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Advanced Practice Nurse Outcomes 1990-2008: A Systematic Review

To validate a transaction prior to commit, the follow- ing steps are executed. All replicas other than the pri- mary have to execute the transaction operations and ver- ify that the returned results match the results previously obtained in the coordinator. Given that the transaction executes in the same snapshot in every replica (as ex- plained in the BEGIN operation), if the coordinator was correct, all other correct replicas should obtain the same results. If the coordinatorwas faulty, the results obtained by the replicas will not match those sent by the client. In this case, correct replicas will abort the transaction and the client throws an exception signaling Byzantine be- havior. In. | ONE CNE Objectives and Evaluation Form appear on page 22. SERIES Robin P. Newhouse Julie Stanik-Hutt Kathleen M. White Meg Johantgen Eric B. Bass George Zangaro Renee F. Wilson Lily Fountain Donald M. Steinwachs Lou Heindel Jonathan P. Weiner Advanced Practice Nurse Outcomes 1990-2008 A Systematic Review Executive Summary 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. Use of clinical nurse specialists in acute care settings can reduce length of stay and cost of care for hospitalized patients. 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. Quality access and cost of health care are high-priority global concerns. In the United States these issues are pressing due to the escalating cost of managing chronic diseases Department of Health and Human Services 2009 the variation in quality of care delivered Kuehn 2009 and the inadequate .