Powerful Advocacy: LB107. Presented by LaDonna Hart, MSN, APRN- NP, FNP

Transcription

1 Powerful Advocacy: LB107 Presented by LaDonna Hart, MSN, APRN- NP, FNP

2 Nurses Matter u Largest segment of the health care workforce u Deliver nearly all care for pacents in the hospital sedng u Quality nursing care is directly related the health outcomes u Nurses direct relaconship to the health of pacents Advocacy on behalf of the nursing profession is a powerful form of pa:ent advocacy. (Mason, Leavi@, Chaffee, 2014)

3 Advanced Practice Registered Nurse Advocacy u Improving the access to care u Reducing health disparices u Policy issues related to reimbursement of services u Provider inclusive language in legislacon (Mason et al., 2013)

4 Nebraska Access to Care Facts u 42% of the Nebraska s populacon live in rural communices u Nearly 65% of Nebraska counces are federally designated health care provider shortage areas (HPSAs) for primary care u 94% of Nebraska counces listed as HPSAs in psychiatric and mental health services u 44% of primary care NPs in the state praccce in rural areas u > 80% of NPs are prepared in Primary Care u AnCquated Nurse NP praccce acts are barriers to the direct access to the care provided by NPs

5 Removing Barriers: Full Practice Authority u DefiniCon: FPA means that NPs are authorized to evaluate pacents, diagnose, order and interpret diagnoscc tests, inicate and manage treatments including prescribing medicacons under the exclusive licensure authority of the state board of nursing u Nomenclature: Full praccce authority not independent praccce health care providers will concnue to work together to provide whole pacent care (American AssociaCon of Nurse PracCConers, 2013)

6 Full Practice Authority u Nineteen states and the District of Columbia provide full praccce authority for NPs several more states introducing legislacon this year u Modernizes state licensure laws by removing IPA which arcficially Ces licensure to a different profession u Does NOT change scope of praccce u Closes the gap between the high level of care that NP s are educated and prepared to provide and the restricted level of care that outdated state licensure laws allow NPs to deliver

7 BeneDits of FPA u Helps to address healthcare shortage by culcvacng a growing health care workforce while maintaining a strong commitment to safe, quality care for pacents u Increases access to care and pacent choice where pacents live and work u Decreases health care costs by avoiding duplicacon of services (AANP, 2013)

8 Full Practice Authority Research u hep:// qualityofpraccce.pdf - liscng of studies u Cochrane Database of SystemaCc Reviews u Meta- analysis of 25 arccles relacng to 16 studies comparing outcomes of primary care nurses (nurses, NPs, clinical nurse specialists, or advance praccce nurses) and physicians u Health outcomes and outcomes such as resource uclizacon and cost were equivalent for nurses and physicians u SaCsfacCon level was higher for nurses

9 Full Practice Authority Research u IOM (2011) Nurses should praccce to the full extent of their educacon and training u NaConal Governor s AssociaCon (2012) In light of the research evidence, states might consider changing scope of praccce restriccons and assuring adequate reimbursement for their services as a way of encouraging and incencvizing greater NP involvement in the provision of primary health care.

10 Full Practice Authority Research u FTC (2014) Empirical research and on- the- ground experience demonstrate that APRNs provide safe and effeccve care within the scope of their training, cercficacon, and licensure. Moreover, effeccve and beneficial collaboracon among health care providers can, and typically does, occur even without mandatory physician supervision of APRNs

11 LB 107 u Introduced by Senator Sue Crawford on u Removal of IPA requirement for APRN licensure u TransiCon to PracCce 2000 hours of praccce supervised by either an MD or experience APRN u Licensure authority remains under APRN Board u Health and Human Services Commieee on January 22 nd u Health and Human Services Commieee vote, January 29 th

12 Where is LB 107 Today?

13 References u American AssociaCon of Nurse PracCConers. (2013). Issues AT- A- Glance: Full PracCce Authority. Retrieved from hep:// toolbox/ fpa_3_2013.pdf u Federal Trade Commission. (2014). Policy perspec:ves: Compe::on and the regula:on of advanced prac:ce nurses. Retrieved from hep:// files/documents/reports/policy- perspeccves- compeccon- regulacon- advanced- praccce- nurses/140307aprnpolicypaper.pdf u InsCtute of Medicine. (2011). Commi@ee on the Robert Wood Johnson Founda:on Ini:a:ve on the Future of Nursing. (2011). The future of nursing: Leading change, advancing health. Na:onal Academies Press. Washington, DC: The NaConal Academies Press. u Legislature of Nebraska. (2013). LegislaCve bill 243. Retrieved from hep:// nebraskalegislature.gov/floordocs/103/pdf/intro/lb243.pdf u Mason, D. J., Leavie, J. K., & Chaffee, M. W. (2007). Policy and poli:cs in nursing and health care. Saunders/Elsevier. Retrieved from hep:// media.maehewsbooks.com.s3.amazonaws.com/documents/tocwork/ 143/ pdf u NaConal Governors AssociaCon. (2012). The role of nurse prac::oners in mee:ng the demand for primary care. Retrieved from hep:// center- for- best- praccces/center- publicacons/ page- health- publicacons/col2- content/main- content- list/the- role- of- nurse- praccconers.html