Exploring the Impact of Policy Restrictions on Advanced Practice Registered Nurse Care: Research Paper

Introduction with the Statement of the Problem

Advanced practice registered nurses (APRNs) have a distinct capability of influencing change in various aspects of healthcare needs. Nevertheless, the nurses face some restrictions in their provisions of health care by various policies and regulations enforced by the state as well as reimbursement policies (Lavis et al., 2009). In spite of numerous researches portraying that the care offered by the APRN is safe, affordable and are of high quality, majority of the professional and medical organizations have been in constant antagonism with the state scope of practice (SOP) barriers claiming that they are laying emphasis on the safety of the patients. Bakanas (2010) argued that both of the nursing organizations, at the national and state levels, have moved ahead to invests in time as well as assets to alter the policy.

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However, empirical evidence concerning the quality of the care provided by the APRNs has to be shared with the policymakers, funding entities as well as the public domain. Moreover, Bouchard (2019) claimed that alterations in the practice policy scope could only be materialized with the introduction of firm persons within the profession of nursing as well as the coming together of various organizations to form one force. The main focus of this paper is, therefore, to conduct a health care policy analysis.

Background

It is unmistakable that the present primary care is advanced and has been subjected to rigorous training. A research that was undertaken in Massachusetts established that it requires an average of thirty-nine days for a new patient to get an appointment with a primary care physician despite the fact that only 50% of the physicians who provide the primary care get to see the new patients. Lowery (2009) argued that the average lengths of visits are about fifteen minutes, making both patients and the physicians feel the pressure resulting from such time restraints. Moore (2006) further claimed that there is a high likelihood of the problem worsening as thousands of individuals that can get access to the Affordable healthcare act to start to seek Medicare. The average increase has, however, not lead to enhanced service accessibility since providers of the health care almost, if not getting to full capacity, then this may ultimately, lead to more elongated durations that patients are compelled to wait without giving rise to better healthcare quality to patients (Hyder et al., 2010). In spite of this, the health care providers may boost the volume of healthcare services supplied either by raising the labor supply or developing new techniques of practice. By so doing, the negative outcome will be mitigated.

Nelumbu (2015) further argued that expanding the roles of the APRNs might be a significant factor when it comes to the provision of solutions for the shortages of the workforce in primary care. Advanced practice registered nurses is sufficiently trained to offer a broad range of services that range from treatments, prescription services as well as specialty services. "National Center for Policy Analysis" (2010) ascertained that masters or doctorate degree, as well as possession of advanced clinical training, are the prerequisites for one to deem fit and qualified for APRN.

Bakanas (2010) maintained that the state scope of practice, for a long time, has been acting as the determining factor for service range that can be provided by APRNs and the degree to which they are permitted to practice independently. Such regulations vary from state to state. The laws are thus responsible for regulating the clinical roles of the APRNs as well as offering an explicit simplification of the needed level oversight by the physician. Bouchard (2019) noted that certain countries permit their nurses to practice independently without supervision while others monitor their practices by the relevant authorities to diagnose, treat, as well as prescribe treatments for the patients. Hyder et al. (2010) further ascertained that over two-thirds of the countries that are subjected to shortages of physicians have regulations that outline the scope of practice, which acts as a major hindrance offering primary care to the patients by the APRNs.

Questions to take into Account

• Whether the policy brief assesses the current characteristics?
• Whether the policy brief addresses the effect of the recommendation from the viewpoint of nurses, consumers, health care professionals, and other stakeholders?
• Whether the policy brief assesses the current solutions?
• Whether the policy brief addresses the existing status in the arena of health policy

Whether the policy brief assesses the current characteristics?

A policy brief needs to consider addressing the prevailing characteristics within the SOP barriers. Nelumbu (2015) argued that the SOP is commonly characterized by close monitoring and supervision of the APRN by the physicians regarding the diagnosis, treatments, and prescriptions of various medications to patients. For this to be achieved, the APRN must be under tight supervision by a physician.

Whether the policy brief addresses the effect of the recommendation from the viewpoint of nurses, consumers, health care professionals, and other stakeholders?

