[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-328220-105":59,"doc-detail-328220-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","an-exploration-of-nurse-practitioner-integration-into-the-delivery-of-healthcare-services-in-the-united-states-dissertation","An Exploration of Nurse Practitioner Integration into the Delivery of Healthcare Services in the United States - Dissertation","","The nurse practitioner (NP) role has become central to primary care in the United States, supporting increased access to high-quality, cost-effective care. Stakeholder debate continues: while nursing and primary care advocates seek broader NP scope, organized medicine and other organizations often resist. Although NP practice is regulated by state law, institutional policies and organizational barriers shape the NP practice environment. This dissertation clarifies NP integration through three specific aims.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/an-exploration-of-nurse-practitioner-integration-into-the-delivery-of-healthcare-services-in-the-united-states-dissertation/328220/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/an-exploration-of-nurse-practitioner-integration-into-the-delivery-of-healthcare-services-in-the-united-states-dissertation/328220.png","ImageObject",300,407,{"name":92,"@type":93},"Aurelia","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-25","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What problem does the dissertation address about nurse practitioners in U.S. healthcare?","Question",{"text":113,"@type":114},"It addresses how NP integration into primary care is limited by opposition from organized medicine, differing state laws, and organizational barriers that prevent full utilization of NPs’ training.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What does Aim 1 focus on?",{"text":118,"@type":114},"Aim 1 reviews terminology used in existing literature to describe NP integration into primary care and identifies characteristics of distinct care models to reduce confusion and support future outcomes research.",{"name":120,"@type":111,"acceptedAnswer":121},"What do Aim 2 and Aim 3 attempt to achieve?",{"text":122,"@type":114},"Aim 2 explains why some states have achieved full NP scope-of-practice authority while others have not, informing state policy and advocacy decisions. Aim 3 provides recommendations to administrators to strengthen the NP-administrator relationship and improve NP practice environments.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},328220,1790471286,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":146,"preview_page_count":4},1099514068365,"https://ap-avatar.wpscdn.com/avatar/10000253d8d9f28188e?x-image-process=image/resize,m_fixed,w_180,h_180&k=1794309523707217728","An Exploration of Nurse Practitioner Integration into the Delivery of Healthcare  \nServices in the United States  \nDissertation  \nPresented in Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy in the Graduate School of The Ohio State University  \nBy  \nLena Stevens  \nGraduate Program in Public Health  \nThe Ohio State University  \n2022  \nDissertation Committee  \nJennifer L. Hefner, Advisor  \nTory H. Hogan  \nTasleem J. Padamsee  \nJudith A. Tate  \nCopyrighted by  \nLena Stevens  \n2022  \nAbstract  \nThe nurse practitioner (NP) role has emerged as a key role in primary care in the United States. NPs can help meet growing primary care needs, contribute to greater access to care for patients, and provide care that is of high quality, leads to high patient satisfaction, and is cost-effective. While many stakeholders in the fields of nursing and primary care have argued for further expanding NP scope of practice, others, predominantly medical organizations, have questioned this approach. NP practice is governed at the state level, but it is also influenced by organizational level factors, like institutional policies, which can influence the NP practice environment. Therefore, organized medicine’s opposition, in combination with varying state laws and regulations, as well as organizational barriers have prevented NPs from practicing to the full extent of their education and training in many states. Thus, the overall goal of this dissertation is to provide further clarity around the integration of the NP role into the delivery of healthcare services in the United States via three specific aims. Aim 1 provides an evidence-based overview of the terms used in the existing literature to describe NP integration into primary care and determines characteristics of distinct models of care. This first aim will help reduce confusion around the labeling and operationalization of terms, it will further allow health professionals to work towards common goals, and it will provide a foundation for future outcomes research around NP-physician models of care. Aim 2 examines why some states have achieved full NP scope of practice authority  \nwhile others have not. This second aim can help guide state policy makers and NP professional organizations in their lobbying efforts and decision making around future NP policy efforts. Further, understanding why some states have achieved full scope of practice authority while others have not is critical as NPs working in full scope of practice states have reported more favorable work environments and, if utilized effectively, NPs can be considered part of the solution to the primary care physician shortage. Aim 3 provides specific recommendations for administrators that will improve the NP-administrator relationship in primary care practices. This third aim can help create more favorable NP practice environments, which are essential for NPs to succeed in their work.  \nDedication  \nI dedicate this dissertation to my parents who supported me from day one, who believed in me every step of the way, and without whom, none of this would have been possible.  \nAcknowledgments  \nI would like to thank everyone who was involved with this dissertation project. First, I would like to acknowledge my amazing dissertation advisor, Dr. Jennifer Hefner, for all her support and assistance throughout the dissertation process. Next, I would like to acknowledge my other dissertation committee members, Dr. Hogan, Dr. Padamsee, and Dr. Tate, for their insightful feedback along the way.  \nI would also like to thank my family and friends for their continuous support and the endless encouragement on this journey.  \nVita  \nBachelor of Business Administration…………………………………………………2015  \nKennesaw State University, Coles College of Business  \nMaster of Human Resource Management…………………………………………......2017  \nThe Ohio State University, Fisher College of Business  \nDoctor of Philosophy in Public Health…………………………………….…..2017-2022  \n","cbCainTuZHEW0e9W","https://ap.wps.com/l/cbCainTuZHEW0e9W","pdf",1814624,339,"English","# Abstract\n# Dedication\n# Acknowledgments\n# Vita\n## Publications\n# Fields of Study","[{\"question\":\"What problem does the dissertation address about nurse practitioners in U.S. healthcare?\",\"answer\":\"It addresses how NP integration into primary care is limited by opposition from organized medicine, differing state laws, and organizational barriers that prevent full utilization of NPs’ training.\"},{\"question\":\"What does Aim 1 focus on?\",\"answer\":\"Aim 1 reviews terminology used in existing literature to describe NP integration into primary care and identifies characteristics of distinct care models to reduce confusion and support future outcomes research.\"},{\"question\":\"What do Aim 2 and Aim 3 attempt to achieve?\",\"answer\":\"Aim 2 explains why some states have achieved full NP scope-of-practice authority while others have not, informing state policy and advocacy decisions. Aim 3 provides recommendations to administrators to strengthen the NP-administrator relationship and improve NP practice environments.\"}]","An Exploration of Nurse Practitioner Integration into the Delivery of Healthcare Services in the United States - Dissertation | PDF",1789978906,854]