NURSE PRACTITIONERS AND PRACTICE BARRIERS

PRESENTED BY:

Bosede O. Adedire

COPPIN STATE UNIVERSITY

CONTENT
Introductory statement
Statement concerning the challenge
Review of the literature concerning Nurse
Practitioners and practice challenge
Discussion of the prevalence of the problem
Resources/agencies that have taken initiatives/efforts
to address this challenge
Discussion of barriers that exist which may impede
independent practice of Nurse practitioners
Conclusion which summarizes nurse practitioners
implications

INTRODUCTION

Nursing practice has been guided and monitored by other

advance health care professionals and political rulings
Advance Practice Nurses has been given the privilege to
practice as independent primary care providers (PCP)
There is a general knowledge that there are obstacles to
practice autonomy of advance practice nurses.

STATEMENT OF THE PROBLEM

There are several road blocks to Nurse practitioners

autonomy to successfully practice independently as primary

care provider.

The scope and practice of Nurse Practitioners as independent

providers are still evolving from state to state.
.

REVIEW OF LITERATURE
Cheater, F. M. (2010). Improving primary and community health services
through nurse-led social enterprise. Quality in Primary Care, 18(1), 5-7.
Muxworthy, H & Bowllan, N. (2011). Barriers to practice and impact on care:
An analysis of the psychiatric mental health nurse practitioner role. Journal of
the New York State Nurses Association, 1 & 2, 8-14.
Gilliss, C. L. (2011). The nurse as social entrepreneur: Revisiting our roots and
raising our voices. Nursing Outlook, 59(5), 256-257. doi:
10.1016/j.outlook.2011.07.003
Weiland, S. (2008). Reflections on independence in nurse practitioner practice.
Journal of the American Academy of Nurse Practitioners, 20(7), 345-352.
Wilson, A., Whitaker, N., & Whitford, D. (2012). Rising to the challenge of
health care reform with entrepreneurial and intrapreneurial nursing initiatives:
The Online Journal of Issues in Nursing Vol. 17, No. 2. doi:
OJIN.Vol17No02Man05

PREVALENCE OF THE CHALLENGE

The prevalence of the challenge of NPs autonomy as
independent health care provider differs from state to state.
The problem is resolving in some states while some other
states still have restrictive policies

BARRIERS TO NPS INDEPENDENT PRACTICE

Decentralized policy for NP practice set by different states

Health plans formulary, and recognition of services provided

by nurse practitioners
Reimbursement is not comparable to other health care
providers and fear on the part of NPs to take on the new role

The degree of competition from other health care professionals

create hindrance to NPs independent practice

Lack of hospital privileges

The consumer perceptions and understanding of nurse
practitioner contributions and duties as independent care
providers

RESOURCES/AGENCIES THAT HAVE TAKEN EFFORTS

TO ADDRESS THIS CHALLENGE

Institute of Medicine of the National Academies

American Association of Nurse Practitioners.
U.S. Census Bureau, Statistical Abstract of the
United States. Reflections on independence in
nurse practitioner practice.

CONCLUSION

A national perspective approach is needed to resolve barriers

to independent practice of NPs

Barriers to independent practice of NPs has implication for
practice and the society as a whole
Sustained obstacles to independent practice of NPs may in
the long run impede access to health care for the vulnerable
population.

References

American Association of Nurse Practitioners. (2013). Fact sheet: Medicare

reimbursement. Retrieved from www.aanp.org/legislation-regulation/federallegislation/medicare/68-articles/325-medicare-reimbursement
Cheater, F. M. (2010). Improving primary and community health services through nursesocial enterprise. Quality in Primary Care, 18(1), 5-7.
Churchman, J. J., & Doherty, C. (2010). Nurses' views on challenging doctors' practice in
acute hospital. Nursing Standard, 24(40), 42-48.
Coddington, J., Sands, L., Edwards, N., Kirkpatrick, J., & Chen, S. (2011). Quality of health
provided at a pediatric nurse-managed clinic. Journal of the American Academy of Nu
Practitioners, 23(12), 674-680. doi: 10.1111/j.1745-7599.2011.00657.x
Gilliss, C. L. (2011). The nurse as social entrepreneur: Revisiting our roots and raising our
voices. Nursing Outlook, 59(5), 256-257. doi: 10.1016/j.outlook.2011.07.003
Institute of Medicine of the National Academies. (2010). The future of nursing leading change
advancing health. Retrieved from www.iom.edu/Reports/2010/The-Future-of-Nursing
Leading-Change-Advancing-Health.aspx
Lee, S. (2011). In support of the abolishment of supervisory and collaborative clauses. The
Journal for Nurse Practitioner, 7(9), 764-769.
Muxworthy, H & Bowllan, N. (2011). Barriers to practice and impact on care: An analysis
the psychiatric mental health nurse practitioner role. Journal of the New York State Nurs
Association, Volume 42, Numbers 1 & 2, 8-14.

Naylor, M. D., & Kurtzman, E. T. (2010). The role of nurse practitioners in

reinventing primary care. Health Affairs, 29, 893-899.
U.S. Census Bureau, Statistical Abstract of the United States. (2012). Washington,
DC, 2011. Retrieved from: http://www.census.gov/compendia/statab/.
Weiland, S. (2008). Reflections on independence in nurse practitioner practice.
Journal of the American Academy of Nurse Practitioners, 20(7), 345-352.
Wilson, A., Whitaker, N., & Whitford, D. (2012). Rising to the challenge of health
care reform with entrepreneurial and intrapreneurial nursing initiatives: The

Online Journal of Issues in Nursing Vol. 17, No. 2. doi: OJIN.Vol17No02Man05