Ruth M. Kleinpell, PhD, RN-CS, FAAN, FAANP - Springer Publishing

Chapter 1 Measuring Outcomes in Advanced Practice Nursing 19
Table 1.5 (continued)
STUDY APN ROLE OUTCOME INDICATORS FINDINGS
Venner & Steelbinder CNS 30-day readmission Average hospital
(1996) rate, LOS, cost of care charges, LOS, readmis-
Evaluation of impact of
sion rate and mortality
case management and
rate ↓ in clinical path
implementation of
patients compared to
CNS-led clinical path in
nonpath patients. Pa-
40 congestive heart pa- tients followed in the
tients compared to 40
outpatient congestive
nonpath patients heart failure clinic (n =
84) had 0% hospital readmission
rate at 2
years.
Mahoney (1994) NP Index of appropriate- NPs scored higher on
National random-sam- ness of prescribing the index of appropriateple
comparison of pre- decisions ness than physicians (p
scribing decisions of
< 0.001), a difference
NPs (n = 298) and MDs
that remained whether
(n = 373) using 3 stan- or not the NP had predardized
geriatric case
scriptive authority. NPs
vignettes
made more recommendations
for nondrug therapeutic
interventions,
compared to MDs (p <
.001).
Hylka & Beschle (1995) NP Cost savings, inservice Implementing NP care
Retrospective chart teaching to RNs, pa- into neurosurgery and
reviews of surgery tient education litera- general surgery resulted
patients and general ture, review of practice in cost savings related
discussion of impact guidelines to patient care orders
of NP care
and creation of practice
guidelines. NPs also
contributed to patient
and RN education.
Brooten & Naylor (1995) NPs- Variety of indicators Substantiated the posi-
Review article on effect CNSs used, including return- tive impact of APN care
of APNs in a variety of to-work rates, patient in: ↓ LOS, ↓ health
settings, including reha- education, hospital ad- care costs, ↓ hospital
bilitation, home care,
mission rates, ER visits, admissions, ↓ readmisnursing
homes, and hospital length of stay, sion rates, ↓ patient edhospitals
and others ucation, and others.
(continued)