APRN Workforce Differences

Many studies exist which highlight the benefits of APRN full practice authority. One study from Duke University, by Conover and Richard (2015), contained this strong statement regarding APRN practice, “studies vary in their methodological rigor, each has concluded that APRN practice outcomes are equivalent or better to those of physicians” (pg. 4). The study goes on to say that three cost effective benefits to full practice authority APRNs are: lower training costs, lower compensation and limited use of expensive resources or procedures. The study also discusses how full practice laws would increase access to care by decreasing primary care provider shortages (pg. 6).

Poghosyan and Knutson conducted a survey of 278 APRNs to better understand their independence and role in New York State primary care settings. Forty two percent of the APRNs surveyed stated they have their own patient panel and do not share panel with physicians and two thirds are able to review the outcome measures of the care they deliver. The study found that despite the restrictions on APRNs they freely apply their clinical knowledge

Increased evidence demonstrates APRN’s provide equivalent quality of patient care as physician and have excellent patient satisfactions scores (Hooker & Muchow, 2015). All the while, APRN’s bill at a lower rate. Hooker and Muchow (2015) state the use of APRN’s can result in a 20% in costs resulting in hundreds of millions of savings.

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

There should be impartial and fair governing board oversight of APRNs. Access to care should also be improved by authorizing third-party cover of APRN care and allowing patients to select providers of their choice. The healthcare workforce should also be given more support by creating more clinical training and graduate level education opportunities for nurses. The primary goals for these changes include giving APRNs the chance to practice their training and education to full limit, filling the gaps created by physician shortages, and improving

Healthcare reform in the United States (U.S.), continues to be a hot topic in the news. Whether it discusses how the program will be financed, the need to redesign the organization, or how the process of delivering healthcare will be implemented; one thing that is a frontrunner, is the need for registered nurses (RNs) and advanced practice registered nurses (APRNs) to fill the increased demands on the primary care system (Institute of Medicine, & Robert Wood Johnson Foundation, 2011, p. 375). “Several programs and initiatives included in the health reform legislation involve interdisciplinary and cross-setting care coordination and care management services of RNs” (Institute of Medicine, & Robert Wood Johnson Foundation, 2011, p. 377).

Some groups, including the American Medical Association, have stated that advanced practice nurses should not have full authority because their training is shorter than physicians (Hain & Fleck, 2014). The concern raised is that an APRN is not trained well enough to safely diagnose and treat a patient without supervision. Many studies have been completed to test this argument. One such study by the Cochran review concluded that in primary care settings APRNs had high patient satisfaction scores and overall improved patient outcomes (Hain & Fleck,

With increasing number of Physicians choosing not to go into primary care and increasing number of baby boomers crossing 65 years by the 2030, there is a very high demand for APRNs to fill up those gaps. The consensus model, which was first initiated in 2004, has been revised many times and finalized in 2008. It helps to regulate APRNs with licensure, accreditation, certification and education (Stanley, 2012).

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).

The APRN is uniquely skilled and trained to meet this growing need, and policy should focus on expanding the role and autonomy of APRNs, and increasing funding, and possibly diminishing the reimbursement gap in order to attract and sustain a greater number of providers in underserved areas and provide them with the financial resources to remain viable, independent providers. Nurse Practitioners are more likely to work in primary care and in rural areas, particularly, remote rural areas,which are characteristically similar to underserved areas, than are

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

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).

In primary care, it has been shown that the average cost of an NP visit is 20% less than a visit with a physician. Medicaid and Medicare reimbursement rate for mid-level providers is 85% of what physicians receive for the same medical services. Due to these lower percentages of reimbursement, studies indicate that fully utilizing NPs could decrease primary care costs by 20%. This decrease would offer an annual national savings of up to $8.75 billion. Additionally, it is believed that the reserves obtained from increasing the percentage of mid-level providers in primary care will compliment the lower compensation-to-visit ratio in family practice. Overall, these findings illustrate significant revenue from increased use of NPs and PAs (Hooker

Advanced practice nurses are known for analyzing and collecting data to help implement interventions and positive outcomes for the public. There are a numerous health conditions in the United States that advanced practice nurses (APNs) play a vital role in research and practicing evidence based medicine. The many influences that may negatively impact a patients health

APRN should have the ability to practice to their level of education. APRNs provide safe, quality, and cost effective primary care and to meet the growing needs for patients, APRNs must have the ability to prescribe controlled substances across the nation.