Assuring quality and access in advanced practice nursing: a challenge to nurse educators.

In an environment characterized by a projected over-supply of primary care providers and a public seeking higher quality, cost-effective care, advanced practice nurses will be measured not only by their comparative value in delivering conventional primary care, but also by the uniqueness of their contributions to health outcomes. These value-added skills, distinctive to nursing practice at all levels, include health education, disease prevention, health promotion, community resource access, and partnerships with patients. Government, private payors, and national and state regulators all authorize increasingly independent practice by advanced practice nurses. When advanced practice nurses assume such fully accountable primary care roles, their title and certification should be distinctive to that level of practice. A Doctor of Nursing Practice (DNP) degree would signal to the public that nurses--at their highest practice competency--are at the same level as other health professionals holding doctorates (such as MD, DDS, or PharmD).