Publications, Articles, and Research
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Publications, Articles, and Research


APRN Prescribing Guide (v.04.16.2016)

 


84WHAS Radio interviews KCNPNM Member Wendy Fletcher about SB51, the future of healthcare in Kentucky, and the primary care shortage affecting the state's residents and restricting their access to quality healthcare.

 


Expanding the Role of Advanced Nurse Practitioners — Risks and Rewards

New England Journal of Medicine (May 16, 2013)

Governor Steve Beshear Signs Opioid Overdose Prevention Law 

News Release (April 2013)

 

Law is Hindering Nurse Practitioners

The Courier Journal (February 2013)

An opinion piece by KCNPNM President Julianne Ewen regarding SB52 and the CAPA-NS.

 Nurse Practitioners and Nurse Midwives Provide Quality, Cost Effective Care but Barriers to their Practice Decrease Patient Access to Care  

A white paper by KCNPNM's Legislative Task Force 
 

           


Scholarly Articles, Newspaper Articles, and Research Published by Other Organizations and Agencies

 

Nearly 80 percent of Kentuckians comfortable with seeing nurse practitioner or physician’s assistant for routine care

The Foundation for a Healthy Kentucky (The Lane Report, February 2013)

The article includes statistics like the fact that nearly 8 in 10 (79 percent) Kentuckians said they would be comfortable seeing a nurse practitioner for routine healthcare. Of those, 50% said they would be very comfortable, according to The Kentucky Health Issues Poll (KHIP).

Sometimes The Best Medical Care Is Provided By Those Who Aren't M.D.s

Amesh Adalja, M.D. (Forbes, February 2013)

"The unique roles played by physicians, nurses, dentists, nurse anesthetists, nurse midwifes, nurse practitioners, physician assistants, podiatrists, pharmacists, paramedics, psychologists, and optometrists are well known and have clinical duties, delineated by government, associated with them. However, for many conditions the expertise of a physician is not strictly required and an individual may be ably served by a nurse practitioner or the like."

Report urges greater use of advanced practice registered nurses

Austin Business Journal (May 2012)

"Using APRNs more fully for treatment and for tasks clearly within the scope of their education and expertise can lead to significant health care savings and efficiencies,” Perryman said. "When these savings are spent for other productive purposes, the economy enjoys benefits. Moreover, as health care needs and costs increase and access becomes more challenging, these benefits also will rise.” The report, conducted by economist Ray Perryman, was funded by Texas Team Advancing Health through Nursing, which is a statewide coalition made up of businesses, higher education, health care advocacy groups, hospitals and others. 

Why Nurses Need More Authority

 

The Atlantic (May 2012) 

Allowing nurses to act as primary-care providers will increase coverage and lower health-care costs. So why is there so much opposition from physicians?   

Effectiveness of Treatments for Noncyclic Chronic Pelvic Pain in Adult Women

Agency for Healthcare research and Quality (April 2012) 

(Clinician Guide) In response to the need for a comprehensive evaluation of the evidence regarding current therapies for chronic pelvic pain (CPP) in adult women, a systematic review assessed the comparative effectiveness of surgical and non-surgical treatments for CPP and the potential harms of non-surgical approaches. This review focused on noncyclic and mixed cyclic/noncyclic CPP, and excluded pain that was associated with dysmenorrhea, dyspareunia, dyschezia, or dysuria. A total of 36 studies published between January 1990 and May 2011 were reviewed.

 

 

 

Fiscal Savings While Enhancing High Quality Medical Care Expanding the Scope of Practice for Advanced Registered Nurse Practitioners and Physician Assistants Would Generate Fiscal Savings While Enhancing High Quality Medical Care

A Product of the Florida TaxWatch Research Institute, Inc. (November 2011)

Current cost savings estimates would increase substantially if PAs and all four categories of ARNPs and were utilized to the maximum capacity of their education and experience.

