Health Care Policy Background Essay

The Texas Nurse Practitioners firmly support allowing APRNs to practice to the full extent of their clinical ability without any arbitrary barriers. A state regulatory system that allows patients to have full and direct access to all of the services that APRNs

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

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

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.

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.

Also, a DNP provider would be able to promote legislative changes in the community or state to ensure APRNs can practice to their full capacity. The Appalachian region is multi-state and providers are unable to practice without having an understanding of the scope of practice and license for the state in which they locate. This is especially problematic when practicing in an area where more than one state is located near a geographic location and could potentially limit access to treatment due to different practice guidelines in each state. DNP prepared practitioners are equipped with the knowledge of policy advocacy and should utilize each opportunity to advocate for standard scope of practice that would enable access to care, despite geographic

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.

With the passing of the Affordable Care Act in 2010 approximately 32 million more people will be insured throughout the United States. The need for healthcare workers and providers will be in drastic demand to provide care to these insured Americans. The 2010 IOM report details out how the advanced practice nurse can be a valuable asset in primary, chronic and transitional care and their skill set should be used to promote better healthcare across the nation (IOM, 2010). This impact of this report should help progress advanced practice nurse’s ability to practice without individual state regulation and be governed under one body to server in and outside of the hospital setting

The Texas Nurses Association is a strong proponent of permitting APRN’s to practice with full authority using their clinical skills and education to their fullest potential (Cates, 2017, p. 2)l. The TNA is a member of the APRN Alliance, which encompasses four statewide associations (Cates, 2017, p. 2). The APRN Alliance joined forces with the Coalition for Health Care Access (CHCA). This coalition is comprised of “over 20 business, consumer-advocacy, and health care stakeholder groups” (Cusack, 2017, p. 2). Currently, APRN’s barriers include expenses associated with partnering physicians (Holmes & Kinsey-Weathers, 2016). Granting APRN’s full practice authority would results in a monetary loss to these physicians. The AMA and AAFP oppose the passing of HB 1415 (Hooker & Muchow, 2015, p. 89). The pushback from these organizations stands regardless of strong evidence of the positive outcomes with allowing APRN’s full practice authority.

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

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.

Defining the scope of practice for an advanced practice nurse (APRN) can be a difficult task. Currently, in the United States, each state has its own policies regarding APRN scope of practice. State policies/laws vary from restrictive to independent. States under a restrictive policy of APRN scope of practice may have strict physician collaboration regulations. For example Missouri requires the collaborating physician to review a percentage of charts and be within so many miles of the APRN’s work place. Restrictive scope of practice can also limit prescriptive authority and decrease reimbursement of services (Hain & Fleck, 2014). States with more independent scope of

Implementation of the Affordable Care Act (ACA) has afforded many individuals the opportunity to obtain health insurance, and many of the newly insured are seeking medical services at the same time a primary care provider shortage is unraveling. This is a great time to be a nurse practitioner, as we will be expected to fill the primary care provider shortage gaps. Upon successful completion of this graduate nurse practitioner program, my main focus will be shifted towards obtaining certification in order to be eligible for reimbursement from the Centers for Medicare and Medicaid Services (CMS).

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).