Performance evaluation and patient outcomes monitored by nurse practitioners and certified nurse-midwives in Florida

In this descriptive survey study, four elements of performance evaluation of advanced practice nurses (APNs) currently in clinical practice were examined: evaluation frequency, evaluation responsibility, evaluation parameters, and monitored patient outcomes. Questionnaires were mailed to 2,093 APNs living in Florida and licensed by the Florida State Board of Nursing. Eight hundred twenty-two usable surveys were returned, for a 39% response rate. Of these respondents, 654 were in clinical practice as APNs, and comprised the final sample. The majority (56.9%) received formal annual evaluations, and most (75.9%) were evaluated primarily by physicians; only 17.5% reported peer evaluation. The most frequent evaluation parameters were appropriateness of care, patient satisfaction, patient outcomes, and patient volume. Patient outcomes fell into four categories: clinical endpoints, complications, compliance, and functional status. A need to increase the regularity, formality, and peer review elements of APN performance evaluation was concluded.