This article discusses the limitations in scope-of-practice caused by state regulation of health professions. It also stresses the importance of allowing APRNs to practice within their full-scope as supported by various research and defined by national regulating organizations in order to improve primary care.
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 The author explains the primary reasons for states retaining restrictions on APRN practice are outdated and include lack of awareness of the current scope of practice of APRNs and organized medicine's persistent opposition to expanding the authority of other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.
This article describes past and current barriers to APRN prescribing abilities in the state of Georgia. While legislation has been passed in the state to allow APRN's to prescribe medications to their patients under a collaborating physician, Georgia remains one of the most restrictive states for APRN prescribing. A descriptive study was conducted to analyze the efficacy and safety of APRN prescribing and found that out of approximately 8000 prescriptions written by APRNs, only 0.003% of those were changed by the supervising physician. The study recommended that more data be collected to support the argument for full-prescriptive authority for APRNs in Georgia.
This article looks at how legislative changes in prescriptive authority for APRNs in Georgia has actually panned out in practice and what barriers APRNs are facing in utilizing their prescriptive authority.
This article discusses the benefits and pit-falls to autonomous primary care Nurse practitioner practice and advocates for cost effective improvements to our healthcare system. The research suggests that Nurse practitioners who practice independently report greater job satisfaction, improved patient outcomes and provide low cost, high quality services that are equal or superior to primary care physicians. Unfortunately, current healthcare reimbursement models, policies and reluctant physicians have created barriers to autonomous NP practices. The author suggests that autonomous practice requires further research across the U.S, the establishment of a well-defined model and the evaluation of patient outcomes, in order to determine whether the present day Nurse Practitioner requires future collaborative agreements with physicians, in order to provide quality patient care across the United States.
Diverse regulatory criteria, such as variable accreditation standards, disparate certification and licensing requirements, inconsistent population foci, and scopes of practice, represent barriers to optimized APRN function within today's complex healthcare system and, ultimately, reduced access to safe, quality care for patients. The Consensus Model for APRN Regulation promises to unify APRN education, practice, and licensure, promoting greater mobility among nursing professionals. Elimination of inconsistencies in APRN licensure, education, certification, and accreditation requirements will promote greater value and mobility for the APRN within the healthcare system.
Rounds, L. R., Zych, J. J. and Mallary, L. L. (2012), The consensus model for regulation of APRNs: Implications for nurse practitioners. Journal of the American Academy of Nurse Practitioners. doi:10.1111/j.1745-7599.2012.00812.x
This article explores how restrictions on CNM scope of practice affect health outcomes. Scope of practice laws were found to be neither helpful nor harmful regarding health outcomes. However, states without scope of practice barriers for CNMs had lower rates of induced labor and cesarean deliveries.