NRP/508: Health Policy And Role Of The Advanced Practice Nurse

Wk 2 – Summative Assessment: Current Legal and Regulatory Issues for Advanced Practice Registered Nurse.

Just a reminder to include in text citations as well as references. Anything referenced must also be cited within the text. Please also cite each table.

 Prepare a table in microsoft Word presentation (up to 20 slides) in which you

Present the following issues facing APRNs:

Describe the importance of the APRN scope of practice and how state-specific regulations impact scope of practice. 

Compare and contrast differences between full scope of practice and restricted scope of practice based on the state of licensure. (You may select 2 states to compare and contrast for reference.)

Explain the key legal, regulatory, and credentialing issues facing APRNs.

Explain regulatory barriers that continue to exist for APRNs, including where progress has been made and what remains to be done.

Describe concepts of professionalism as they pertain to the APRN.

Compare professionalism in the APRN role to professionalism in your current registered nurse (RN)role.

Cite references to support your assignment.

Format your assignment according to APA guidelines. Grammar and spell check your work. Review the rubric criteria before submitting your work. Work must have text citations and a reference slide.

Tracy, M. F., & O’Grady, E. T. (2018). Hamric & Hanson’s advanced practice nursing – e-book (6th ed.). Elsevier Health Sciences.  School book CHAPTERS: 7,8,11,15 & 22. Additional two other references making it a total of 4 to 5  references.

NRP/508: Health Policy and Role of the Advanced Practice Nurse

Importance of the APRN Scope of PracticeAdvanced practice registered nurses are healthcare providers with an expanded scope of practice beyond that of registered nurses. In this regard, APRNs are highly trained and educated professionals that can perform different roles in healthcare delivery, including managing chronic and acute illnesses, diagnosing conditions, preventative care, and prescribing medications (Tracy & O’Grady, 2018). The importance of the APRN scope of practice lies in the ability of Advanced Practice Nurse Practitioners to provide patient-centered and high-quality healthcare services that are cost-effective and accessible. Allowing APRNs to practice to the full extent of their training and education can help to fill important gaps in the healthcare system (Tracy & O’Grady, 2018). This is especially true in contemporary times, where the demand for healthcare services has continued to increase because of the aging population. The current number of positions across the U.S. can not be able to fill the demand for healthcare services, which increases the importance of APRNs practicing to the full extent of their training and education (Dillon & Gary, 2020). The scope of practice for APRNs is also important because they can be able to intervene in underserved communities where there is a significant shortage of primary care providers. Furthermore, the expansion of the APRN scope of practice has been shown to play a significant role in increasing patient satisfaction, improving patient outcomes, and reducing healthcare costs. APRNs are able to provide care that is more efficient across communities, contribute to better health outcomes in populations, and reduce the need for hospitalization and other costly medical interventions (Dillon & Gary, 2020).    
How State-Specific Regulations Impact the Scope Of PracticeState-specific regulations will have a significant impact on the scope of practice for APRNs. Each state in the U.S. has its own regulation and laws that govern the practice of nursing. Some States have regulations that are more permissive and allow APRNs to practice to the fullest extent of their training and education, while some states have restrictive regulations that limit the scope of practice for APRNs (DePriest et al., 2020). For example, in some states, APRNs are required to work under the supervision of a physician or to write collaboration protocols with such physicians, which can limit their ability to provide different healthcare services independently. The scope of practice regulations might also vary significantly depending on the type of APRN. For example, in some states, nurse practitioners might have a different scope of practice compared to certified nurse Midwives, nurse anesthetists, and certified registered nurses. State-specific regulations might therefore contribute to the ability of APRNs to provide needed healthcare services, especially in underserved areas that have nursing shortages (DePriest et al., 2020).  
Differences between Full Scope of Practice and Restricted Scope of Practice Based On State Of Licensure  The scope of practice for APRNs can vary between states. California and Florida have different scopes of practice. In California, APRNs have a full scope of practice, which means they are allowed to perform the full range of activities within their profession. This includes the ability to diagnose, treat, and prescribe medications, among other activities. For example, nurse practitioners in California have full authority to diagnose, order tests and prescribe medications. In contrast, Florida has a more restricted scope of practice for APRNs. For example, in Florida, nurse practitioners have limited prescribing authority and must have a collaborative agreement with a physician to prescribe certain medications (Poghosyan et al., 2021). This means that nurse practitioners in Florida are not allowed to prescribe all types of medications, and they are required to work with a supervising physician to provide care to their patients. Overall, the main difference between the full scope of practice in California and the restricted scope of practice in Florida is the level of autonomy and authority that APRNs have in their respective states. California allows its APRNs to practice to the full extent of their education and training, while Florida has more restrictions on certain activities and requires collaboration with supervising physicians (Poghosyan et al., 2021).  
Key Legal, Regulatory, and Credentialing Issues Facing APRNs  In contemporary times, they are key legal, regulatory, and credentialing issues that are facing APRNs, including state practice, acts, licensure and certification, prescriptive authority reimbursement, and collaborative agreements. Relating to state practice acts, every state has its own nurse practice act that defines the scope of practice for APRNs and nurses. Some States allow APRNs to practice independently, while others require APRNs to practice under the supervision of physicians (Moore et al., 2020). The discrepancy in the ability of APRNs to practice from one state to the other is a major issue facing APRNs. The issue of certification and licensure is also a major issue facing APRNs. Every state requires nurses to obtain licensure from their state board of nursing, while some may require obtaining certification from national certifying organizations such as the American Nurses Credentialing Center. Normally licensure and certification requirements vary state-by-state, which has a negative impact on APRNs who might want to move and practice in different states. Reimbursement is also a key regulatory issue affecting advanced practice registered nurses. In different states, some insurance companies refuse to reimburse APRNs for certain services or consistently reimburse them at lower rates than physicians (Moore et al., 2020).  
Regulatory Barriers That Continue To Exist For APRNs, Including Where Progress Has Been Made And What Remains To Be Done.  Regulatory barriers that exist for APRNs can limit their ability to provide high-quality, accessible healthcare to patients. These barriers can include restrictions on practice autonomy, limited prescriptive authority, and barriers to reimbursement for services. APRNs continue to face regulatory barriers, including the scope of practice restrictions. In some states, APRNs are required to work under the supervision of a physician, which can limit their ability to practice independently and provide timely care to patients. However, progress has been made in recent years to reduce these restrictions(Barton et al., 2020). For example, in 2022, New York became the latest state to grant full practice authority to nurse practitioners permanently, allowing them to practice independently without physician supervision. However, currently, only 25 states allow full practice authority for the APRN. Nursing organizations need to be involved in more advocacy for full practice authority for APRNs in the remaining states.  Another form of regulatory barrier that has continued to exist for nurses is prescriptive authority restrictions: Some states limit the types of medications that APRNs can prescribe or require them to have a collaborative agreement with a physician in order to prescribe certain medications (Barton et al., 2020). However, progress has been made in recent years to expand prescriptive authority for APRNs. For example, in 2021, Massachusetts passed legislation allowing nurse practitioners to prescribe medication without a collaborative agreement with a physician. Overall, progress has been made in recent years to reduce regulatory barriers for APRNs, but there is still work to be done to ensure that APRNs have the autonomy, prescriptive authority, and reimbursement they need to provide high-quality, accessible healthcare to patients. Professional nursing organizations need to be involved in advocacy efforts targeting the states that do not allow APRNs to practice to the full extent of their education and training (Barton et al., 2020).  
Concepts of Professionalism As They Pertain To the APRNProfessionalism is a crucial aspect of the Advanced Practice Registered Nurse (APRN) role. Professionalism refers to the set of behaviors, attitudes, and values that characterize a professional in their work. The key concepts of professionalism as they pertain to the APRN role include competence. APRNs must demonstrate a high level of competence in their practice. This means having the knowledge, skills, and ability to perform the duties of their role effectively and efficiently (Tracy & O’Grady, 2018). APRNs must also adhere to ethical principles in their practice. This includes respecting patient autonomy, maintaining confidentiality, and providing care that is consistent with professional standards. APRNs are also accountable for their actions and decisions in their practice. They must take responsibility for their performance and be willing to admit and learn from their mistakes (Tracy & O’Grady, 2018). APRNs are also required to engage in ongoing learning to maintain and enhance their professional competence. This includes keeping up to date with the latest research, technologies, and trends in their field. Finally, when it comes to advocacy, APRNs have a responsibility to advocate for their patients and their profession. This may involve participating in professional organizations, promoting policies that benefit patients, and educating the public about the role and importance of APRNs in healthcare (Tracy & O’Grady, 2018).
Professionalism in the APRN Role to Professionalism in Registered Nurse Role  While there are similarities between professionalism in the APRN and RN roles, there are also some important differences. Relating to the scope of practice, the APRN role has a broader scope of practice than the RN role, which includes diagnosing, treating, and managing illnesses. As a result, APRNs are expected to have a higher level of expertise and knowledge in their field. On the other hand, relating to educational requirements, APRNs must have a master’s degree, while RNs may have an associate’s or bachelor’s degree. This additional education and training contribute to the higher level of professionalism expected of APRNs. Finally, relating to autonomy, APRNs have more autonomy in their practice than RNs, which means they are responsible for making clinical decisions and developing care plans independently. This requires a higher level of professionalism and accountability (Tracy & O’Grady, 2018).

