The Importance Of Aprn's Scope Of Practice

Therefore, there is great need to have all stakeholders at both national and state levels to address these emerging challenges. This will help to achieve the triple objective of healthcare, which is to provide better care, ensuring better health, and reducing the costs of accessing healthcare (Hain, & Fleck, 2014). Among the barriers the authors point out include practice and licensure laws in various states, payer policies, and other physician related issues among others. Licensure and practice laws for the profession vary across the states. Nonetheless, the challenge lays in the way these laws and practices relate with the full practice authority governing practice and licensure (Hain, & Fleck, 2014). A big proportion of the country has only adopted certain parts of the legal requirements, creating a significant barrier for NP practice. The other challenge is the perception among some groups of physicians that NPs cannot provide quality and safe patient care at the same level as the physicians (Hain, & Fleck, 2014). This perception emanates from the notion that NPs do not receive a rigorous and longer training and education unlike other physicians. This hinders effective performance of nurse practitioners and greatly affects the work of professionals such as family nurse

Bahadori and Fitzpatrick conducted a study regarding the actual level of autonomy of the APRNs in primary care settings. They compared clinical outcomes for patients assigned to either APRNs or physicians and found there was no significant differences in reported health status between patients treated by NPs or by the physicians. Also Bahadori and Fitzpatrick (2009) stated within their report although the APRNs had more restrictions regarding their professional authority and struggle with maximal autonomy they recommend APRNs have more autonomy and decision-making authority to allow them to work as competent professionals, and improve patient care outcomes.

Many studies exist which highlight the benefits of APRN full practice authority. One study from Duke University, by Conover and Richard (2015), contained this strong statement regarding APRN practice, “studies vary in their methodological rigor, each has concluded that APRN practice outcomes are equivalent or better to those of physicians” (pg. 4). The study goes on to say that three cost effective benefits to full practice authority APRNs are: lower training costs, lower compensation and limited use of expensive resources or procedures. The study also discusses how full practice laws would increase access to care by decreasing primary care provider shortages (pg. 6).

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.

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.

Advanced practice nurse practitioners (APRNs) have been attempting for many years to eliminate barriers that prevent full practice authority nationwide. Each state has its own licensure and regulates APRN practice roles. APRNs benefit health care by addressing two pertinent needs: the lack of available physicians; and, the increase in patient comorbidities (Gray, 2016). Florida is about to experience a shortage of medical practitioners. According to the Physician Workforce Annual Report of 2014, statistics state 13.4% of medical providers are expected to retire within the following five years after 2014 due to an increase

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.

According to reports found on the web page MEDPAGETODAY (2014) there has been an increase in the independent practice for advanced practice registered nurses (APRN). The article quotes data from the American Association of Nurse Practitioners (AANP) which reports 17 states and the District of Columbia allowing “full practice” with this meaning the APRN evaluates, diagnoses, orders testing, prescribes medication and initiates and manages treatments. 21 states require “collaborative agreement” with a physician and 12 requiring supervision of a physician. Collaborative agreement scope of practice varies by state and institution of employment.

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,

This is a very interesting post regarding the IOM report for advanced practice nurses in the future. You state “that more autonomy with APRNs will be very beneficial.” One of the key recommendations of the IOM report is for “nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression” (IOM, 2011). By allowing APRNs to have more autonomy, there will a higher chance of the population to have more access to the health care system. There is a high rate of physician shortage and by allowing the APRNs to have more autonomy, this will help bridge the gap of available providers for patient care. The APRNs can work collaboratively with the physician and other

APRNs are an integral part of the health care system, yet are treated unfairly in

APRNs assume responsibility that are often similar to the those of a physician, often time working side by side or collaborate as a team. APRNs have a significant role in promoting health and providing care to patients in numerous settings.

APRN should have the ability to practice to their level of education. APRNs provide safe, quality, and cost effective primary care and to meet the growing needs for patients, APRNs must have the ability to prescribe controlled substances across the nation.