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An Unclear Partnership: Key Questions about Physician and Advanced Practice Provider Collaboration in Primary Care
01-17-25
More than 83 million people in the United States live in primary care shortage areas. As the US healthcare system faces a contracting primary care physician workforce, advanced practice providers are playing an increasingly important role in the delivery of primary care services. In parallel,...
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Nurse Practitioner Race and Ethnicity and Interest in Independent Primary Care Practice and Serving Medicaid Enrollees
12-15-24
Nurse practitioners (NPs) are important providers of primary care to underserved populations, particularly in areas with lower physician supply. In 2023, California implemented new regulations aimed at improving access to care, especially primary care services, by providing a pathway for NPs to...
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Understanding California’s Midwife Workforce
10-22-24
Midwives are licensed clinicians who play a key role in the maternity care workforce. In California, licensed midwives (LMs) and nurse-midwives (NMs) provide comprehensive, person-centered care focused on pregnancy, childbirth, and the postpartum period.
To better understand the midwife workforce...
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California’s Nurse Practitioner Workforce: Understanding Demographics, Education, and Scope of Practice
09-27-24
Nurse practitioners — often referred to as NPs — are the largest group of nonphysician primary care providers and play a growing role in filling gaps in health care provision in both primary care and behavioral health across California. NPs are registered nurses who have completed additional...
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The Social Ecology of Burnout: A Framework for Research on Nurse Practitioner Burnout
05-03-24
The US health system is burdened by rising costs, workforce shortages, and unremitting burnout. Well-being interventions have emerged in response, yet data suggest that the work environment is the problem. Nurse practitioner (NP) burnout is associated with structural and relational factors in the...
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State Scope of Practice Restrictions and Nurse Practitioner Practice in Nursing Homes: 2012-2019
02-12-24
Abstract: Increased engagement of nurse practitioners (NPs) has been recommended as a way to address care delivery challenges in settings that struggle to attract physicians, such as primary care and rural areas. Nursing homes also face such physician shortages. We evaluated the role of state scope...
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Perspectives on APRN Prescribing of Medications for Opioid Use Disorder: Key Barriers Remain
11-16-23
Deaths from drug overdoses are rising dramatically in the United States. Treatment for opioid use disorders may include behavioral treatments as well as medications for opioid use disorders (MOUD). Buprenorphine can be prescribed by physicians, nurse practitioners (NPs), other advanced practice...
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Advanced Practice Clinician Care and End-of-life Outcomes for Community- and Nursing Home-dwelling Medicare Beneficiaries with Dementia
04-18-23
Older adults with Alzheimer's disease and related dementias (ADRD) often face burdensome end-of-life care transfers. Advanced practice clinicians (APCs), which include nurse practitioners and physician assistants, increasingly provide primary care to this population. To fill current gaps in the...
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Influences on Advance Practice Nursing Education to Prescribe Medications for Opioid Use Disorder
03-30-23
Opioid misuse is a major public health concern in the United States. Opioid agonist medications are evidence-based treatments for opioid use disorders (OUD) that can be prescribed by advance practice registered nurses (APRNs) with prescriptive authority and appropriate training. This article...
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Eliminate the Buprenorphine DEA X Waiver: Justification Using a Policy Analysis Approach
01-09-23
Drug overdoses have reached a historic milestone of over 100,000 deaths in a single year, 75,673 related to opioids. The acceleration in opioid-related deaths coupled with stark health inequities demands a close examination of opioid use disorder (OUD) treatment barriers and swift consideration of...
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Rural-Urban Prescribing Patterns by Primary Care and Behavioral Health Providers in Older Adults with Serious Mental Illness
11-30-22
Older adults with serious mental illness (SMI) often have multiple comorbidities and complex medication schedules. Shortages of behavioral health specialists (BHSs), especially in rural areas, frequently make primary care providers (PCPs) the only clinician managing this complex population. The aim...
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Analysis of US County Characteristics and Clinicians With Waivers to Prescribe Buprenorphine After Changes in Federal Education Requirements
10-21-22
Buprenorphine is associated with decreased mortality from opioid use disorder, but prescribing is limited in office-based settings to clinicians with federal waivers. To expand this workforce, on April 28, 2021, the US federal government eliminated educational requirements for waivers to prescribe...
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Buprenorphine Treatment: Advanced Practice Nurses Add Capacity
09-01-22
During the COVID-19 pandemic, there was slower growth in the number of new waivers authorizing clinicians to provide buprenorphine treatment for opioid use disorder. However, treatment capacity grew at a stable rate as a result of already authorized clinicians obtaining waivers for larger patient...
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Beyond State Scope of Practice Laws for Advanced Practitioners: Additional Supervision Requirements for Buprenorphine Prescribing
07-01-22
Buprenorphine is a life-saving medication for people with opioid use disorder (OUD). U.S. federal law allows advanced practice clinicians (APCs), such as nurse practitioners (NPs) and physician assistants (PAs), to obtain a federal waiver to prescribe buprenorphine in office-based practices....
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Changes in U.S. Clinician Waivers to Prescribe Buprenorphine Management for Opioid Use Disorder During the COVID-19 Pandemic and After Relaxation of Training Requirements
05-12-22
The COVID-19 pandemic worsened the opioid overdose crisis. Buprenorphine management for opioid use disorder (OUD) reduces overdose risk and can be offered in office-based settings or via telehealth. Federal regulations require that clinicians complete training and obtain a waiver from the Drug...
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Barriers and Facilitators of Advanced Practice Registered Nurse Participation in Medication Treatment for Opioid Use Disorder
07-01-21
The misuse of opioids is a health crisis in the United States. Medication treatment for opioid use disorder reduces negative health outcomes, but there are widespread shortages of appropriately trained and credentialed providers. Advanced practice registered nurses (APRNs) have recently become...
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Time Trends in the Regional Distribution of Physicians, Nurses and Midwives in Europe
10-12-20
Country-level data suggest large differences in the supply of health professionals among European countries. However, little is know about the regional supply of health professionals taking a cross-country comparative perspective. The aim of the study was to analyse the regional distribution of...
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Scope-of-Practice Regulation and Nurse Practitioners as Usual Source of Care Providers
10-01-20
Several trends suggest that the nurse practitioner (NP) workforce has untapped potential to expand healthcare capacity to increase access to care. The aim of this study was to examine NPs as usual source of care providers and investigate their relationship with state scope-of-practice regulations.
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Role of Nurse Practitioners in Caring for Patients With Complex Health Needs
10-01-20
The objective of this study was to estimate trends in the percentage of Medicare beneficiaries cared for by nurse practitioners from 2012 to 2017, to characterize beneficiaries cared for by nurse practitioners in 2017, and to examine how the percentage of beneficiaries cared for by nurse...
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Effect of State Regulatory Environments on Advanced Psychiatric Nursing Practice
10-01-20
Although there has been significant progress across states to remove or diminish barriers to the exercise of full scope of practice by advanced practice registered nurses (APRN), state regulations continue to unnecessarily restrict APRN practice in most of the United States. This article integrates...
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Measurement of Nonbillable Service Value Activities by Nurse Practitioners, Physicians Assistants, and Clinical Nurse Specialists in Ambulatory Specialty Care
06-30-20
Revenue-generating health care activities, generally accepted as a measure of productivity, do not account for the full range of health care activities that enhance patient care. We analyzed the quantity, duration, and type of "service value activities" performed by nurse practitioners (NPs),...