[IPA in primary care: a new gateway to the healthcare system]. / L'IPA en soins primaires : une nouvelle porte d'entrée dans le système de santé.

In France, the supply of healthcare services remains insufficient to meet the growing needs of the population, which has prompted the legislator to authorize direct access to certain professionals, in particular advanced practice nurses (APNs) working in coordinated practice structures. This article details an innovative multi-professional pathway in a nursing home, where the APN takes direct charge of people without a general practitioner, with the aim of improving their access to care and reintegrating them into the healthcare system.

Perceptions and beliefs about the regulation of advanced nurse practitioners.

BACKGROUND: The role of the advanced nurse practitioner (ANP) is not regulated in the UK, which has led to wide variation in the skills, competencies and academic qualifications of nurses using this title. Urgent treatment centres (UTCs) require a broad and experienced knowledge base to meet the demand of patients presenting with undifferentiated illnesses and injuries, which can be stressful and challenging. AIM: To examine the perceptions and beliefs about ANP regulation, and to explore and discuss any ideas about proposed regulation. METHOD: The author used interpretative phenomenological analysis to uncover valuable insights into the experiences of two ANPs working in an UTC, and their beliefs around regulation of the ANP role. RESULTS: Both ANPs had different backgrounds and qualifications yet still had similar perceptions and beliefs regarding the regulation of ANPs. Five main themes were developed from the interview transcripts. CONCLUSION: This study identified the need to consider the importance of ANPs' identity and the complex regulatory process required to standardise the role.

APRNs' controlled substance prescribing and readiness following Florida legislative changes.

ABSTRACT: Two years after the Florida legislature expanded APRN prescribing to include schedule II-IV drugs in 2017, we studied APRN utilization of this prescriptive authority. Study results reveal that Florida APRNs are meeting the educational requirements to prescribe and apply the use of these drugs in practice, improving patient access to care.

33rd Annual APRN Legislative Update: Unprecedented changes to APRN practice authority in unprecedented times.

ABSTRACT: In a year unlike any other in recent history, healthcare workers, including advanced practice registered nurses (APRNs), faced challenges and triumphs as the frontline in the battle against COVID-19. This 33rd Annual Legislative Update covers the scope of practice changes and legislative decisions that most impacted APRNs across the US in 2020.

Seventeen states enacted executive orders expanding advanced practice nurses' scopes of practice during the first 21 days of the COVID-19 pandemic.

CONTEXT: Rural hospitals in the USA are often served by advanced practice nurses, due to the difficulty for such facilities to recruit physicians. In order to facilitate a full range of services for patients, some states permit advanced practice nurses to practice with full independence. However, many states limit their scopes of practice, resulting in the potential for limited healthcare access in underserved areas. The COVID-19 pandemic temporarily upended these arrangements for several states, as 17 governors quickly passed waivers and suspensions of physician oversight restrictions. ISSUES: Physician resistance is a primary hurdle for states that limit advanced practice nurse scopes of practice. Longstanding restrictions were removed, however, in a short period of time. The pandemic demonstrated that even governors with strong political disagreements agreed on one way that healthcare access could potentially be improved. LESSONS LEARNED: Despite longstanding concerns over patient safety when advanced practice nurses practice with full autonomy, governors quickly removed practice restrictions when faced with a crisis situation. Implied in such behavior are that policymakers were aware of advanced practice nurses' capabilities prior to the pandemic, but chose not to implement full practice authority, and that governors appeared to disagree as to whether to temporarily waive specific restrictions or suspend restrictions entirely, consistent with their political affiliation. We propose more research into understanding whether or not such changes should become permanent.

[Legal responsibility of the advanced practice nurse]. / La responsabilité juridique de l'infirmier en pratique avancée.

While the profession of advanced practice nurse has finally been codified, this new regulation raises issues. Today, nursing is no longer subject to altruistic ideology. Advanced practice nurses have real expertise which has consequences on their responsibility. It is essential to be fully aware of the legal framework in which they practise.

