Credentialing From Advanced Practice Registered Nurses

This paper explores the perception of clinical practitioners to the change in policy related to the advanced practice registered nurse (APRN) full practice authority. The author conducts a one-on-one, open-ended interview of 5 nurse practitioners and 5 physicians licensed to practice in Maryland on their perceptions of the recent passage of the Advanced Practice Registered Nurse Full Practice Authority. A literature review was conducted in a policy report by the professional nursing organization, and discussion within the peer-reviewed article supported an overview, regulatory differences among 50 states, including the District of Columbia. Their policy implication for enhancing APRNs role nationally. The author discusses a critical component

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,

In recent years, APRNs have been very vocal through many nursing coalitions and associations. The voices of all ARNPs seeking full practice authority has been heard with the proposed bills. The Florida Panhandle Nurse Practitioner Coalition (FRNPC), has given information to all ARNPs to keep ahead in legislative issues. A white paper published by the American College of Physicians have been shared to all Floridian ARNPs through the

The afore= mentioned issues being addressed through legal channels by the AANP are barriers to effective and efficient practice, the type of barriers that were to be eliminated by the expansion of the Affordable Care Act (ACA) (Dunphy, Winland-Brown, Porter, & Thomas, 2015). Only twenty-two states have allowed full practice authority, which is less than half of the nation. It is imperative that every advance practice nurse has a voice that is heard in their state and the nation, this is the message of the AANP (Hain & Fleck,

There are some legal issues, which are very restrictive; thus, affect the advanced nursing practice by hindering APRNs from serving patients better (Stephens, 2015). One of these issues is the requirement that APRNs should have a training arrangement with supervising physicians. Existing healthcare laws limit them from ordering diagnostic tests and prevent them from writing prescriptions for certain

Three issues or trends I see that are important with regard to credentialing are reimbursement, malpractice and education. Within each issue are opportunities for the advance practice nurse (APN) to grow in knowledge and participate in change. It is important to understand why each one effects credentialing for the APN.

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

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 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).

Advanced practice registered nurses (APRNs), whether they are nurse practitioners (NP), clinical nurse specialists (CNS), certified nurse anesthetists (CRNA), or nurse midwife (CNM), play a pivotal role in health care (American Nurses Association [ANA], 2015). APNs are quite often providing primary, preventative, chronic, and routine care to patients. According to BMJ Open (Kanda et al., 2015) nurses are on the frontline and continue to be the largest profession in the world. APRNs obtain at least a Master’s degree, have an expert knowledge base, possess superlative clinical skills and demonstrate complex decision making skills often time utilizing the interdisciplinary team approach. As Indicated by the Journal of Pediatric Health Care,

The role of the Advanced Practice Nurse (APN) is expanding internationally throughout the healthcare system. Since the initiation of the Patient Protection and Affordable Care Act in 2010, there has been an increased need for APNs due to the growing demand for primary care services and increased population that have gained healthcare coverage (Lanthrop & Hodnicki, 2014). The purpose of this paper is to explore the role of APN and develop a professional development plan for my future career.

Thank you for your informative post regarding the Advanced Practice Registered Nurses (APRNs) barriers in utilizing their full potential to practice their education and training. According to Kunic and Jackson (2013), the Institute of Medicine report titled “The Future of Nursing: Leading Change, Advancing Health,” also identified other political and regulatory barriers which include: (a) the resistance of organized medicine to support expanded APRN scope of practice, (b) the resistance of state legislators to introduce bills that expand scope of practice for APRNs, (c) restrictive credentialing and privileging practice within health care institutions, (d) a lack of public awareness and recognition of the education, training, and clinical

While the ACA has implemented measures to increase the numbers of nurse practitioners in primary care areas by funding graduate nurse education, financial incentives for nurse practitioners to work in MUAs, and increased funding for FQHCs and NMHCs that support the nurse practitioner role as a primary care provider. A common barrier cited and discussed among policymakers is the mixture of state level regulations and federal policy demonstrating an obstacle to the full and efficient utilization of nurse practitioners.