Advanced Practice Registered Nurses Case Study

The Arizona Campaign for Action Coalition is formed of a comprehensive team of health care professionals and diverse Arizona stakeholders. Arizona has chosen multiple areas to focus on for implementation however this paper will discuss two. The first initiative for discussion will be that of the removal of the scope-of-practice barriers that face advance practice nurses in Arizona. The report states that Arizona has one of the most liberal practice scopes in The United States however nurse practitioners often have difficulty with receiving credentialing by the Arizona version of Medicaid known as AHCCCS (Randolph, Hrabe,

In the Texas, state law prohibits Advanced Practice Registered Nurses (APRNs) including nurse practitioners (NPs) from practicing to the full extent of their education and clinical ability. Currently, Texas law requires than an APRN receive approval from an individual physician prior to engaging in the practice of advanced nursing. This type of complex regulatory scheme is outdated and restricts patients’ access to care, creates geographic disparities in services, and unnecessarily increases health care costs. For example, current law requires APRNs to meet periodically face-to-face with a supervising physician; with few physicians choosing to practice in rural areas, many APRNs who are willing to work in rural areas are essentially forbidden from delivering care to these underserved areas.

This paper explores the perception of clinical practitioners to the change in policy related to the advanced practice registered nurse (APRN) full practice authority. The author conducts a one-on-one, open-ended interview of 5 nurse practitioners and 5 physicians licensed to practice in Maryland on their perceptions of the recent passage of the Advanced Practice Registered Nurse Full Practice Authority. A literature review was conducted in a policy report by the professional nursing organization, and discussion within the peer-reviewed article supported an overview, regulatory differences among 50 states, including the District of Columbia. Their policy implication for enhancing APRNs role nationally. The author discusses a critical component

The Full Practice Authority for APRNs (HB 1415/ SB 681) deals with the legislation which will permit Nurse Practitioners (NPs) to practice to the complete magnitude of their education and training. It will also eliminate expensive and difficult regulatory requirements like having contracted delegation arrangements with physicians, and will place NPs under the select supervisory authority of the Texas Board of Nursing (BON). Bill HB 1415 was filed on 02/01/2017 and was “Left pending in committee” as of 04/25/2017. Bill HB 681 was filed on 01/31/2017 and was “Referred to Health and Human Services” as of

There have been concerns regarding the identification and credentialing of advanced practiced registered nurses (APRNs). A APRN is a registered nurse who has successfully completed an accredited graduate-level education program, in which the individual is well prepared and successfully passed the nationwide certification examination (APRN Consensus Model, 2008). However, there are still debating issues of who would fall under the APRN category. The National Council of State Boards of Nursing (NCSBN) has identified four APRNs who are deem fit to be called ARPNs; however, only two will be named. They would be certified registered nurse anesthetists (CRNAs) and certified nurse practitioners (CNPs). Whereas, the nurse informatics and the nurse administrations are not considered to be APRNs; although, they are still license registered nurses but they do not provide direct patient care and are not required to take the national certification examination (ARPN Consensus Model, 2008).

The scope of practice for APRNs in Texas are quite dynamic in range. It evolves through experience, acquisition of knowledge, evidence-based practice, technology development and changes in the health care delivery system. The standards of Nursing practice in rule is 217.11. The scope of practice is determined by advanced practice education in a role and specialty if applicable, legal implications such as Board rules, and scope of practice statements as published by national professional specialty and advanced practice nursing

The Texas Nurses Association is a strong proponent of permitting APRN’s to practice with full authority using their clinical skills and education to their fullest potential (Cates, 2017, p. 2)l. The TNA is a member of the APRN Alliance, which encompasses four statewide associations (Cates, 2017, p. 2). The APRN Alliance joined forces with the Coalition for Health Care Access (CHCA). This coalition is comprised of “over 20 business, consumer-advocacy, and health care stakeholder groups” (Cusack, 2017, p. 2). Currently, APRN’s barriers include expenses associated with partnering physicians (Holmes & Kinsey-Weathers, 2016). Granting APRN’s full practice authority would results in a monetary loss to these physicians. The AMA and AAFP oppose the passing of HB 1415 (Hooker & Muchow, 2015, p. 89). The pushback from these organizations stands regardless of strong evidence of the positive outcomes with allowing APRN’s full practice authority.

