This paper explores the practice of the APRNs autonomy in the state of Georgia and compares it with other states. Also to advocate for policy recommendations of the APRNs scope of practice that are needed to improve the healthcare in the state of Georgia. APRNs are registered nurses that provide continuous care and treatment in many different areas, such as pediatrics, primary care, acute care, maternity, mental health and chronic disease management. APRNs also have advanced education, training, and national certification in specific areas of practice. Even with the changing and expanding of healthcare, APRNs continue to face challenges in practicing to the full extent of
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.
These organizations developed the Consensus Model document in 2008 to unify practice, identify APRN clinical roles, identify the acceptable titles to for NPs, and define the requirements for general practice and licensure. Note to mention that laws and regulations statute on the APN scope of practice may vary by states, whereas some adhere to full scope of practice, other to reduced practice, or restricted practice. For instance, the state of Florida defines advanced registered nurse practitioner as a licensed person with ability to practice professional nursing and certified to in advanced or specialized nursing practice (Buppert, 2011). The four advanced clinical specialized roles include certified registered nurse anesthetists, certified nurse midwives, clinical nurse specialist, and nurse practitioners (Buppert, 2011). In terms of licensure, 46 states out of 50 require nurse practitioners to pass a certification exam. The Florida Board of Nursing requires certification by an appropriate specialty board and graduation from a program leading to a master’s degree (Buppert,
While the demand of healthcare need increasers the United States facing a physician shortage. In recent years the number of nurse practitioners (NPs) and physician assistants (PAs) has significantly increased and they are taking the part in providing healthcare cervices to the majority of patients. I believe nurse practitioners and physician assistants can practice independently from doctors and be free of oversight. Expanding the scope of NPs and PAs is essential to overcome the healthcare crisis we are facing; it will increase patient satisfaction and stabilizing the healthcare economy.
Consensus Model for APRN Regulation has 4 components: Licensure, Accreditation, Certification, and Education It supports goals of the ANCC APRN certification process and will align the inter-relationships among licensure, accreditation, certification, and education to create a more uniform practice across the country. Its aim is to improve consistency and clarity and take APRNs to the next level and also enhance patient care (“American Nurses Credentialing Center," 2015)
Insurers are less likely to reimburse APRN’s in states that mandate physician supervision. Nurses need to push for reform of the regulations governing APRN;s.
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 practice nurse practitioners (APRNs) have been attempting for many years to eliminate barriers that prevent full practice authority nationwide. Each state has its own licensure and regulates APRN practice roles. APRNs benefit health care by addressing two pertinent needs: the lack of available physicians; and, the increase in patient comorbidities (Gray, 2016). Florida is about to experience a shortage of medical practitioners. According to the Physician Workforce Annual Report of 2014, statistics state 13.4% of medical providers are expected to retire within the following five years after 2014 due to an increase
Hi Swanthi, great post on the APN Consensus Model. In your post you mentioned many healthcare organizations had “criticized the inconsistencies in APRN practice and brought up concerns of patient safety issues due to these competency irregularities.” Although this model was developed in 2008, there are still many regulations and unclear terms that need to be clarify. I can see for nurses that are just beginning their APRN education will be able to eventually achieve the same licensure, accreditation, credentials, and education (LACE), but what about those are currently practicing now? If I was the APRN that had to take extra courses to be licensed in my state than I would feel a bit dissatisfied when another APRN from another state that required
APRN’s have been practicing formally, providing primary care, since the 1960s. The importance of APRN’s role has increased over the years with the shortage of primary care physicians plus the increase demands of accessible and affordable care. It’s important to differentiate and understand APRN’s roles, and the purpose of this interview. Further, to develop my opinion and formulate a recommendation.
As resistant as some states’ legislative and regulatory bodies are to grant APNs autonomy of practice, the damage being done by over-regulation is clear (Safriet, 1992). Physicians are forced into a position to either supervise the APN’s practice or be constantly consulted for approval of their practice decisions. Safriet (1992) described that in and of itself, this constant supervision may appear to patients that the APN is not competent to provide adequate or care equivalent to that of a physician. If the role of the APN is to bridge gaps in health care by relieving the medical establishment of some of the patient load by performing the same function as a physician in a primary care setting, it seems wholly unnecessary to restrain their scope of practice in those areas. This type of restrictions affect cost and patient care accessibility (Safriet, 1992). This was a problem stated in the article, however 25 years later, populations of patients remain unseen or cared for and APNs continue to be underutilized (Safriet, 1992). Rigolosi and Salmond (2014) cite the American Association of Nurse Practitioners (AANP) when they state that not utilizing nurse practitioners due to practice restrictions costs $9 billion annually in the US (p. 649).
As the young and rapidly-aging population continues to increase, the demands of primary, acute and chronic disease management will also increase. As a result, more health care professionals who provide primary care will be needed to meet these demands. Thus, the emergence of Advanced Practice Registered Nurse (APRN) evolve. APRN is a nurse who has completed a graduate degree and has acquired advanced knowledge and skills. APRNs are grounded with theory, concepts and principles that enable them to assess, diagnose, treat and manage their patients. APRNs can work in conjunction with other health care professionals or independently. APRNs improve access to health care by providing care in the rural and underserved areas. APRNs also reduce the cost to health care (Joel, 2013).
The overall health care industry has undergone fundamental change over the last decade. Most of the changes have occurred within the underlying business operation of the healthcare industry. Legislation in particular has had a profound impact on the health care industry. First, due to the Affordable Care Act of 2010, the nursing profession is undergoing a fundamental shift in regards to the patient experience. The U.S. health care system is now shifting the focus from acute and specialty care to that of primary care which requires a shift in business operations. Also, due primarily to that aging of the baby boomer generation, the need for primary car overall is shifting and will be needed heavily in the future. The last 10 years in particular has seen an increasing influx of retiring baby boomers that subsequently need care. A positive impact on the ACA legislation is that more individuals are now insured. As such, the need for primary care will also increase over subsequent years, particular within the minority population. This patient centric approach will require more care predicated on specific communities in a seamless manner. Furthermore, primary care physicians will be in high demand over the coming years.
As the healthcare system in America is overhauled, advanced practice nurses are going to increasingly assume the role of primary care providers. Many states have kept up with the evolving expansion of