Prescriptive practice differences between nurse practitioners and physicians in the treatment of uncomplicated urinary tract infections in the emergency department setting.
Journal
Journal of the American Association of Nurse Practitioners
ISSN: 2327-6924
Titre abrégé: J Am Assoc Nurse Pract
Pays: United States
ID NLM: 101600770
Informations de publication
Date de publication:
23 Sep 2020
23 Sep 2020
Historique:
received:
26
09
2019
accepted:
05
05
2020
pubmed:
26
9
2020
medline:
25
11
2021
entrez:
25
9
2020
Statut:
epublish
Résumé
Nurse practitioners (NPs) have increasingly broad prescribing authority, yet there is insufficient information available on the prescribing practices of NPs working in the emergency department setting. The purpose of this study was to describe prescriptive practices between two provider groups, NPs and physicians, in an emergency department setting in the United Arab Emirates. This comparison focused on treatment of a common emergency department diagnosis of uncomplicated urinary tract infection (UTI). The investigators reviewed a sample of 690 UTI patients during the period of August 30, 2016 to June 30, 2018. Physician and NP provider groups were then assessed for treatment selection and associated patient outcomes. A Chi-square test was used to compare empiric antibiotic selection using variables of population type, gender, age, and provider type. There were similar prescriptive practices for beta-lactam, nitrofurantoin, and trimethoprim prescriptions. The investigators noted a statistical difference for fluoroquinolone use, with the physician group selecting fluoroquinolones more often than the NP group. Also, fluoroquinolone use within the physician group varied significantly; however, the investigators did not see this within the NP group. The findings support that there is comparable care quality in the treatment of uncomplicated UTIs between physician providers and NPs in this setting. Comparing outcome similarities and differences on a commonly occurring medical problem in the emergency department provides an early look at the value-added services that NPs provide.
Sections du résumé
BACKGROUND
BACKGROUND
Nurse practitioners (NPs) have increasingly broad prescribing authority, yet there is insufficient information available on the prescribing practices of NPs working in the emergency department setting.
PURPOSE
OBJECTIVE
The purpose of this study was to describe prescriptive practices between two provider groups, NPs and physicians, in an emergency department setting in the United Arab Emirates. This comparison focused on treatment of a common emergency department diagnosis of uncomplicated urinary tract infection (UTI).
METHODS
METHODS
The investigators reviewed a sample of 690 UTI patients during the period of August 30, 2016 to June 30, 2018. Physician and NP provider groups were then assessed for treatment selection and associated patient outcomes. A Chi-square test was used to compare empiric antibiotic selection using variables of population type, gender, age, and provider type.
RESULTS
RESULTS
There were similar prescriptive practices for beta-lactam, nitrofurantoin, and trimethoprim prescriptions. The investigators noted a statistical difference for fluoroquinolone use, with the physician group selecting fluoroquinolones more often than the NP group. Also, fluoroquinolone use within the physician group varied significantly; however, the investigators did not see this within the NP group.
IMPLICATIONS FOR PRACTICE
CONCLUSIONS
The findings support that there is comparable care quality in the treatment of uncomplicated UTIs between physician providers and NPs in this setting. Comparing outcome similarities and differences on a commonly occurring medical problem in the emergency department provides an early look at the value-added services that NPs provide.
Identifiants
pubmed: 32976254
pii: 01741002-202103000-00003
doi: 10.1097/JXX.0000000000000472
doi:
Types de publication
Journal Article
Langues
eng
Pagination
194-199Informations de copyright
Copyright © 2021 American Association of Nurse Practitioners.
Déclaration de conflit d'intérêts
Competing interests: The authors report no conflicts of interest.
Références
Cipher D., Hooker R., Guerra P. (2006). Prescribing trends by nurse practitioners and physician assistants in the United States. Journal of the American Academy of Nurse Practitioners, 18, 291–296.
Gupta K., Hooton T., Naber K., Wullt B., Colgan R., Miller L. G., Moran G. J., Nicolle L. E., Raz R., Schaeffer A. J., Soper D. E.; Infectious Diseases Society of America; European Society for Microbiology and Infectious Diseases. (2011). International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clinical Infectious Diseases, 52, e103–e120.
Holliday A., Samanta D., Budinger J., Hardway J., Betha A. (2017). An outcome analysis of nurse practitioners in acute care trauma services. Journal of Trauma Nursing, 24, 365–370.
Jennings N., Clifford S., Fox A., O'Connell J., Gardner G. (2015). The impact of nurse practitioner services on cost, quality of care, satisfaction and waiting times in the emergency department: A systematic review. International Journal of Nursing, 52, 421–435.
Running A., Kipp C., Mercer V. (2006). Prescriptive patterns of nurse practitioners and physicians. Journal of the American Academy of Nurse Practitioners, 18, 228–233.
Stanik-Hutt J., Newhouse R., Kathleen M., Johantgen M., Bass E., Zangar G., Wilson R., Fountain L., Steinwachs D. M, Heindel L., Weiner J. P. (2013). The quality and effectiveness of care provided by nurse practitioners. Journal of Nurse Practitioners, 9, 492–500.
Yeong Woo B. F., Yu Lee J. X., Tam W. S. (2017). The impact of the advanced practice nursing role on quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings: A systematic review. Human Resources for Health, 15, 1–22.