The Importance Of Attending The Texas Nurses Association

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

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.

The Texas Nurses Association (TNA) District one meeting for the El Paso area, took place on September 20, 2016 at 1845. The President of District one, Paula Meagher was unable to attend the meeting as she was ill. She did however provide us with a list of the current Advanced Practice Registered Nurse (APRN) issues that TNA is engaged in. The issue that really caught my attention was Texas Occupations Code, section 157.011 (b-1) which deals with APRN restrictions on writing prescriptions for Schedule two controlled substances. The TNA website states:

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.

The Full Practice Authority for APRNs (HB 1415/ SB 681) deals with the legislation which will permit Nurse Practitioners (NPs) to practice to the complete magnitude of their education and training. It will also eliminate expensive and difficult regulatory requirements like having contracted delegation arrangements with physicians, and will place NPs under the select supervisory authority of the Texas Board of Nursing (BON). Bill HB 1415 was filed on 02/01/2017 and was “Left pending in committee” as of 04/25/2017. Bill HB 681 was filed on 01/31/2017 and was “Referred to Health and Human Services” as of

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%.

Advanced practice nurses are held responsible for assessing, diagnosing, treating, and educating patients. How effective the APN utilizes their resources is measured through the economic status within their facility (Manion & Odiaga, 2014). By being aware of supply and demand within the organization, the APN can accommodate to the needs of the organization and the clients. For instance, the APN discovers less patients are seen on Wednesday and adjusts staffing to be more economically sound by scheduling less employees to work. According to Manion and Odiaga (2014), APN’s have made a huge impact on cost to medical insurances. The cost adjustments come from the APN utilizing lower cost treatments and from providing better education to the patient and family.

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).

Expanding the scope of practice for APRN remains a controversial issue in Missouri, where I currently reside. Expanding the scope of practice also remains an issue for the health care field nationwide. Stakeholders that I can identify include The American Association of Colleges of Nursing (AACN), The National Organization of Nurse Practitioner Faculties (NONPF), APRN Consensus Work Group, National Council State Boards of Nursing (NCSBN), APRN Advisory Committee, along with other health care organizations, health care educators, and health care providers nationwide (IOM Report., n.d., p. 133). Focusing in on Missouri, the stakeholders for this endeavor include health care

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).

The APRN is uniquely skilled and trained to meet this growing need, and policy should focus on expanding the role and autonomy of APRNs, and increasing funding, and possibly diminishing the reimbursement gap in order to attract and sustain a greater number of providers in underserved areas and provide them with the financial resources to remain viable, independent providers. Nurse Practitioners are more likely to work in primary care and in rural areas, particularly, remote rural areas,which are characteristically similar to underserved areas, than are

The American Nurses Association (ANA) is a full-service professional organization that symbolizes the interests of registered nurses through its constituent and state nurses associations. The ANA implements the nursing profession by raising high standards of nursing practice, honoring the rights of nurses in the work field, promoting a positive and realistic view of nursing, and by pushing the Congress and regulatory agencies on health care issues affecting nurses and the public. Their mission statement is, “Nurses advancing our profession to improve health for all.” Some of ANA’s main focuses are reformation of the health care system so that it delivers primary health care in the communities, growing roles for

Advanced practice nurses (APRNs) are increasingly playing a crucial role in the healthcare delivery system as they positively impact the accessibility of primary and specialty care in both rural and urban Minnesota. Fortunately for advanced practice nurses, Minnesota continues to answer the call of the Institute of Medicine (IOM) for states’ adaptation of laws and policies that would promote advanced practice nurse practicing at their fullest degree of their education and training ( IOM, 2010). The scope of practice for APRNs in Minnesota and its governance will be discussed in this paper

The issue that can create an impact in the practice of the APRNs it is not uniform. One of the main problems in the nursing career is the different type of practice from each state. According to Timmons (2016), each state has their own rules and their regulations for the APRNs. This is the biggest issues in providing the real care to our patients. According to Yee, Boukus, Cross, and Samuel (2013), the clinical role of NPs is governed largely by state scope-of-practice (SOP) laws that determine the range of services NPs can provide and the extent to which they can practice independently. The curriculum and the training are kind of the same almost in every state; nevertheless, the scope of practice is controversial. To benefit the patient’s