Texas, State Law Prohibits Advanced Practice Registered Nurses ( Aprns )

The Arizona Campaign for Action Coalition is formed of a comprehensive team of health care professionals and diverse Arizona stakeholders. Arizona has chosen multiple areas to focus on for implementation however this paper will discuss two. The first initiative for discussion will be that of the removal of the scope-of-practice barriers that face advance practice nurses in Arizona. The report states that Arizona has one of the most liberal practice scopes in The United States however nurse practitioners often have difficulty with receiving credentialing by the Arizona version of Medicaid known as AHCCCS (Randolph, Hrabe,

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

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

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

In 2008, the coalition of members from the Alliance for Advanced Practice Credentialing and the National Council of State Boards of Nursing (NCSBN) created the Consensus Model for Advanced Practicing Registered Nurses (APRN’s). This model creates a framework for APRN’s in licensing, accreditation, certification, and education in the United States (Alleman & Houle, 2013). The establishment of this Consensus Model has developed a bases for the ARNP’s comprehensive knowledge base, ability for clinical reasoning, cultural, and ethical competencies, establishing a model of practice for ARNPs in which to follow. These concepts will be further discussed in this paper.

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.

After attending the Arizona State Board of Nursing meeting through live stream on September 18, 2015 at approximately eleven in the morning, I had the opportunity to witness how the board enforces all the rights and regulations of the Nurse Practice Act and upholds the requirements set for each standard. The board consists of the board president Randy Quinn, RN, MSN, CRNA, the boards vice president Carolyn Jo Mccormies, RN, MS, FNP-BC, Kathryn Busby, J.D., Public Member, Lori A. Gutierrez, BS,RN-C,DON-CLTC,CBN, Terri Berrigan, LPN, C-AL who is the board secretary, Patricia Johnson, LPN, M. Shawn Harrell, RN, MS, Charleen Snider, BSN,RN , Dr. Kimberly A. Post, DNP,MBA/HCM,RN,NEA-BC, and Leslie Dalton, MSN, RN. Nine out of the ten board member were in attendance and conducting rulings in this particular meetings.

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.

The scope of practice for APRNs in Texas are quite dynamic in range. It evolves through experience, acquisition of knowledge, evidence-based practice, technology development and changes in the health care delivery system. The standards of Nursing practice in rule is 217.11. The scope of practice is determined by advanced practice education in a role and specialty if applicable, legal implications such as Board rules, and scope of practice statements as published by national professional specialty and advanced practice nursing

Attending the Texas Nurses Association District 8 annual meeting was educational, remarkable, and inspirational. Meeting the new officers for the coming year and the recognition for outgoing officers had a sense of camaraderie, which envelops nursing. The legislative updates and highlights included a significant bill to APRN’s, House Bill 1415. Although left pending in committee, this bill will allow APRN’s full practice authority. TNA has partnered with coalitions to assist in the passing of this bill. While there has been opposition to this bill by physician based associations, the impact of the passage and implementation of this bill is beneficial to the state, medical community and most importantly, our patients.

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

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.

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 healthcare system in America is overhauled, advanced practice nurses are going to increasingly assume the role of primary care providers. Many states have kept up with the evolving expansion of

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