The Impact of Nurse Practitioners on Outcomes and Efficiency Key terms
Nurse practitioners (NPs) These are advanced practice registered nurses with specialized training in diagnosis, treatment, and management of various health conditions. They are essential in healthcare administration, providing comprehensive and holistic patient care, often focusing on preventive measures and patient education. Emergency department This is a specialized unit within a healthcare facility designed to provide immediate care to patients with acute injuries. It serves important purpose in delivering patient outcomes by addressing urgent medical needs. Patient outcomes The end results of overall healthcare interventions reflecting the impact on a patient's health, well-being, and overall quality of life defines patient outcomes. The significance of these outcomes is to gauge the effectiveness of healthcare practices and interventions, including those implemented in emergency departments. Healthcare efficiency The patient care and satisfaction can be improved when there is optimal resource utilization and minimal delays. The extent to which the available service is delivered can be termed as healthcare efficiency and is important in ensuring effective responses to emergencies and meeting high demand for services.
Interprofessional collaboration This is the collective effort of healthcare professionals from different disciplines in delivering patient-centered care. Interprofessional collaboration promotes synergy among healthcare team members, promoting communication, teamwork, and the overall quality of care, especially in fast-paced environments like emergency departments. Summaries of research studies
Fowler et al. (2019) emphasize the diverse roles of NPs in emergency departments (EDs) and their potential impact on patient satisfaction and throughput. This study acknowledges that healthcare delivery is evolving, and NPs assume increasingly essential roles in emergency care settings, playing diverse roles today, unlike in the traditional setups that engaged NPs in a standardized approach (Fowler et al., 2019). Therefore, healthcare institutions can harness the full potential of NPs, optimizing their contributions to improve patient satisfaction and streamline the throughput process in emergency care settings. Keough et al. (2016) comprehensively explore the educational needs of Emergency Nurse Practitioners (ENPs) through an in-depth qualitative analysis. The study employs a survey-based approach, drawing insights directly from Nurse Practitioners (NPs) actively engaged in emergency care settings. The primary objective is to identify specific educational gaps and highlight the critical importance of tailoring training programs to meet the unique demands existing in emergency care. ENPs operate in a high-stress, fast-paced environment; thus high need for continuous training and education necessitating interprofessional relationships and collaboration in order to navigate and excel. The study sheds light on the essential areas that demand targeted educational interventions, including critical patient management, pharmacology, and diagnostic interpretation through a tailored approach.
There are several legal considerations that facilitate standardized education and skills training to ensure optimal and timely emergency care. The state law clarifies that the approval of standardized procedures by the Division of Licensing of the Medical Boards or the Board of Registered Nursing is not a requirement (Castner & Boris, 2020). This explains the autonomy of the nursing profession in defining and interpreting the practice of nursing within the scope of licensure. According Castner & Boris, (2020) there is need for a harmonized approach to education and skills training, so as to bridge the gap between legal considerations and the practical realities of emergency nursing practice. Interprofessional teamwork in healthcare has the potential to enhance patient safety through effective communication and collaboration (Rezaei et al., 2021). Despite the implementation of different approaches, methodologies designed to enhance patient safety, like implementation of advanced technologies and improvements in communication systems, challenges persist, leading to compromised patient safety. Rezaei et al (2021) explore and describes interprofessional communication processes and teamwork during patient assessment in the emergency department, focusing on patient safety from the perspectives of healthcare professionals and patients. Rezaei et al (2021) reveal that organizational changes influence communication, teamwork strategies, and safety attitudes within the interprofessional team. Both healthcare professionals and patients express a desire for a more structured flow of information in the emergency department, highlighting the need for increased psychological safety. The need for interprofessional teamwork and collaboration in the emergency department serves a key role in ensuring the psychological safety of healthcare professionals and patients.
The coordination and continuity of healthcare during a patient's move from one healthcare setting to another, such as the transition from hospital to home, require nurse practitioners (NPs) intervention. The key findings of Mora et al., (2017) of the systematic review highlight nurse practitioners' important role in facilitating smoother transitions from hospital to home for older adults with chronic illnesses, increasing the overall patient outcomes. This includes improved health status, better management of chronic conditions, and an enhanced quality of life for older adults. The study by Mora et al. (2017) suggests that the effectiveness of NP-led transitional care interventions contributes to reducing healthcare resource utilization. This reduction implies that patients, particularly older adults with chronic illnesses, may require fewer healthcare resources, resulting in potential cost savings for individuals and the healthcare system. Strengths and Weaknesses of the evidence
One of the notable strengths of the evidence lies in its relevance and timeliness. The selected studies, conducted between 2013 and 2019, offer a contemporary perspective on the evolving role of NPs in emergency care. The diversity of sources, including peer-reviewed academic journals, enhances the credibility of the information by drawing on varied studies and methodologies. The structured application of the PICOT framework provides a systematic approach to framing clinical questions, aiding in the organization and categorization of evidence. The evidence consistently points towards positive outcomes associated with NP-led care in emergency settings, where NPs may contribute to streamlined processes, efficient patient assessments, and timely decision-making, resulting in reduced wait times and quicker discharges.
The restricted publication years (2013-2019) may omit recent developments, potentially impacting the comprehensiveness of the review. The inherent risk of publication bias, where positive outcomes are overrepresented, could skew the findings. Additionally, the generalization of results across diverse emergency department settings may oversimplify the complexities featuring in various healthcare environments. References
Castner, J., & Boris, L. (2020). State laws and regulations addressing nurse-initiated protocols and use of nurse-initiated protocols in emergency departments: a cross-sectional survey study. Policy, Politics, & Nursing Practice, 21(4), 233-243. Rezaei, S., Roshangar, F., Rahmani, A., Tabrizi, F., Sarbakhsh, P., & Parvan, K. (2021). Emergency nurses' attitudes toward interprofessional collaboration and teamwork and their affecting factors: A cross-sectional study. Nursing and Midwifery Studies, 10(3), 173-173. Keough, V. A., Tell, D., Andreoni, C., & Tanabe, P. (2016). Unique educational needs of emergency nurse practitioners. Advanced Emergency Nursing Journal, 38(4), 300-307. Mora, K., Dorrejo, X. M., Carreon, K. M., & Butt, S. (2017). Nurse practitioner-led transitional care interventions: An integrative review. Journal of the American Association of Nurse Practitioners, 29(12), 773-790. Fowler, L. H., Landry, J., & Nunn, M. F. (2019). Nurse practitioners improving emergency department quality and patient outcomes. Critical Care Nursing Clinics, 31(2), 237-247. Milton, J. (2022). Interprofessional Teamwork in the Emergency Department-Communicating for Patient Safety.