The Impact of Establishing a Full Scope of Practice for Advanced Practice Registered Nurses in the State of Indiana

Martsolf, Grant R.; Kandrack, Ryan

doi:10.7249/rr1864

Cited by 9 publications

(9 citation statements)

References 23 publications

(67 reference statements)

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“… 47 Saving time for both NPs/PAs and physicians may result in more time for patient care, thereby improving access to care. 42 To our knowledge, the present study is the first to account for time in this regard.…”

Section: Discussionmentioning

confidence: 81%

“…Although prices could decrease for NP/PA services, the number of services provided may increase, raising overall costs of healthcare. 42 48 For example, USA granting NPs independent prescriptive authority had higher rates of prescriptions filled and higher prescription costs, leading to higher overall costs. 46 At the time of this evaluation NP’s/PA’s operations were registered in the name of the supervising physician or department instead of the individual NP/PA.…”

Section: Discussionmentioning

confidence: 99%

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National mixed methods evaluation of the effects of removing legal barriers to full practice authority of Dutch nurse practitioners and physician assistants

et al. 2018

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ObjectiveTo evaluate the effects of granting legal full practice authority (FPA) to nurse practitioners (NP) and physician assistants (PA) regarding the performance of specified reserved medical procedures and to support governmental decision-making.DesignNationwide mixed methods design with triangulation of quantitative (Pre-post test design) and qualitative data (expert interviews and focus groups).MethodsSurveys focused on the performance of the procedures (monthly number, authorisation mode, consultations and procedural time) and legal cross-compliance requirements (adherence with protocols, competence). Interviews focused on competence, knowledge, skills, responsibilities, routine behaviour, NP/PA role, acceptance, organisational structure, collaboration, consultation, NP/PA positioning, adherence with protocols and resources. Data collection took place between 2011 and 2015.ResultsQuantitative data included 1251 NPs, 798 PAs and 504 physicians. Besides, expert interviews with 33 healthcare providers and 28 key stakeholders, and 5 focus groups (31 healthcare providers) were held.After obtaining FPA, the proportion of NPs and PAs performing reserved procedures increased from 77% to 85% and from 86% to 93%, respectively; the proportion of procedures performed on own authority increased from 63% to 76% for NPs and from 67% to 71% for PAs. The mean number of monthly contacts between NPs/PAs and physicians about procedures decreased (from 81 to 49 and from 107 to 54, respectively), as did the mean duration in minutes (from 9.9 to 8.6 and from 8.8 to 7.4, respectively). Utilisation of FPA was dependent on the setting, as scepticism of physicians and medical boards hampered full implementation. Legal cross-compliance requirements were mostly fulfilled.ConclusionsInformal practice was legalised. The opportunities to independently perform catheterisations, injections, prescribing, punctures and small surgical procedures were highly used. Care processes were organised more efficiently, services were performed by the most appropriate healthcare provider and conditions were met. This led to the recommendation to continue with FPA.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

National mixed methods evaluation of the effects of removing legal barriers to full practice authority of Dutch nurse practitioners and physician assistants

et al. 2018

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“…NPs have a proven track record of delivering high‐quality care in the 28 states with full practice authority before the pandemic. However, a national full practice authority would potentially improve APRN provider supply and salaries, reduce racial and ethnic disparities, and increase access to care 43 . The results from a recent survey concluded that 87% of Americans reported that nurses were indispensable during the COVID‐19 pandemic, and 89% desire the same level of care from nurses postpandemic 44 .…”

Section: Progressing Toward National Full Practice Authority Amid Covmentioning

confidence: 99%

COVID 19: An unprecedented opportunity for nurse practitioners to reform healthcare and advocate for permanent full practice authority

2020

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The coronavirus disease 2019 (COVID‐19) pandemic ushered in a new era for advanced practice registered nurses, as emergency regulatory and policy changes expanded the nurse practitioner (NP) scope of practice. The legislative changes enabled NPs to bolster the national pandemic response by working to the full extent of their education and training. The changes are only temporary, and many have contemplated the permanent impact of COVID‐19 when healthcare transitions to a postpandemic normal. NPs now have a unique opportunity to educate others about the merit of their role and advocate for permanent legislative changes. In this creative controversy manuscript, we build a case that national NP full practice authority increases access to care and is vital for a sustainable and resilient healthcare system that can react to future pandemic crises.

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“…States with full-practice rights for PMHNPs demonstrate increased service provision to vulnerable and rural populations and associated cost savings, improved self-reported mental health among patients, and decreased mental health–related mortality (Alexander & Schnell, 2019; Martsolf, Auerbach, & Arifkhanova, 2015; Phoenix, Hurd, & Chapman, 2016; Xue, Ye, Brewer, & Spetz, 2016). Of note, PMHNPs with independent practice rights working in community mental health clinics provided twice as many mental health visits and treated more patients compared with colleagues in states who did not have independent practice rights and can combat the opioid crisis after obtaining a prescribing waiver (e.g., buprenorphine) once they have completed a 24-hour training (Andrilla et al, 2018; Substance Abuse and Mental Health Services Administration, 2017; Tierney, Finnell, Naegle, LaBelle, & Gordon, 2015; Yang et al, 2017).…”

Section: Psychiatric Mental Health Nurse Practitioner Solutions For Rmentioning

confidence: 99%

Psychiatric Mental Health Nurse Practitioners Meeting Rural Mental Health Challenges

Finley

2019

J Am Psychiatr Nurses Assoc

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OBJECTIVE: To describe the current rural mental health system crisis in the United States and how psychiatric mental health nurse practitioners (PMHNPs) can holistically mitigate this systemic issue. METHOD: Respective to the objective, relevant literature is reviewed. RESULTS: PMHNPs have successfully increased access to care in underserved rural communities by practicing at the fullest extent of their scope without mandated supervision, utilizing telepsychiatry practice, while expanding PMHNP rural mental health education and research to meet and absolve pressing rural mental health challenges. CONCLUSIONS: Current evidence supports that rural mental health care improves when PMHNPs have full scope of practice, utilize telepsychiatry, engage in related scholarly activity, and have formalized education and training for rural health care delivery, which collectively answer the professional and moral call serving the underserved rural population with mental illness.

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The Impact of Establishing a Full Scope of Practice for Advanced Practice Registered Nurses in the State of Indiana

Cited by 9 publications

References 23 publications

National mixed methods evaluation of the effects of removing legal barriers to full practice authority of Dutch nurse practitioners and physician assistants

National mixed methods evaluation of the effects of removing legal barriers to full practice authority of Dutch nurse practitioners and physician assistants

COVID 19: An unprecedented opportunity for nurse practitioners to reform healthcare and advocate for permanent full practice authority

Psychiatric Mental Health Nurse Practitioners Meeting Rural Mental Health Challenges

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