to practice to the full extent of their education and training is supported by the National Academy of Medicine ( Institute of Medicine , 2010 ), the Federal Trade Commission ( Gilman & Koslov , 2014 ) and the National Governors ’ Association ( National Governors Association , 2012 ).
SB 717 does not alter the legal scope of practice for NPs . Under current law , NPs :
• Diagnose and treat common conditions such as sore throats and earaches
• Write prescriptions for medications such as antibiotics
• Provide immunizations like the flu shot
• Help patients manage their chronic conditions such as high blood pressure and diabetes
SB 717 removes an unnecessary regulation that provides no benefits to patients . Indeed , the collaborating physician is not required to be present or review NP clinical records . Written collaborative agreements are even required for NPs who practice in hospitals surrounded by physicians .
This policy brief focuses on the single issue that concerns some elected officials : Is it safe for NPs to provide care without written physician collaborative agreements ? The answer is clearly yes . This article reviews the independent , objective evidence supporting that conclusion .
Quality and Safety of NP Care
Scientific journals have printed hundreds of studies within the past 40 years on the safety of care provided by NPs . Studies have not shown that patients cared for by NPs have worse outcomes than those whose care is provided by physicians . Moreover , patients are highly satisfied with NPs and voluntarily choose to receive their care from NPs . Major conclusions find :
• Outcomes of patients cared for by NPs are comparable to and in some respects better than the care delivered by physicians ( Spitzer et al ., 1974 ; Newhouse et al ., 2011 ; Horrocks , Anderson , & Salisbury , 2002 ; Kuo , Chen , Baillargeon , Raji , & Goodwin , 2015 ; Mundinger et al ., 2000 ).
• Patients are highly satisfied with care provided by NPs ( Newhouse et al ., 2011 ; Horrocks et al ., 2002 ).
• Millions of fully-insured patients with a choice of providers elect care by NPs ( Druss , Marcus , Olfson , Tanielian , & Pincus , 2003 ; Dill , Pankow , Erikson , & Shipman , 2013 ).
• Chronic illness management by NPs is equally as effective as physician-managed care ( Horrocks et al ., 2002 ; Mundinger et al ., 2000 ; Stanik-Hutt et al ., 2013 ).
• Primary care NP outcomes for preventing hospitalizations for patients with chronic illnesses are equivalent to physicians ( Kuo et al ., 2015 ).
• Preventative cancer screenings are increased with NP-provided primary care ( Mandelblatt et al ., 1993 ).
• NPs in acute care settings decrease length of stay and hospitalization costs ( Newhouse et al ., 2011 ; Edkins , Cairns , & Hultman , 2014 ; Collins et al ., 2014 ; Kapu , Kleinpell , & Pilon , 2014 ) and reduce hospital readmissions after discharge to home ( Mc- Cauley , Bixby , & Naylor , 2006 ; Naylor , Brooten , Campbell , Maislin , McCauley , & Schwartz , 2004 ).
• NPs are more likely than physicians to provide care to Medicaid beneficiaries and underserved populations ( Buerhaus , Des- Roches , Dittus , & Donelan , 2015 ).
• In states with full NP practice authority , appointment availability for Medicaid patients is better and visit costs are lower in primary care practices with NPs ( Richards & Polsky , 2016 ).
Fall 2016 Pennsylvania Nurse 13