Nurs Econ
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As leaders, we must feel a sense of moral obligation to implement evidence about end-of-life care in our practice setting. Nurse leaders can help patients and families orchestrate a beautiful experience that is an alternative to futile, expensive end-of-life care. ⋯ Courageous nurse leaders are well adapted to maneuvering through political traps and advocating for patients and their families. Everyone benefits personally and financially, including our communities and nation, when courageous leaders advocate successfully for effective end-of-life care.
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In 2006, the Institute of Medicine cited growing visit volumes, hospital closures, financial pressures, and operational inefficiencies as the principal reasons for emergency department (ED) overcrowding and called for regulatory measures to resolve the problem. A Midwest medical center with 59,000 annual ED visits instituted a bed management strategy to decrease the need to board, or hold, admitted hospital patients in the ED awaiting transfer to an inpatient care unit. ⋯ During this same time, the overall hospital mortality decreased by 0.07% and patient satisfaction scores improved 1%. The greatest outcome from this intervention was realized in the potential revenue increase of over $2 million.
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Review Comparative Study
Advanced practice nurse outcomes 1990-2008: a systematic review.
Advanced practice registered nurses have assumed an increasing role as providers in the health care system, particularly for underserved populations. The aim of this systematic review was to answer the following question: Compared to other providers (physicians or teams without APRNs) are APRN patient outcomes of care similar? This systematic review of published literature between 1990 and 2008 on care provided by APRNs indicates patient outcomes of care provided by nurse practitioners and certified nurse midwives in collaboration with physicians are similar to and in some ways better than care provided by physicians alone for the populations and in the settings included. ⋯ These results extend what is known about APRN outcomes from previous reviews by assessing all types of APRNs over a span of 18 years, using a systematic process with intentionally broad inclusion of outcomes, patient populations, and settings. The results indicate APRNs provide effective and high-quality patient care, have an important role in improving the quality of patient care in the United States, and could help to address concerns about whether care provided by APRNs can safely augment the physician supply to support reform efforts aimed at expanding access to care.