1. Snapp, Barbara DNP, NNP-BC
  2. Wilson, Janice DNP, NNP-BC
  3. Puchalski, Mary DNP, CNS, NNP-BC
  4. Wallace, Tamara DNP, NNP-BC
  5. Task Force Leader

Article Content


As healthcare models evolve, there is an increasing demand for continuous evaluation of neonatal nurse practitioner (NNP)-driven outcome measures as a professional practice requirement.1,2 To accomplish this goal, NNPs must show continuous quality improvement (QI) by participating, directing, and developing performance metrics.



Historically, establishing provider outcome comparisons was critical to demonstrate both the safety and efficacy of nurse practitioner care.3-5 In the current practice environment, outcome measures specific to the NNP must now be incorporated into professional requirements to continue to prove the value of NNP care and contribution to measurable outcomes.1,2 Developing these outcome evaluation tools and processes will assist in the benchmarking and validation of care provided by NNPs.



Developing and choosing the appropriate outcome metrics for NNPs are challenging. The majority of neonatal patient care outcomes are the result of the collaborative efforts of multiple healthcare providers, along with family members who provide care. As part of the healthcare team, NNPs need to be well informed about the outcomes specific to their practice. Unfortunately, despite the fact that NNPs are perfectly positioned to drive QI, they often lack the education and preparation to do so. Basic QI education should be included in current and future nursing programs so that graduating NNPs will be prepared for these new requirements.



As the professional voice of neonatal nurses, the National Association of Neonatal Nurses recommends that every NNP should be aware of and participate in multidisciplinary or interprofessonal QI. In addition, NNPs should track and evaluate outcomes relevant to their practice and be aware of measurable metrics relating to the outcomes of the patients for whom they provide care.


National Association of Neonatal Nurses


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2. Kapu AN, Klienpell R. Developing nurse practitioner associated metrics for outcomes assessment. J Am Assoc Nurse Pract. 2013;25(6):289-296. doi:10.1111/1745-7599.12001. [Context Link]


3. Brown SA, Grimes DA. A meta-analysis of nurse practitioners and nurse midwives in primary care. Nurs Res. 1995;44(6):332-339. [Context Link]


4. Spitzer WO, Sackett DL, Sibley JC, et al The Burlington randomized trial of the nurse practitioner. N Engl J Med. 1974;290(5):251-256. [Context Link]


5. U.S. Congress, Office of Technology Assessment. Health Technology Case Study 37: Nurse Practitioners, Physician Assistants, and Certified Nurse-Midwives: A Policy Analysis. Washington, DC: US Government Printing Office. Accessed May 16, 2016. [Context Link]