NURS 6050 REGULATION FOR NURSING PRACTICE STAFF DEVELOPMENT MEETING

Walden University NURS 6050 REGULATION FOR NURSING PRACTICE STAFF DEVELOPMENT MEETING – Step-By-Step Guide

This guide will demonstrate how to complete the Walden University NURS 6050 REGULATION FOR NURSING PRACTICE STAFF DEVELOPMENT MEETING assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NURS 6050 REGULATION FOR NURSING PRACTICE STAFF DEVELOPMENT MEETING

Whether one passes or fails an academic assignment such as the Walden University NURS 6050 REGULATION FOR NURSING PRACTICE STAFF DEVELOPMENT MEETING depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NURS 6050 REGULATION FOR NURSING PRACTICE STAFF DEVELOPMENT MEETING

The introduction for the Walden University NURS 6050 REGULATION FOR NURSING PRACTICE STAFF DEVELOPMENT MEETING is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

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How to Write the Body for NURS 6050 REGULATION FOR NURSING PRACTICE STAFF DEVELOPMENT MEETING

After the introduction, move into the main part of the NURS 6050 REGULATION FOR NURSING PRACTICE STAFF DEVELOPMENT MEETING assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NURS 6050 REGULATION FOR NURSING PRACTICE STAFF DEVELOPMENT MEETING

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NURS 6050 REGULATION FOR NURSING PRACTICE STAFF DEVELOPMENT MEETING

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NURS 6050 REGULATION FOR NURSING PRACTICE STAFF DEVELOPMENT MEETING

  • Both national nursing associations and boards of nursing play significant roles in the nurse practitioner profession and the general scope of their practice. Therefore, understanding the differences between the two helps lend credence to the expertise of different healthcare professionals.  

Nurses at all stages of their careers ought to commit to ongoing career growth and development. Therefore, national nursing associations provide unique opportunities for career advancement, opportunities for networking, as well as the provision and promotion of the best practice guidelines. National nursing associations offer access to leadership development as well as mentoring that are not always accessible to professionals within their organization of work. National nursing associations provide opportunities for general membership and can sometimes target specific roles, including critical care nurses and student nurses (Alotaibi, 2017). National nurses associations often gain strength through expansive collaboration and exchange of ideas. Members of national nurse associations often benefit from the foundation built on shared professional experiences. Boards of Nursing refers to the agencies that promote and protect the general public’s health and welfare by assuring and overseeing that licensed nurses are involved in the provision of competent and safe healthcare services. The Board of Nurses is led by the elected Board of Directors, who oversee different activities to ensure effective operational processes.  

Differences between A Board Of Nursing and a Professional Nurse Association 

  • Private membership requiring potential members to pay dues to enjoy benefits 
  • Mainly involved in the protection of nursing professionals 
  • Involved in the protection of nurse’s interests and may assist in cases of disciplinary actions  
  • Members are elected, no payment of due 
  • Mainly involved in the protection of public interest 
  • Boards of Nursing supervise the licensure renewals, issuance, and applications; they also pursue disciplinary actions in case nurses violates the laws  

Both national nurse associations and the Board of nursing are led by directors elected that mainly consist of nurses and other members. The Board of Nurses is not always involved in the drafting of legislation. Also, they cannot oppose or support the proposed bills during legislative processes. However, the Board of nurses often establishes measures that ensure the provision of quality healthcare services to the general public. They are also involved in the development of policies that ensure that nurses and other healthcare professionals are involved in the provision of quality healthcare services to different types of patients. Even though it can sometimes appear that the board of nursing restricts different nursing practices, they often try to have an uneven keel when it comes to the protection of the public from harm through setting minimum qualifications and competencies (Stanley et al., 2019). National nurse associations, on the other hand, are involved in the protection of nurse’s interests. They always act on behalf of nurses to ensure proper working conditions.  

Board for a Specific Region/Area:  
Alabama Board of Nursing 

  • The main objective of the Alabama Board of Nursing is to promote and safeguard the safety, health, as well as welfare of the general public through licensing and approvals of qualified persons as well as adopting and imposing the legal standards for nursing education and nursing practice.  

The Alabama Board of Nursing is mainly involved in the promotion and safeguarding of health and safety of the members of the public through the formulation of policies aimed at ensuring the nurse and other healthcare professionals adhere to the best practices that lead to the delivery of high-quality care. The Alabama Board of Nursing endeavors to ensure the delivery of quality care through the provision of regulatory excellence. The Alabama Board of Nursing is often involved in the enforcement and implementation of the Nurse Practice Act as well as rules and regulations in line with the Alabama Administrative code to ensure maintenance of public safety. The Alabama Board of Nursing is often involved in state-specific licensing and sets standards for the provision of safe nursing care (Heale & Rieck Buckley, 2020). The board also set or decide on the scope of practice among the nurses within Alabama’s jurisdiction and issue licenses to qualified candidates. Alabama Board of Nursing ensures that nurses are involved in providing quality care to all the public members.  

