Week 12 Module Discussion Board: Modernizing State Nurse Practice Acts for APRNs and Grassroots Efforts for Full Practice Authority
In 2008, the APRN Consensus Work Group and the National Council of State Boards of Nursing APRN Advisory Committee published the APRN Consensus Model (Links to an external site.)
The Consensus Model was meant to provide uniformity in practice for APRNs from state to state to allow them to practice to their fullest extent and improve patient access to care. Unfortunately, in the past 12 years, the work to implement these changes has met a lot of resistance. States have implemented the Consensus Model to varying degrees (Links to an external site.).
Many professional organizations are leading the charge from state-to-state to make policy changes toward full implementation of the Consensus Model. In Mississippi, MANP (Links to an external site.) and MNA (Links to an external site.) are those organizations.
Read through the Consensus Model.
Discuss your thoughts on the changes called for in the document.
Look at the implementation map and scoring grid (Links to an external site.). Discuss where your state and the surrounding states stand in implementation. (Mississippi).
Are there any other grassroots organizations striving for modernization of the Nurse Practice Acts that you know about? Discuss these if you do.
*****Please see PDF attached*****
Discussion Board Initial Posting Rubric
Criteria Ratings Pts
This criterion is linked to a Learning Outcome Relevance to the topic or problem 20 pts
Exemplary
18-20 points. The posting directly addresses key issues, questions, or problems related to the text and the discussion activity. The posting applies course concepts well, connecting them to the actual activity. 17 pts
Satisfactory
15-17 points. The posting addresses key issues, questions or problems related to the text and the discussion activity, but in some cases only indirectly or obliquely. It does not always apply course concepts fully. 0 pts
Unsatisfactory
0-14 points. The posting does not directly address the question or problem posted by the discussion activity.
20 pts
This criterion is linked to a Learning Outcome Insight and application of course concepts 40 pts
Exemplary
37-40 points. The posting offers original or thoughtful insight, analysis, or observation that demonstrates a strong grasp of concepts and ideas pertaining to the discussion topic. 36 pts
Satisfactory
30-36 points. The posting does offer some insight, analysis, or observation related to the topic, but may not demonstrate a full understanding or knowledge of concepts and ideas pertaining to the discussion topic. 0 pts
Unsatisfactory
0-29 points. The posting does not offer any significant insight, analysis or observation related to the topic. No knowledge or understanding is demonstrated regarding concepts and ideas pertaining to the discussion topic.
40 pts
This criterion is linked to a Learning Outcome Use of evidence and support 25 pts
Exemplary
23-25 points. The posting supports all claims and opinions with either rational argument or evidence. Evidence is documented with appropriate citations. 22 pts
Satisfactory
19-22 points. The posting generally supports claims and opinions with evidence or argument, but may leave some gaps where unsupported opinions still appear. 0 pts
Unsatisfactory
0-18 points. The posting does not support its claims with either evidence or argument. The posting contains largely unsupported opinion.
25 pts
This criterion is linked to a Learning Outcome Grammar, Punctuation & APA 15 pts
Exemplary
14-15 points. The posting has less than 3 errors in grammar, Punctuation, and/or APA. 13 pts
Satisfactory
11-13 points. The posting has 3-5 errors in Grammar, Punctuation, and/or APA. 0 pts
Unsatisfactory
0-10 points. The posting has more than 5 errors in Grammar, Punctuation, and/or APA.
15 pts
Modernizing State Nurse Practice Acts
Advanced practice registered nurses (APRNs) perform nursing roles that are more advanced than those performed by other registered nurses. All states of the United States have developed Nurse Practice Acts (NPAs), a set of rules and regulations, which govern the practices of registered nurses within their territories (Russel, 2017). In 2008, the Advanced Practice Nursing Consensus Work Group and the National Council of State Boards of Nursing (NCSBN) APRN Committee provided recommendations of the licensure, accreditation, certification, education, and recognition of APRN roles as a strategy to increase healthcare access for populations. However, some states are yet to recognize these roles and some still prohibit APRNs from practicing and prescribing drugs independently (APRN Joint Dialogue Group Report, 2008). This assignment will provide personal thoughts regarding the recommendations documented in the Consensus Model. It will also discuss how the state of Mississippi and its neighbors have implemented the Consensus Model.