 

ACEIs, ARBs, or DRI for Adults With Hypertension

 

Agency for Healthcare research and Quality (October 2011) 

(Clinician Guide) A systematic review of 110 clinical studies published between 1988 and 2010 sought to determine the comparative effectiveness, benefits, and adverse effects of angiotensin-converting enzyme inhibitors (ACEIs), angiotensin II receptor blockers (ARBs), and a direct renin inhibitor (DRI) for adults with hypertension.

 

 

Managing Chronic Gastroesophageal Reflux Disease

 

Agency for Healthcare research and Quality (September 2011)

(Clinician Guide) As an update to a 2005 report, a systematic review of 166 clinical studies published between January 2004 and August 2010 examined the comparative effectiveness, benefits, and adverse effects of treatments for gastroesophageal reflux disease (GERD) and investigated whether there are factors that influence or predict treatment effectiveness. 

 

 

 

Interprofessional Collaboration – It’s All About the Patient 

Andrea Brassard (Robert Wood Johnson Foundation Human Capital Blog, September 2011)

As a nurse, she knows that removing barriers to care and allowing advanced practice registered nurses to practice to the full extent of their education and training helps patients receive the care they need. Ms. Brassard notes that interprofessional collaboration is a partnership that starts with the patient and includes all involved health care providers working together to deliver patient and family centered care. In the end, it’s all about the patient. 

 

APRNs: A Big Part of the Solution to the Primary Care Provider Shortage

Sharing Nursing's Knowledge (Robert Wood Johnson Foundation, August 2011)

An article demonstrating that advanced practice registered nurses are filling unmet needs for primary care, especially in rural and underserved areas. 

APRNs Achieve Comparable or Better Outcomes than Physicians, Review Suggests

Robin P. Newhouse, PhD, RN, NEA-BC, et al (Nursing Economics, July 2011) 

How do ARPN outcomes compare to other providers? Read this systematic review of research conducted 1990-2008.
Download a free copy by following the link above.

Comparative Effectiveness of Therapies for Children With Autism Spectrum Disorders

Agency for Healthcare research and Quality (June 2011) 

Clinician Guide

 

 

STUDY: Patients Prefer Nurse Practitioners

Sara Jackson (FierceHealthcare.com,  June 2011)

Patients indicated they are more satisfied with nurse practitioners' care than with doctors', according to a small survey conducted researchers at the University of Michigan. NPs outscored physicians on more than three-quarters of the satisfaction questions, the findings show. 

Pain Management Interventions for Elderly Patients With Hip Fracture

Agency for Healthcare research and Quality (May 2011) 

(Clinician Guide) A systematic review of 83 clinical studies published from 1990 through 2010 was conducted by independent researchers, funded by AHRQ, to synthesize the evidence on what is known and not known on this clinical issue.

 

 

 

 

Uninsured, Improving Access to Adult Primary Care in Medicaid: Exploring the Potential Role of Nurse Practitioners and Physician Assistants  

Kaiser Commission on Medicaid and the Uninsured (March 2011)  

One important strategy is greater reliance on primary care health professionals other than physicians. This brief provides basic information about two major types of primary care providers – nurse practitioners and physician assistants – and considers their potential to increase the supply of primary care as Medicaid expands to cover more uninsured adults.  

 

The States' Next Challenge — Securing Primary Care for Expanded Medicaid Populations

Leighton Ku, Ph.D., M.P.H., Karen Jones, M.S., Peter Shin, Ph.D., M.P.H., Brian Bruen, M.S., and Katherine Hayes, J.D.
(New England Journal of Medicine, February 2011)

Eight states — Oklahoma, Georgia, Texas, Louisiana, Arkansas, Nevada, North Carolina, and Kentucky — face the greatest challenges. These states are expected to have large Medicaid expansions yet now have weak primary care capacity. 

