by 19 percent, which is more than any other profession. Nurses make up the largest component of staff in hospitals but are also able to provide care in clinic settings, patient's homes, schools, nursing homes, public health agencies, and mental health centers. In addition, nurses can be found in the military, in industry, nursing education, and do health care research. Nurses in these various roles and settings can provide direct patient care and case management, but also develop and establish nursing practice and quality standards within complex healthcare systems. As each degree can provide a different level of care for patients and function in vastly different roles, it is important to differentiate between them. The levels of nursing degrees have different educational requirements, licensure, and credentialing that can vary state to state.

An acute care nurse practitioner (ACNP) is a registered nurse who has completed an accredited graduate-level educational program that prepares them as a nurse practitioner. This program includes supervised clinical practice to acquire advanced knowledge, skills, and abilities. This education and training qualifies them to independently: (1) perform comprehensive health assessments; (2) order and interpret the full spectrum of diagnostic tests and procedures; (3) use a differential diagnosis to reach a medical diagnosis; and (4) order, provide, and evaluate the outcomes of interventions. The purpose of the ACNP is to provide advanced nursing care across the continuum of health care services to meet the specialized physiologic and psychological needs of patients with acute, critical, and/or complex chronic health conditions. This care is continuous and comprehensive and may be provided in any setting where the patient may be found. The ACNP is a licensed independent practitioner and may autonomously provide care. Whenever appropriate, the ACNP considers formal consultation and/or collaboration involving patients, caregivers, nurses, physicians, and other members of the interprofessional team.

Advanced Practice Registered Nurse (APRN) refers to a nurse with advanced education, typically at least a master's degree, and certification by a national certifying program. The APRN provides specialized and multifaceted care and are able to do 60 to 80 percent of preventative and primary care done by physicians. Minnesota Statutes section 148.171, subd. 3 states that in Minnesota, APRN "means an individual licensed as a registered nurse by the board, and certified by a national nurse certification organization acceptable to the board to practice as a clinical nurse specialist, nurse anesthetist, nurse midwife, or nurse practitionerr".

