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德克萨斯州人的健康福利-一名执业护士国家监管政策分析
Laura A Ivey1, Patrick Flavin2, Katy Vogelaar1
1Louise Herrington School of Nursing, Baylor University, Dallas, Texas.
Journal of the American Association of Nurse Practitioners
|October 31, 2023
概括
执业护士 (NP) 的全职执业权限 (FPA) 并没有对健康结果产生负面影响. FPA与NP的不良反应报告较少相关,支持其可行性.
科学领域:
- 卫生政策 卫生政策
- 护理实践 护理实践
- 公共卫生 公共卫生
背景情况:
- 国家级执业护士 (NP) 条例限制了在初级保健短缺的情况下获得负担得起的优质护理的机会.
- 有证据表明,国家医院是成本效益高的提供者,而不会影响医疗质量.
- 变化的国家政策决定了NP实践的自主性和监督要求.
研究的目的:
- 分析德克萨斯州对NP实践监管的政策选择.
- 量化评估FPA对所有州的健康结果的影响.
- 为政策调整提供基于证据的基础,对NP实践范围进行调整.
主要方法:
- 使用Bardach和Patasnik的框架进行政策分析.
- 使用差异回归模型对FPA政策的定量评估.
- 对健康福利结果的分析,包括急诊室的利用率,健康支出和NP不良反应报告 (AAR).
主要成果:
- FPA政策对急诊室使用率,家庭平均卫生支出或身体健康状况不佳的日子没有统计学上显著的影响.
- 完全实践权威与NP特定不良反应报告的减少有关.
- 该研究没有发现FPA采用对人口健康造成的有害后果.
结论:
- 对于像德克萨斯州这样寻求提高NP能力的州来说,完全实践权力是一个可行的政策选择.
- 证据不支持FPA对人口健康结果产生负面影响的说法.
- 支持FPA的政策调整可以提高患者获得护理的机会,并优化NP利用率.
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