DNP preparation of primary care nurse practitioners and clinical outcomes for patients with chronic conditions

Abstract

Background: Many professional nursing organizations have proposed that the Doctor of Nursing Practice (DNP) is the most appropriate entry-level degree for nurse practitioners (NPs). There have been no studies to date examining the impact of DNP preparation on quality of care or patient outcomes.

Purpose: To examine differences in emergency department utilization and hospitalizations among patients with chronic conditions cared for by Master of Science in Nursing (MSN)- and DNP-prepared primary care NPs.

Methods: We use survey data from over 1,000 primary care NPs in 6 states linked to Medicare claims data. Using regression models, we controlled for various patient, NP, and practice characteristics that might confound the relationship.

Resuls: We find that patient outcomes are not statistically different between patients attributed to MSN- and DNP-prepared primary care NPs.

Discussion: These findings suggest that there remains little evidence that DNP education has led to significant improvements in patient outcomes.

Conclusions: Further empirical analysis related to the clinical outcomes other than health care utilization of the DNP degree is warranted. Future studies might consider examining (a) NPs in settings other than primary care, (b) practice-wide or system-wide outcomes, (c) other measures of care quality, and (d) impact of DNP program content.

Keywords: Health services utilization; Nurse practitioner; Nursing education.