In an effort to meet increasing demands for primary care services, governors throughout the United States have spoken out in favor of expanding scope-of-practice laws for nurse practitioners (NPs) and other advanced practice nurses (APNs). Support stemmed from evidence gathered through a comprehensive literature review sponsored by The National Association of Governors. The full report is available at http://www.nga.org/cms/home/news-room/news-releases/page_2012/col2-content/nurse.
In reviewing 22 studies, the governor's group concluded that several specific aspects and processes of healthcare provided by NPs and APNs are comparable with physician-provided care. The literature review also supported that NPs allowed for improved access to healthcare. Care provided by NPs compared favorably with care provided by physicians in terms of patient satisfaction, prescriptive accuracy, preventive education, and amount of time the provider spent with each patient. Chronic conditions, including hypertension, diabetes, and obesity, can be successfully managed by NPs and APNs. Nurse practitioners are actually more successful in achieving patient compliance in reducing both blood pressure and blood sugar. A similar literature review, carried out by the same organization in 2003, determined that NPs and APNs are more likely to work with underserved urban and rural populations than are primary care physicians. The study also illustrated that patients self-reported having no preference as to who provided their "nonmedical" aspects of care.
Currently, 16 states, including the District of Columbia, allow NPs to practice and prescribe medications without supervision by physicians. Thirty-four states require physician involvement. Ten states plan to expand NP independence in 2013.
Changes in healthcare resulting from the Affordable Care Act are predicted to add 15 million to 25 million primary care visits yearly until 2020. The report by the National Association of Governors recommends that states ease their scope of practice restrictions and modify reimbursement policies to include greater nurse involvement in primary care. The 2010 Institute of Medicine Report has previously noted the restrictive nature of NP and advanced practice nursing laws as a barrier to healthcare delivery.
Our role as nurse educators involves continuing to effectively prepare these APNs. In addition, as healthcare leaders in each state, we can work to impact and advance policy changes related to the role of APNs and better meet the healthcare needs of each state.
Source: Pittman D. NPs care equal to Doc's, review finds. MedPage Today. December 28, 2012. Available athttp://www.medpagetoday.com/nursing/Nursing/36648. Accessed February 14, 2013.
Submitted by: Robin E. Pattillo, PhD, RN, CNL, News Editor at [email protected].