References

Barton, M. J., Cahill Hannum, B., Lindsey, M., & Towle, T. (2020). The path toward full practice authority: One state’s strategy. The Journal for Nurse Practitioners, 17(2). https://doi.org/10.1016/j.nurpra.2020.09.011

DePriest, K., D’Aoust, R., Samuel, L., Commodore-Mensah, Y., Hanson, G., & Slade, E. P. (2020). Nurse practitioners’ workforce outcomes under implementation of full practice authority. Nursing Outlook, 68(4). https://doi.org/10.1016/j.outlook.2020.05.008

Dillon, D., & Gary, F. (2020). Full Practice Authority for Nurse Practitioners. Nursing Administration Quarterly, 41(1), 86–93. https://doi.org/10.1097/naq.0000000000000210

Moore, C., Kabbe, A., Gibson, T. S., & Letvak, S. (2020). The Pursuit of Nurse Practitioner Practice Legislation: A Case Study. Policy, Politics, & Nursing Practice, 21(4), 222–232. https://doi.org/10.1177/1527154420957259

Poghosyan, L., Pulcini, J., Chan, G. K., Dunphy, L., Martsolf, G. R., Greco, K., Todd, B. A., Brown, S. C., Fitzgerald, M., McMenamin, A. L., & Solari-Twadell, P. A. (2021). State Responses to COVID-19: Potential Benefits of Continuing Full Practice Authority for Primary Care Nurse Practitioners. Nursing Outlook, 70(1). https://doi.org/10.1016/j.outlook.2021.07.012

Tracy, M. F., & O’Grady, E. T. (2018). Hamric & Hanson’s advanced practice nursing – e-book

            (6th ed.). Elsevier Health Sciences. 

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