Abstract
Background: Acute care comprises a significant amount of health care, with over 35 million hospitalizations in the United States annually.1 As the population ages and comorbidities and chronic illness increase, demand for hospital care is forecasted to grow.2 To meet the demand for acute care, clinicians, healthcare organizations, and policymakers are calling for increased nurse practitioner (NP) utilization in hospital care.3,4
Significance: Acute care NPs practice across clinical specialties and assume diverse roles providing high-quality, interdisciplinary hospital care.3,5,6 Despite demand for NPs in hospital care, barriers, including organizational regulations and state scope-of-practice restrictions, limit full implementation of their roles.7-9 These restrictions constrain the effectiveness of NPs by decreasing their capacity to contribute to care, fueling access to care problems, and increasing the cost of care.10
Purpose: The purpose of this study was to examine changes in the acute care NP work environment in the decade after formalizing the role in nursing policy.11
Methods: Using a repeated cross-sectional design and data from the National Sample Survey of Nurse Practitioners (2012) and the National Sample Survey of Registered Nurses (2018, 2022), the analysis included NPs certified in pediatric or adult acute care NP roles. Examining work environment characteristics measured in all three surveys, we perform descriptive statistics to summarize data distributions and trends. All analyses accounted for the complex survey design and weighting used to generate national workforce estimates.
Results: The majority (≥85%) of acute care NPs were satisfied with their jobs. However, there were gaps in the full attainment of acute care NP role implementation. Despite working in hospitals, less than one-third of acute care NPs had hospital admitting privileges or managed their own panel of patients. Only three out of five acute care NPs billed for their care. Some report they were not fully practicing to their scope (11.3-18.9%), and their skills were not fully utilized (11.7-23.3%).
Implications: Acute care NPs identified persistent opportunities to improve the work environment and remove practice restrictions that constrain their effectiveness. Future work should include advocacy to remove practice barriers and evaluation of policy interventions intended to improve the work environment of acute care NPs and meet the growing demand for care.
Notes
Reference list included in attached poster file.
Sigma Membership
Iota at-Large, Delta Theta
Type
Poster
Format Type
Text-based Document
Study Design/Type
Cross-Sectional
Research Approach
Quantitative Research
Keywords:
Acute Care, Workforce, Workforce Planning and Development, Leadership, Nurse Practitioners
Recommended Citation
Gigli, Kristin Hittle, "Characteristics of the United States Acute Care Nurse Practitioners’ Work Environment, 2012 to 2022" (2025). Biennial Convention (CONV). 16.
https://www.sigmarepository.org/convention/2025/posters_2025/16
Conference Name
48th Biennial Convention
Conference Host
Sigma Theta Tau International
Conference Location
Indianapolis, Indiana, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2025-11-19
Characteristics of the United States Acute Care Nurse Practitioners’ Work Environment, 2012 to 2022
Indianapolis, Indiana, USA
Background: Acute care comprises a significant amount of health care, with over 35 million hospitalizations in the United States annually.1 As the population ages and comorbidities and chronic illness increase, demand for hospital care is forecasted to grow.2 To meet the demand for acute care, clinicians, healthcare organizations, and policymakers are calling for increased nurse practitioner (NP) utilization in hospital care.3,4
Significance: Acute care NPs practice across clinical specialties and assume diverse roles providing high-quality, interdisciplinary hospital care.3,5,6 Despite demand for NPs in hospital care, barriers, including organizational regulations and state scope-of-practice restrictions, limit full implementation of their roles.7-9 These restrictions constrain the effectiveness of NPs by decreasing their capacity to contribute to care, fueling access to care problems, and increasing the cost of care.10
Purpose: The purpose of this study was to examine changes in the acute care NP work environment in the decade after formalizing the role in nursing policy.11
Methods: Using a repeated cross-sectional design and data from the National Sample Survey of Nurse Practitioners (2012) and the National Sample Survey of Registered Nurses (2018, 2022), the analysis included NPs certified in pediatric or adult acute care NP roles. Examining work environment characteristics measured in all three surveys, we perform descriptive statistics to summarize data distributions and trends. All analyses accounted for the complex survey design and weighting used to generate national workforce estimates.
Results: The majority (≥85%) of acute care NPs were satisfied with their jobs. However, there were gaps in the full attainment of acute care NP role implementation. Despite working in hospitals, less than one-third of acute care NPs had hospital admitting privileges or managed their own panel of patients. Only three out of five acute care NPs billed for their care. Some report they were not fully practicing to their scope (11.3-18.9%), and their skills were not fully utilized (11.7-23.3%).
Implications: Acute care NPs identified persistent opportunities to improve the work environment and remove practice restrictions that constrain their effectiveness. Future work should include advocacy to remove practice barriers and evaluation of policy interventions intended to improve the work environment of acute care NPs and meet the growing demand for care.
Description
Despite demand for acute care nurse practitioners, barriers limit role implementation. This study used national survey data to examine changes in the acute care nurse practitioner work environment over the last decade. Participants can expect to learn about the persistent barriers in the work environment of acute care nurse practitioners. Further, they will understand what policy changes can most effectively remove practice barriers that constrain the effectiveness of these nurse practitioners.