Board Members and How to Become a Member 

The board members consists of:  

  • President- Cheryl Bailey 
  • Vice president- Valorie Dearmon 
  • Secretary- Janice Seip 
  • Advanced practice registered nurses 

Members of the Alabama Board of Nursing are appointed by the governor and they serve a four-year term limits. Besides, members can be re-appointed for additional term.  

Alabama Board of Nursing consists of the president who is in charge of all the activities undertaken. The president is always elected by the members; the election process is often done after the determination of the qualification of the potential candidates. The president is assisted by the vice president, who is also elected. The main role of the board members is to make policies and decide on different practices that ought to be followed to ensure successful operational processes. The current president of the Alabama Board of Nursing, Cheryl Bailey, is serving her second four-year term, she was re-elected as the Board president in the year 2019, and she is mainly interested in assisting team members in promoting and safeguarding the safety, health as well as the welfare of the public. The board members have well-defined objectives that are expected to enhance the operation of the entire organization. Board members are always elected based on their level of competency.  

Regulation Related to General Nurse Scope of Practice and How the Regulation Influence The Nurse’s Role 

  • One of the regulation related to the general nurse scope of practice is the licensing processes.  
  • All nursing practice licenses are only given to the qualified  nurses after successfully undergoing the required training   
  • The above regulation impact’s the nurses roles in different ways including: 
  1. Improved development of competency in the nursing practice 
  1. Improved quality of healthcare delivered to patients 
  1. Advocate for the well-being of the patients 

Alabama State has stiff regulations that ensure the delivery of quality healthcare services to patients. These regulations impact nursing practice in different ways. The regulations also ensure that patients are given quality healthcare services from different healthcare institutions. Alabama State has strict regulations on the licensing processes. In other words, licenses are only given to qualified healthcare professionals or nurses; the reason is to ensure that only qualified and competent nurses are given the opportunity to manage patients and to provide effective healthcare services. The regulations are meant to enhance effective patient outcomes and ensure that proper treatment guidelines are followed. Every state often has unique regulations that ensure that healthcare professionals adhere to the required practices. Also, these regulations are meant to facilitate the delivery of quality healthcare to all patients. The state government of Alabama is committed to providing quality healthcare services to all the patients and ensuring general improvement in public health; thus, they are often engaged in the formulation of effective strategies. 

How the Regulation Influence Delivery, Cost, and Access to Healthcare 

Strict licensing process for nurses ensures that only qualified nurses are recruited in different healthcare facilities; thus the impacts are observed:  

  1. In the improved delivery of quality care 
  1.  Reduction the costs of healthcare delivery due to quality procedures and research-based approaches 
  1. The general improvement access to different types of healthcare services 

Strict licensing procedures ensure that only highly qualified healthcare professionals are recruited to serve patients in different healthcare institutions. Highly qualified nurses are able to apply evidence-based practices and other research processes in ensuring that healthcare services are delivered in line with the required standards and within the ethical regulations. Also, with the effective licensing processes, healthcare institutions are able to acquire enough nurses, a scenario that can lead to the delivery of different healthcare processes at different levels of care. In most cases, the cost of medication often arises as a result of a lack of enough facilities in different healthcare institutions. Thus, with the flexibility yet, strict licensing process, healthcare institutions can significantly reduce the cost of medication and other healthcare services. Additionally, the cost rising cost of healthcare is normally attributed to inadequate research processes and qualified healthcare professionals. However, with the effective licensing processes, there are always opportunities for the management to receive qualified healthcare professionals capable of providing evidence-based practice healthcare services.  

State Regulation Related to Advanced Practice Registered Nurses (APRNS) 

  • The state of Alabama has specific regulations for the Advanced Practice Registered Nurses (APRNs).  
  • One of the regulation is: APRN ought to have Master’s degree in nursing as well as the certification from the national certifying agency recognized by the board of nursing.  