References

  1. "Mid-level health providers: a promising resource to achieve the health Millennium Development Goals" (PDF). World Health Organization. 2010. Archived from the original (PDF) on 19 Jul 2021. Retrieved 4 April 2021.
  2. "Mid-Level Practitioners Authorization by State" (PDF). US Department of Justice. 4 January 2021. Retrieved 4 April 2021.
  3. Lohr, Robert H.; West, Colin P.; Beliveau, Margaret; Daniels, Paul R.; Nyman, Mark A.; Mundell, William C.; Schwenk, Nina M.; Mandrekar, Jayawant N.; Naessens, James M.; Beckman, Thomas J. (9 Oct 2013). "Comparison of the Quality of Patient Referrals From Physicians, Physician Assistants, and Nurse Practitioners". Mayo Clinic Proceedings. 88 (11): 1266–1271. doi:10.1016/j.mayocp.2013.08.013. PMID   24119364.
  4. Stokowski, RN, MS, Laura A. "APRN Prescribing Law: A State-by-State Summary". Medscape. Retrieved 25 November 2015.{{cite web}}: CS1 maint: multiple names: authors list (link)
  5. "Scope of Practice for Nurse Practitioners" (PDF). AANP Policy Statements. American Association of Nurse Practitioners. Retrieved 14 November 2017.
  6. "State Practice Environment".
  7. 1 2 "Eligible Nurse Practitioners Questions and Answers". Department of Health and Aged Care . 11 October 2018. Retrieved 14 September 2022.{{cite web}}: CS1 maint: url-status (link)
  8. 1 2 "Ford, Loretta C." National Women’s Hall of Fame. Retrieved 2019-11-15.
  9. "Historical Perspectives on an Expanded Role for Nursing". Nursingworld.org. Retrieved 2017-05-10.
  10. "The History of Nurse Practitioners". Graduatenursingedu.org. Retrieved 2017-05-10.
  11. 1 2 3 Dicenso, Abla; Bryant-Lukosius, Denise. "Clinical Nurse Specialists and Nurse Practitioners in Canada: A Decision Support Synthesis" (PDF). Canadian Health Services Research Foundation. Archived from the original (PDF) on 2012-03-13. Retrieved 1 June 2019.
  12. 1 2 Deering, Maura (13 October 2022). "How to Become a Nurse Practitioner". Nurse Journal. Retrieved 28 October 2022.
  13. "Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners | Occupational Outlook Handbook - Credo Reference". search.credoreference.com. Retrieved 2022-03-02.
  14. 1 2 "Advanced Practice Nurses | Gale Encyclopedia of Nursing and Allied Health - Credo Reference". search.credoreference.com. Retrieved 2022-03-28.
  15. "Statement Regarding Nurse PractitionerStudentsandDirect Care Clinical Hours" (PDF). Nccwebsite.org. Retrieved 30 January 2022.
  16. "Nursing Master's Programs With 100% Admit Rates". Usnews.com. Retrieved 30 January 2022.
  17. "NP Fact Sheet". Aanp.org. Retrieved 30 January 2022.
  18. "FNP vs ACNP: What are The Differences? | NurseJournal.org". Nursejournal.org. 3 June 2020. Retrieved 30 January 2022.
  19. McCleery, E.; Christensen, V.; Peterson, K.; Humphrey, L.; Helfand, M. (2011). "Evidence Brief: The Quality of Care Provided by Advanced Practice Nurses". VA Evidence Synthesis Program Evidence Briefs. VA Evidence Synthesis Program Reports. Department of Veterans Affairs (US). PMID   27606392.
  20. Lozada, M. James; Raji, Mukaila A.; Goodwin, James S.; Kuo, Yong-Fang (2020). "Opioid Prescribing by Primary Care Providers: A Cross-Sectional Analysis of Nurse Practitioner, Physician Assistant, and Physician Prescribing Patterns". Journal of General Internal Medicine. 35 (9): 2584–2592. doi:10.1007/s11606-020-05823-0. PMC   7459076 . PMID   32333312.
  21. Hughes, Danny R.; Jiang, Miao; Duszak, Richard (2015). "A Comparison of Diagnostic Imaging Ordering Patterns Between Advanced Practice Clinicians and Primary Care Physicians Following Office-Based Evaluation and Management Visits". JAMA Internal Medicine. 175 (1): 101–107. doi:10.1001/jamainternmed.2014.6349. PMID   25419763.
  22. Woo, B. F.; Lee, J. X.; Tam, W. W. (2017). "The impact of the advanced practice nursing role on quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings": A systematic review". Human Resources for Health. 15 (1): 63. doi:10.1186/s12960-017-0237-9. PMC   5594520 . PMID   28893270.
  23. "Nurse Practitioner | Encyclopedia of Women's Health - Credo Reference". search.credoreference.com. Retrieved 2022-03-28.
  24. "Nurse practitioner standards for practice". Nursing and Midwifery Board of Australia. 1 March 2021. Retrieved 14 September 2022.{{cite web}}: CS1 maint: url-status (link)
  25. "Nurse Practitioners Career Guide" (PDF). Australian College of Nurse Practitioners. Retrieved 20 August 2021.
  26. 1 2 Davey, Melissa (16 August 2022). "Nurses are the solution to bulk-billing crisis, says peak body". The Guardian . Retrieved 14 September 2022.
  27. "Scope of Practice for Nurse Practitioner - College and Association of Registered Nurses of Alberta" (PDF). College and Association of Registered Nurses of Alberta. 2019. Retrieved 6 December 2019.
  28. "How to Become an Advanced Practice Nurse in Canada". Graduatenursingedu.org. Retrieved 2017-05-16.
  29. "Scope of Practice for Nurse Practitioner" (PDF). College and Association of Registered Nurses of Alberta. December 2019. Retrieved 6 December 2019.
  30. "Minister for Health publishes Final Evaluation Report which demonstrates the many benefits of Advanced Nursing Practitioners". Gov.ie . Department of Health (Ireland).
  31. "Changing role of nursing profession". Sligo Champion . September 26, 2020 via Independent.ie.
  32. Hancock, Jay (2010-04-14). "Jay Hancock's blog: Md. should make nurse practitioners independent". Weblogs.baltimoresun.com. Retrieved 2011-08-31.
  33. Vestal, Christine (2013-07-19). "Nurse Practitioners Slowly Gain Autonomy". Kaiser Health News. Retrieved 2019-05-22.
  34. Flanagan, Lyndia (October 1998). "Nurse Practitioners: Growing Competition for Family Physicians?". Family Practice Management. 5 (9): 34–43. PMID   10187057.
  35. Brown, Deonne J. (October 2007). "Consumer perspectives on nurse practitioners and independent practice". Journal of the American Academy of Nurse Practitioners. 19 (10): 523–9. doi:10.1111/j.1745-7599.2007.00261.x. PMID   17897116. S2CID   9389332.
  36. Kaplan, Louise; Brown, Marie-Annette (March 2004). "Prescriptive Authority and Barriers to NP Practice". Nurse Practitioner. 29 (3): 28–35. doi:10.1097/00006205-200403000-00004. PMID   15021500. S2CID   4001124. INIST:15566634.
  37. "Nurse Practitioner State Practice Environment". American Association of Nurse Practitioners. February 2017. Retrieved 2017-06-06.
  38. "Registration standard for endorsement for scheduled medicines registered nurses (rural and isolated practice)". Nursing and Midwifery Board of Australia. 31 March 2010. Retrieved 20 August 2021.
  39. "Guidelines: For nurses applying for endorsement as a nurse practitioner". Nursing and Midwifery Board of Australia. Australian Health Practitioner Regulation Agency. 8 August 2019. Retrieved 20 August 2021.
  40. "ות בריאות העם )אישור תואר מומחה בסיעוד התשע"ד-2" (PDF). Health.gov.il. Retrieved 30 January 2022.
  41. "Nurse Practitioner Salary | Certified Nurse Midwife | Anesthetist Salaries". Graduatenursingedu.org. Retrieved 2017-05-16.
  42. Stucky, Christopher H.; Brown, William J.; Stucky, Michelle G. (2020-10-12). "COVID 19: An unprecedented opportunity for nurse practitioners to reform healthcare and advocate for permanent full practice authority". Nursing Forum. 56 (1): 222–227. doi:10.1111/nuf.12515. ISSN   0029-6473. PMC   7675696 . PMID   33047352.
  43. "COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers" (PDF). CMS. 30 March 2020. Retrieved 6 March 2022.