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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
 
4048.0: Tuesday, December 13, 2005 - 8:50 AM

Abstract #113048

Nurse practitioners as attending providers in a workers’ compensation system: Policy evaluation of recent legislation in Washington State

Jeanne M. Sears, MS, RN, PHN1, Thomas M. Wickizer1, and Gary F. Franklin, MD, MPH2. (1) Department of Health Services, University of Washington, Box 357660, Seattle, WA 98195-7660, 425-828-4241, jeannes@u.washington.edu, (2) Department of Environmental Health, University of Washington, Box 357660, Seattle, WA 98040

Advanced registered nurse practitioners (ARNPs) are treating providers in Washington's workers' compensation (WC) system; however, prior to July 2004, they were restricted from independently performing the functions of an attending physician. SHB 1691 took effect 7/1/04, allowing ARNPs to independently perform those functions of an attending physician within their scope of practice, including signing accident report forms and time loss forms.1 An evaluation of the legislation is required prior to the scheduled sunset date of 6/30/07. Utilization of ARNPs can mitigate sociodemographic and geographic disparities in access to care.2 The supply of primary care physicians is decreasing in rural areas,3,4 however the overall supply of ARNPs is projected to increase.5 SHB 1691 may increase provider supply, particularly in rural areas, which could decrease travel distance or waiting time to a first visit, and potentially lead to better outcomes.6,7 Within their area of competence, ARNPs provide care that is at least equivalent to that of physicians.2,8,9 Allowing ARNPs to provide independent care for appropriate patients may be cost-effective, and may also impact quality of care, health outcomes, and patient satisfaction.2,8-14 Removing the requirement for a physician signature on key forms may improve administrative efficiency. Few WC systems designate ARNPs as attending providers. Little information is available on outcomes of WC-related care provided by ARNPs.8 The evaluation of this policy experiment will include factors such as geographic distribution of providers, administrative efficiency, service patterns, and health and cost outcomes, and will provide important information to policy makers in other states.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

Keywords: Workers' Compensation, Nurse Practitioners

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Workers' Compensation Research

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA