Acute Care Nurse Practitioner Role

First, the state licensure regulates NP practice and it has been a big issue since NPs are not able to practice to the fullest extent despite of their education and training. NPs practice is regulated by state licensure and only about one-third of the nation has adopted full practice authority licensure and practice laws for NPs (Hain & Fleck, 2014). The American Association of Nurse Practitioners (AANP) reports that, under a full practice authority model, NPs are still required to meet

The health care industry is experiencing a surge in the number of baby-boomers needing health care and increased demands on the physicians providing the care. This trend has made the role of Advanced practice providers more important (cite). It is imperative to understand the differences and similarities in the advanced practice provider roles as it pertains to healthcare. This paper will identify specialty nursing roles including advanced practice registered nurses (APRN). It will further compare and contrast the advanced practice nurse (APN) and physician assistant (PA) roles in practice.

ACNPs have been propelled to the forefront as health care providers for the acute & critically ill as a response to a mandated eighty-hour weekly work limit for physician residents. The Accreditation Council

The role of the nurse practitioner began in the 1960’s, with the development of an advanced nursing role in pediatrics in Colorado, to meet the need of treating children of low-income families. Since the inception of the advanced nursing role, there has been controversy in educational standards, educational requirements, knowledge base needed, and state imposed restrictions on practice. It is through the rapid development of ARNP programs and inconsistencies in educational standards that have created obstacles in the advancement of these roles, licensure differences, and restrictions that have minimized the role of the ARNP (Stanley, 2011).

Since the inception of the Nurse Practitioner (NP) role in the 1960s, NPs have thrived in the delivery of primary healthcare and nurse case management. Despite patient satisfaction with NPs ' style of care, nurses have been critical of NPs, while physicians have been threatened by NP encroachment on MD practice. Balancing assessment, diagnosis, and treatment with caring defines NPs ' success as primary care providers. Understand the role and Scope of Practice of NPs is sometimes difficult for some to understand. The purpose of this paper is to define the role and history of NP, compare and contrast licensure versus certifications, understand NP Scope Of Practice and Standards of Care, discuss how the State Practice Acts regulate FNP practice, discuss credentialing and privileging, and differentiate between legislative and regulatory processes.

Many Americans use Advance Practice Nurse Practitioners (APRN) for a number of their health care needs. For more than fifty years, APRN’s have provided a great amount of services in primary care and acute settings, making their presence in the health care system important. Likewise, expectations are that APRN’s will become even more crucial to the delivery of healthcare as more Americans gain access to providers through the new tax reform. With this being said, it is imperative that the APRN be able to practice to his or her full practice authority. “Full practice authority is comprised of state practice and licensure laws that allow advanced practice registered nurses to practice fully in the four domains of practice, under the exclusive licensure

Advanced Practice Nurses are Registered Nurses with specialty training at the master 's-degree level, in primary care settings, such as the Nurse Practitioners and Nurse Midwives and acute care of inpatients, such as the Clinical Nurse Specialists and in operating rooms, such as Nurse Anesthetists. This has opened a door in the nursing field. Nurses ' roles are no longer limited. Nurses now have opportunities to advance their career and expand their roles. Advanced Practice Nurses can be more directly involved in patient care

The Gerontology Primary Care Nurse Practitioner competencies entail a combination of acute gerontology and primary care. In order to gain entry into this field, there is need to meet the requirements for an adult-gerontology care nurse practitioner. The competencies of this field are based on the APRN along with NP core competencies. Their scope of practice is based on patient healthcare needs. Their healthcare obligations tend to reflect the work of a national Expert Panel that entails a host of adults related to gerontology and acute care (Geetter, et al., 2013).

State licensure controls NP practice and is a barrier to NP practice to the fullest extent of their education and training. Full practice authority allow the Np to assess patents, diagnose, order and interpret diagnostic tests, initiate and manage treatments including prescribing medications independently. At present only one third of the nation has adopted full practice authority and practice laws for NPs. The remainder of the NPs in the U.S have reduced or restricted practice licensure (Hain & Fleck, 2014). In reduced practice, state practice and licensure law reduces the ability of NP to engage in at least one element of NP practice. State law necessitates a regulated collaborative agreement with an outside health discipline for the Np to provide patient care or limits the settings or scope of one or more elements of NP practice. Whereas in restricted practice, State practice and licensure law restricts the ability of a NP to engage in at least one element of NP practice. In Texas, Np practice is restricted. State requires supervision, delegation, or team-management by an outside health discipline in order for the NP to provide patient care in Texas (American Association of Nurse Practitioners, 2017). Full practice authority for NP referred to autonomous practice or independent practice. The IOM report has identified, restrictive scope of practice regulation is one of the most serious barriers to accessible care. Variation in scope of practice across states has an indirect impact on patient care since the degree of physician supervision may affect practice opportunities and payer polices for NPs (Hain & Fleck, 2014). In 2010, a full practice status model was recommended by the institute of medicine and national council for state boards of nursing. However, 29 states including Texas, still holding reduced or restricted practice regulations for NPs (Simmons School of Nursing

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 previous version had a heavy emphasis on physician collaboration for all prescription drugs. A written agreement between the APRN and the physician was to be submitted to the state board of nursing (H.B.4334, 2016). The board would then forward the agreement to the board of Medicine and the board of Osteopathic Medicine (H.B.4334, 2016). Within these written agreements, one would find guidelines or protocols for prescriptive authority, individual and shared responsibilities, periodic evaluations, and review of guidelines as agreed upon through collaboration (H.B.4334, 2016). The updated version of the bill eliminated these requirements. Instead, the bill proposed APRNs to have the authority to prescribe any drug with minimal limitations or exceptions (H.B.4334, 2016). An APRN may not prescribe more than a seventy-two-hour supply of any Schedule II controlled substance, and it cannot be refillable (H.B.4334, 2016). An APRN may prescribe up to a thirty-day supply of any Schedule III controlled substance with zero refills (H.B.4334, 2016). Additionally, an APRN may prescribe treatment for an individual with Attention Deficit Disorder for up to thirty days with zero refills (H.B.4334,

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).

APRN’s residing in New York must comply with Title 9: New York Code of Regulations: Article 139, Nursing of the Education Law. Per the U.S. Department of Labor statistics, of the 122, 050 APRNs practicing in the U. S., 9, 980 reside in California and 10,310 reside in New York. Within each of these two statues, the specifics related to the scope of practice are categorized in terms of: legal authority (oversight requirements and practice authorities); reimbursement; and prescriptive

The role that nurse practitioner (NP) plays within the increasing complex health care system is a constant changing role with the Consensus Model and the introduction of the Affordable Care Act in 2010. The scope of the nurse practitioner (NP) includes the care of the young, the old, the sick and the well. The educational needs of a nurse practitioner vary greatly from that of a Registered Nurse (RN), in the amount of education as well as the focus of the education. NPs provide coordinated primary care with the use of comprehensive health histories and physical examinations, diagnosing and treating acute and chronic illnesses, the management of medications and therapies, ordering and interpreting tests results, and educating and

Teamwork is vital in healthcare.  When all participants are engaged in a program, goals are successfully achieved. Being able to communicate and work collectively as a team requires an appreciation for each other’s area of practice.  Every team member has an important role and being acknowledged provides a sense of responsibility and accountability. Essentially, inter-professional collaboration helps ensure that the patient is getting care that is not only accessible but also comprehensive.  The plan of a patients’ care includes active participation by all health care professionals working interdependently in accordance to the patient’s preferences, values and beliefs. The health care team accomplishes the goal of meeting the patient’s medical needs by delivering evidence-based practice.   To deliver quality care, the patient should always be involved.