APRN Scope Of Practice Case Study

This document contains information about scope of practice* for registered nurses (includes licensed graduate nurses) and nurse practitioners in British Columbia. It also includes important information for registered nurses related to scope of practice that is established by the College of Registered Nurses of British Columbia (CRNBC). The scope of practice for registered nurses and nurse practitioners in British Columbia is set out in the Nurses (Registered) and Nurse Practitioners Regulation under the Health Professions Act. Additional scope of practice information is

This statement clearly defines the scope of practice of a nurse. But in the field of nursing there are several kinds of care givers. It includes registered nurses, midwives, licensed practitioner nurses, enrolled nurses and nurse assistants. The scopes of practice for these care givers are not so common. The scope of practice depends on their education qualification and experience which are well defined by the governing bodies. Some areas in the scope of practice of a nurse according to Queensland nursing council are,

In 2008, the coalition of members from the Alliance for Advanced Practice Credentialing and the National Council of State Boards of Nursing (NCSBN) created the Consensus Model for Advanced Practicing Registered Nurses (APRN’s). This model creates a framework for APRN’s in licensing, accreditation, certification, and education in the United States (Alleman & Houle, 2013). The establishment of this Consensus Model has developed a bases for the ARNP’s comprehensive knowledge base, ability for clinical reasoning, cultural, and ethical competencies, establishing a model of practice for ARNPs in which to follow. These concepts will be further discussed in this paper.

There have been concerns regarding the identification and credentialing of advanced practiced registered nurses (APRNs). A APRN is a registered nurse who has successfully completed an accredited graduate-level education program, in which the individual is well prepared and successfully passed the nationwide certification examination (APRN Consensus Model, 2008). However, there are still debating issues of who would fall under the APRN category. The National Council of State Boards of Nursing (NCSBN) has identified four APRNs who are deem fit to be called ARPNs; however, only two will be named. They would be certified registered nurse anesthetists (CRNAs) and certified nurse practitioners (CNPs). Whereas, the nurse informatics and the nurse administrations are not considered to be APRNs; although, they are still license registered nurses but they do not provide direct patient care and are not required to take the national certification examination (ARPN Consensus Model, 2008).

Advanced practicing registered nurses (APRNs) serve essential roles in providing acute care, pediatric care, maternity care, chronic disease management, adult primary care, and mental health treatment. They are registered nurses who have additional training, education, and certification in a given field of practice. There are many potential issues which can influence their practice setting. This paper covers the legislative issues affecting advanced practice nursing formulates a possible policy change to address that matter. Legislative Issues Affecting Advanced Practice Nursing Legal issues affecting advanced practice nursing refer to the policies or laws enacted by legislatures to give guidelines in the field of advanced practice nursing.

The Scope of Practice describes the procedures, actions, and processes that a healthcare practitioner is permitted to undertake in keeping with the terms of their professional license (Wikipedia). Stories such as Delean Botkins’ is a primary example of why the Scope of Practice needs to be terminated once and for all. The Scope of Practice is causing a shortage of medical help, can cause more harm than good, inconsistent, unfair, and most of all, unnecessary. APN nurses should not only be able to, but should be encouraged to practice to the fullest extent of their education and

Defining the scope of practice for an advanced practice nurse (APRN) can be a difficult task. Currently, in the United States, each state has its own policies regarding APRN scope of practice. State policies/laws vary from restrictive to independent. States under a restrictive policy of APRN scope of practice may have strict physician collaboration regulations. For example Missouri requires the collaborating physician to review a percentage of charts and be within so many miles of the APRN’s work place. Restrictive scope of practice can also limit prescriptive authority and decrease reimbursement of services (Hain & Fleck, 2014). States with more independent scope of

Advance Practice Registered Nurse (APRN) is a broad term that is used to define the masters prepared nurse that participates directly in patient care. This definition includes four different facets of nursing: certified nurse-midwives, nurse anesthetists, clinical nurse specialists and nurse practitioners (Joel, 2009). Of these four professions that are included in the APRN definition, Western Carolina University offers two: nurse anesthetist and nurse practitioner. Nurse educator and nurse leader, which are also offered at Western Carolina University, are not currently included in this definition.

Expanding the scope of practice for APRN remains a controversial issue in Missouri, where I currently reside. Expanding the scope of practice also remains an issue for the health care field nationwide. Stakeholders that I can identify include The American Association of Colleges of Nursing (AACN), The National Organization of Nurse Practitioner Faculties (NONPF), APRN Consensus Work Group, National Council State Boards of Nursing (NCSBN), APRN Advisory Committee, along with other health care organizations, health care educators, and health care providers nationwide (IOM Report., n.d., p. 133). Focusing in on Missouri, the stakeholders for this endeavor include health care

The scope of practice changes from state to state and it is good that we have the Nurse Practice Act of the state that we practice at the tip of our fingers because these laws are written by the board of that state to implement the standards of practice that is required. Further more, Federal too have their laws

The South Carolina State Board of Nursing is responsible for licensure of APRNs (American Association of Nurse Practitioners, 2014). South Carolina (SC) is a restricted practice state, requiring Nurse Practitioners (NP) to be 1) supervised by, 2) perform delegated tasks from or 3) work as part of a team managed by, a medical doctor or dentist (American Association of Nurse Practitioners, 2014). To obtain an APRN license in SC requires a RN license, in good standing, a graduate degree and certification from an approved national credentialing source (American Association of Nurse Practitioners, 2014).

The APRNs Regulatory Model specializes roles and titles and population foci within a regulatory framework (Hamric, Hanson, Tracy, & O'Grady, 2014). This was implemented to resolve the issue of inconsistent rules, policies and standards of care across states. APN practice is faced with many barriers or obstacles put in place with notion of regulating practice and provision of quality and safe care. This have led to reviewing of the regulations to broaden the spectrum of APN practice as health care is fast evolving. Diverse regulatory criteria like variable accreditation standards, licensing requirements, inconsistent population foci and scopes of practice, represent barriers to optimize APRN function within today’s complex health care system

Advanced Practice Registered Nurse (APRN) has evolved tremendously since it was establish in 1965 to service vulnerable populations, however there are still barriers that must be addressed in order to free APRNs from limitation imposed by state scope of practice (SOP) laws and payers, which disrupts health care financing/costs, access, delivery, and quality patient care. Currently, only one third of the states in the U.S. permit APRNs to fully practice within their scope without limitations (Hain & Fleck, 2014; Yee, Boukus, Cross, and Samuel, 2013).

APRNs are structured by the Consensus Model for APRN Regulation. The model was created by the APRN Consensus Work Group and the National Council of State Boards of Nursing (NCSBN) APRN Advisory Committee. This was developed to provide consistency so that the standards and scope of practice of APRNs will be the same (APRN, 2008).

The scope of the practice for APRN is to consider the specific population and territory of their independent practice to determine regulatory model which is appropriate and effective to the need of the community