HB 216 Case Study

In the United States, health care accessibility, quality, and affordability continue to be ongoing topics of discussion that effect many Americans on a regular basis. The need for affordable, quality healthcare continues to grow, not only due to a growing elderly population, but also as a result of the Affordable Care Act which has allowed millions of previously uninsured Americans access to health insurance and therefor better access to healthcare services (Patient Protection and Affordable Care Act, 2010). According to the Institute of Medicine (IOM) the projected demand increased for healthcare have led to a call for expansion of primary care services by policy makers (Institute of Medicine, 2010; National Governors Association, 2012). Since Advanced Practice Nurses or Nurse Practitioners (APNs or NPs will be used interchangeably for the purpose of this paper) are one of the fastest growing groups of healthcare providers, and continue to practice and provide care in a range of settings including primary care, it is important to investigate and address any potential barriers to practice. This author believes that allowing APNs to write prescriptions for commonly used controlled substances will help improve timeliness and flexibility in health care delivery; studies have shown that there is a positive impact on high

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

In the State of Ohio, the scope of practice provides a guideline for nurses to care for their patients

This paper will discuss the elements associated with the request to amend and to enact the revised code to authorize a person not otherwise authorized to do so to administer certain drugs pursuant to delegation by an advanced practice registered nurse who holds a certificate to prescribe. This act, also known as House Bill 96, was introduced on March 3, 2015. H. B 96 was amended into Senate Bill 110. The amended H.B. 96 now the Senate Bill 110- APRN Delegation of Drug Administration was introduced on March 3, 2015. The bill if passed would authorize certain advanced practice registered nurses (APRNs) to delegate to persons not otherwise authorized to administer drugs the authority to do so under specified conditions. Currently, Ohio law

State law is made up of two different forms: statues and regulations (Buppert, 2015). Under the established rules and regulations, an ARNP can: (a) monitor and alter drug therapies; (b) initiate therapies for certain diagnosis’; (c) perform additional functions as may be determined by rule; (d) and order diagnostic tests and appropriate therapies (The Florida Legislature, 2016). A practitioner licensed under chapters 458, 459 or 466, must maintain supervision for directing certain course and medical treatment (The Florida Legislature, 2016). Within the context of advanced nursing practice and the Florida Statues chapter 464.003(2), an ARNP may diagnosis, treat, alter medication regimes, diagnose, prescribe and operate, which are approved by a joint committee composed of three members appointed by the Board of Nursing, three members appointed by the Board of Medicine and the State Surgeon General or his/her designee (The Florida Legislature, 2016). On the other hand, the federal government regulates nurse practitioner practice through statutes passed by Congress and regulations (Buppert, 2015). According to Buppert (2015), federal law can override state law, and when federal and state law conflict with one another, federal law usually triumphs. Due to these state and federal statutes and regulations, this can impose a huge threat and impact to NP practice since the BON and the Nurse Practice Act usually help

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,

The common perception of a recruiter is evolving quickly in the workplace (Boswell 2001). Where once recruiters were viewed as a tool to simply acquire candidates, modern recruiters have greater responsibilities to their clients. These responsibilities can include tasks such as organizing paperwork, completing pre-screening measures, and even occasionally preparing training curriculum (Darrell 2002). Recruiters are further expected to provide quality screening of candidates and ensure the optimal match for each applicable position within a company (Posner 2006). As with any other job within a company, recruiters must take this work seriously and avoid procrastination to ensure a smooth transition for their candidates into the new workplace. Should the transition fail to be smooth, the full blame modernly falls on the recruiter who failed to use proper coordinating strategy.

There have been no major votes on this bill. The trackers displays the bill being introduced still and it has not yet passed the House.

The benefits of JCAHO accreditation to a healthcare facility is that it demonstrates a level of competence to provide safe and effective care to its patients. Accreditation

The Texas Nurses Association (TNA) District one meeting for the El Paso area, took place on September 20, 2016 at 1845. The President of District one, Paula Meagher was unable to attend the meeting as she was ill. She did however provide us with a list of the current Advanced Practice Registered Nurse (APRN) issues that TNA is engaged in. The issue that really caught my attention was Texas Occupations Code, section 157.011 (b-1) which deals with APRN restrictions on writing prescriptions for Schedule two controlled substances. The TNA website states:

Last year, the House approved the measure with a 55-38 vote, but the legislation was thought to have been dead when it was sent to a committee. The effort to have the bill approved was revived last week when the Senate Judiciary Committee gave it the green light.

|Diagnostic Test (x-ray, blood work) |$35.00 copay or 20% of coinsurance if copay |Office visit copay or 20% of coinsurance |Office visit copay or 20% of coinsurance |

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).

It is important for stockholders to continuously re-evaluate their investments. Although some investors do this more frequently and thoroughly than others, the majority of shareholders do so at least once each year. Therefore, Torres’ desire to update her analysis in order to determine whether Costco was still operating efficiently makes perfect sense. After thorough examination, my analysis proves that Costco remains one of the industry’s leading competitors and there seems to be no reason for Torres to sell her shares as long as she wishes to retain holdings of a retail wholesale club in her portfolio.

How did the competitive environment change for the John Deere Component Works between the 1970's and the 1980's? What information must management accounting systems provide to support effective decision-making in these different environments?