Collaborative agreements or other physician signature for Advanced Practice Nurse Practitioners in the State of Texas.
Considering this problem, I would propose to introduce a new policy to establish independent practice authority for APRNs in Texas in accordance with the educational preparation to meet the health care needs of Texas population and reduce primary care shortage. State regulations for Advanced Practice Registered Nurses (APRN) Practice varies from state to state. According to Stout(2007), Texas is one of the highly regulated states in the United States (U.S) in comparison to all other states in relation to APRN practice. In the state of Texas, APRN requires physician supervision and prescriptive delegation for
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According to Texas Medical Association (2016), Texas has a severe shortage of primary care providers due to consistent growth of populations which ranks Texas in the second most populated states in America.Besides that, Texan has high obesity rates and comorbidity related to obesity are soaring high in this state recently (Texas Medical Association,2016). According to American Medical Association, Texas along with other states are facing severe primary care shortage with a projected number of 125,000 to 160,000 primary care providers due to increased number of baby boomers and newly insured clients (Conway,2010).On nationwide primary care shortage rising up 39% and especially in the state of Texas due to a steady population growth and the highest number of the uninsured population compared to other states(Conway,2010). According to Miller(2017), a recent report shows 35 counties in Texas do not have any kind of physician …show more content…
However, the barriers in providing independent care by midlevel providers cause impediments to meet this requirement(Bodenheimer& Pham,2017).According to Texas Medical Association(2016), in Texas, the patient ratio to primary care providers is 1:2500 and it is expected to grow much worse due to projected population growth.Texas population increase tremendously each year due to more people relocating to Texas ascribed to more job opportunity and multicultural status. In the view of increasing number of the population, there are not enough combined physicians to meet health care demand of these growing population(Texas Medical Association,2016).Therefore this agenda for independent practice authority for APRN is proposed. The Agenda is initiated by a practicing APRN and all the APRNs in Texas is extremely supportive in taking this agenda to the next level. This agenda is encouraged and further guided by Texas a coalition for APRNs in Texas leader Linda Woolbert and Texas Nurse Practitioner(TNP) Advisory chairman Mr.Travis Poe.
The Texas Board of Nursing,(2009). Nursing practice act. Nursing peer review, nurse licensure compact, & advanced practice registered nurse compact. Austin, TX
I now that I have the knowledge to aspire to take up my role within one of the identified population foci. APRNs program developed my core competencies by allowing me to be more efficient adaptability with regards to newly emerging APRN roles or population focus. Furthermore, achieving my course objectives enable me to understand the specific APRN roles. For example, course objectives provide me with a better detail, and align my licensure goals with the responsibilities expected of each role. Licensure will provide me and my fellow APRN graduates with the full authority to practice. Also, certification is required to meet the highest possible standards as APRNs are expected to align knowledge, skills and experience with the standards of health care professionals. This field has very narrow margins for error, and it is therefore important, for APRNs to meet the highest and most stringent academic qualifications. In order to be a recognized as APRN graduate, one is required to complete formal education with a graduate degree or post-graduate certificate awarded by an academic institute and accredited by a recognized accrediting agency empowered by the relevant government education
In 2011, Barbara Safriet published an article “Federal options for maximizing the value of Advanced Practice Nurses in providing quality, cost-effective health care” from a legal perspective. The article focused on the benefits of utilizing Advance Practice Nurses to the full extent of their abilities as well as the current barriers that APNs encounter in their practice. The aim of this paper is to discuss two regulatory provisions to full deployment of APNs in current health care system, as well as three principle causes of current barriers to removal of the restrictive provisions for the APN. Furthermore, I will discuss the critical knowledge presented in the article and how it relates the APN practice. This article was incorporated into a two-year initiative was launched Institute of Medicine (IOM) and by the Robert Wood Johnson Foundation (RWJF) in 2008 which addressed the urgency to assess and transform the nursing profession.
The model discusses the impact of new regulations on education for APRN, Licensure Accreditation, Certification & Education Document, certification and practice. The model is implemented to grasp the general understanding and definition of advance practice registered nurse APRN role, inconsistencies with state by state recognition of APRN roles, and determining eligibility for APRN licensure (Consensus Model for APRN Regulation, 2015). The consensus model definition of APRN is a nurse who is educationally rounded to assume the responsibility of assessing, diagnosis, treating, teaching health promotion and disease maintenance, acquired advanced clinical knowledge and skills to provide direct patient care, has passed a national certification examination, and licensed to practice in one of the four roles (Consensus Model for APRN Regulation, 2015).
