The association between Doctor of Nursing Practice Nurse Practitioner staffing and hospital outcomes
Abstract
Background:
The National Organization of Nurse Practitioner Faculties advocates for the doctoral level as the entry-to-practice standard for NPs. Understanding the impact of Doctor of Nursing Practice NPs (DNP-NPs) on health care systems is vital for shaping policy, regulations, and practice.
Purpose:
This study quantitatively assesses the relationship between DNP-NP staffing levels and hospital quality and cost outcomes using major datasets.
Methodology:
Data from the 2022 Iowa and Kentucky State Boards of Nursing (BON) and the Centers for Medicaid & Medicare Services (CMS) were used. The BON databases identified DNP-NPs matched to CMS data, with hospital affiliation determined by Hospital CMS Certification Number codes. Doctor of Nursing Practice NP counts were scaled by hospital size, with DNP-NPs per 100 beds as the treatment variable. Outcome variables and hospital characteristics were analyzed by DNP-NP quintiles.
Results:
Hospitals in the lowest quintile of DNP-NP staffing had a significantly higher mean readmission rate of 14.84% (SE = 0.245), which was 0.39% points higher (p = .005) than the adjusted mean of 14.45% (SE = 0.214) for other hospitals. No systematic relationship was found between DNP-NP staffing and readmission rates across the remaining distribution, and no correlation was detected between DNP-NP staffing and other hospital quality or cost efficiency measures.
Conclusion:
The study underscores the need for improving data infrastructure to further research the relationship between DNP-NP staffing and hospital quality outcomes and address hospital staffing questions.
Implications:
Recommendations are provided for enhanced data sources on NP education and practice to inform health care workforce research, staffing, policies, and regulations.
Department
Nursing
Publication Date
5-2025
Journal Title
Journal of the American Association of Nurse Practitioners
Publisher
American Association of Nurse Practitioners
Digital Object Identifier (DOI)
Document Type
Article
Recommended Citation
Roberts, Meaghan H. PhD-c, RN, MA (Graduate Student)1; Ainslie, Marcy EdD, APRN, FNP (NONPF Senior Fellow, Assistant Professor)2; Idzik, Shannon DNP, ANP-BC, FAANP (Professor, Associate Dean Doctor of Nursing Practice Program)3; Bigley, Mary Beth DrPH, ANP-BC, FAAN (Chief Executive Officer)4; Fogg, Louis PhD (Statistician, Assistant Professor)5; Schrader, Kara Elena DNP, RN, FNP-C (Assistant Professor, Primary Care Nurse Practitioner Program Director)5; Buchholz, Susan W. PhD, ANP-BC, FAANP (Professor, Associate Dean for Research)5. The association between Doctor of Nursing Practice Nurse Practitioner staffing and hospital outcomes. Journal of the American Association of Nurse Practitioners 37(5):p 262-271, May 2025. | DOI: 10.1097/JXX.0000000000001120
Rights
© 2025 American Association of Nurse Practitioners