Advanced practice registered nurses is always required to have advanced educational achievement, preferably Master’s level. At this level, they are supposed to have research skills as well as knowledge of evidence-based practices. Thus, they are the main agents when it comes to the provision or delivery of quality care to different patients. Advanced Practice Registered Nurses include clinical nurse specialists, nurse practitioners, nurse anesthetists, as well as nurse-midwives. All these professionals play significant roles in the provision of quality healthcare services. The APRN is regarded as the primary care provider; they are always at the forefront of engaging in the provision of preventive care services to the public members. Advanced Practice Registered Nurses ought to have a Master’s degree from a recognized university in the state of Alabama. With this qualification, it is believed that they have research skills as well as evidence-based practices surrounding the provision of quality care. The state of Alabama has specific regulations for the Advanced Practice Registered Nurses (APRNs).  

How the State Regulation Related to Advanced Practice Registered Nurses (APRNS) Influence The Nurse’s Role 

  • The regulation allow nurses to engage in the provision of quality healthcare services 
  • The regulation also allow nurses to adhere to the evidence-based practices which are critical in the effective patient outcomes 
  • Also, the regulation allow nurses to develop collaborative skills in the delivery of quality healthcare services to all the patients. 

One of the major roles of APRNs is to ensure the provision of quality healthcare services to all patients. They can achieve this through engagement in research-based healthcare services. Advanced practice registered nurses also play critical roles in the provision of effective leadership in the nursing processes. They guide other professionals in ensuring that patients are given healthcare services in line with their consent. In Alabama, for nurses to be become APRNs, they ought to have a Master’s degree from a recognized university. They also need to have research skills and the knowledge of evidence-based practices to ensure that there is the delivery of quality care. The state government of Alabama has advanced nursing training processes meant to produce more APRN nurses to meet the demands of the growing healthcare needs. However, the training processes offered differ significantly from the areas of specialties. Over the years, the state has been able to enhance the provision of quality care through the recruitment of more APRNs.  

How the APRN Regulation Influence Delivery, Cost, and Access to Healthcare 

  • Recruiting APRNs with Master’s degree has enabled delivery of quality healthcare services. Improved delivery of healthcare processes has open the door for treatment of various complications and management of different patients within the healthcare institutions. 
  • With the recruitment of more APRN nurses, healthcare institutions have been able to undertake training processes aimed at increasing the number of nurses (Partin, 2019). The increase in the number of nurses has significantly reduced the cost of healthcare delivery. Also, with the increase in nurses, there have been an increase in the access of different healthcare services.    

The recruitment of highly qualified professionals to be part of the APRN has led to the delivery of quality services. Alabama State has stiff regulations that ensure the delivery of quality healthcare services to patients (National Council of State Boards of Nursing, 2018). These regulations impact nursing practice in different ways. The regulations also ensure that patients are given quality healthcare services from different healthcare institutions. Alabama State has strict regulations on the educational qualification has allowed for the increased research processes and adherences to the evidence based practices. In other words, licenses are only given to qualified healthcare professionals or nurses; the reason is to ensure that only qualified and competent nurses are given the opportunity to manage patients and to provide effective healthcare services. The regulations are meant to enhance effective patient outcomes and ensure that proper treatment guidelines are followed. Every state often has unique regulations that ensure that healthcare professionals adhere to the required practices. Also, these regulations are meant to facilitate the delivery of quality healthcare to all patients. The state government of Alabama is committed to providing quality healthcare services to all the patients and ensuring general improvement in public health; thus, they are often engaged in the formulation of effective strategies. 

Also Read:

EVIDENCE BASE IN DESIGN

THE ROLE OF THE RN/APRN IN POLICY-MAKING

ADVOCATING FOR THE NURSING ROLE IN PROGRAM DESIGN AND IMPLEMENTATION

THE ROLE OF THE RN/APRN IN POLICY EVALUATION

ASSESSING A HEALTHCARE PROGRAM/POLICY EVALUATION

GLOBAL HEALTHCARE COMPARISON MATRIX AND NARRATIVE STATEMENT

Conclusion 

  • Both national nurse associations and the Board of nursing are led by directors elected that mainly consist of nurses and other members. The Board of Nurses is not always involved in the drafting of legislation. Also, they cannot oppose or support the proposed bills during legislative processes.  

National nursing associations provide opportunities for general membership and can sometimes target specific roles, including critical care nurses and student nurses. National nurses associations often gain strength through expansive collaboration and exchange of ideas. Advanced practice registered nurses is always required to have advanced educational achievement, preferably Master’s level. At this level, they are supposed to have research skills as well as knowledge of evidence-based practices. Thus, they are the main agents when it comes to the provision or delivery of quality care to different patients. The Alabama Board of Nursing is mainly involved in the promotion and safeguarding of health and safety of the members of the public through the formulation of policies aimed at ensuring the nurse and other healthcare professionals adhere to the best practices that lead to the delivery of high-quality care. 

