APRN Scope of Practice
APRN Scope of Practice
Review the Case study below and discuss the restrictiveness of your state’s nurse practice act regarding APRN practice in the context of the recommendation in the IOM Report regarding scope of practice. Answer the six questions in the case study as part of your small group notes. My state is Maryland
Please the questions on the rubric should be your headings and all the questions should be addressed!!!!!!!!!!!!
READINGS AND RESOURCES
o Chapter 66-70 from Policy and Politics in Nursing and Health Care.
o Consensus Model for APRN Regulation: Licensure, Accreditation, Certification & Education. (2008). APRN Consensus Work Group & the National Council of State Boards of Nursing APRN Advisory Committe.
o Standards for Supervision of Nursing Practice – Sermchief v. Gonzales, 660 S.W.2d 683 (Mo. 1983).
Text and Materials
READINGS AND RESOURCES
• Mason, D., Gardner, D., Hopkins-Outlaw, F., & O’Grady, E. (2016). Policy and Politics in Nursing and Health Care (7th ed.) ISBN: 978-0323241441.
• American Psychological Association. (2009). Publication Manual for the American Psychological Association (6th Ed.). Washington, DC: The American Psychological Association. ISBN: 978-1433805615.
• Various articles linked within the course.
Week Seven Small Group Work Rubric
Week Seven Small Group Work Rubric
Criteria Ratings Pts
Investigate the scope of practice governed by each group member’s state nurse practice act (NPA). Cite the source in appropriate APA format.—-Maryland is my state. So you are writing about Maryland in this case. This area will be used by the assessor to leave comments related to this criterion. 10 pts
How restrictive is your NPA?—Maryland
Then answer the six questions below from the case study This area will be used by the assessor to leave comments related to this criterion. 10 pts
Case Study Question 1 This area will be used by the assessor to leave comments related to this criterion. 5 pts
Case Study Question 2 (for example: if you identify physicians as major stakeholders, what is the position of your state’s medical association on the practice of APRNs?) This area will be used by the assessor to leave comments related to this criterion. 10 pts
Case Study Question 3 This area will be used by the assessor to leave comments related to this criterion. 10 pts
Case Study Question 4 This area will be used by the assessor to leave comments related to this criterion. 10 pts
Case Study Question 5 – see #1 above This area will be used by the assessor to leave comments related to this criterion. 0 pts
Case Study Question 6 – what five or six major points would you include in testimony to convince your state legislator to remove restrictions on scope of practice? I need all these six points This area will be used by the assessor to leave comments related to this criterion. 15 pts
Total Points: 70
Implementation Strategies: Consensus Model fot APRN Regulation – 133 lcian in accortlf of the phytants (PAs) to ealth services te fact that the ian documen- >rior to orderltory practice 2. Discuss the most appropriate way to notify these agencies/organizations that an infringement has occurred. 3. Identify the gaps in implementation that may contribute to this situation. 4. Discuss what actions need to be taken by the players involved to address the compliance charges. 5. Identify mechanisms that need to be in place to prevent discrimination from occurring in the future. Vledicare and luence changlanguage that ner participa- =uu .rses can play ble, and com- :!r as barriers :ar in private : insurers and whe_n private pecialty pro- ‘RNs at rates scrirnination : health plans !spect to parwho is acting 1licable State ;sure that the sms and pen- 1 of discrimiIMPLEMENTATION STRATEGIES FOR THE 2008 CONSENSUS MODEL FOR APRN REGULATION: LICENSURE, ACCREDITATION, CERTIFICATION, & EDUCATION Background Reaching consensus around a standardized model for all APRN regulation is a significant accomplishment for the APRN community. The process of adopting the 2008 Consensus Model for APRN Regulation took four years. In March 2004, the American Association of Colleges of Nursing (AACN) and the National Organization of Nurse Practitioner Faculties (NONPF) submitted a proposal to the Alliance for Nursing Accreditation, now named Alliance for APRN Credentialing, to establish a process to develop a consensus statement on the credentialing of advanced practice registered nurses. Thirty-two organizations responded to an invitation by the Alliance for APRN Credentialing to participate in the APN Consensus Conference in Washington, D.C., in June 2004. After this meeting, the Alliance for APRN Credentialing formed a smaller work group made up of designees from 23 organizatiorfs with broad representation of APN certification, licensure, education, accreditation, and practice. The charge to the work group was to develop a statement that addresses the issues delineated during the APN Consensus Conference with the goal of envisioning a future model for APNs. The July 2008 report of the Consensus Model for APRN Regulation: Licensure, Accreditation, Certification, and Education was completed through the collaborative work of the APRN Consensus Work Group and National Council of State Boards of Nursing (NCSBN) APRN Advisory Committee, with extensive input from a larger APRN stakeholder community. The target date for full implementation of the Regulatory Modd and all embedded recommendations is the year 2015. The expectation is that the consensus reached on recommendations in the regulatory model will inform decision-makers as the APRN community moves towards full implementation. Stanley, Werner, and Apple (2009) indicated that implementation will occur incrementally or sequentially, but cautioned that there is not time to devote to an education campaign or a discussion regarding how components of the model should be implemented between now and 2015. The APRN community must capitalize on the work done in the 2008 Consensus Model for APRN Regulation: Licensure, Accreditation, Certification, and Education as all stakeholders I i ‘! , I , ,… Ii MSN NURS602: Health Care Policy 134 Chapter 6 • Implementation move t9wards the 2015 target date for full implementation (APRN Consensus Work Group and the National Council of State Boards of Nursing APRN Advisory Committee, 2008). Building consensus among diverse entities or organizations is rarelieasy. This laudable goal is particularly challenging within a community that in the past has perceived more advantage to preserving unique differences than moving toward unity. The consensus process requires sustained commitment by all participants and the ability of each participating organization to tolerate the push-and-pull phenomena that occurs during the process. This tenacity, supported by a culture of open communication, is what allowed each participant to state his or her position or understanding and to push