Full Practice Authority For Nurse Practitioners Research Articles

Perspectives on APRN prescribing of medications for opioid use disorder: Key barriers remain

IntroductionDeaths from drug overdoses are rising dramatically in the United States. Treatment for opioid use disorders may include behavioral treatments as well as medications for opioid use disorders (MOUD). Buprenorphine can be prescribed by physicians, nurse practitioners (NPs), other advanced practice registered nurses (APRNs), and physician assistants (PAs) and required a training and a federal waiver until recently. The number of NP MOUD prescribers grew steadily over the past decade, but research has identified state-level scope of practice regulations as a barrier to NP MOUD prescribing. This article explores the contributions of, and remaining barriers faced by NP and other APRN MOUD prescribers. We describe qualitative findings from a study of NPs and other key stakeholders involved in MOUD treatment in four states with two differing levels of regulatory structure. MethodsIn this qualitative study, we conducted site visits and semi-structured interviews with NPs and other APRNs, physicians, clinic managers, and regulators in four states including New Mexico and West Virginia (full practice authority for NPs), and Ohio and Michigan (which require physician supervision). Interview notes were entered into a qualitative software package and coded and reviewed by two members of the research team. Data were grouped into key themes. ResultsA total of 76 participants participated in individual or small group interviews in the four states. We found key themes and several subthemes that describe NP practice in MOUD. Participants described key contributions of NP engagement in MOUD, including increasing access, serving rural areas, the unique role of psychiatric NPs, and the value of the nursing model of care in working with people with substance use disorders (SUD). Participants also identified barriers including scope of practice regulations, other regulatory barriers, stigma, and lack of supportive services to address psychosocial needs. ConclusionsThe waiver requirements were eliminated at the end of 2022 in federal budget legislation. Other barriers for NP and other APRN prescribers remain and should be addressed in practice, and in state and federal regulations. Research needs to explore the impact of the waiver elimination on MOUD prescribing and access to services.

Exploring the Relationship between Nurse Practitioner Full Practice Authority, Nurse Practitioner Workforce Diversity, and Disparate Primary Care Access

In this study, we examine how full nurse practitioner (NP) practice authority affects racial and ethnic diversity of the NP workforce. Specifically, the purpose of our research is to understand the relationship between the racial and ethnic composition of the NP workforce, NP level of practice authority, and the communities they service. In this paper, we compare the ethnic and racial composition of the NP workforce to the composition of the state's population, and then observe if there are any noticeable differences in the patients served by NPs when we compare full practice authority (FPA) and non-FPA states. We also estimate how FPA affects the race and ethnicity of Medicare patients served by NPs.

A tree with deep roots: 54th anniversary of nurse practitioners.

More than 270,000 nurse practitioners (NPs) celebrate the profession's 54th anniversary this year. NPs have significantly expanded patient care options and availability. Many states now allow full practice authority for NPs, and all states now allow NPs to prescribe. Doctor of Nursing Practice-prepared NP enrollment is rising. The NP profession as an integral part of the US health care system has significantly strengthened our health care system, making the tree with deep roots even stronger and more substantial than ever.

Leveraging health care reform to accelerate nurse practitioner full practice authority: Corrigendum

Journal of the American Association of Nurse Practitioners 30(11):p 662, November 2018. | DOI: 10.1097/JXX.0000000000000164

Leveraging health care reform to accelerate nurse practitioner full practice authority.

Since development of the nurse practitioner (NP) role, NPs have been advocating for policy allowing them to practice to the full extent of their training. The aim of this research was to determine whether passage of the Affordable Care Act (ACA) had an impact on expansion of NPs' scope of practice. This was a retrospective descriptive study of NPs' scope of practice legislation from 1994 to 2016 using regulatory theory. Data sources included annual reports on NP legislation and state-level legislative and media coverage. Eight states adopted full practice authority (FPA) from 2011 to 2016, representing a two-fold increase compared with the previous 10 years. Seven states adopted Medicaid expansion. Nursing interest groups and politicians shaped their argument in favor of FPA around the increasingly insured population because of the ACA, provider shortages, and rural health care access issues. Shaping the discourse of FPA beyond the benefits to the NP profession makes way for broader political interest and participation. Although the future of the ACA is unknown, as the 28 states without FPA continue to advocate for legislative change, they could benefit from the strategies of these newly adapted FPA states.

States' Progress Toward Nurse Practitioner Full Practice Authority: Contemporary Challenges and Strategies

States' Progress Toward Nurse Practitioner Full Practice Authority: Contemporary Challenges and Strategies

The Struggle for Full Practice in North Carolina

That nurse practitioners (NPs) delivery high-quality care, equivalent to that provided by physicians, is well documented. However, many states have laws that restrict NPs from full practice authority, limiting their ability to comprehensively meet patient needs. North Carolina is a state that has very restrictive laws, with NPs working under physician supervision. In this article we address the effect restricted practice has had in North Carolina and the introduction of Senate Bill 695 (the Modernize Nursing Practice Act) that, if passed, would legislate full practice authority for NPs in our state.

Maryland's nurse practitioner full practice authority act of 2015.

Achieving full practice authority may require an incremental approach. This is the case in Maryland where the requirement for nurse practitioners (NPs) to collaborate with a physician was eliminated in 2010. Another achievement that year was revising regulatory control so that NPs are now regulated