References 

Sample Answer 2 for NURS 6050 REGULATION FOR NURSING PRACTICE STAFF DEVELOPMENT MEETING

 As we are all working toward our Advanced practice registered nurse (APRN) degree, evaluating how our scope of practice will differ based on the state in which we will practice is essential. The Nursing Practice Act (NPA) is the law set to govern and regulate the scope of nursing practice in each state by the state board of nursing (BON) (Boehining & Haddad, 2023). It plays a critical role in regulating APRN’s professional scope of practice within that state, determining if nurse practitioners operate with full practice, reduced practice, or restricted practice ( AANP, 2023). Limitations placed on APRN’s scope of practice significantly impact access to healthcare as there is a need for more access to primary healthcare providers. I have chosen to evaluate the different regulations of nurse practitioners in California and New Mexico.

     California BON and the Board of Medicine are in charge of regulating the practices of nurse practitioners; before 2023, NPs in California could only act with restrictions. In 2020, Bill (AB) 890 became law, removing impediments to the scope of practice and allowing independent practice effective January 2023 (Munday, 2023). It includes the ability to prescribe medications, including schedule II-V.

     The California Board of Registered Nursing (CBRN) developed 103 NP and 104 NP categories. The licensure process is complicated and requires many steps based on the level of independence and clinical setting the practitioner desires on top of the requirement of a master’s or higher in nursing. 103 NPs are required to complete 4600 hours and work full time for three years while working in their population of focus, but they still need to work in a group setting with a physician or surgeon (CBRN, n.d.). To become a 104 NP, a practitioner must first meet the requirements of 103 NPs. However, once completed, they may work independently without the supervision of a physician or surgeon within their population of focus (CBRN, n.d.). 

     Arizona Board of Nursing (AZBN), like California, requires a nurse practitioner to complete an approved educational program focusing on nursing, get certification from the board, and hold a valid nursing license (AZBN, 2020). Unlike California, NPs in Arizona can act autonomously upon licensure. However, they must refer and collaborate with other healthcare professionals when it is in patients’ best interest and well-being. AZBN does have specific requirements of at least 45 hours of education and a separate application for prescriptive authority to prescribe schedule II medications (AZBN, n.d.). 

     Although each state regulates its scope of practice, we are slowly changing to a more unified standard of practice from state to state. Removing administrative barriers  and increased privileges for NPs creates more face to face time with patients and decrease healthcare cost. Independent nurse practitioners benefit the American people as the healthcare professional shortage is a major issue creating healthcare disparities that reduce the quality of care.

Sample Answer 3 for NURS 6050 REGULATION FOR NURSING PRACTICE STAFF DEVELOPMENT MEETING

Nursing is one of the most highly regulated professions as nurses directly deal with the care of human beings, hence requiring the nurses to uphold the ethical principles. The high rate of regulation is evident by the current existence of over one hundred national nursing associations and boards of nursing in the USA along. Even though they serve to promote, inform and regulated the nursing profession, the two have differences which a nurse should know. Attempts to have a grasp of the knowledge concerning nursing associations and boards of nursing requires an elaborate analysis since the numbers can be overwhelming. However, with such knowledge, nurses become aware of the options and benefits offered by each and in adding credence to an individual’ expertise as a nursing professional. This presentation therefore, entails such a comparison as well as analysis of the Massachusetts State board of nursing.

Boards of Nursing vs. Professional Nurse Associations

As earlier indicated, the USA currently has over 100 boards of nursing and professional nurse associations, hence it can be an uphill task deciphering the difference between the board of nursing and professional nurse associations. Even though they both contribute a lot to the nursing profession, they have various differences. The first difference is that while the board of nursing majorly aims to regulate the nursing practice to protect the general public, the professional nurse associations mainly advocate for the nurses having membership with them and also advance the interest of the profession. In addition, the boards of nursing are State agencies aiming to promote and protect the welfare and the health of the public by ensuring that the licenced nurse professionals of competent and safe patient care. One the hand, professional nurse associations are usually private entities, created by the professional nurses where members need registered and subscribe to enjoy the benefits.

Massachusetts as a State has both board of nursing and professional nurses association. One of the most prominent association is the Massachusetts Nurse Association (MNA) and operates as a one member democratic organization. The organization was founded in the year 1903 and then the organization formulated Nurse Practice Act. The organization has more than twenty three thousand members working throughout the State, it is a democratic organization where the members set the agenda and the members get opportunity to deal with various local issues. For one to obtain registration with the Massachusetts Board of Nursing, one has to complete an accredited nursing program and then pass the NCLEX examination before seeing for a licence. The board licenses various practical nurses and registered nurses such as Licensed Practical Nurse Endorsement, Licensed Practical Nurse Initial Licensure, Registered Nurse Endorsement and Registered Nurse Initial Licensure.