The Texas Board of Nursing,(2009). Nursing practice act. Nursing peer review, nurse licensure compact, & advanced practice registered nurse compact. Austin, TX
The modern nurse has much to be thankful for because of some of the early pioneers of nursing, such as Florence Nightingale and Jensey Snow. However, the scope and influence of professional nursing, as well as the individual nurse, has seen more exponential growth and change in North America since the establishment of the first professional organization for nursing, the Nurses Associated Alumnae of the United States and Canada, which in 1911 came to be known as the American Nurses Association.
The number of doctors that present in the United States of America directly affects the communities that these doctors serve and plays a large role in how the country and its citizens approach health care. The United States experienced a physician surplus in the 1980s, and was affected in several ways after this. However, many experts today have said that there is currently a shortage of physicians in the United States, or, at the very least, that there will be a shortage in the near future. The nation-wide statuses of a physician surplus or shortage have many implications, some of which are quite detrimental to society. However, there are certain remedies that can be implemented in order to attempt to rectify the problems, or alleviate some of their symptoms.
This certification will strengthen as well as show potential employers an intiative towards personal growth as well as professional achievement. To be specialized in a particular area of this field, one must amass knowledge by going through continuing education programs, formal coursework, self-study, and clinical experience. Then, you must successful pass a certification exam, which will then show their recognition of expertise. There are two programs, The National Association of Practical Nurse Education and Service (or NAPNES) and National Federation of Licensed Practical Nurses (or NFLPN), that offer certification courses in such areas as: infection control, nursing administration long term care, hospice and palliative, managed care, among
Advanced practice registered nurses play a significant part in extending access to health care by providing primary care and specialty care services to clients. Advanced practices registered are mentors, educators, researchers, and administrators. According to Health Resources and Services Administration, “Ninety-six percent of the NP workforce reported being in clinical practice, providing direct patient care” (Health Resources and Services Administration 2016). Furthermore, “Nearly three percentages were in faculty positions and approximately one percent was in administrative positions”(Health Resources and Services Administration 2016).
My plans after obtaining my advanced degree is to acquire licensure to practice as AGNP in the state of Texas. The Texas BON acknowledges that APN education, experiences, and competency levels vary, hence, holds individual APN accountable for knowing and practicing within their own scope of practice and competency always. The APN’s education is the grounds to their scope of practice: however, the APN can expand the scope of practice within the role and population-focus, as long as it remains within limits of the law. The Texas BON restricts the scope of practice for the APNs. The Nurse Practitioner Supervision Laws require¬¬¬¬¬ APN to work under physician supervision within seventy five mile perimeter. In addition, there is the Texas ' Nurse Practitioner Prescribing Laws which require APNs to prescribe medications under physician supervision and APNs are not allowed to prescribe schedule two drugs. All prescriptions written by the NPs must include the supervising physician 's name, address, Drug Enforcement Administration (DEA) number and phone number (Texas BON,
National Council for the State Boards of Nursing, APRN background, (2012). Report of the nursing policy and legislative efforts. Retrieved from https://www.ncsbn.org/428.htm#Nurse_Practitioner_Certification
Doctors have traditionally had the domain of prescribing medications. Advanced practice nurses have had some prescription authority in the United States since 1969, yet this has varied from state to state. The American Medical Association (AMA) has lobbied for years to limit the scope of practice of the APN (Kuntz, 2011). In 2009, the AMA disseminated scare tactics around the country, concerning the health and safety concerns of allowing APNs to expand their scope of practice. Finally, in 2014, the APN role is being expanded to include more autonomy and expanded prescription authority in all states.
Defining the role of an advanced nurse practitioner (ANP) is complex and commonly open to interpretation. Internationally there are many variances in what the role of the advanced practitioner entails, and the characteristics of individual roles are often shaped by the country and particular speciality in which they are practising (Mantzoukas & Watkinson 2006), (Sheer & Wong 2008), (Stasa et al 2014), (ICN 2008), (Dalton 2013), (NHS Wales 2010), (Haidar 2014), (Lowe et al 2011), (Pearson 2011).
In a 2012 collection of state workforce studies and reports, each state evidently needs more physicians. There are shortages of primary care physicians and specialists in every health professions: dental, mental health, pharmacy, and many others. Previously to the Affordable Care Act (ACA) passing, a convergence of difficulties had added to labor force problems. The ACA will inflict additional pressures on the health care labor force.
According to Hamric, Spross and Hanson (2005), “advanced practice nursing is the application of the expanded range of practical, theoretical and research based- competencies” to provide patient care in different settings (Pulcini, 2013). Advanced practice registered nurse APRN is a nurse that completed a graduate level program that can practice as a certified nurse practitioner, (NP) certified registered nurse anesthetist (CRNA), clinical nurse midwife (CNM) or clinical nurse specialist (CNS) (Scope and standard, 2010). To be licensed to practice as APRN, they need to pass a national certification exam and maintained their license via recertification through continuous competencies.