Collaborative Team to Study Nurse Impact on Health Care Quality


News Release index

Posted: 12/29/2008

Two Hopkins nurse researchers, Julie Stanik-Hutt, PhD, ACNP, CCNS and Kathleen M. White, PhD, RN, CNAA, BC, are part of a trans-disciplinary team that will study the impact Advanced Practice Registered Nurses (APRNs) have on health care quality and patient outcomes. 

The research, sponsored by the Tri-Council for Nursing and 27 national nursing organizations, is the first comprehensive study of its kind in 20 years.  Investigators from Johns Hopkins University and the University of Maryland will examine the evidence connected to care provided by nurses in the four APRN roles Clinical Nurse Specialists, Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners.  The team is led by Robin P. Newhouse, PhD, RN, CNAA, BC, CNOR, now at the University of Maryland School of Nursing. Other members of the trans-disciplinary team are Donald M. Steinwachs, PhD,  and  Jonathan P. Weiner, DrPH, from the Johns Hopkins University School of Public Health, and Eric B. Bass, MD, MPH , from the Johns Hopkins University School of Medicine.

“Our team is conducting a review of the scientific literature since 1990 to evaluate the role that APRNs play in determining health outcomes,” says Stanik-Hutt.  “The results of this study will be very important in determining policies of hospitals and other health care institutions that employ APRNs.”

Though APRNs have been linked to improved access to health care services, enhanced patient safety, and cost-effective care, a contemporary systematic review is needed to gauge the overall impact these providers are having in today’s healthcare system. In 1987, the federal Office of Technology Assessment conducted a meta-analysis of the quality and safety of care delivered by nurse practitioners, physician’s assistants, and certified nurse midwives. The overwhelming conclusion of that analysis was that these clinicians are highly skilled, knowledgeable, and effective providers of care. This study also concluded that a significant portion of the care needs of this country could be delivered by these clinicians. Since this study was released, no other national analysis of the growing body of research on APRN practice has been conducted.

This new research effort, titled An Assessment of the Safety, Quality, and Effectiveness of Care Provided by Advanced Practice Nurses, will culminate in an expansive final report which will summarize the latest data on APRNs as well as an article for publication in a peer-reviewed journal. The work is expected to be completed by March 2009.

The organizations supporting this work understand the essential role APRNs play in the healthcare delivery system and recognize the ability of these clinicians to provide effective, high-quality interventions.  The Tri-Council for Nursing, a long-standing alliance whose members include the American Association of Colleges of Nursing, American Nurses Association, American Organization of Nurse Executives, and National League for Nursing, initiated this analysis of current APRN practice and associated outcomes. To date, 23 additional nursing organizations have endorsed this work and provided the financial contributions needed to fund this sizable study.

Supporting organizations include:
Academy of Medical-Surgical Nurses
American Association of Colleges of Nursing
American Association of Critical Care Nurses
American Association of Nurse Anesthetists
American College of Nurse Midwives
American Nephrology Nurses’ Association
American Nurses Association
American Nurses Credentialing Center
American Organization of Nurse Executives
Association of periOperative Registered Nurses
American Psychiatric Nurses Association
Association of Rehabilitation Nurses
Association of Women’s Health, Obstetric and Neonatal Nurses
Commission on Graduates of Foreign Nursing Schools
Hospice and Palliative Nurses Association
National Association of Clinical Nurse Specialists
National Association of Neonatal Nurses
National Association of Pediatric Nurse Practitioners
National Board for Certification of Hospice and Palliative Nurses
National Council of State Boards of Nursing
National League for Nursing
National Student Nurses Association
Nursing Economics Foundation
Oncology Nursing Society
Sigma Theta Tau International
Society of Trauma Nurses
Society of Urologic Nurses and Associates  


Robin P. Newhouse, PhD, RN, CNAA, BC, CNOR, University of Maryland School of Nursing
Julie Stanik-Hutt, PhD, ACNP, CCNS; Johns Hopkins University School of Nursing

Donald M. Steinwachs, PhD, Johns Hopkins University School of Public Health
 Jonathan P. Weiner, DrPH, Johns Hopkins University School of Public Health
Eric B. Bass, MD, MPH , Johns Hopkins University School of Medicine
Kathleen M. White, PhD, RN, CNAA, BC, Johns Hopkins University School of Nursing