Week 4 Advocacy Through Legislation
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Advocacy Through Legislation
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Problem
The identified issue is the state practice and licensures. According to Hain and Fleck (2014), state licensure is responsible for regulating the advanced practice registered nurses (APRNs); however, it hinders them from practicing to the full extent of their education and training. Essentially, APNRs’ practice and licensure differ across states. For example, Florida has restrictive practices, which implies that there should be a written agreement between APRNs and physicians to provide care (American Association of Nurse Practitioners, 2018). A restrictive practice environment adversely affects access to care. If this issue continues, there will be a high demand for primary care providers in Florida, leading to nursing shortages to meet increased patient care demands. The issue can also result in anti-competitive measures such as elevated healthcare, prevent innovation and negatively affect quality care. This is consistent with a previous study that found that restrictive practice authority is associated with anti-competitive actions resulting in low quality of care and increased medical costs (Ortiz et al., 2018). Additionally, the restrictive scope of practice regulation prevents nurses from practicing independently.
Week 4 Advocacy Through Legislation
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Idea for Addressing Solution
To address the issue of restrictive practice authority in Florida, full practice authority or independent practice should be implemented through the APRN Consensus Model. The Institute of Medicine (IOM) report also recommended that regulations be designed to support nurses practicing to the full extent of their skills and education in all states (Rudner, 2016). The full practice authority can provide APRNs in Florida with the opportunity to practice based on their education as well as training. Since restrictive policies are associated with shortages of primary care providers and medical expenses, full practice authority would allow nurses in my state to practice autonomously so as to meet insured Floridians under the Affordable Care Act (ACA). Altman, Butler and Shern, (2016) state that APRN Consensus Model put emphasis on uniting nursing licensure, accreditation, certification and education (LACE) requirements. The inconsistence in scope of practice makes practice challenging in states with restrictive and reduced authority. In particular, adopting the APRN Consensus Model at the federal level could promote continuity of care and standardization of LACE requirements. Basically, advocacy through legislative process is appropriate since it would highlight the standardization of scope of practice. Essentially this would lead to continuity of care while improving collaboration among providers.
Week 4 Advocacy Through Legislation
Research the Issue
Evidence 1
The full practice authority is a suitable solution in addressing restrictive policies in the state of Florida. This is consistence with a study by Bosse et al. (2017) demonstrating that full practice authority allows nurses to practice based on the education and training. In turn, this contributes to fewer ER visits, increased access to care, lower medical costs, hospitalization. Even though only a third of states have implemented full practice authority, the adoption in all states will contribute to increased collaboration among healthcare professionals and reduce prescription-related deaths.
Evidence 2
Conversely, full practice authority will lead to continuity among state regulatory boards. Research shows that the scope of practice is one where barriers do not hinder practice (Scanlon, Hibbert, DeKeyser East & Fraser, 2014). Hence, full practice authority through the consensus model can foster standardization of APRNs practice leading to continuity of care.
Stakeholder Support
Stakeholder(s) Supporting 1
Nurses will support full practice authority because it will allow them to practice based on their training and skills to provide patient care.
Stakeholder(s) Supporting 2
The National Council of State Boards of Nursing (NCSBN) will support full practice authority because it fosters harmonization of state regulations to consider APRNs as licensed Practioners.
Stakeholder Opposition
Stakeholder(s) Opposed 1
Professional organizations: Some organizations, especially, the American Medical Association (AMA) think that physicians have adequate training than nurses who are not able to provide safe and quality care (Hain & Fleck, 2014).
Stakeholder(s) Opposed 2
Physicians are likely to oppose the full practice authority because they believe they have high education and training than nurses
To debate for opposition from professional organizations and physicians, I will use evidence to advocate how quality of care provided by nurses is equivalent or better than physicians in terms of improved clinical outcomes. Specifically, I will use the findings of Woo, Lee and San Tam (2017) who suggested the APRNs in ERs and critical care settings contribute to improved patient outcomes. Moreover, I will focus on how nurses have the necessary education and skills to provide a broad scope of care.
Financial Incentives/Costs
Restrictive practice polices are related to increased medical cost. For example, restrictive state policies hinder APRNs from practice, which autonomously leads to shortages of primary care providers, increased healthcare costs and reduced access to care (Ortiz et al., 2018). Therefore, this would enable APRNs to build a workforce to meet healthcare needs of diverse populations, especially those in medically underserved areas. Furthermore, full practice authority offers increased access to healthcare services and allows patients to see their preferred provider.
Legislature: Information Needed and Process for Proposal
Provide the name and complete contact information for the legislator.
