Advanced practice nursing (APN) reflects the combination of graduate education and nursing. In the APN practice, the importance of “competent, efficient, and readily available care”, “quality, cost-effective care”, and “appropriate patient choice and accountability” is remarkable (Safriet, 2011). Throughout history, APNs have been and are called to serve by gathering patient histories, performing physical exams, ordering procedures, diagnosing, treating, and managing disease, prescribing medications, and making referrals. In 1965, Loretta Ford and Henry Silver began the first certificate program that provided the skills to provide primary care to patients. In 1970, APN education began to include bachelor and master degree programs. According to Hain & Fleck (2014), “These early nursing pioneers revolutionized advanced practice nursing” (Hain & Fleck, 2014). Today, APNs have proven they play a valuable role in primary- and acute-care and as generalists and specialists. This paper will identify and discuss regulatory provisions (restrictions) to full deployment of APNs and principal causes of current barriers to removal of the restricted provisions for an APN, identify proposed strategies for change, and discuss how critical this knowledge is for prospective APNs and how a prospective APN could apply this knowledge in implementing the advanced practice role.
Regulatory Provisions (Restrictions)
Two regulatory provisions (restrictions) to full deployment of APNs in current health system are: “ State-based limitations on the licensed scopes of practice for APNs (and other providers) which prevent them from practicing to the full extent of their abilities” and “Pay...
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...ange, discussed how critical this knowledge is for prospective APNs, and discussed how a prospective APN could apply this knowledge in implementing the advanced practice role. Advanced practice nursing is constantly evolving and diversifying. However, the provisions (restrictions) and barriers on the care that can be given by APN groups has resulted in NPs not being able to reach their full potential in autonomous care. Likewise, the expansion of managed health care systems has presented APN with new obstacles and challenges. Due to these changes and challenges, “the history of advanced practice nursing continues to be written” (Hamric, Spross, & Hanson, 2014); however, hopefully, the changes that will evolve in the future will reflect a more autonomous, independent, cost-effective practice without losing sight of the quality of care given to each and every patient.
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