The Impact Scope-of-practice Laws Have on Urologic Care Outcomes

Raychael Noland, BSN, RN; Peggy Ward-Smith, PhD, RN

Disclosures

Urol Nurs. 2020;40(5):251-255. 

In This Article

Urology-related Health Outcomes When Care is Provided by an NP

Various research articles describe and document care and care outcomes, but little attention has been given to urology patient outcomes when care is provided by NPs. While not comprehensive, the following articles do provide the varied input urology NPs have had on health outcomes. Williams and associates (2020) compared the circumcision experience when the procedure was performed by either an NP within a specialty clinic or by a physician in the operating room. Using survey and retrospective chart data, performing a circumcision by the NP resulted in high family satisfaction, few adverse events, and cost benefits.

A community-based educational program focused on continence education was provided and assessed by Cera and colleagues (2019). Longitudinal data identified a significant improvement in knowledge, self-efficacy in continence health, the severity of urinary incontinence, and quality of life for the 28 female participants. Along with 72% of the study population disclosing they would seek care from an NP because of the program, a fitness facility was identified as a potential assessment site, resulting in early treatment-seeking behaviors.

Using a case-study format, Cadet and associates (2019) articulated how NPs can perform a thorough workup, order appropriate diagnostic tests, educate the patient on treatment options, and guide decision-making. During treatment, the NP can provide education, support, and guidance, while acting as an advocate, if necessary. Once treatment is completed, the NP can provide all necessary follow up and monitoring.

A national collaborative effort aimed at evaluating the ability of APRNs to provide high-value care includes an Enhanced Recovery After Surgery (ERAS) pathway, part of the Choosing Wisely® campaign, This ERAS pathway allows patients undergoing appropriate post-cystectomy or post-urinary diversion procedure to bypass a routine intensive care unit (ICU) stay. Recuperating in an intermediate care unit provides the opportunity to administer non-narcotic analgesics for pain control, early ambulation, removal of the nasogastric tube, progression of diet, and unhurried health teaching (Kleinpell et al., 2020).

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