Bouchard (2019) argued that the implementation of this recommendation would have a vital impact not only on the APRNs but also to the service consumers, other health professionals, as well as stakeholders. Lowery (2009) noted that states that are characterized by an extended practice authority for APRNs would register substantial rates of growth and advancements in the primary care provided by the APRNs. This will enable the nurses to gain more power and authority in their medical prescriptions. Furthermore, this will also result in an enhanced APRN workforce (Bosse, 2014). These recommendations will be of paramount significance to the prospective consumers, specifically those in regions with a shortage of provision of primary caregivers. Furthermore, evidence has proposed that eliminating the barriers related to the scope of practice is associated with enhancing care provision by the APRNs, especially in an understaffed region as well as the rural areas. This will enhance the accessibility of primary care by consumers.

Whether the policy brief assesses the current solutions?

Bakanas (2010) advocates for the development of licensing processes that will permit an experienced APRN to be capable of practicing without any form of hindrance. This is because the APRN are subjected to rigorous training programs that can be compared to physicians who provide primary care. Nelumbu (2015) further maintained that after undergoing the same experience of practice under supervision for some duration, the APRN could then be subjected to a licensing examination that is the same as the ones undertaken by the physician who provides primary care. Passing such exams will then permit the APRNs to execute duties within their scope of practice without restrictions (Bakanas, 2010). This, therefore, means that after the APRN has attained sufficient training under supervision, they can then be permitted to offer the highest quality care. Consequently, the barriers associated with the scope of practice can then be abolished hence making the APRN be considered as providers of the primary care in various programs and settings (Hyder et al., 2010). It, therefore, follows that different states should implement policies that eliminate the laws associated with the scope of practice.

Whether the policy brief addresses the existing status in the arena of health policy

The policy brief handles the prevailing status of health care policies. This kind of policy brief is a discussion of the hindrances to the scope of practice and laws in different states and prohibits the APRN to practice and freely make usage of the knowledge that they have acquired from training (Bakanas, 2010). It, therefore, proposes the abolition of the scope of practice barriers to enable qualified nurses to practice their training and education to the fullest extent.

Final Conclusions

Countries and states with extended APRN practice authorities have registered high growth rates as well as enhancements in the primary care that is provided by the APRN. If the above recommendations are implemented, a substantial influence will be registered on the health care consumers, health care professions as well as other stakeholders. The scope of practice, for a long time, has been the key determinant of the type of services that APRN can offer as well the extent at with they are permitted to operate independently. However, the abolition of the scope of practice barriers will make advanced practice registered nurses to practice their training and education to the fullest extent.

References

Bakanas, L. (2010). Physicians and advanced practice registered nurses: The supervisor-employer relationship. AMA Journal of Ethics, 12(1), 12-15. https://doi.org/10.1001/virtualmentor.2010.12.1.ccas2-1001

Bosse, J. (2014). Position statement: advanced practice registered nurses full practice authority. Journal of the Association of Nurses In AIDS Care, 25(5), 465-467. https://doi.org/10.1016/j.jana.2014.06.003

Bouchard, L. (2019). Compassion fatigue in advanced practice registered nurses. Nursing Clinics of North America, 54(4), 625-637. https://doi.org/10.1016/j.cnur.2019.08.002

Hyder, A., Syed, S., Puvanachandra, P., Bloom, G., Sundaram, S., Mahmood, S., Peters, D. (2010). Stakeholder analysis for health research: case studies from low- and middle-income countries. Public Health, 124(3), 159-166.

Institute of Medicine. (2010).The future of nursing: Leading change, advancing health: Report recommendations. Retrieved from http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2010/The-Future-of-Nursing/Future%20of%20Nursing%202010%20Recommendations.pdf

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Lowery, B. (2009). Obesity, bariatric nursing, and the policy process: The connecting points for patient advocacy. Bariatric Nursing & Surgical Patient Care, 4(2), 133-138.

Moore, K. (2006). How can basic research on children and families be useful for the policy process? Merrill-Palmer Quarterly, 52(2), 365-375.

Nelumbu, L. (2015). Implementation of a reflective practice program for registered nurses. International journal of advanced nursing studies, 4(2), 115. https://doi.org/10.14419/ijans.v4i2.4983

National Center for Policy Analysis (2010). Ideas changing the world: Free-market health care policy. Retrieved from http://www.ncpathinktank.org/healthcare