Personal Thoughts
The fact that different states of the United States have been granted the power to independently determine the APRN legal scope of practice has significantly limited the clinical roles that APRNs are able to perform, a factor that has decreased healthcare access for patients, especially in the rural areas. Even in their attempt to increase health care access, states must ensure that APRNs are adequately trained and have attained the right certifications and licensure before they can be granted full practice authority (Russel, 2017). Therefore, the changes called for in the Consensus Model are highly appropriate because they will ensure that all APRNs obtain licensure, accreditation, certification, and education that authorize them to practice their respective roles independently (Peterson, 2017). In their efforts to implement the Consensus Model, states should strive to include in their respective NPAs guidelines that will enable them to have qualified APRNs who can practice and prescribe independently (APRN Joint Dialogue Group Report, 2008).
Implementation Map
From the scoring grid, Mississippi is among those states that still lag behind in the implementation of the Consensus Model. The state of Mississippi recognizes the four APRN titles including certified registered nurse anesthetists (CRNA), certified nurse-midwife (CNM), clinical nurse specialist (CNS), and certified nurse practitioner (CNP) (National Council of State Boards of Nursing, 2021). However, only three roles are allowed to practice in the state including CRNA, CNM, and CNP. APRNs are expected to meet specific educational requirements, licensure, and certification before they can be allowed to perform in their respective specialties. However, the state of Mississippi still prohibits its APRNs from practicing independently and prescribing certain medications (National Council of State Boards of Nursing, 2021). These prohibitions continue to limit healthcare access for the citizens of the state. This is the same in neighboring states including Tennessee, Georgia, and Louisiana. However, Arkansas State has granted CNS and CNP independent practice while Alabama authorizes only CNSs to practice independently (National Council of State Boards of Nursing, 2021).
Grassroots Organizations
Another grassroots organization that is striving for the modernization of the Nurse Practice Act in Mississippi is the Mississippi Nurses Association. The association is constantly working with relevant stakeholders to fight for the authorization of independent practice and prescribing for APRNs (Mississippi Nurses Association, 2020). For several years, the Mississippi Nurses Association has advocated for the removal of barriers to grant APRNs full practice authority.
Conclusion
APRNs have received adequate training that equips them with the knowledge and skills which they can apply to provide quality and safe health care to patients just like physicians. In this respect, restrictions imposed by state NPAs are preventing APRNs from practicing independently, a factor that limits healthcare access for residents. Therefore, by fully implementing the Consensus Model, states will grant APRNs full practice authority thereby increasing healthcare access for patients and populations.
References
APRN Joint Dialogue Group Report. (2008). Consensus model for APRN regulation: Licensure, accreditation, certification, & education. file:///C:/Users/User/AppData/Local/Temp/Consensus_Model_for_APRN_Regulation_July_2008.pdf
Mississippi Nurses Association. (2020). Commit to support, and advocate for the removal of barriers to provide full practice authority for APRNs. https://www.msnurses.org/wp-content/uploads/2021/02/Final-2020-HOD-Resolution-1-Full-Practice-Authority.pdf
National Council of State Boards of Nursing. (NCSBN). (2021). APRN consensus implementation status. https://www.ncsbn.org/5397.htm
Peterson, M. E. (2017). Barriers to practice and the impact on health care: A nurse practitioner focus. Journal of the Advanced Practitioner in Oncology, 8(1), 74–81.
Russel, K. (2017). Nurse Practice Acts guide and govern: Update 2017. Journal of Nursing Regulation, 8(3), 18-25. https://www.ncsbn.org/2017_NPA_Guide_and_govern.pdf