State Nurse Practitioner Practice Regulations and U.S. Health Care Delivery Outcomes: A Systematic Review.

Medical care research and review : MCRR Pub Date : 2021-06-01 Epub Date: 2020-01-30 DOI:10.1177/1077558719901216

Bo Kyum Yang, Mary E Johantgen, Alison M Trinkoff, Shannon R Idzik, Jessica Wince, Carissa Tomlinson

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引用次数: 58

Abstract

There is a great variation across states in nurse practitioner (NP) scope of practice moderated by state regulations. The purpose of this study was to synthesize the evidence from studies of the impact of state NP practice regulations on U.S. health care delivery outcomes (e.g., health care workforce, access to care, utilization, care quality, or cost of care), guided by Donabedian's structure, process, and outcomes framework. This systematic review was performed using Medline, CINAHL, PsycINFO, and PubMed according to Preferred Reporting Items for Systematic and Meta-Analysis on the literature from January 2000 to August 2019. The results indicate that expanded state NP practice regulations were associated with greater NP supply and improved access to care among rural and underserved populations without decreasing care quality. This evidence could provide guidance for policy makers in states with more restrictive NP practice regulations when they consider granting greater practice independence to NPs.

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国家执业护士实践条例和美国卫生保健服务成果:系统回顾。

在护士执业(NP)的实践范围有很大的变化跨州调节的国家法规。本研究的目的是在Donabedian的结构、过程和结果框架的指导下，综合来自国家NP实践法规对美国医疗保健服务结果(例如，医疗保健劳动力、获得护理、利用、护理质量或护理成本)影响的研究证据。本系统评价使用Medline、CINAHL、PsycINFO和PubMed，根据2000年1月至2019年8月文献的系统和荟萃分析首选报告项目进行。结果表明，扩大国家NP实践法规与更多的NP供应和改善农村和服务不足人口的护理机会有关，而不会降低护理质量。这一证据可以为那些具有更严格的NP实践法规的州的政策制定者提供指导，当他们考虑给予NP更大的实践独立性时。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Medical care research and review : MCRR

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