20430 Gator Lane
Land O’Lakes, FL 34638-2804
Phone: (813) 929-1001
Ardian.Zika@myfloridahouse.govMr. Ardian Zika
Contact: District Address:
Building #4
Describe the steps for how you would present this to your legislator.
I will call Mr. Zika’s office to schedule for a meeting.
After finalizing on the meeting date, I will prepare myself to ensure the discussion is clear and short. I will also articulate facts using PowerPoint presentation to show why Florida should adopt full practice authorityOutline the process if your legislator chooses to introduce your idea as a bill to congress.
Mr. Zika was fascinated with the issue of barriers that hinder nurses’ practice. Essentially, the legislator alleged that there are various organizations with the state to ensure APRNs provide safe and quality care while increasing access. Additionally, Mr. Zika suggested that full practice authority was a good move towards ensuring increased access to Floridians, hence promised to discuss it with various organizations such as Florida Action Coalition, State board of nursing (BON) and other legislators before introducing it to the congress.
Christian Principles and Nursing Advocacy
Research shows that voluntary services through healing are characterized by the zealous works of Christians (Cuellar De la Cruz, & Robinson, 2017). In addition, the Christians are a present-day voice for a body of social teachings, which is embedded on the dignity of every person created in the image of God. Christian principles include subsidiarity, human dignity, solidarity, and the common good of all persons regardless of their gender, sexual orientation, culture, race, and religion/belief.
Week 4 Advocacy Through Legislation
The human dignity principle focuses on Christ-based care which reinforces the need to love your neighbor as self (Cuellar De la Cruz, & Robinson, 2017). As health providers advocates for patient care, the attitude is inclined on respecting holiness of life to improve their health outcomes. Moreover, the principle of solidarity advocates for people being created in God’s image. Hence, Christians advocate for positive health outcomes not because they are related but due to the fact that they depend on each other.
Conversely, the principle of common good highlights the need to advocate for healthcare without focusing on persons interests and by accommodating everyone including those who cannot afford or use most of healthcare resources (Cuellar De la Cruz, & Robinson, 2017). Finally, the principle of subsidiarity is where Christians unite locals and the government to accomplish goals such as, advocating for the devolvement of healthcare that the government then supports.References
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References
Altman, S. H., Butler, A. S., & Shern, L. (Eds.). (2016). Assessing progress on the Institute of Medicine report The Future of Nursing. Washington, DC: National Academies Press. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK350168/
American Association of Nurse Practioners. (2018). State practice environment. Retrieved from https://www.aanp.org/advocacy/state/state-practice-environment
Bosse, J., Simmonds, K., Hanson, C., Pulcini, J., Dunphy, L., Vanhook, P., & Poghosyan, L. (2017). Position statement: Full practice authority for advanced practice registered nurses is necessary to transform primary care. Nursing Outlook, 65(6), 761-765. DOI: https://doi.org/10.1016/j.outlook.2017.10.002
Cuellar De la Cruz, Y., & Robinson, S. (2017). Answering the call to accessible quality health care for all using a new model of local community not-for-profit charity clinics: A return to Christ-centered care of the past. The Linacre Quarterly, 84(1), 44-56. doi: 10.1080/00243639.2016.1274631
Hain, D., & Fleck, L. (2014). Barriers to nurse practitioner practice that impact healthcare redesign. OJIN: The Online Journal of Issues in Nursing, 19(2). DOI: 10.3912/OJIN.Vol19No02Man02
Ortiz, J., Hofler, R., Bushy, A., Lin, Y. L., Khanijahani, A., & Bitney, A. (2018). Impact of nurse practitioner practice regulations on rural population health outcomes. In Healthcare (Vol. 6, No. 2, p. 65). . doi: 10.3390/healthcare6020065
Rudner Lugo, N. (2016). Full practice authority for advanced practice registered nurses is a gender issue. OJIN: The Online Journal of Issues in Nursing, 21(2).DOI: 10.3912/OJIN.Vol21No02PPT54
Scanlon, A. Hibbert, D., DeKeyser G, F., East, L. & Fraser, D. (2014). Addressing issues impacting advanced nursing practice worldwide. Online Journal of Issues in Nursing, 19(2), 1. DOI:10.3912/OJIN.Vol19No02Man05
Woo, B. F. Y., Lee, J. X. Y., & San Tam, W. W. (2017). The impact of the advanced practice nursing role on quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings: a systematic review. Human Resources for Health, 15(1), 63. doi: 10.1186/s12960-017-0237-9
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