APRN Legislation in Illinois
Drashti Jani
Olivet Nazarene University
Women’s Health Therapeutics and Management Across the Lifespan
NRSG-665B-114
Professor Ashley Darin-Messmer
October 16, 2017
Certification of Authorship: I certify that I am the author of this paper and that any assistance I received in its preparation is fully acknowledged and disclosed in the paper. I have also cited any sources from which I used data, ideas, or words, either quoted directly or paraphrased. I also certify that this paper was prepared by me specifically for the purpose of this assignment.
Your Signature: _Drashti Jani_ Introduction
With the baby boomers aging, the need for primary care providers has been in high demand now more than ever.
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Martinez, Heather A. Steans, Kyle McCarter, Pat McGuire, Omar Aquino, David Koehler, Patricia Van Pelt, Donne E. Trotter, Mattie Hunter and Jacqueline Y. Collins. The title of this bill is called Nurses-APRN scope of practice. The bill was officially signed into law by Governor Bruce Rauner on September 20, 2017. According to the newly passed bill, APRN’s area allowed to practice independently provided certain requirements are met. First off, APN’s will now be called APRN which stands for Advanced Practice Registered Nurse which goes into effect immediately. Newly graduated APRN’s will still need collaborative physicians or APRN’s until they complete 4000 hours of clinical experience as well as 250 hours of continuing education credit. It is only then that APRN’s are given authority to practice independently. Also, newly graduated APRN will have limitations on prescriptive authority until they fulfill the requirements (Illinois General Assembly, 2017).
Potential Effects for APRN Practice With the new bill going into effect next year, the effects on APRN practice are beneficial to both the patient and the provider. Patients living in underserved areas have a better chance of seeing a provider rather than one physician that may be booked months in advance. APRN’s now have the ability to own their own practice and utilize their knowledge and skills without needing a collaborating physician (National Academies of Sciences, Engineering, and Medicine, 2016). The
The APRN Consensus Model was released in July of 2008 to define advanced practice registered nurse, identify the titles to be used by APRNs, and define specialty area of practice. The Consensus Model also describes population foci, suggests a process for recognition of new APRN roles, and recommends requirements for implementation (American Nurses Association [ANA], 2010). The APRN regulatory model helps uniform scope of practice of APRN across the United States, which benefit individual APRN, enhance patient outcomes, and improve the quality of care. Consensus Model consists of Licensure, Accreditation, Certification, and Education. The Education criteria in LACE Consensus Model relate to all APRN programs regardless of master’s or doctoral
This paper explores the practice of the APRNs autonomy in the state of Georgia and compares it with other states. Also to advocate for policy recommendations of the APRNs scope of practice that are needed to improve the healthcare in the state of Georgia. APRNs are registered nurses that provide continuous care and treatment in many different areas, such as pediatrics, primary care, acute care, maternity, mental health and chronic disease management. APRNs also have advanced education, training, and national certification in specific areas of practice. Even with the changing and expanding of healthcare, APRNs continue to face challenges in practicing to the full extent of
This piece of legislation can affect the (APRN) in many ways. This will allow the APRN to delegate administration of drugs to a person who has met certain criteria’s such as a medical assistant. This will increase the quality of care to patients and decrease cost by having the ability of being seen by one provider such as the APRN. The APRN can more effectively to support the quality of patient care.
This paper explores the perception of clinical practitioners to the change in policy related to the advanced practice registered nurse (APRN) full practice authority. The author conducts a one-on-one, open-ended interview of 5 nurse practitioners and 5 physicians licensed to practice in Maryland on their perceptions of the recent passage of the Advanced Practice Registered Nurse Full Practice Authority. A literature review was conducted in a policy report by the professional nursing organization, and discussion within the peer-reviewed article supported an overview, regulatory differences among 50 states, including the District of Columbia. Their policy implication for enhancing APRNs role nationally. The author discusses a critical component
These organizations developed the Consensus Model document in 2008 to unify practice, identify APRN clinical roles, identify the acceptable titles to for NPs, and define the requirements for general practice and licensure. Note to mention that laws and regulations statute on the APN scope of practice may vary by states, whereas some adhere to full scope of practice, other to reduced practice, or restricted practice. For instance, the state of Florida defines advanced registered nurse practitioner as a licensed person with ability to practice professional nursing and certified to in advanced or specialized nursing practice (Buppert, 2011). The four advanced clinical specialized roles include certified registered nurse anesthetists, certified nurse midwives, clinical nurse specialist, and nurse practitioners (Buppert, 2011). In terms of licensure, 46 states out of 50 require nurse practitioners to pass a certification exam. The Florida Board of Nursing requires certification by an appropriate specialty board and graduation from a program leading to a master’s degree (Buppert,
According to Health Resources and Services Administration If the system for providing primary care in 2020 were to stay fundamentally the same as today, there will be an estimated shortage of 20,400 primary care physicians ("Projecting the Supply and Demand for Primary Care Practitioners Through 2020," n.d.). In addition this projection doesn’t include the decreasing number of people perusing the medical degree and the baby boomers retiring form this filed of science. In the hand we are experiencing a significant increase in NPs and PAs. Considering this projected shortage, which is actually a very frightening situation the increasing number of NPs and PAs, can effectively be integrated; we could reduce the number of physician shortage by over 69 percent in 2020.
