Barriers to NP Practice That Impact Healthcare Redesign
Barriers to NP Practice That Impact Healthcare Redesign
The continued dialogue about whether nurse practitioners are prepared to provide quality, cost effective healthcare reduces the ability to have meaningful conversations about strategies to address the growing need for primary care providers and decrease healthcare disparities. State legislative reforms continue to focus on NPs issues such as state scope-of-practice and payer polices. National nursing organization such as the American Nurses Association (ANA) and the American Association of Nurse Practitioners (AANP) are leading advocates for allowing NPs to practice to the fullest extent of their education and training. In addition there are many state and local NP organizations that continue to struggle to move legislative initiatives forward.
The level of physician supervision appears to have the greatest impact on NPs ability to practice the fullest extent of their education and training (Devi, 2011). Despite physician organizations opposition, certain consumer groups like AARP (2013) have shown support for the independent NP practice. The 'call to action" is loud and clear; nursing organizations are not able to move policy and legislative initiatives forward without the financial support of its members. Becoming an active member of nursing organizations at the national, state, and local levels is a major way to address the barriers to NP practice.
Eliminating variances in state licensure and scope-of-practice and removing barriers to independent practice are necessary elements of providing superior primary care. The Consensus Model for APRN Regulation (APRN Joint Dialogue Group Report, 2008) recommends having a single-advanced practice RN license, allowing independent practice with no regulatory mandates for physician supervision or collaborative agreement (a formal agreement that is submitted to state boards of nursing). Standardizing APRN regulation may promote nationwide consistency and quality of NP educational programs so that there is uniformity among the graduates (Round, Zych, & Mallary, 2012). NPs have demonstrated the ability to provide quality, cost effective care, therefore are deserving of equitable pay for services rendered. In alignment with the concept of quality care, NPs should be held accountable for contributions to "high-value primary care" by including performance measures of NPs who are independently practicing or in a collaborative practice in the Agency for Healthcare Research and Quality Health Care Quality Report Card (Naylor & Kurtzman, 2010, p. 897).
Addressing Barriers
Policy Initiatives
The continued dialogue about whether nurse practitioners are prepared to provide quality, cost effective healthcare reduces the ability to have meaningful conversations about strategies to address the growing need for primary care providers and decrease healthcare disparities. State legislative reforms continue to focus on NPs issues such as state scope-of-practice and payer polices. National nursing organization such as the American Nurses Association (ANA) and the American Association of Nurse Practitioners (AANP) are leading advocates for allowing NPs to practice to the fullest extent of their education and training. In addition there are many state and local NP organizations that continue to struggle to move legislative initiatives forward.
The level of physician supervision appears to have the greatest impact on NPs ability to practice the fullest extent of their education and training (Devi, 2011). Despite physician organizations opposition, certain consumer groups like AARP (2013) have shown support for the independent NP practice. The 'call to action" is loud and clear; nursing organizations are not able to move policy and legislative initiatives forward without the financial support of its members. Becoming an active member of nursing organizations at the national, state, and local levels is a major way to address the barriers to NP practice.
Eliminating variances in state licensure and scope-of-practice and removing barriers to independent practice are necessary elements of providing superior primary care. The Consensus Model for APRN Regulation (APRN Joint Dialogue Group Report, 2008) recommends having a single-advanced practice RN license, allowing independent practice with no regulatory mandates for physician supervision or collaborative agreement (a formal agreement that is submitted to state boards of nursing). Standardizing APRN regulation may promote nationwide consistency and quality of NP educational programs so that there is uniformity among the graduates (Round, Zych, & Mallary, 2012). NPs have demonstrated the ability to provide quality, cost effective care, therefore are deserving of equitable pay for services rendered. In alignment with the concept of quality care, NPs should be held accountable for contributions to "high-value primary care" by including performance measures of NPs who are independently practicing or in a collaborative practice in the Agency for Healthcare Research and Quality Health Care Quality Report Card (Naylor & Kurtzman, 2010, p. 897).
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