Origin and Outcomes of Acute Care Nurse Practitioner Practice

Drivers of hospital nurse practitioner turnover: A national sample survey analysis

BACKGROUND

Hospital nurse practitioner (NP) turnover is costly and complex.

PURPOSE

Provide a pre-COVID-19 pandemic baseline of hospital NP turnover.

METHODS

A secondary analysis of NSSRN18 data on 6,558 (67,863 weighted) NPs employed in hospitals on 12/31/2017. We describe rates of turnover, intention to leave, and reasons for leaving or staying. Using multivariate logistic regression, we examine the association between individual and organizational characteristics and turnover. Survey weights and jackknife standard errors were applied to analyses.

DISCUSSION

Approximately 10% of NPs left their job the following year, and 53% of NPs that remained considered leaving at some point. The top reasons cited for leaving or staying were largely organizational factors. Regression analysis revealed not practicing to one's fullest scope, lower income, lack team-based care, and non-white race were associated with an increased likelihood to leave.

CONCLUSION

We find several modifiable factors associated with hospital NP turnover that can be used to tailor recruitment and retention strategies.

An Effective Model for Unit-Based Advanced Practice Provider/Physician Collaboration on a Complex Medicine Hospital Unit

Advanced practice provider care effectively improves outcomes and reduces costs. During COVID-19 challenges and staffing shortages, a team developed and piloted a collaborative advanced practice provider/physician hospital medicine model that resulted in improved outcomes, costs, and quality metrics, including increased productivity and revenue, decreased length of stay, and decreased medical emergency team/rapid response calls.

Advanced Practice Provider Care Team Models: Best Practices From an Academic Medical Center

Health care leaders must be innovative to meet the demands of patient access and cost efficiency, all while never compromising patient safety or experience. A clear understanding of the care team model with optimal utilization of all team members is paramount to success. This article discusses 5 nurse practitioner and physician assistant (collectively called advanced practice providers) care team models that regularly occur in health care organizations across the country. Examples of each practice model, a discussion on when each model would be appropriate, as well as data on patient experience and financial return of investment of each model are provided.