The purpose of this review of literature article was to create a conceptual framework model of practice recommendations and interventions that can be used to acknowledge the benefit of expanding nurse practitioner scope of practice (SOP); develop a uniform nationwide consensus APRN SOP; and reveal evidence that shows that poor patient healthcare outcomes can occur as a result of restricted NP scope of practice due to barriers created by either physician-related, political, and/or organizational opposition. According to Poghosyan, Boyd & Clarke (2015) over a 4-month period articles were used to build the model. Policy papers, research studies, including original research and reviews, and reports focused on nursing workforce in the United
Texas is home to nearly 10,000 nurse practitioners. Nurse practitioners (NPs) in Texas do not have as many freedoms as NP 's in many other states. In fact, Texas falls at the lower end of the spectrum regarding the freedoms it offers nurse practitioners. House Bill 1885 would grant full practice authority in Texas to all advanced practice registered nurses (APRNs), including nurse practitioners (NPs). It would authorize APRNs to evaluate and diagnose patients; order and interpret diagnostic tests; and initiate and manage treatments; prescribing of medications, these are currently job descriptions of APRNs and NPs that they are already doing, however, it would move these items under the exclusive licensure authority of the Texas Board of Nursing.
One similarity between NPs, other APNs and PAs is that, they all play a very important role in health care and patient centered approach of care is their objective. Also, their practice is based upon their education, training and certification in collaboration and under supervision of physicians. Another similarity is that, their scope of practice face limitations and restrictions in practicing be it state base or nationally. State laws and regulations act as barriers towards the broadening of PAs professional competencies same as NPs face licensure and practice laws that prevent full extent of their education practice. NP practice requires supervision, delegation, or team-management by an outside health discipline in order to provide
Jessica, I agree with you 100%. The differences and variation in the ANP scope of practice among the nation, does not allow for others especially legislators, to have a clear view of the ANP nurse and what it can be accomplish it all the restrictions and barriers were eliminated. It will also change the public perception and attitudes towards nurse practitioners. I firmly believe that NPs have not only the power, but the ability to improve and make sustaintials changes to our health care system, Excellent
In Arizona, NP’s do not have to work with a physician, but can manage patients independently (Buppert, 2015). This author’s understanding of NP’s scope of practice was changed. It is confusing to try to learn
From the research, it is believed by the author, that since the licensing is done at the state level, this is where changes in America should be implemented. APNs need lobbyists to advocate for the changes needed. It appears that in the states where there APNs have restricted practices, it is due to lobbying by the state’s medical board. The legislators should be presented with the facts, APNs provide safe and cost effective care to the patients. Citizens should get involved and write letters to make the legislators aware of the problem.
As we have been noted the role and the scope of practice of the nurse practitioners in the healthcare system are unmeasurable. The nurse practitioners (NPs) play a tremendous role in providing healthcare to the people in the United States. Their presence has been recognized in developing the health care industry not only in the US but also globally. Despite the role that the NPs have played into the healthcare system, they still encounter some challenges that can impact their practice. One of these challenges is the NP autonomy of practice.
Role of Family Nurse Practitioners: Case Study The shortage of primary care physicians has been a problem in health care system and will continue to the next decade due to increasing of aging population. According to National Governors Association (NAG) (2012), the growth of the aging population combined with the initiative of the Affordable Care Act, the problem of primary care providers shortage is worsening. Nurse Practitioners (NPs) are educated and prepared to perform primary care services as physicians do. More importantly, studies showed that NPs’ role as primary care providers achieve equal or higher patient satisfaction rates (Evangelista et al., 2011, Albers-Heitner et al., 2013).
Outcomes demonstrated that patient access to care improved and there was high quality of care provided. Edmunds, M. (1978). Evaluation of nurse practitioner effectiveness: An overview of the literature. Evaluation and the Health Professions. 1, 69-82 (E, A, I P/A) This article provides an overview of published literature that focuses on the effectiveness of the NP.
Decision makers will need to determine how to best utilize nurses, technicians, and other professionals to close the gap in providing services to patients. Nurses require less time to train, are less expensive to train, cost less to employ, and can increase the efficiency and productivity of physicians who provide care to patients. The increase in the use of health care services as well as the increase in the number of venues where health care is provided has also increased the job opportunities for nurses and other members of the healthcare workforce. The demand for primary care services has stimulated the training of nurse practitioners, physician assistants, and certified nurse
The nursing profession plays a vital role at the policy table in implementing full practice autonomy for Nurse Practitioners. Nurse Practitioners are contributing experts of the health care system. They have the education and skills needed to be a resource and partake in the policy process and political implementation. This particular policy development will require not just one nursing representative, but many, to push for and symbolize the dire need of full practice autonomy for Nurse Practitioners. In fact, the National Council of State Boards of Nursing [NCSBN] (2017) has formed the Advanced Practice Registered Nurse (APRN) Consensus Model, which streamlines the education, regulation, licensure, accreditation, and certification across the nation.
Despite accepting advanced roles and responsibilities APRNs have often encountered various barriers in the delivery of effective health care based on the variability in the legislative requirements endorsed by various states. To overcome these barriers and improve the delivery of healthcare the Consensus Model for APRNs has been endorsed by 41 various nursing organizations focusing on defining the roles, population foci and implementation strategies across the nation (American Nurses Association [ANA], 2017). Creating a standard expectation regarding the practice of APRNs will help to foster more consistent, quality education APRN programs nationwide (Rounds, Zych, & Mallary,
With the ongoing healthcare demands and shortages, the appropriate role and responsibilities of the advanced practice registered nurse (APRN) will continue to be a controversial debate. There were many points addressed in your post that I agree and don’t agree with. It is most certainly not arguable that physicians do endure a longer, more intense education. I personally believe their role as a hospitalist is valuable and should never be discredited for their knowledge and expertise. However, I also believe that they are doing their patients a disservice if they are being overworked due to provider shortages.
The Affordable Care Act has shifted focus on health and wellness of patient populations urging hospitals to do a community needs assessment and come up with a strategy to address these needs. Hospitals most often partner with community and professional organizations to address the health need (Stempniak, 2014). This is an example of how the four spheres are all interrelated. Nurses are at the heart of this movement, providing the necessary skills, experience and expertise to address the needs of the population being served (Shamian,
LPN Scope of Practice Are you considering becoming an LPN? LPN stands for Licensed Practical Nurse. The nursing field can be a challenging, but rewarding field to enter into. Before one starts a career as an LPN, there are six questions and pieces of information that needs to be addressed in order to fully understand the role of the LPN.
In the clinical setting, the nurses’ expertise can be used to make clinical assessments and recommendations for routine care at a lower cost than a physician visit. This would increase the number of patients seen and increase the quality of the care provided. The advance practice nurse would be able to hone in on preventative measures and increase patient education. The advance practice nurse can also make recommendations about practice changes needed to facilitate better health outcomes through the use of evidence-based practice. Nursing leaders are aware of how important nursing science is to provide needed evidence to transform practice, even though, finding the time and resources to support any research activity is often challenging (Stone, 2017).