The Impact of Federal Regulation on Healthcare 

Among the federal regulations or laws that have influence healthcare in America is the Affordable Care Act or the Obama Care of 2010 since it became a law in the year 2010. The major aim of the law was to offer affordable health insurance coverage to every American. Besides, it was also meant to protect consumers from insurance companies which engage in strategies that restrict care or increase the cost of care. Many people who had low-paying jobs or not employed have since benefited from the law since its inception hence improved access to care. Even though it has come with many benefits, the Affordable Care Act has remained to be highly controversial leading to Trump’s administration to seek several times to make changes to this law. Among some changes that have been done to this law in the last five years include eliminating individual mandate, ending the cost sharing reduction subsidies to insurers and allowing States to add work requirements to the Medicaid.

The Impact of State Regulation on Nurse Practice 

Health Care Legislation Increasing Access to Quality, Affordable Care, Promoting Telehealth and Protecting Access To COVID-19 Testing, Treatment is among the regulations in Massachusetts that currently affect the scope of practice of the nurses. Signed into law recently by Governor Baker, the regulation has expanded the scope of practice for nurse practitioners and other advanced registered nurses. For instance, to help the physicians to better deal with the pandemic, the regulations allows them to fully respond to COVID-19 cases among other things. Apart from expanding the scope of practice, the regulation improved access to care by patients as the nurses can offer services that were previously only meant to be offered by  the doctors. In addition, the new regulation lowers costs as it seeks to implore the insurers to apply a standard credential form and bar additional costs for the same day billing.

The Massachusetts as a State has various regulations that influence how the advanced practice registered nurses operate or function. One of such regulations is the regulation giving the advanced practice registered nurses the prescriptive authority after licensure. The APRNs are therefore allowed to prescribe, order, administer, dispense and furnish the therapeutic measures independently without having to consult a doctor. The regulation was brought into force by the NCSBN 2012 model which allowed the board of nursing to grant such authority. This regulation also increases access to care for patients as patients can get medication prescriptions from the advanced practice registered nurses. The expansion of the roles of the APRNs by this regulation also allows the nurses to undertake therapeutic procedures hence improving patient access to care and also lower costs.

References

´Center, H., Woods, C. A., Manchikanti, L., & Purdue Pharma, L. P. (2017). A 
         critical analysis of Obamacare: Affordable care or insurance for many
         and coverage for few. Pain physician, 20, 111-138.
         https://pubmed.ncbi.nlm.nih.gov/28339427/

´Massnurses.org (2021). The Massachusetts Nurses Association.
          https://www.massnurses.org/about-mna.

´Mass.gov (2021).Board of Registration in nursing staff .       
         https://www.mass.gov/service-details/board-of-registration-in-nursing-
        staff

In the United States there are Full Practice, Reduced Practice and Restricted Practice states for AANP according to the article. 

Full Practice is an authorization given to the nurse practitioners to meet, evaluate, diagnose, order, and interpret diagnostic tests of the patients. It gives a permission to initiate and manage health care, including prescribing medications, with exclusive license authority, provided nurse meets and completes all the requirements. The difference between reduces and restricted practice is in the amount of oversight that is needed for the nurse (what nurse can and cannot do in their scope of practice). The restrictions are determined by the state’s board of registered nursing. Restricted and reduced nurse practitioners must be supervised by the physician throughout their career.2

Minnesota is a full practice state for APNPs.  In a full practice state for nurse practitioners refers to a state in which nurse practitioners (NPs) are allowed to practice independently, without the supervision of a physician. In Minnesota, NPs are able to diagnose and treat patients, prescribe medications, and order and interpret diagnostic tests, just like physicians, which given a huge advantage and easy up workload for the healthcare system.3

Nurse practitioners are advanced practice registered nurses (APRNs) who have completed advanced education and training beyond their initial nursing education. In addition to their nursing skills and knowledge NPs are trained in diagnostic and therapeutic practices, and are able to provide a wide range of healthcare services to patients of all ages.  The scope of practice for NPs varies by state, and some states such as Texas have what is called restrictive practice. In states that do not have full practice authority for NPs, they are required to have a lifetime collaborative or supervisory agreement with a physician in order to practice. That can be advantageous in some retrospective, but on the other hand it is handicaps not only the opportunities for continued education of NP, but also to the patients. For example, something as simple as appointment opportunities and waiting lists can get longer, time spent in the waiting rooms, even the amount of time spent with the physician shortens due to the lack of healthcare providers available.3,4,5

In a restricted practice state, nurse practitioners (NPs) are not able to work to the full extent of their education and training. In these states, NPs are typically required to have a collaborative agreement with a physician in order to provide certain types of care or to prescribe certain medications. 

