Nurse practitioner perceptions regarding the impact of regulatory requirements for physician oversight on nurse practitioner practice

Abstract

The purpose of this study was to investigate the perceptions of Nurse Practitioners (NPs) regarding the impact of regulatory requirements for physician oversight on NP practice regarding the impact of physician oversight on patient care (safety, access to care, and costs) and NP practice (scope of practice, job mobility, job satisfaction, autonomy, and resolution of practice and disciplinary complaints). An exploratory survey was developed from NP regulatory research in the literature. A mixed mode, 34 question survey containing Likert scales, multiple choice, and open-ended questions was developed. Content validity was evaluated through 10 content experts. The survey entitled Impact of Regulatory Requirements for Physician Oversight on Nurse Practitioner Practice was sent to 24,000 NPs. Twenty-four inclusion states were selected using a table of random numbers. Five hundred NPs were sampled from each state for a total of 12,000 NPs surveyed. The data was exported from QualtricsTM to IBM SPSS Statistics 19 for analysis. Nurse practitioner experience and type of physician oversight emerged as predictors of agreement of NP perceptions regarding the impact of physician oversight on NP practice. Direct physician oversight; oversight provided in the same practice location as the NP, was perceived as less restrictive for NPs with less than 5 years NP experience compared to more experienced NPs. Nurse practitioners with more than five years and those with indirect physician oversight, physician oversight provided from a remote location, were 2.7 times more likely to perceive that requirements for physician oversight limited NPs from practicing to the full extent of their licensure, education, certification and competence. Understanding the impact of regulatory requirements for physician oversight on the NP practice has implications for nurse educators, NPs, policy leaders, regulators and legislators. This data can inform public policy and expand the evidence base of nursing knowledge. Nursing leadership is required in this important policy discussion.