an agenda, but ultimately pull back when necessary and appropriate to reach common ground. Finding the balance to accommodate differing viewpoints without missing out on achieving meaningful consensus is essential. At any point, the process can begin to unravel when a party does not believe it has been heard or its perspective recognized in the document. A separate challenge is overcoming the fear or attitude that the end product is a compromise and therefore not the “best” decision. Because the definition of consensus itself is unclear, some can easily assume that anything less than unanimous consent is compromise. It is critical that participants in the process not adopt this attitude, but instead continue to work through the issues to reach a common agreement that addresses not only the concerns and needs of individual organizations, but is the best decision for the profession. Implementation of the model is the responsibility of each individual organization, but ongoing communication and transparency of actions and decisions are critical. As the implementation of the consensus model for APRN regulation moves forward, only time will tell if the APRN community was successful in reaching true consensus that has a lasting impact on the nurse profession. Successful implementation of the regulatory model will involve the commitment, coordination, and continued collaboration of all nurse stakeholders, including academic institutions, professional organizations, certification and accreditation bodies, and state boards of nursing. Implementation is the responsibility of each of these entities and has already been put into motion at a variety of levels. Communication is critical to implementation among the academic institutions, professional organizations, certification and accreditation bodies, and state boards of nursing. It is important to develop solutions that include all four types of advanced practice: APRN, CNM, CNS, and CRNA. The LACE communication network will provide a pl< ;tform for the LACE entities to communicate and continue this collaborative effort.’ Stakeholder groups have made a long-term commitment to working together to ensure the success of the consensus model. Implementation of the model is the responsibility of each individual organization, but ongoing communication and transparency of actions and -decisions are critical. As the APRN stakeholders move forward with implementation of the consensus model for APRN regulation, time will tell if the APRN community MSN NURS602: Health Care Policy Implementation Strategies: Consensus Model for APRN Regulation 135 was successful in reaching true consensus that has a lasting impact on the nursing profession. This is the case study ,please each question on the rubric should be a heading meaning all the questions should be answered accordingly. In all you will be having eight headings. CAsE 5Tuov 6: Restricted Scope of APRN Practice You are attending a regional/national APRN conference. At lunch, you are seated with APRNs from different states. A conversation ensues and you are educated on the fact that many states have restrictions on the scope of practice for APRNs. One of the keynote speakers addressed how components of the consensus model should be implemented between now and 2015, stressing that the APRN community must capitalize on the work done in the 2008 Consensus Model for APRN Regulation: Licensure, Accreditation, Certification, and Education. Your assignment is to work with your colleagues to develop an approach to address the inconsistency among states regarding restrictions on scope of practice. 1. Identify stakeholders in this endeavor. 2. Document the position that each identified stakeholder has in this issue. 3. Address each potential variable in the implementation process that could impact your endeavors related to this issue. 4. Discuss strategies that could be used tb address the variables. 5. Where would you find the most current information about individual states and restrictions on scope of practice? 6. Write testimony that you would present to a state legislature to convince them to remove restrictions on scope of practice for APRNs. Responses to Consider for Case Study 6: Restricted Scope of Practice APRN professional organizations need to commit to strategies to override or remove restrictions on nursing practice in state scope of practice laws and regulations. The 41 member organizations of the Nursing Community, a-forum for professional nursing and related organizations, produced a document addressing healthcare reform (Nursing Community, n.d.). This consensus document, titled The Commitment to Quality Health Reform: A Consensus Statement from the Nursing Community, encourages nurses to be involved in every discussion regarding impending changes in health reform. When addressing scope of practice, nurses are encouraged to use the Institute of Medicine (10M) definition of primary care, which states “Primary care is the provision of integrated, accessible healthcare services by clinicians who are accountable for addressing a large majority of personal healthcare needs, developing a sustained partnership with patients, and practicing in the context of family and community” (Institute of Medicine, 1994). ‘· REFERENCES American Academy of Nursing. .(2010). Implementing health care reform: Issues for nursing. Retrieved KE from http://www.aannet.org/files/public/ImplementingHealthCareReform.pdf APRN Consensus Work Group and the National Council of State Boards of Nursing APRN Advisory E Committee. (2008). Consensus model for APRI'(regulation: Licensure, accreditation, certification, and education. Retrieved from http://www.aacn.ncfie.edu/education/pdf/APRNReport.pdf E Bardach, E. (1977). The implementation game: What happens after a bill becomes a law. Cambridge, MA: MIT Press. Deleon, L., & Deleon, P.(2002). What ever happened to policy implementation? An alternative approach. Journal of Public Administration Research and Theory; 12(4), 467-492. Health Care Education and Reconciliation Act. (2010). Pub. L. No.111-152, 124 Stat. 1029. ( Hill, M.1.,& Hupe, P. L. (2002). Implementing public policy: Governance in theory and practice.Thousand Oaks, CA: Sage. Institute of Medicine. (1994). Defining primary care: An interim report. Washington, DC: National Academies Press. I Nursing Community. (n.d.).The commitment to quality health reform: A consensus statement from the nursing community. Retrieved from http://www.thenursingcommunity.org/#/health-reform/4542347781 Palumbo, D.1., & Calista,D.J. (1990). Implementation and the policy process: Opening up the black box. l New York: Greenwood Press. Patient Protection and Affordable Care Act. (2010). Pub. L. No. 111-148, 124 Stat. 119. Stanley, J., Werner, K., & Apple, K. (2009). Positioning advanced practice registered nurses for healthcare reform: Consensus on APRN regulation. Journal of Professional Nursing, 25(6), 340-348.