The specific requirements for NPs practicing in a restricted state such as Texas vary by state, but may include the following:

-Having a written collaborative agreement with a physician

-Consulting with a physician on certain cases or for certain types of care

-Seeking approval from a physician before prescribing certain medications

-Having a physician available for a consultation via phone or other means

In summary, the APNP is restricted in at least one aspect of NP practice in the reduced practice and the restricted practice states by the licensure law. 

It is important to note that the terms “full Practice” and “autonomous practice” are often used interchangeably, but they do not necessarily mean the same thing. Autonomous practice refers to the ability of NPs to make clinical decisions and provide care to patients without the need for physician oversight, while full practice refers to the complete scope of NP practice and includes the authority to prescribe medications

 

It is no surprise that years of nursing experience is directly related to the level of expertise as demonstrated with the results of the Fresno Test which measures the Evidence Based Practice knowledge and skills.  The aspect of experience is taken into consideration in Minnesota which is a full practice state.  This means that in Minnesota a collaborative agreement is necessary only for the first number of hours in independent practice as an APNP.  By contrast in the state of Texas with a restrictive practice an APNP will be required to have a lifelong collaborative agreement with a physician.6

It is proven that states with a more restrictive APRN licensure have a more restrictive structure for accessing healthcare.7 

Since in states with a restricted practice an APNP will have to pay a fee to a physician who is in a collaborative agreement with him or her.  Such fees may be fiscally prohibitive for the APNP to open his/her own clinic and operate independently outside of a large healthcare structure.  Practicing as a APNP may also be prohibiting due to physician availability who is willing to enter into such an agreement.  This leaves the APNP in a chronic dependency to a physician for the collaborative agreement piece making the field of an APNP much less desirable for RNs to enter. 

It has been proven and evidence demonstrates that NP have consistently proven to be a cost-effective provider of the higher quality, attending not only to the immediate needs of the patients, but providing a preventive care that further reduces the costs of the healthcare. Not only cost effectiveness is in NPs academic preparation, but also in their compensation, which amounts to one-third to one-half that of the physician. Based on the Newhouse et al (2011) study8, cost-reduced evidence is in the length of stay, emergency visits, and hospitalization. The interesting thing, that is NPs cost effectiveness is not dependent on the practice settings. It has been shown in the one study (Spritzer, 1997) NPs practicing in the state of Tennessee’s state-managed managed care organization (MCO) provided health care at 23% below the average cost associated with other primary care providers, achieving a 21% reduction in hospital inpatient rates and 24% lower lab utilization rates compared to physicians. Examples like that are across the board, showing the advantage of making every state a full practice one.5,9

 “CNP and CNS beginning practice after July 1, 2014 must practice for at least 2,080 hours within the context of a collaborative management setting in a hospital or integrated clinical setting where APRNs and physicians work together.”

Reference

  1. https://waldenu.instructure.com/courses/21317/pages/module-3-learning-resources?module_item_id=467430
  2. https://www.aanp.org/advocacy/state/state-practice-environmentLinks to an external site.
  3. American Academy of Nurse Practitioners (2010). Documentation of Quality of Nurse Practitioner Care. Retrieved December 3, 2009.
  4. American Medical Group Association (2009). 2009 Physician Compensation Survey. Retrieved September 22, 2009.
  5. https://www.aanp.org/advocacy/advocacy-resource/position-statements/nurse-practitioner-cost-effectivenessLinks to an external site.
  6. https://mn.gov/boards/nursing/advanced-practice/advanced-practice-registered-nurse-(aprn)-licensure-general-information/Links to an external site.
  7. https://www.sciencedirect.com/science/article/pii/S0029655417306164
  8. Newhouse, R. et al (2011). Advanced practice nurse outcomes 1999-2008: A systematic review. Nursing Economic$, 29 (5), 1-22.
  9. Spitzer, R. (1997). The Vanderbilt experience. Nursing Management, 28(3), 38-40.

