Independent Practice for Aprn in Georgia
Limited Scope of Practice for APRNs in Georgia and the movement toward Autonomy
Ann Giedd
Catholic University of America
November 21, 2011
Executive Summary Independent practice is central to the APRNs professional role (Weiland, 2008). In Georgia, factors involving state rules and regulations such as the need for physician collaboration and supervision in order to diagnose and prescribe have created practice environments that are detrimental for full recognition of APRNs as autonomous providers, hence, keeping them from practicing to the full scope of their education (Weiland, 2008). In Georgia, the social and economic outcomes of supervision and lack of utilization of APRNs include a decrease in patient access to care, increased health care costs and a denial of the primary care provider status (Weiland, 2008). Additionally with the possibility of a physician shortage of almost 200,000 by 2020 and the influx of almost 23 million newly insured Americans needing primary care providers, the impact is that society is paying for the underutilization of a capable resource, not just financially but by a serious lack of access to care (Weiland, 2008). In Georgia, the role of APRNs can be carried out only with full professional recognition as independent providers (Weiland, 2008). Twenty Four states and the District of Columbia allow independent practice for APRNs (Pearson, 2010). APRNs have independent offices and practices and work as hospitalists in various capacities in all of these regions (IOM, 2010). They provide competent, safe care and still collaborate with other medical professionals for the wellbeing of the patient they treat when needed (IOM, 2010). The collaboration of providers in these states are now working toward implementing a new model of patient care called the patient centered medical home model (PCMH) (IOM, 2010). This model stresses collaboration of all independent medical professionals. Clearly, APRNs must articulate their
Ann Giedd
Catholic University of America
November 21, 2011
Executive Summary Independent practice is central to the APRNs professional role (Weiland, 2008). In Georgia, factors involving state rules and regulations such as the need for physician collaboration and supervision in order to diagnose and prescribe have created practice environments that are detrimental for full recognition of APRNs as autonomous providers, hence, keeping them from practicing to the full scope of their education (Weiland, 2008). In Georgia, the social and economic outcomes of supervision and lack of utilization of APRNs include a decrease in patient access to care, increased health care costs and a denial of the primary care provider status (Weiland, 2008). Additionally with the possibility of a physician shortage of almost 200,000 by 2020 and the influx of almost 23 million newly insured Americans needing primary care providers, the impact is that society is paying for the underutilization of a capable resource, not just financially but by a serious lack of access to care (Weiland, 2008). In Georgia, the role of APRNs can be carried out only with full professional recognition as independent providers (Weiland, 2008). Twenty Four states and the District of Columbia allow independent practice for APRNs (Pearson, 2010). APRNs have independent offices and practices and work as hospitalists in various capacities in all of these regions (IOM, 2010). They provide competent, safe care and still collaborate with other medical professionals for the wellbeing of the patient they treat when needed (IOM, 2010). The collaboration of providers in these states are now working toward implementing a new model of patient care called the patient centered medical home model (PCMH) (IOM, 2010). This model stresses collaboration of all independent medical professionals. Clearly, APRNs must articulate their
References: Agosta, L. (2009) Patient satisfaction with nurse practitioner-delivered primary healthcare services. Journal of the American Academy of Nurse Practitioners .21. p. 610–617. Ameringer, C. F. (2002). Health care professionals and exclusive scopes of practice. Journal of Health Politics, Policy and Law. 27. P. 307–317. Farrell, M. P., Schmitt, M. H., and Heinemann, G. D. (2001). Informal roles and the stages of interdisciplinary team development. Journal of Interprofessional Care, 15(3). P. 281–295. AARP Public Policy Institute, Creating a 21st Century Nursing Workforce to Care for Older Americans: Modernizing Medicare Support for Nursing Education, Insight on the Issues (Washington, DC: AARP, October 2009). Brown, M. A., and Draye, M. A. (2003). Experiences of pioneer nurse practitioners in establishing advanced practice roles. Journal of Nursing Scholarship. 35, p. 391–397. Grumbach, K., and Coffman, J. (1998). Physicians and nonphysician clinicians: Complements or competitors? Journal of the American Medical Association, 280. P. 825–826. Everett, C., Schumacher, J., Wright, A., & Smith, M. (2009).Physician assistants and nurse practitioners as a usual source of care. The Journal of Rural Health, 25(4). P. 407-414. Institute of Medicine. (2010). The future of nursing: leading change, advancing health. Washington, DC: National Academies Press. Keenan, J National Council of State Boards of Nursing, Campaign for APRN Consensus, The Consensus Model for APRN Regulation: Licensure, Accreditation, Certification and Education, accessed November 7, 2011. https://www.ncsbn.org/aprn.htm Naylor, M., and Kurtzman, E Pohl, J. A., Hanson, C., Newland, J. A., Cronenwett , L.(2010) Analysis and commentary: Unleashing Nurse Practitioners ' Potential To Deliver Primary care and lead teams. Health Affairs. 29 (5). P. 900-5. The Pearson Report, The National Overview of Nurse Practitioner Legislation and Healthcare Issues, 2011. http://www.pearsonreport.com. Kaplan, L., Brown, M. A. (2007). The transition of Nurse Practitioners to changes in prescriptive authority. Journal of Nursing Scholarship. 39(2). P. 184-190. Kaplan, L., Brown, M.A Kaplan, L., Brown, M.A., Andrilla, H., & Hart, L.G. (2006). Barriers to autonomous practice. The Nurse Practitioner, 31(1) p. 57–63. Cajulis, C., Fitzpatrick, J.J. (2007) Levels of autonomy of nurse practitioners in an acute care setting. Journal of the American Academy of Nurse Practitioners. 19(10). P. 500-507. Street, D., Cossman, J. (2010) Does familiarity breed respect? Physician attitudes toward nurse practitioners in a medically underserved state. Journal of the American Academy of Nurse Practitioners. 22. P. 431–439. Weiland, S.A. (2008) Reflections on independence in nurse practitioner practice. Journal of the American Academy of Nurse Practitioners. 20. p. 345–352. Center for the Health Professions (2007) Chart Overview of Nurse Practitioner Scopes of Practice in the United States. Retrieved on November 15, 2011. http://futurehealth.ucsf.edu.