The present healthcare system in the United States (U.S) faces various challenges due to changing demographic, economic and political pressures. The need of primary care provides are increasing as a result of increasing access to healthcare, increasing expenditures, and growing populations of the elderly and chronically ill patients. Even with the plenty of evidences that Nurse Practitioners (NP)are well educated, competent, health care professionals who are able to improve access to high-quality health care and lower health care costs, restrictive practice regulations still exist. The quest for NPs independence practice has surpassed and it became a necessary practice transformation to improve the health of the nation (The National Organization …show more content…
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
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
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
This paper explores the practice of the APRNs autonomy in the state of Georgia and compares it with other states. Also to advocate for policy recommendations of the APRNs scope of practice that are needed to improve the healthcare in the state of Georgia. APRNs are registered nurses that provide continuous care and treatment in many different areas, such as pediatrics, primary care, acute care, maternity, mental health and chronic disease management. APRNs also have advanced education, training, and national certification in specific areas of practice. Even with the changing and expanding of healthcare, APRNs continue to face challenges in practicing to the full extent of
In order to practice as a Nurse Practitioner (NP) in Indiana you must hold a state registered nursing license complete a master 's program with certain course requirements. According to NursingLicensure.com (n.d.) there are two educational options leading to Advanced Practice Nurse (APN) recognition in Indiana: obtain a master 's degree or higher in nursing, or obtain a bachelor 's degree in nursing plus national certification. There is not a specific application to become a NP unless you are also pursuing prescriptive authority. Most laws in Indiana focus on regulating practice of nurse practitioners center around prescribing.
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.
According to the Pearson Report, there is a total of 147,295 Nurse Practitioners throughout the United States (Pearson, 2009). However, for NPs in some states the battle continues over some forms of prescriptive authority or physician involvement in NP prescribing, such as the state of Pennsylvania. State regulatory approaches to NP prescribing range from no authorization for prescribing (in Georgia, 2006 legislation passed which recognized NPs as prescribers, but the rules have not been approved at the time of this writing) to unencumbered prescriptive authority (Arizona, DC, Montana, Oregon, Washington, and Wyoming) (Lugo, O’Grady, Hodnicki & Hanson, 2007).
Family Nurse Practitioners (FNP) are nurses who have acquired a higher level of education after Nursing. FNP are trained to treat, prescribe, and to provide quality healthcare needs for patients. The role of a FNP varies according to their realm of practice and state requirements. The amount of service that they can provide depends on the freedom of practice the state gives the FNP. Each state has various boundaries set for NPs to practice their field of healthcare. Nurse Practitioners can use their knowledge as a RN to boost their NP skills by using improved patient care techniques and evidence-based practice. Evidence-based practice provide NPs support by laying out the necessary components of healthcare methods in an organized fashion. NP learn to use evidence based practice to provide patients with the best possible care and treatment available. write more..
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.
Healthcare reform continues in a time where a new president has taken office and is attempting to change or “bridge gaps” in health care policy. Currently, NPs are focused on a new shift to prevent disease rather than to solely cure or treat it which is the major difference between physician practice and the nursing profession. NPs receive extensive schooling and clinical practice to achieve full practice rights, however, the restrictions continue. The Florida Association of Nurse Practitioners (FLANP) monitors Florida legislative sessions on regards to the scope of NPs. As of March 7th, 2017, Bills of interest that affect full practice authority in the state of Florida are: “HB 7011 which introduces independent practice for NPs; CS HB129: which allows NPs to be medical directors and gain signature authority; SB 96 which allows NPs to be medical directors and S634/HB 645 which allows NPs to sign Certificates of Involuntary Commitment (Baker Act)” (Florida Association of Nurse Practitioners (FLANP), 2017). If these bills are finally approved all bilingual NPs can address many patients in need of healthcare without any barriers as to which provider they can see.
Every individual in the world deserves to enjoy health and wellness. Maintaining or achieving proper health needs enables individuals to be productive at work and leisure. Traditionally, many people have had barriers obtaining adequate healthcare due to economic constraints or personal inconveniences. Despite impressive technological advances in medicine, the challenge of delivering quality healthcare to the Americans continues to be debated amongst the nation’s political and healthcare leaders. The aging baby-boomers and the increased number of uninsured people add to the equation of population growth which results in limited access to primary healthcare for the entire public. On the
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).
There is an increasing demand for nurse practitioners, which makes this a crucial period in the development of their practice and profession. Nurse practitioners must face increased opportunity and continuing opposition towards independent practice all while defining their role in health care delivery and establishing their connections. The practice of nurse practitioners still varies widely across the states. These inconsistencies make it difficult for nurse practitioners as well as patients when practice
Primary care practice will be greatly impacted by health care reform. To provide better health care, the country will see a trend away from specialty to primary care and the avoidance of acute issues by delivering this care in the community setting. As a result, primary care physicians will be overwhelmed with the patient load as the number of the insured increases exponentially. The committee recognizes the scope of nursing practice that remains untapped and therefore the profession
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
These impose severe constrictions on the ability of the nurse to move forward or advance into the areas of practice where traditional nursing practices were not allowed {Institute of Medicine, 2010}. However with the increase in the number of nurses graduating with advance degrees in nursing; the situation is changing. These well educated nurses are leading the charge to confront the complex issues that the rapidly changing health care situation presents. Regulatory barriers must be lifted so that nurses can practice within their scope in order to be reimbursed by private insurance for the services they provide. These changes can be done through the federal and state legislators as well as supervisory agencies and bodies such as congress and licensing regulatory boards. The IOM also recommends that nurses will expand their scope of practice and increase their responsibility through teaching and counseling of patients. {Institute of Medicine,2010}. The use of Advance Practice Registered Nurses and Physician Assistant in providing primary care services will decrease wait time and increase patient satisfaction. The high turnover of nurses transitioning from school to practice also affects the quality of care. These nurses do not have enough experience to make decisions in patient care.{Institute of Medicine,2010}.The IOM and JCAHO{2012} report supports the recommendations for the introduction of nursing residency