NR 506 Week 6 Assignment
Scope of Practice and Patient’s Healthcare Accessibility
Purpose
The purpose of this assignment is to identify the scope of practice in one’s state including level of independence of practice, prescribing authority, any limitations of practice, process for obtaining licensure in your state, certification and education requirements for licensure. Next, students will discuss how the level of independence of practice in their state, i.e., reduced, restricted or full practice, affects patient’s access to care in their local community.
Activity Learning Outcomes
Through this discussion, the student will demonstrate the ability to:
- Understand NP practice as defined by law (CO2)
- Determine legislation as defined by legislation, statutes and regulations (CO2)
- Identify barriers to ensuring patient’s rights (CO3)
Due Date: Wednesday by 11:59pm MST of Week 6
Initial responses to the discussion topic must be posted by Wednesday 11:59pm MT. Two additional posts to peers and/or faculty are due by Sunday at 11:59pm MT. Students are expected to submit assignments by the time they are due.
A 10% late penalty will be imposed for discussions posted after the deadline on Wednesday of week 6, regardless of the number of days late. NOTHING will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0).
Total Points Possible: 100
Requirements:
- Discuss your state NP community in terms of scope of practice. Include the your state’s scope of practice for NPs including:
- Level of independence of practice **In California, NPs are required to practice under Standardized Procedure Guidelines. If CA is your intended practice state, please provide details on how Standardized Procedures Guidelines are developed in California and an example of a California SPG.
- Prescribing authority
- Any limitations of practice
- Process for obtaining licensure in your state
- Certification and education requirements for licensure.
- If you live in a restricted or reduced practice state, how has patient care been impacted in your local community from these barriers? For instance, is the ED used for primary care? Are the EDs overcrowded with long wait times? Are there urgent care clinics readily available? Is there adequate access to primary care? If you live in a full practice, how has independent practice of the APN resulted in improved patient access to healthcare?
- How does access to NPs impacts any healthcare disparities?
- A scholarly resource must be used for EACH discussion question each week.
Sample Discussion Post
Nursing Practice Act (NPA) Section 2725 of the Business and Profession Code authorizes standardized procedures, also defined in the California Code of Regulations (CCR 1480) (State of California Department of Consumer Affairs [DCA], n.d.). Standardized procedures are the legal frameworks that allow registered nurses and nurse practitioners to carry out tasks that would otherwise be deemed medical practice. According to the State of California Department of Consumer Affairs [DCA], (n.d.), standardized procedure guidelines must be written and undoubtedly state under what circumstances tasks can be performed by the nurse or nurse practitioner, along with the specification of their education, training, and experience, the need for supervision. The interdisciplinary Practice Committee (IDPC) membership includes nurses, nurse practitioners, physicians, and administrators who develop all standardized procedures.
Health Care Organizations such as acute care facility has protocol developed to treat patients with health conditions, for example, urinary tract infection, and according to the protocol, a nurse practitioner is allowed to initiate and carry out the protocol without a physician’s supervision. Practicing medicine is not in the scope of nurse practitioners’ practice; all nurses and nurse practitioners must follow the standardized procedure guidelines. In order to practice as a nurse practitioner in California, one must hold a valid RN license and then apply for NP. The application can be filled out online via CA breeze account, and transcripts can be uploaded electronically (California Board of Registered Nursing, n.d.). A nurse practitioner must obtain a nurse practitioner furnishing number to prescribe medications and equipment in the state of California. If a nurse practitioner with a furnishing number wants to order controlled substances for patients, the NP can get a Drug Enforcement Administration (DEA) registration number.
Currently, the State of California has a restricted practice which means a nurse practitioner’s ability to engage in at least one aspect of NP practice is limited by state practice and licensure requirements (American Association of Nurse Practitioners [AANP], 2022). My hometown is Visalia, CA. The biggest hospital we got is Kaweah Health, with a capacity of 419 beds, which provides all emergency services, including trauma, MI, Stroke, and HD. The regular wait time to see patients is about 4 hours, and admission wait time 8 hours and 44 minutes were recorded in 2020, before the pandemic (Emergency Room Near Me, 2020). The waiting time has doubled and tripled since then. Kaweah Health has set up many urgent care centers around the town to meet the community’s needs. NPs play a vital role in the ED and urgent care centers in providing urgent and emergency services. According to Ortiz et al., (2018), those in full-practice states had 62 percent more geographic access to primary care physicians (including ARNPs) than those in limited practice states, compared to only 35 percent in restricted practice states. The rising nurse practitioner (NP) workforce represents an ample supply of primary care providers who, if properly utilized, can help racial and ethnic minorities gain access to health care (Poghosyan & Carthon, 2017).
References
American Association of Nurse Practitioners. (2022). State practice environment. https://www.aanp.org/advocacy/state/state-practice-environmentLinks to an external site.
California Board of Registered Nursing. (n.d.). Advance practice and public health nurse certification. CA.GOV. https://www.rn.ca.gov/applicants/ad-pract.shtml.
Emergency Room Near Me. (2020). Kaweah delta medical center er wait time visalia ca. Emergencyroomnearme.org. https://emergencyroomnearme.org/kaweah-delta-medical-center-er-wait-times-visalia-ca/Links to an external site.
Ortiz, J., Hofler, R., Bushy, A., Lin, Y., Khanijahani, A., & Bitney, A. (2018). Impact of nurse practitioner practice regulations on rural population health outcomes. Healthcare, 6(2), 65. https://doi.org/10.3390/healthcare6020065.
Poghosyan, L., & Carthon, J. (2017). The untapped potential of the nurse practitioner workforce in reducing health disparities. Policy, Politics, & Nursing Practice, 18(2), 84–94. https://doi.org/10.1177/1527154417721189.
State of California Department of Consumer Affairs. (n.d.). An explanation of standardized procedure requiremnts for nurse practitioner practice [Pdf]. rn.ca.gov. https://rn.ca.gov/pdfs/regulations/npr-b-20.pdf
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