In recent years, APRNs have been very vocal through many nursing coalitions and associations. The voices of all ARNPs seeking full practice authority has been heard with the proposed bills. The Florida Panhandle Nurse Practitioner Coalition (FRNPC), has given information to all ARNPs to keep ahead in legislative issues. A white paper published by the American College of Physicians have been shared to all Floridian ARNPs through the

Advanced Practice nursing (APN) is considered the usage of a broader scope of constructive, logical and research-based expertise related to the health and well-being of patients, within a varying disciplines (DeNisco & Barker, 2013). What is the future position of APNs in the progression of our healthcare system? What role will this writer assume, educator, practitioner, population health coach, or all three? The use of theory, primarily Sister Callista Roy’s Adaptation Model, and EBP give this writer a firm foundation to develop and modify her own practice framework.

According to the American Association of Colleges of Nursing (2015) the traditional roles of the advanced practice nurses include nurse practitioners, clinical nurse specialists, nurse midwives and nurse anesthetists. Therefore, the impact of the research on the practice of the preparation of DNP nurse educator requires education in evidence-based practice, quality improvement, leadership, policy advocacy, informatics, and systems theory. Furthermore, transitioning to the DNP as a nurse educator does not change the current scope of practice of the Advance Practice Registered Nurses (APRNs) for their current roles. The transition of the DNP better prepares APRNs by utilizing new models of the care delivery system and growing complexity of health

Some practical obstacles that hinder the delivery of proficient and economical services include differences in language, cultural and knowledge of health issues. However, the prudent advanced practice nurse (APN) considers these obstacles to communication when providing patient-centered care. Nevertheless, when language barriers are not addressed, the provision of quality care to patient and families are undermined, which then transcends to both economic and ethical dilemmas. According to the centers for disease control and prevention (CDC, 2016), the gateway to healthcare is often hindered to a great extent by the lack of the ability to communicate medical necessities due to language barrier. In any clinical setting, efficient patient communication is essential in the delivery and accessibility of quality care and safety.

The role of Advanced Practice Nursing continues to change and develop. In the past few years, state legislatures authorized Nurse Practitioners to receive direct payment and write prescriptions. These changes have increased the Nurse Practitioner 's independence. This has resulted in Nurse Practitioners establishing independent practices that provide the same health care of primary care physicians, or they can also work in practices where the Nurse Practitioner and the doctor care for patients together (Spitzer 1974). "Many states are increasing the level of authority and reimbursement for Nurse Practitioners. Most private insurance companies and health maintenance organizations cover the services of Nurse Practitioners (Pearson 1993). Some blame the nursing shortage partly on Advanced Practice Fields. Registered Nurses are obtaining their master 's degree in order to earn more money and have more opportunities.

Among older adults aged 65 years and older are found to have difficulty in reading and to comprehend discharge instructions. This has been found to be a concern regarding continuing care and re-admission concerns throughout urban and rural hospitals. Does the integration of Advanced Practice Nurse (APN) guiding discharge education, along with a follow-up contact with the patient after discharge effect compliance and readmission rates, more than not having an APN guiding discharge teaching to help decrease readmission rates?

Advance Practice Registered Nurse (APRN) is a broad term that is used to define the masters prepared nurse that participates directly in patient care. This definition includes four different facets of nursing: certified nurse-midwives, nurse anesthetists, clinical nurse specialists and nurse practitioners (Joel, 2009). Of these four professions that are included in the APRN definition, Western Carolina University offers two: nurse anesthetist and nurse practitioner. Nurse educator and nurse leader, which are also offered at Western Carolina University, are not currently included in this definition.

As the young and rapidly-aging population continues to increase, the demands of primary, acute and chronic disease management will also increase. As a result, more health care professionals who provide primary care will be needed to meet these demands. Thus, the emergence of Advanced Practice Registered Nurse (APRN) evolve. APRN is a nurse who has completed a graduate degree and has acquired advanced knowledge and skills. APRNs are grounded with theory, concepts and principles that enable them to assess, diagnose, treat and manage their patients. APRNs can work in conjunction with other health care professionals or independently. APRNs improve access to health care by providing care in the rural and underserved areas. APRNs also reduce the cost to health care (Joel, 2013).