 

APRNs Are Safe Prescribers in Kentucky

Sharon Eli Mercer, MSN, RN, NEA, BC Nursing Practice Consultant, and Charlotte Beason, EdD, RN, NEA, Executive Director Kentucky Board of Nursing KBN Connection 2011, Winter, Edition 30, P. 24 

 

 

 

 

Gaps in the supply of physicians, advance practice nurses, and physician assistants

Sargen M, Hooker RS, Cooper, RA (The American College of Surgeons, 2011)

Efforts must be made to expand the output of clinicians in all 3 disciplines, while also strengthening the infrastructure of clinical practice and facilitating the delegation of tasks to a broadened spectrum of caregivers in new models of care

(Follow the link on right side of page for entire article)

 

 

The Future of Nursing: Leading Change, Advancing Health 

Institute of Medicine (October 2010) 

One of the four key messages of the report is that nurses should practice to the full extent of their education and training.  

Brief Summary 
Full Report  (586 pages)

 

Physician Shortages to Worsen 

American Association of Medical Colleges (June 2010) 

Physician Shortages to Worsen Without Increases in Residency Training.  Unless We Act Now, America Will Face a Shortage of More than 90,000 Doctors in 10 Years  

Nurse Practitioners in Primary Care

Tine Hansen-Turton, Jamie Ware,and Frank McClellan (Temple Law Review, 2010) 

In this Article we argue that nurse practitioners, properly authorized and acknowledged under the law of every state, serve an important role in helping individuals gain access to quality primary care

Nurse practitioners as an underutilized resource for health reform: Evidence-based demonstrations of cost-effectiveness

Jeffrey C. Bauer, PhD Journal of the American Academy of Nurse Practitioners 22 (2010) 228–231 

The bottom line: nurse practitioners reduce overall health spending.

 

Physician Assistant and Advance Practice Nurse Care in Hospital Outpatient Departments 

Esther Hing, M.P.H. and Sayeedha Uddin, M.D., M.P.H. (2008–2009) 

This National Center for Health Statistics Data Brief notes APRNs and PAs are treating folks in rural areas throughout the country and serving a role in the primary care arena where the need is greatest.

 

Rural Kentucky's Physician Shortage

Baretta R. Casey, M.D., Judy Jones, J.D., David A. Gross and Lola Dixon (Journal of the Kentucky Medical Association, September 2005)

Writing about the 600 family practice physician shortfall in the University of Kentucky Rural Health Assessment, "To further complicate matters within the Commonwealth, approximately 400 of Kentucky’s family physicians are age 60 or above (6). At the same time, the state’s rural medical residency programs, as they now exist, realistically can be expected to produce only 16 to 18 new family physicians each year (6). And there is more bad news: Student interest in family medicine at the University of Kentucky, University of Louisville and many other colleges and universities across the country has waned in recent years, as has the number of residency applications."

 

State Practice Environments and the Supply of Physician Assistants, Nurse Practitioners, and Certified Nurse Midwives

ES Sekscenski et al; New England Journal of Medicine 1994, 331:1266-1271

"Favorable practice environments are strongly associated with a larger supply of these practitioners.”

 

Matching Supply to Demand: Addressing the U.S. Primary Care Workforce Shortage

National Institute for Health Care Reform

The Pearson Report

Each year this report recaps and updates the nurse practice act, rules and regulations for all states and the District of Columbia – a national overview of Nurse Practitioner legislation and healthcare issues. 

Subscribe to the Pearson Report

Federal Options for Maximizing the Value of Advanced Practice Nurses in Providing Quality Cost-effective Health Care

Barbara J. Safriet JD LLM (National Academies Press)

...wider deployment of, and expanded practice parameters for, advanced practice nurses (APNs). The efficacy of this option is uniquely proven and scalable. These well-trained providers—including nurse practitioners, nurse midwives, nurse anesthetists, and clinical nurse specialists—can and do practice across the full range of care settings and patient populations.

 

 

 

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