The use of acute care nurse practitioners (ACNPs) began in the early 1990s, fueled predominantly by economic forces such as managed care and changes in training of residents that emphasized primary care versus in-hospital acute care.1 Continued momentum for integration of ACNPs into the healthcare system since then has been provided by additional forces such as legislative restrictions in the amount of care provided by residents (ie, reduction to an 80-hour work week) and increasing concerns about continuity of care because of the increasing acuity of patients and the shortening of hospital lengths of stay. In addition, concerns related to achieving positive clinical and economic outcomes have increased the interest in using ACNPs in a number of acute care models.2,4 

Typically ACNPs have a mix of medical and nursing responsibilities, medical responsibilities only, or...

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