Evaluating newly acquired authority of nurse practitioners and physician assistants for reserved medical procedures in the Netherlands: a study protocol

Authors

  • Daisy P. De Bruijn-Geraets MSc,

    Researcher, Corresponding author
    1. Department of Patient & Care, Maastricht University Medical Centre & CAPHRI, the Netherlands
    2. Department of Health Services Research, Maastricht University, the Netherlands
    Search for more papers by this author
  • Yvonne J.L. Van Eijk-Hustings MSc,

    Rheumatology Nurse and Researcher
    1. Department of Patient & Care, Maastricht University Medical Centre & CAPHRI, the Netherlands
    2. Department of Health Services Research, Maastricht University, the Netherlands
    Search for more papers by this author
  • Hubertus J.M. Vrijhoef MSc PhD

    Professor of Health Systems and Policy
    1. Scientific Center of Care and Welfare Tranzo, Faculty of Social Sciences, Tilburg University, the Netherlands
    2. Saw Swee Hock School of Public Health, National University of Singapore, Singapore
    Search for more papers by this author

Abstract

Aim

The study protocol is designed to evaluate the effects of granting independent authorization for medical procedures to nurse practitioners and physician assistants on processes and outcomes of health care.

Background

Recent (temporarily) enacted legislation in Dutch health care authorizes nurse practitioners and physician assistants to indicate and perform specified medical procedures, i.e. catheterization, cardioversion, defibrillation, endoscopy, injection, puncture, prescribing and simple surgical procedures, independently. Formerly, these procedures were exclusively reserved to physicians, dentists and midwives.

Design

A triangulation mixed method design is used to collect quantitative (surveys) and qualitative (interviews) data.

Methods

Outcomes are selected from evidence-based frameworks and models for assessing the impact of advanced nursing on quality of health care. Data are collected in various manners. Surveys are structured around the domains: (i) quality of care; (ii) costs; (iii) healthcare resource use; and (iv) patient centredness. Focus group and expert interviews aim to ascertain facilitators and barriers to the implementation process. Data are collected before the amendment of the law, 1 and 2·5 years thereafter.

Groups of patients, nurse practitioners, physician assistants, supervising physicians and policy makers all participate in this national study. The study is supported by a grant from the Dutch Ministry of Health, Welfare and Sport in March 2011. Research Ethics Committee approval was obtained in July 2011.

Conclusion

This study will provide information about the effects of granting independent authorization for medical procedures to nurse practitioners and physician assistants on processes and outcomes of health care. Study findings aim to support policy makers and other stakeholders in making related decisions. The study design enables a cross-national comparative analysis.

Ancillary