Abstract

Research has documented the positive impact of the nurse practitioner workforce on patient and system outcomes in multiple countries. Achieving these outcomes relies on successfully integrating the workforce into the health system. Research has reported negative effects of integration barriers on the ability for nurse practitioners to improve outcomes. Barriers include scope of practice restrictions, organizational climates inconducive to nurse practitioner care, and lacking mentorship. To design efficacious policies, organizational and national policy decision-makers require knowledge of the factors affecting the integration of this human resource into care settings. No research has synthesized these factors into an easily understandable and applicable inventory for policy decisionmakers. This study aimed to reach expert consensus on an inventory of factors affecting the integration of nurse practitioners into the health system.

Notes

This previously published article is posted in the Sigma Repository pursuant to a Creative Commons license.

Original citation:

Porat-Dahlerbruch, J., Clark, R., Dutchess, B., Blumenthal, N. P., & Ellen, M. E. (2025). Factors affecting integration of the nurse practitioner workforce into health systems: A Delphi Consensus Study. BMC Health Services Research, 25(1). https://doi.org/10.1186/s12913-025-12929-w

Author Details

Joshua Porat-Dahlerbruch (1), Rebecca Clark (2,3,4), Branden Dutchess (1), Nancy P. Blumenthal (2) and Moriah E. Ellen (5)

(1) Department of Acute & Tertiary Care, School of Nursing, University of Pittsburgh, 336 Victoria Building, 3500 Victoria Street, Pittsburgh, PA 15261, USA; (2) 2School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, PA 19104, USA; (3) Center for Health Outcomes & Policy Research, 418 Curie Blvd., Philadelphia, PA 19104, USA; (4) Pennsylvania Hospital, 800 Spruce Street, Philadelphia, PA 19107, USA; (5) Department of Health Policy and Management, Faculty of Health Sciences and Guilford Glazer Faculty of Management, Ben-Gurion University of the Negev, P.O. Box 653, Be’er Sheva 841051, Israel

Sigma Membership

Eta

Lead Author Affiliation

University of Pennsylvania, Pittsburgh, Pennsylvania, USA

Type

Article

Format Type

Text-based Document

Study Design/Type

Delphi Study

Research Approach

Qualitative Research

Keywords:

Nurse Practitioners, Integration, Health Disparities, Advanced Practice Nursing, Delphi Technique, Health Workforce, Implementation Science, Nursing Workforce

Identifier Type

Other

Identifiers

https://doi.org/10.1186/s12913-025-12929-w

Publisher

Springer Nature

Version

Publisher's Version

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

External Review: Previously Published Material

Acquisition

Indexed Previously Published Material (Per Creative Commons License)

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