Group items tagged

In this article, author Lugo discusses the findings of her study relating limits on full practice authority for APRNs to issues of gender equality. She investigated the link between state support of the Equal Rights Amendment (ERA) and laws in these states allowing APRNs full scope of practice and prescribing rights. Her study showed that states that have historically and currently supported the ERA in fact allow greater APRN scope of practice, and thus she draws conclusions about attitudes towards women's equality and the regulation of advanced practice nursing, which remains to be a woman-dominated profession.

In this May 2016 article published in the Online Journal of Issues in Nursing, Dr. Nancy Rudner Lugo argues that advanced practicing nursing viewed through a gendered perspective due to nursing's history as a predominantly female profession; because of this, APRNS in states that are less accepting of women's equality have a more narrow scope of practice. There is not currently a national-level evidence based method used to determine APRN scope, and is instead decided at the state level. The author seeks to explain the cause of the discrepancy between differing APRN scopes of practice in different states by comparing the APRN scope of practice between states that did and did not vote to pass the Equal Right Amendment, positing that states with cultural attitudes that are more equitable between genders reflect this at the legislative level, thus explaining the wider or full practice authority given to APRNs in these states. In conclusion, Lugo advocates for increasing the number of women in legislative positions, forming relationships between women's equality organizations and groups working towards expanded health care access, and emphasizing the skills and competency of APRNs in achieving positive patient health outcomes.

This article discusses the barriers to NP practice with the current healthcare reform by addressing the shortage of primary care providers and the limitations of APRN practice. Barriers that were emphasized include state practice and licensure, physician related issues, education, and role perception. This article stresses that an APRN should be able to practice to the fullest extent of their training.

This is an excellent overview of common barriers to APRN practice that effect the Triple Aim for healthcare: better care (individuals), better health (populations), and lower cost.

This article first provides a brief history on APRNs. It also discusses barriers to the APRN scope of practice.

The purpose of this hermeneutic phenomenology (van Manen, 1990) was to gain insight into the meaning and lived experience of nurse practitioners (NP) with at least one year of work experience regarding their initial transition from new graduate to hospital-based practitioner. This study provided information regarding NP hospital-based transition experience that had not been revealed in the nursing literature. The meaning of transitioning into hospital-based practice was discovered through analysis of nurse practitioner letters and interviews in this phenomenological study. Six themes emerged from this research including: Going from expert RN to novice NP; system integration; "Don't Give Up"; Learning "On the Fly"; They Don't Understand my NP Role; and Succeeding Through Collaboration.   Master's prepared, board-certified NPs in North Carolina (NC) with between one and three years of NP practice experience in a hospital setting comprised the population of interest for this study. Twelve participants were purposefully sampled from nine hospitals in NC. Individual, voice-recorded, in-depth, open-ended telephone interviews were conducted with each participant.   The majority of the participants indicated a timeframe that ranged from six to 18 months regarding how long it took them to feel more comfortable in their NP role, the lack of comfort was most intense during the first nine months of practice. Participants confronted multiple obstacles and challenges as new NPs. These challenges included navigating and negotiating a new health care provider role; becoming integrated into a hospital system in what was a new role for them and sometimes for the system; learning how to function effectively as a NP while simultaneously working to re-establish themselves as proficient clinicians with a newly expanded practice scope; building key relationships; and educating physicians, hospital leaders, clinical staff, patients, and families about the NP

This 2015 article, written in the Journal of Pediatric Health Care, discusses the critical importance of intervening and advocating for APRNs to have full practice authority as opposed to the current varying state-by-state practice laws. The author explains the primary reasons for states retaining restrictions on APRN practice are outdated and include lack of awareness of the current scope of practice of APRNs and organized medicine's persistent opposition to expanding the authority of other providers to practice and receive the full amount for their rendered services. The author supports her argument by including the IOM Committee's view; removing APRN practice restrictions would assist in addressing health care access, high-quality care, and an overall healthier population.

Summary of key points and link to FTC paper (March 2014) addressing regulation of APRN scope of practice

This is an interesting article that conducted a lit review to see how expanding the scope of practice for APRNs would affect health care delivery and costs in Ohio. Although it is specific to Ohio, the lit review they did highlights many benefits to full practice authority that could be generalized to any state.

This 2016 article provides a brief overview of progress made in expanding APRN scope of practice to utilize a practitioner's education to the fullest extent. Although the removal of barriers to scope of practice is progressing, there is still much work ahead. This article recommends that to meet our goals, we must encourage other HCPs, policy makers, etc. that investing in our profession, i.e. becoming stakeholders, is a necessity to optimize health care practice.

This article is about the scope of practice of midwives and childbirth outcomes. It discusses the relationship between autonomous practice and better birth outcomes. The article suggests there should be future policies to expand the access to midwifery services.

This article discusses the difficulties APRNs experience while attempting to expand their scope of practice. It explores arguments between nurse practitioners and physicians on how APRNs will contribute to the shortage of primary care providers.

This is an excellent overview of NP history and practice changes written by Arlene W. Keeling PhD, RN, FAAN. It includes a historical narrative for the NP role that includes key figures (Lillian Wald, Mary Breckenridge, Loretta Ford) with seminal legislation, challenges to the practice, and future implications.

This article describes entry-level competencies for NPs practicing in emergency care - it was the first to define these competencies which is key since the roles of APRNs have expanded. A Nurse Practitioner (NP) Validation Work Team was formed and a Delphi study was conducted to verify and gain consensus on professional and clinical competencies for NPs in emergency care.

This is a nice synopsis of key moments in history that have triggered the growth and development of the NP role in the US.

This article discusses the impact of differing scope of practice legislations on healthcare delivery and utilization. Overall, the study found that states with expanded practice fro NPs experienced increased healthcare utilization by patients and improved healthcare delivery.

The role of APRNs continues to expand when current gaps in patient care management and outcomes are identified. Central Arkansas Veteran Healthcare System created the role of Abnormal Radiology Findings APRN with the aim of improving patient outcomes by decreasing the length of time between abnormal radiology findings and decrease of care for our veterans. During the year of research since the advent of this position, the days until decision dropped on average from 38 to 7 demonstrating the efficacy of the role and the ways APRN are well placed within the health care system to provide patient-centered care.