Insurers are less likely to reimburse APRN’s in states that mandate physician supervision. Nurses need to push for reform of the regulations governing APRN;s.
Hi Swanthi, great post on the APN Consensus Model. In your post you mentioned many healthcare organizations had “criticized the inconsistencies in APRN practice and brought up concerns of patient safety issues due to these competency irregularities.” Although this model was developed in 2008, there are still many regulations and unclear terms that need to be clarify. I can see for nurses that are just beginning their APRN education will be able to eventually achieve the same licensure, accreditation, credentials, and education (LACE), but what about those are currently practicing now? If I was the APRN that had to take extra courses to be licensed in my state than I would feel a bit dissatisfied when another APRN from another state that required
According to reports found on the web page MEDPAGETODAY (2014) there has been an increase in the independent practice for advanced practice registered nurses (APRN). The article quotes data from the American Association of Nurse Practitioners (AANP) which reports 17 states and the District of Columbia allowing “full practice” with this meaning the APRN evaluates, diagnoses, orders testing, prescribes medication and initiates and manages treatments. 21 states require “collaborative agreement” with a physician and 12 requiring supervision of a physician. Collaborative agreement scope of practice varies by state and institution of employment.
Reimbursement for the advanced practice nurse (APN) is improving but how they fit into reimbursement systems is vey important. One question that arises is if the APN should be paid the same fee for service as a physician or should only a percentage of the payment be received. Most third-party reimburses, which include a few large insurance companies are now reimbursing APNs and more states are getting on board with reimbursements by developing reimbursement models for APNs (Hamric, 2009). For example, Aetna US Healthcare, Anthem Blue Cross and Blue Shield of Kentucky, Medicare and Medicate all credential NPs as primary care providers and pay at 85% of the physician rate. Tricare of Kentucky credentials NPs and pays 100%.
As resistant as some states’ legislative and regulatory bodies are to grant APNs autonomy of practice, the damage being done by over-regulation is clear (Safriet, 1992). Physicians are forced into a position to either supervise the APN’s practice or be constantly consulted for approval of their practice decisions. Safriet (1992) described that in and of itself, this constant supervision may appear to patients that the APN is not competent to provide adequate or care equivalent to that of a physician. If the role of the APN is to bridge gaps in health care by relieving the medical establishment of some of the patient load by performing the same function as a physician in a primary care setting, it seems wholly unnecessary to restrain their scope of practice in those areas. This type of restrictions affect cost and patient care accessibility (Safriet, 1992). This was a problem stated in the article, however 25 years later, populations of patients remain unseen or cared for and APNs continue to be underutilized (Safriet, 1992). Rigolosi and Salmond (2014) cite the American Association of Nurse Practitioners (AANP) when they state that not utilizing nurse practitioners due to practice restrictions costs $9 billion annually in the US (p. 649).
As the young and rapidly-aging population continues to increase, the demands of primary, acute and chronic disease management will also increase. As a result, more health care professionals who provide primary care will be needed to meet these demands. Thus, the emergence of Advanced Practice Registered Nurse (APRN) evolve. APRN is a nurse who has completed a graduate degree and has acquired advanced knowledge and skills. APRNs are grounded with theory, concepts and principles that enable them to assess, diagnose, treat and manage their patients. APRNs can work in conjunction with other health care professionals or independently. APRNs improve access to health care by providing care in the rural and underserved areas. APRNs also reduce the cost to health care (Joel, 2013).
I believe the Future of Nursing report can impact the APRN role in many different ways. One major way I feel the report can directly impact the APRN role is the recommendation to remove the scope-of-practice barriers. The recommendation includes, "States with unduly restrictive regulations should be urged to amend them to allow advanced practice registered nurses to provide care to patients in all circumstances in which they are qualified to do so"(Institute of Medicine, 2010, p. S-9). I currently reside in Missouri and I intend to continue practicing in Missouri even after I become an APRN. Unfortunately, Missouri is one of the most restricted states in regards to the scope of practice for APRNs. According to the Kaiser Family Foundation
The Affordable Care Act set forth millions of dollars to address the problems and concerns that are associated with existing physicians shortages. The Affordable Care Act also has provisions that are aimed to improve the education, ongoing training as well as to help with the recruitment of nursing, physicians, doctors as well as other health care personnel. In addition, there are provisions in place that help to increase workforces’ cultural competency, enhance faculty training of healthcare professionals, and diversity. The provisions also play a vital role because of the fact they are put into place to examine innovative reimbursement and care delivery models that highlight primary care services value and offer in improvement in the patient care coordination.
Currently, in the state of Texas APRN, such as nurse practitioners must legally document as APRN. Texas BON states, “At a minimum, an individual must legally represent themselves, including in a legal signature, as an APRN and by the role. He/she may indicate the population as well. No one, except those who are licensed to practice as an APRN, may use the APRN title or any of the APRN role titles. An individual also may add the specialty title in which they are professionally recognized in addition to the legal title of APRN and role” (APRN Joint Dialogue Group Report, 2008). Example: After successfully completing Loyola University’s post BSN-DNP program, and obtaining a passing score on the certification exam, I will be entitled to documents