Analysis and Recommendations of Advanced Practice Nursing Issues
Advanced Practice Registered Nurses (APRNs) are increasingly essential in increasing
access to high-quality, affordable, and patient-centered care, especially in underserved and rural
communities. Nevertheless, in most states, the scope-of-practice laws remain restrictive, and
APRNs still have to face unnecessary supervision of the physician to implement clinical
decision-making that they are trained and certified to make independently. These barriers lead to
a shortage of providers, higher costs of healthcare, and disparities in access to care. To improve
population health, provide better care, and enhance the healthcare workforce, it is necessary to
address limitations to the APRN full practice authority (FPA).
Contextual Analysis of the Issue
Historical Development
Advanced Practice Registered Nurse (APRN) autonomy started to take shape in
the middle of the 20th century when clinical nurse specialists and nurse practitioners began to fill
the primary care physician shortages (Lewis, 2022). Initial projects, including the creation of
nurse practitioner programs in the 1960s, provided evidence of the capacity of APRNs to provide
safe and affordable care. With time, professional recognition and standard regulation were fought
for by national organizations such as the American Nurses Association (ANA) and the American
Association of Nurse Practitioners (AANP). One of the key achievements was the Consensus
Model of APRN Regulation in 2008 that aimed at harmonizing licensure, accreditation,
certification, and education across states (Tracy, O’Grady, & Phillips, 2023). Adoption has not
been uniform according to this framework, and the country is still left with the situation of
fractured authority and different restrictions on practice.
Socio-Political Influences
Political lobbying by physician organizations has a significant impact on the scope-
of-practice policies by claiming that increased APRN authority can jeopardize patient safety.
Conversely, nursing organizations and health policy analysts highlight massive studies that prove
equivalent or better results of APRN-led care. The existing issue of population health, including
aging populations, disproportionate burden of chronic diseases, and shortage of healthcare
providers in rural communities, points to the urgent necessity to eliminate these restrictive laws.
In addition, the COVID-19-induced temporary increase in APRN autonomy proved the superior
access and flexibility of the system, which supports the importance of FPA.
Literature Review and Analysis
Evidence strongly supports granting APRNs full practice authority. Harrison et al. (2023)
discovered that FPA states enjoyed more access to primary care services and fewer preventable
hospitalizations, especially amongst Medicaid and rural groups. Similar to the Future of Nursing
2020-2030 report by the National Academy of Medicine, practice barriers are stated as the key to
the promotion of health equity. Comparative research indicates that APRNs have no worse or
worse results in chronic disease management, preventive care, and patient satisfaction (Htay &
Whitehead, 2021). Despite this fact, the socio-political opposition and inconsistent state
adoption remain in the way of the full implementation of APRN contributions.
Recommendations
To promote FPA, states ought to implement comparable scope-of-practice laws based on
the 2008 Consensus Model, which removes compulsory physician supervision clauses that do
not contribute to patient safety. Secondly, parity would be created in terms of reimbursement
between Medicare, Medicaid, and private insurance through which APRNs would sustain
themselves in underserved locations. Enhancing the representation of APRNs in health policy leadership and hospital governance would also foster equitable decision-making and
collaborative models of care. Such changes would improve access to healthcare, decrease the
costs of the system, keep APRNs, and empower them to practice to their full extent of learning
and competence.
Conclusion
Barriers to the full practice authority of the APRN should be eliminated to enhance
healthcare access, quality, and equity. Independent practice will increase primary care access,
especially in rural and underserved groups, and further advance cost-effective, patient-centered
care frameworks. The role of policy reform and further advocacy is essential in ensuring the full
realization of the contribution of APRNs towards enhancing the outcome of population health.
References
Harrison, J. M., Kranz, A. M., Chen, A. Y.-A., Liu, H. H., Martsolf, G. R., Cohen, C. C., &
Dworsky, M. (2023). The Impact of Nurse Practitioner-Led Primary Care on Quality and
Cost for Medicaid-Enrolled Patients in States With Pay Parity. INQUIRY the Journal of
Health Care Organization Provision and Financing, 60, 469580231167013-
469580231167013. https://doi.org/10.1177/00469580231167013
Htay, M., & Whitehead, D. (2021). The effectiveness of the role of advanced nurse practitioners
compared to physician-led or usual care: A systematic review. International Journal of
Nursing Studies Advances, 3, 100034–100034.
https://doi.org/10.1016/j.ijnsa.2021.100034
Lewis, R. (2022). The evolution of advanced nursing practice: Gender, identity, power, and
patriarchy. Nursing Inquiry, 29(4), e12489–e12489. https://doi.org/10.1111/nin.12489
Tracy, M. F., O' Grady, E. T., & Phillips, S. J. (2023). Hamric & son's advanced practice nursing integrative approach (7th ed.). Elsevier.
Summary
Topic: Assignment
Type: Essay (any type)
Education level: Master’s
Citation style: APA 7th edition
Service: Writing
Size: 2 pages (550 words), double spacing
Sources: 4 sources required
Subject: Nursing
Language: English (US)
Deadline:
Description
Analysis and Recommendations of Advanced Practice Nursing Issues
The purpose of this paper is to identify a critical issue that relates to population health and the role of the Advanced Practice Registered Nurse (APRN). Some examples may include improving patient access to Medicare Hospice services, removing barriers to nurse practitioners’ ability to practice, and enabling APRNs to participate fully as members of hospital and medical staff. Additional examples are included on the American Association of Nurse Practitioners website.
Other sources for topic identification may include the Gerontological Advanced Practice Nurses Association and/or your local/state chapter of the AANP.
Review the Assignment rubric to ensure you have met the assignment criteria.
Submission Parameters:
Please use the following as a guide for drafting your paper.
- Introduction
- Contextual analysis of the issue
- Provide a summary of the historical development of the issue
- Provide a summary of the socio-political influences
- Literature Review and Analysis on the selected issue
- Identify at least 2 primary sources that examine the impact of the selected issue
- Recommendations
- Provide some recommendations to solve the issue
- Determine how the recommendations may impact the APRN role/setting, and practice dimensions
- Conclusion
Regarding APA format, please use the following as a guide:
- Include a title page
- Include transitions in your paper (i.e., headings or subheadings)
- Use in-text citations throughout the paper
- Use double space, consistent font, and font size throughout
- Spelling, grammar, and organization are appropriate
- Include a reference list
- Attempt to use primary sources only. That said, you may cite reliable electronic sources (i.e, NCSBN, AANP)