The perceptions and experiences of national regulatory nurse leaders in advancing the advanced practice registered nurse compact policy agenda.

BACKGROUND AND PURPOSE: The Advanced Practice Registered Nurse (APRN) Compact was approved at the National Council of State Boards of Nursing Delegate Assembly in May 2015. Since that date, only three states have been successful in the legislative adoption of the compact. Thus, the purpose of this study was to explore the experiences and perceptions of nursing regulatory leaders involved with the individual state adoption of the APRN Compact. METHODS: This qualitative study followed a phenomenological-hermeneutic methodology approach. CONCLUSIONS: Four themes emerged from within the data: legislative political environment; professional organizational barriers; strategies to push past barriers; and moving forward. An overarching theme of consistent communication was evident. IMPLICATIONS FOR PRACTICE: This study identifies barriers experienced in the legislative state adoption process and successful strategies to overcome these barriers to move the APRN compact forward.

A scoping review of Advanced Practice Registered Nurses Consensus Model outcomes: Part four of a four-part series on critical topics identified by the 2015 Nurse Practitioner Research Agenda.

BACKGROUND AND PURPOSE: The Advanced Practice Registered Nurses (APRN) Consensus Model was produced by the APRN Joint Dialogue Group in 2008. The aim of the Consensus Model is to guide state boards on the implementation of APRN practice components, including licensure, accreditation, certification, and education and to clarify the legal scope of practice and APRN roles. The purpose of this scoping review and gap analysis was to appraise the evidence related to patient, nurse practitioner (NP) and organizational outcomes resulting from the Consensus Model. METHODS: A scoping review of research studies and grey literature reports was conducted and focused on the outcomes and key concepts related to the Consensus Model. Areas of foci included patients, NPs, and organizations. A subsequent gap analysis was conducted. CONCLUSIONS: Several positive findings related to the Consensus Model, or components thereof, were identified for patient, NP, and organizational outcomes on various levels. Research gaps exist. Additional research is needed to fully evaluate the health outcomes on a broader scale. IMPLICATIONS FOR PRACTICE: Existing evidence may support NPs and supporting organizations to further legislative efforts to more fully implement the Consensus Model nationwide.

Benefits of Less Restrictive Regulation of Advance Practice Registered Nurses in Florida.

BACKGROUND: Advanced Practice Registered Nurses (APRNs) provide access to cost-effective, high quality care. APRNs are underutilized in states that restrict their practice. Removing restrictions could expand access to quality health care, cost-effectively relieve the physician shortage, and contribute economically. PURPOSE: This study forecasts the health system and economic impacts of reducing practice restrictions for Florida APRNs. METHODS: The analysis utilized a number of data sources and IMPLAN software and estimated changes in APRN supply given less restrictive practice laws, and consequential health system and economic benefits. FINDINGS: Between 2013 and 2025 APRN full time equivalents could increase an additional 11% with less restrictive practice regulations. This could eliminate or reduce the shortage of different types of physicians. Health care cost-savings could be $50 to $493 per resident. There would be a number of general economic benefits. DISCUSSION: A number of health system and economic benefits would ensue from less restrictive APRN regulation.

[Advanced practice nurse in France: first outline]. / Infirmière de pratique avancée en France : première esquisse.

After several years of discussions and debate, regulations should soon be applied in France allowing for the deployment of advanced practice nurses as provided for by law no. 2016-41 of January 2016 relating to the modernisation of the French health system. The profile of this new category of nurse, whose scope of practice will be extended, will combine clinical practice carried out with patients with stabilised chronic diseases and activities aimed at promoting the continuing development of the nursing teams' skills and at supporting change processes.

AMA Resolution Opposes Independent Practice by APRNs.

An old debate heats up again.

Removing Practice Barriers.

States continue to expand practice authority and innovation opportunities for APRNS.

30th Annual APRN Legislative Update: Improving access to healthcare one state at a time.

The Annual Legislative Update describes recent legislative changes to practice, reimbursement, and prescriptive authority that have the most impact on NPs and other advanced practice nurses across the country.