Table 1.

Outcomes Associated with Care Provided by Nurse Practitioners

Author	Population	Methods	Outcomes
Donald et al (2013)¹⁶	4 studies described in 15 articles	Systematic review of studies examining effectiveness of APRNs compared to other providers in long-term care settings	Long-term care residents with APRNs had lower rates of depression, urinary incontinence, pressure ulcers, restraint use, and aggressive behaviors; more residents who experienced improvements in meeting personal goals; and family members who expressed more satisfaction with medical services
Kilpatrick et al (2020)¹⁵	Six long-term care facilities in Quebec, Canada, 538 residents, 6 NPs	Mixed methods quality improvement study including a prospective cohort	A decrease in polypharmacy, falls, restraint use, and transfers to acute care were observed with care provided by part-time NP
Lovink et al (2017)¹	12 studies (2 RCTs, 4 before-after, and 6 observational studies)	Systematic review of studies examining APRNs’ and physician assistants’ substitution of physicians	Substitution of physician-only care with NP or physician assistants produce equivalent or better patient (quality of life, hospital admissions, mortality, health status), process (treatment, adherence and compliance to guidelines, quality of health care), and resource use (emergency department visits, number of medications, unplanned consultations, hospital admissions, hospital days, outpatient and primary health care contacts) outcomes and no increase in cost.
Newhouse et al (2011)¹⁷	69 studies, 37 of which examined NPs (14 RCTs and 23 observational)	Systematic review of studies reporting comparisons in patient outcomes associated with APRNs vs other providers	When comparing NPs to physicians, a high level of evidence was found that NPs contribute to equivalent outcomes in patient satisfaction, self-reported patient perception of health, functional status, glucose control, serum lipid levels, blood pressure control, emergency department visits, hospitalizations, and mortality rates. Moderate levels of evidence were found to support equivalent length of hospital stay for patients of physicians and NPs, and there was low levels of evidence supporting equivalent duration of mechanical ventilation.
Christian and Baker (2009)¹⁸	7 studies (non-RCT and before-after studies) including 12,681 residents in 238 long-term care homes	Systematic review of studies reporting outcomes associated with NPs as the primary care provider for long-term care nursing home residents	Lower hospitalization rates, a decrease in emergency department transfers, and shorter length of hospitalizations were found to be associated with NPs as primary care providers or part of the medical team. One study found no difference in emergency department use, although NP patients were less likely to be admitted to the hospital later in their trajectory of care.
Tchouaket et al (2020)¹⁹	538 residents in long-term care homes in Quebec, Canada	Prospective observational study following 6 long-term care homes between September 1, 2015, and August 31, 2016	The total cost savings for the Canadian health care system associated with a reduction in adverse events (falls, pressure ulcers, short-term hospital transfers) due to care provided by NPs were estimated to be between $1,942,533.6 and $3,253,403.4

APRN, advance practice registered nurse; RCT, randomized control trial.