Pros And Cons Of Aprns

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

chance to be able to prove to themselves and everybody else that they can do what a

Making the health information available, reducing duplication of tests, reducing delays in treatment, and patients well informed to take better decisions.

been restricted on what they can and can’t do including signing certain documents and orders they can prescribe. With the Affordable Care Act the demand for primary care providers is growing (Gadbois, Miller, Tyler, & Intrator, 2015). This means that the need for APRNs is rising and the need change is approaching. In the primary care setting, there is a variety of medical staff working including medical assistance, LPNs, and RNs. This can become more for the APRN when delegating medication administration. When the APRN cannot delegate medication administration the quality of patient care is sacrificed and is not productive in providing care to the patients.

Currently, the Affordable Care Act establishes nurse practitioners as providers whom are eligible providers in ACOs; however, the current Medicare Shared Savings program statute prevents beneficiaries of Medicare, who are receiving primary care service from a nurse practitioner, from being assigned to Accountable Care Organizations inside the program (AANP, 2015). The American Association of Nurse Practitioners (2015) also claim the exclusion of nurse practitioners must be repealed if ACOs want to develop further as models of practice, which improve cost effectiveness, patient access and quality.

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.

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.

Reimbursement for the advanced practice nurse (APN) is improving but how they fit into reimbursement systems is vey important. One question that arises is if the APN should be paid the same fee for service as a physician or should only a percentage of the payment be received. Most third-party reimburses, which include a few large insurance companies are now reimbursing APNs and more states are getting on board with reimbursements by developing reimbursement models for APNs (Hamric, 2009). For example, Aetna US Healthcare, Anthem Blue Cross and Blue Shield of Kentucky, Medicare and Medicate all credential NPs as primary care providers and pay at 85% of the physician rate. Tricare of Kentucky credentials NPs and pays 100%.

Nurse Practitioners have been providing primary care since the 1970S, but with recent changes in legislation, they are able to practice with a greater level of autonomy. This leads many to question whether ACNPs are able to meet the increasing

With increasing number of Physicians choosing not to go into primary care and increasing number of baby boomers crossing 65 years by the 2030, there is a very high demand for APRNs to fill up those gaps. The consensus model, which was first initiated in 2004, has been revised many times and finalized in 2008. It helps to regulate APRNs with licensure, accreditation, certification and education (Stanley, 2012).

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).

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).

A large study (10,911 patients) showed that APRNs demonstrated equal or better outcomes than physician groups for physiologic measures, patient satisfaction and cost. The study concluded that there were no significant differences in primary care provided by APRNs vs physicians; and actually in some parameters APRNs care was superior. While studies are needed to assess longer term outcomes, these data suggest that the APRNs workforce is well-positioned to provide safe and effective primary care (Swan, Ferguson, Chang, Larson, & Smaldone,

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