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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 The author explains the primary reasons for states retaining restrictions on APRN practice are outdated and include lack of awareness of the current scope of practice of APRNs and organized medicine's persistent opposition to expanding the authority of other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.

BACKGROUND: The trauma service experienced preventable delays caused by an Accreditation Council for Graduate Medical Education work restrictions and a 16% increase in patient census. Furthermore, nurses needed a consistently accessible provider for the coordination of care. We hypothesized that using experienced acute care nurse practitioners (ACNPs) on the stepdown unit would improve throughput and decrease length of stay (LOS) and hospital charges. Moreover, we hypothesized that adding ACNPs would improve staff satisfaction. On December 1, 2011, the Vanderbilt University Medical Center Division of Trauma reassigned ACNPs to the stepdown area 5 days a week for a pilot program. METHODS: LOS data from December 1, 2011 through December 1, 2012 was compared with data from the same months from the previous two years and estimated hospital charges and patient days were extrapolated. Physician and nursing surveys were performed. Data from 2010 (n = 2,559) and 2011 (n= 2,671) were averaged and the mean LOS for the entire trauma service was 7.2 days. After adding an experienced ACNP, the average LOS decreased to 6.4 days, a 0.8 day reduction. Per patient, there was a $ 9,111.50 savings in hospital charges, for a reduction of $27.8 million dollars in hospital charges over the 12 month pilot program. RESULTS: A confidential survey administered to attending physicians showed that 100% agreed that a nurse practitioner in the stepdown area was beneficial and helped throughput. Dayshift nurses were surveyed, and 100% agreed or strongly agreed that the ACNPs were knowledgeable about the patient's plan of care, experienced in the care of trauma patients, and improved patient care overall. CONCLUSION: The addition of experienced ACNPs resulted in the decrease of overall trauma service LOS, saving almost $9 million in hospital charges

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

The Online Journal of Issues in Nursing ANA Home About OJIN FAQs Author Guidelines Featured Authors Editorial Staff Board Contact Us Site Map What's New New Postings Journal Recognition OJIN News Journal Topics Care Coordination Cornerstone Documents in Healthcare Emotional Health: Strategies for Nurses Healthy Nurses: Perspectives on Caring for Ourselves APRN Roles Opportunities and Challenges Societal Violence: What is Our Response? Healthcare and Quality: Perspectives from Nursing Delivering Nursing Care: Current Factors to Consider Patient and Visitor Violence More... Columns Cochrane Review Briefs Informatics Legislative Ethics Information Resources Keynotes of Note Table of Contents Vol 21 2016 Vol 20 2015 Vol 19 2014 Vol 18 2013 Vol 17 2012 Vol 16 - 2011 Vol 15 - 2010 Vol 14 - 2009 Vol. 13 - 2008 More... Letters to the Editor Continuing Ed ANA Home Login » ANA OJIN About Logo OJIN is a peer-reviewed, online publication that addresses current topics affecting nursing practice, research, education, and the wider health care sector. Find Out More... Announcements Permission to Reprint OJIN Articles Planning a conference or class? Call for OJIN Manuscripts on a previous topics... Benefit for Members Members have access to current topic Send a Letter to the Editor on any OJIN column or article... More... Letter to the Editor Since the introduction of the Health Insurance Portability and Accountability Act (HIPAA) in 1996, nurses have become the frontline

This observational study utilizes census data and geographic distribution of providers to illustrate current trends in distribution of providers, relative to uninsured patients and areas of limited access. Further, they discuss the policy changes aimed at bolstering access to primary care providers, specifically NP's, as a short term solution to a deficit in primary care providers. Additionally, the researchers explore distribution of APRNs, relative to scope of practice restrictiveness.

Understanding Medicare Supplement Plans is essential for those approaching Medicare eligibility. Medicare Nationwide places significant emphasis on education, providing an array of resources to assist beneficiaries in comprehending the intricacies of these plans. Through detailed brochures, informative articles, and interactive online platforms, Medicare Nationwide ensures individuals have access to comprehensive knowledge about Medicare Supplement options.

With increasing interaction between governing bodies and cultures this article explores the APRN scope of practice on a global scale. It also examines access to care as a global issue postulating the need to standardize the scope of the Nurse Practitioner.

This is a great systematic review that delves into state by state regulations on scope of practice for APRNs and how restrictive practice ultimately reduces access to healthcare particularly in rural populations. The impact of the ACA and shortage of PCPs to meet this demand is also explored. Enjoy!

This article describes the results of a survey conducted of nurse leaders in Latin America and the Caribbean about their perception and knowledge of advance practice nursing. The results show that the majority of nurse leaders recognize a need for APRNS in order to create better access to care, however, the nursing education and legislation in the majority of the countries does not support APRN practices. This is an interesting introduction of APRNs in Latin America and the Caribbean for anyone who has interest of working in these areas.

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.

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This is a Canadian public ad campaign, defining what nurse practitioners are, what they can do, and how they can help improve quality of and access to care. It is well-made. I feel that similar campaigns in the U.S. Would help to increase public knowledge and understanding of our profession.

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.

Nurse practice laws and regulations are specific to each state. Check out AANP's quick reference guide below for licensure and regulatory requirements, as well as practice environment details, for all 50 states and the U.S. Territories. Download State Regulatory Map Members get more! Log in for access to State Policy Fact Sheets.

This systematic literature search article is in two parts: deinition and application of telehealth for APRNs and describes an approach for telehealth training for APRNs. APRNs can utilize telehealth technologies to improve patient access to care with cost-saving measures, collaborate with other disciplines, and remote patient monitoring. Students need to become competent and skilled with the evolving technologies and regulations to improve patient outcomes with limited resources to healthcare.