In order to begin this discussion, it is important to understand what exactly and APRN is. The American Nurses Association defines an APRN as, “Certified Nurse Practitioners (NPs), Certified Registered Nurse Anesthetists (CRNAs), Clinical Nurse Specialists (CNS), and Certified Nurse Midwives (CNMs).” I live and will be practicing as an APRN in the state of Pennsylvania. The mission statement “The State Board of Nursing protects the health and safety of the citizens of the Commonwealth of Pennsylvania through the licensure/certification and regulation of the practice of professional and practical nursing and dietetics-nutrition by registered nurses, practical nurses, certified registered nurse practitioners, clinical nurse specialists, dietitian-nutritionists, and graduate nurses.” (2022) It is interesting to review the differences in practice regulations from one state to the next when it comes to APRNs.

When you think about moving from a registered nurse to an advanced practice nurse, it is important to know what you are allowed to do vs. not allowed to do as far as legality goes. In the state of Pennsylvania, Nurse Practitioners are required to work under the supervision of a physician when diagnosis or prescribing medication. This is not consistent with all states. This is defined as a collaborative practice agreement. “The collaborative agreement must include provisions regarding: the immediate availability of the physician through direct communication, radio, telephone, or telecommunications; a predetermined plan for emergency services; and the physician’s availability to the NP on a regularly scheduled basis for referrals, review of the standards of medical practice incorporating consultation and chart review, drug and other medical protocols within the practice setting, periodic updating in medical diagnosis and therapeutics, and co-signing records when necessary to document accountability by both parties.” (2021) To help understand how states may differ, let’s look at a few different states that have different regulations and requirements. In South Dakota, while APRNs are required to follow the same collaborative agreement as PA holds, it is not long term. According to the American Medical Association, South Dakota only requires this agreement for the first 1,040 hours of practice. Virginia is similar, however they require this agreement for the first 5 years of practice. On the complete opposite end of the spectrum, states such as North Dakota and New Jersey do not require its APRNs to follow a collaborative agreement.

Another regulation that is important that can vary from state to state is the amount of continuing education that is required to renew your license. The Pennsylvania Coalition of nursing outlines the required CNEs for APRNs to be 30 hours over a 2 year renewal period, with 16 of those hours being required in pharmacology. The Coalition also states that it is not required by all applicants to provide proof, but every applicant is required to sign a statement that they did complete the required work. The board will complete “random audits” to which have no rhyme or reason. While New Jersey and Pennsylvania have different practicing regulations when it comes to diagnosing and prescribing, they do not differ in the required amount of continuing education in order to renew their licensure. While PA requires CNEs in pharmacology, New Jersey requires 1 hour of prescription opioid drug education. (2022b)

The state of Pennsylvania makes it easy and accessible for APRNs to maintain, manage and practice with their advanced degree. While it can be seen as difficult to have to work underneath of a physician, it also provides extra security as the sole responsibility is shared and is not placed solely on the NP. When it comes to the continuing education piece, there are multiple resources available that will allow NPs to ensure that they are able to access the required CNEs in order to maintain their licenses.

 

 

References:

(n.d.) Advanced Practice Registered Nurses. American Nurses Association. https://www.nursingworld.org/practice-policy/aprn/Links to an external site.

(2022). State Board of Nursing. Pennsylvania Department of State. https://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/Nursing/Pages/default.aspx#:~:text=Mission%20Statement&text=The%20Board%20issues%20licenses%20and,the%20Acts%20and%20the%20regulationsLinks to an external site..

(2021). State Law Chart: Nurse Practitioner Authority. American Medical Association. https://www.ama-assn.org/system/files/2020-02/ama-chart-np-practice-authority.pdfLinks to an external site.

(n.d.). FAQs. Pennsylvania Coalition of Nurse Practitioners. https://www.pacnp.org/page/faqsLinks to an external site.

(2022, October 12). New Jersey Board of Nursing Frequently Asked Questions – Continuing Education (CE). New Jersey Division of Consumer Affairs. https://www.njconsumeraffairs.gov/nur/pages/continuing-education-faq.aspxLinks to an external site.

NURS 6050 Week 8 Advocating for the Nursing Role in Program Design and Implementation

Week 8 Assignment: Interview Script 

Tell us about a healthcare program, within your practice. What are the costs and projected outcomes of this program? 

