Toward national comparable nurse practitioner data: proposed data elements, rationale, and methods

Federal funds have supported Nurse Practitioner (NP) education and the establishment of nurse-managed centers. Yet, important questions are raised about the quality and appropriate scope of NP care. Few NP-patient encounters are documented in the largest national surveys of ambulatory care, sponsored by the National Center for Health Statistics, due to sampling frames that are based on physician practices. In addition, these national surveys lack essential outcome indicators, therefore limiting their data to descriptions of patient demographics and practice patterns. Informatics principles are applied to a proposed expansion of the National Ambulatory Medical Care Survey. Its sample would include nurse-managed centers and its variables would include quality outcome and process indicators in standardized language that are nurse-sensitive and that reflect national priorities for action on health care quality. Variables for inclusion in a draft pilot instrument are identified.