Full practice authority and burnout among primary care nurse practitioners

Area of Science:

• Health Services Research
• Nursing Practice
• Occupational Health

Background:

• Full practice authority (FPA) enhances clinical autonomy for nurse practitioners (NPs).
• Increased autonomy is hypothesized to mitigate NP burnout.

Purpose of the Study:

• To evaluate the impact of transitioning from restricted to full practice authority on nurse practitioner burnout.
• Assessing the relationship between practice authority changes and NP well-being.

Main Methods:

• Quasi-experimental design comparing NP burnout pre- and post-FPA regulation in the Veterans Health Administration (VHA).
• Burnout data collected from 1,352 primary care NPs via the VHA All Employee Survey in 2016 and 2018.
• Analysis of burnout proportions across VHA facilities before and after the FPA policy change.

Main Results:

• 77% of VHA facilities adopted FPA after the regulation.
• A non-statistically significant six-point reduction in burnout was observed among NPs in facilities that transitioned to FPA.
• Burnout levels were compared between facilities that adopted FPA and those with pre-existing FPA.

Conclusions:

• The policy change to full practice authority did not yield a statistically significant decrease in nurse practitioner burnout.
• The association between FPA and NP burnout may be influenced by the specific healthcare setting.
• Burnout measurement (individual vs. team) could affect observed associations with FPA.