The association between Doctor of Nursing Practice Nurse Practitioner staffing and hospital outcomes.

Meaghan H Roberts, Marcy Ainslie, Shannon Idzik, Mary Beth Bigley, Louis Fogg, Kara Elena Schrader, Susan W Buchholz
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Abstract

Background: The National Organization of Nurse Practitioner Faculties advocates for the doctoral level as the entry-to-practice standard for NPs. Understanding the impact of Doctor of Nursing Practice NPs (DNP-NPs) on health care systems is vital for shaping policy, regulations, and practice.

Purpose: This study quantitatively assesses the relationship between DNP-NP staffing levels and hospital quality and cost outcomes using major datasets.

Methodology: Data from the 2022 Iowa and Kentucky State Boards of Nursing (BON) and the Centers for Medicaid & Medicare Services (CMS) were used. The BON databases identified DNP-NPs matched to CMS data, with hospital affiliation determined by Hospital CMS Certification Number codes. Doctor of Nursing Practice NP counts were scaled by hospital size, with DNP-NPs per 100 beds as the treatment variable. Outcome variables and hospital characteristics were analyzed by DNP-NP quintiles.

Results: Hospitals in the lowest quintile of DNP-NP staffing had a significantly higher mean readmission rate of 14.84% (SE = 0.245), which was 0.39% points higher ( p = .005) than the adjusted mean of 14.45% (SE = 0.214) for other hospitals. No systematic relationship was found between DNP-NP staffing and readmission rates across the remaining distribution, and no correlation was detected between DNP-NP staffing and other hospital quality or cost efficiency measures.

Conclusion: The study underscores the need for improving data infrastructure to further research the relationship between DNP-NP staffing and hospital quality outcomes and address hospital staffing questions.

Implications: Recommendations are provided for enhanced data sources on NP education and practice to inform health care workforce research, staffing, policies, and regulations.

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护理实践医生护士从业人员配备与医院结果之间的关系。
背景:全国执业护士学院组织倡导将博士水平作为执业护士的入门标准。了解护理实践博士NPs (DNP-NPs)对医疗保健系统的影响对于制定政策、法规和实践至关重要。目的:本研究使用主要数据集定量评估np - np人员配备水平与医院质量和成本结果之间的关系。方法:数据来自2022年爱荷华州和肯塔基州护理委员会(BON)和医疗补助和医疗保险服务中心(CMS)。BON数据库确定了与CMS数据匹配的dnp - np,医院隶属关系由医院CMS认证编号代码确定。护理实践医生NP计数按医院规模进行缩放,以每100张病床的NP-NP作为治疗变量。结果变量和医院特征采用DNP-NP五分位数进行分析。结果:DNP-NP人员配置最低五分位数医院的平均再入院率为14.84% (SE = 0.245),显著高于其他医院14.45% (SE = 0.214)的调整后平均再入院率0.39% (p = 0.005)。在其余分布中,没有发现DNP-NP人员配备与再入院率之间的系统关系,也没有发现DNP-NP人员配备与其他医院质量或成本效率措施之间的相关性。结论:该研究强调了改善数据基础设施的必要性,以进一步研究np - np人员配备与医院质量结果的关系,并解决医院人员配备问题。含义:建议提供了关于NP教育和实践的增强数据源,以告知卫生保健人力研究,人员配置,政策和法规。
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来源期刊
自引率
16.70%
发文量
172
期刊介绍: The Journal of the American Association of Nurse Practitioners (JAANP) is a monthly peer-reviewed professional journal that serves as the official publication of the American Association of Nurse Practitioners. Published since 1989, the JAANP provides a strong clinical focus with articles related to primary, secondary, and tertiary care, nurse practitioner education, health policy, ethics and ethical issues, and health care delivery. The journal publishes original research, integrative/comprehensive reviews, case studies, a variety of topics in clinical practice, and theory-based articles related to patient and professional education. Although the majority of nurse practitioners function in primary care, there is an increasing focus on the provision of care across all types of systems from acute to long-term care settings.
期刊最新文献
A guide to the creation of a professional advancement program for advanced practice registered nurses and physician associates. Improving advance care planning completion in primary care through provider education and workflow redesign. Artificial intelligence in advanced practice nursing education: Opportunities and challenges. Comparative Analysis of 2025 American College of Cardiology/American Heart Association/Multisociety and 2023 European Society of Cardiology Acute Coronary Syndrome Guidelines: Implications for Advanced Practice Registered Nurses. Reimagining primary care delivery: Evaluation of nurse practitioner-owned primary care practices.
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