DNP 835 Topic 6 Discussion Question One – NursingPaperSlayers

The DNP degree empowers nurses to create programs for improving quality outcomes. What barriers need to be alleviated to increase the APN role in health care change?

Individual states regulate NP practice. Currently, 22 states and the District of Columbia, or 44%, have adopted full practice authority licensure and practice laws for NPs. Full practice authority is defined by the American Association of Nurse Practitioners (AANP) as follows: “State practice and licensure law provides for all nurse practitioners to evaluate patients, diagnose, order and interpret

DNP 835 Topic 6 Discussion Question One

diagnostic tests, initiate and manage treatments—including prescribe medications—under the exclusive licensure authority of the state board of nursing.” The remaining states are categorized as either “reduced practice” (17 states, or 34%) or “restricted practice” (12 states, or 24%). The AANP further defines these categories as follows (AANP, 2016):

Reduced Practice: The NP has the ability to engage in at least one element of the NP practice and is regulated through a collaborative agreement with an outside health discipline to provide patient care.

Restricted Practice: The NP has the ability to engage in at least one element of NP practice and requires supervision, delegation, or team management by an outside health discipline to provide patient care.

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In 2010, the Institute of Medicine (IOM), with the Robert Wood Johnson Foundation (RWJF), published a landmark report titled, “The Future of Nursing: Leading Change, Advancing Health.” This paper outlined four key messages: (1) Nurses should practice to the full extent of their education; (2) nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression; (3) nurses should be full partners, with physicians and other health-care professionals, in redesigning health care in the United States; and (4) effective work force planning and policy making require better data collection and an improved information infrastructure (IOM, 2010).

The report gives recommendations for implementing the key messages and recognizes “overly restrictive scope-of-practice regulation of NPs in some states as one of the most serious barriers to accessible care” (IOM, 2010). Soon after the release of this report, the RWJF, with the American Association of Retired Persons (AARP), launched the Future of Nursing: Campaign for Action (the Campaign), which has since worked at the national and state levels to shepherd the report’s recommendations.

As a follow-up to the 2010 report, in 2015 RWJF released the report, “Assessing Progress on the Institute of Medicine Report: The Future of Nursing,” which states that the Campaign had made significant progress in a short period of time, but points out that barriers still exist and more work needs to be done. The report adds that we need to continue to “address challenges in the areas of health care delivery and scope of practice, education, collaboration, leadership, diversity in the nursing profession, and work force data.

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