Urinary tract infections (UTIs) are prevalent inside nursing institutions. Several factors contribute to the elevated prevalence of urinary tract infections in nursing homes. The process of aging, characterized by the gradual decline of immune system function, along with the heightened occurrence of cognitive illnesses such as dementia, poses challenges for patients in effectively communicating their symptoms to nurses. These aspects, among others, contribute to the complexity of the situation. Hence, it is crucial that nursing homes establish a comprehensive program aimed at avoiding and effectively treating urinary tract infections (UTIs) in order to safeguard the well-being and security of its residents. It is noteworthy that the cost of the program includes not only the tuition fee for the UTI training program, but also the expenses associated with the acquisition of training materials used by nurses to acquire knowledge on optimal strategies for the prevention and treatment of urinary tract infections (UTIs) in nursing home settings. Antibiotics for urinary tract infections have their own associated expenses. According to Mundell (2022), the prevalence of urinary tract infections (UTIs) in the United States is estimated to be about 4700 individuals at any one time. 

Who is your target population? 

The program’s intended demographic consists of those who dwell in nursing homes. The primary objective of the program is to mitigate the incidence of urinary tract infections among the geriatric demographic residing in long-term care facilities. 

What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples? 

Given that nurses often engage with the elderly demographic residing in nursing homes, they possess direct observations on the increasing prevalence of urinary tract infections (UTIs) within this specific community. Therefore, the primary responsibility of the nurse will be to provide evidence-based information or data that will contribute to the development of the healthcare program (Milstead & Short, 2019). For example, nurses have the ability to gather data pertaining to the prevalence of urinary tract infections among patients residing in nursing homes by means of their direct engagement with patients. Subsequently, the data might be used to underscore the prevalence of the problem inside these particular settings (Sacristán & Dilla, 2015). Furthermore, nurses possess the ability to discern potential factors contributing to urinary tract infections (UTIs) in order to argue for the integration of targeted educational resources into the UTI training curriculum. 

What is your role as an advocate for your target population for this healthcare program? Do you have input into design decisions? How else do you impact design? 

In my capacity, I am tasked with providing empirically supported perspectives that lead to well-informed choices throughout the development and execution of the intervention aimed at mitigating and managing urinary tract infections (UTIs) inside nursing home settings. I get valuable insights via the implementation of comprehensive study on the occurrence of urinary tract infections (UTIs) among the inhabitants of long-term care facilities. Additionally, I acquire information pertaining to the matter via engaging with the target community and seeking insights from colleagues employed inside these establishments. The program’s design is informed by research results and data obtained from encounters with patients and other nurses. 

What is the role of the nurse in healthcare program implementation? How does this role vary between design and implementation of healthcare programs? Can you provide examples? 

The nurse’s role in implementing the healthcare program encompasses several responsibilities, including providing care to patients, implementing preventive measures as specified in the training program, and pushing for further actions to enhance the health of the target population (American Nurses Association (ANA), n.d.). As an example, nurses would have the responsibility of administering therapeutic interventions, such as antibiotics, to elderly patients diagnosed with urinary tract infections (UTIs) as an integral component of the program aimed at preventing and managing UTIs within nursing home settings. The individuals intend to use the preventive measures they formulate throughout the duration of their training. 

 The duties and obligations of individuals during the implementation stage change from those assigned during the planning phase. Nurses play a crucial role in the implementation process, assuming leadership responsibilities that contribute to the realization of program efforts (Tummers & Bekkers, 2014). Nevertheless, Sacristán and Dilla (2015) argue that individuals transition into facilitators throughout the design phase when they engage in collective decision-making processes. For example, they have the capacity to provide us with the required data to facilitate the enhancement of our healthcare system. 

Who are the members of a healthcare team that you believe are most needed to implement a program? Can you explain why? 

Interprofessional collaboration is required in order to carry out the program in an effective manner. A registered nurse, a pharmacist, a physician, and a physician assistant will all be members of the multidisciplinary healthcare team. It is essential to get the feedback of all team members who are participating in the design and execution of the program since each of these individuals has direct contact with the population that will be the focus of the initiative. However, it is important to emphasize that pharmacists and chemists play a unique part in the program, namely in the distribution of medication for the treatment of urinary tract infections (UTIs). 

References 

American Nurses Association (ANA). (n.d.). Advocacy. Retrieved September 20, 2018, from https://www.nursingworld.org/practice-policy/advoc. 

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Jones & Bartlett Learning. 

Mundell, E. J. (2022, May 30). Dangerous urinary tract infections are common in nursing homes. HealthDay. Retrieved October 24, 2022, from https://consumer.healthday.com/caregiving-information-6/nursing-homes-and-elder-care-health-news-501/dangerous-urinary-tract-infections-common-in-nursing-homes-711612.html 

Sacristán, J., & Dilla, T. D. (2015). No big data without small data: Learning healthcare systems begin and end with the individual patient. Journal of Evaluation in Clinical Practice, 21(6), 1014–1017. 

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