Holmes Olivia, Kinsey-Weathers Shanieka
Olivia Holmes is the chief acute care nurse and Shanieka Kinsey-Weathers is a nurse manager for primary care at the Overton Brooks VA Medical Center in Shreveport, La.
Nursing. 2016 Mar;46(3):51-4. doi: 10.1097/01.NURSE.0000480602.37640.a1.
The Institute of Medicine (IOM) recommended in its 2010 report on the future of nursing that advanced practice registered nurses (APRNs) should factor prominently in providing care to the millions of Americans who access healthcare services under the Affordable Care Act (ACA). The IOM also recommended that APRNs practice to the full extent of their education and training.However, many states have laws in place that limit full practice authority for APRNs, specifically NPs, in providing basic health services such as primary care. These laws place restrictions on independent practice and Medicaid and Medicare reimbursement, which prevent nurses from “responding effectively to rapidly changing health care settings and an evolving health care system.” Less than half of the United States has adopted full practice authority licensure and practice laws (see APRN practice authority at a glance). This article discusses how the primary care needs of millions of Americans can be met by granting full practice authority to APRNs nationwide and provides evidence to support the high level of care these practitioners can provide independently.
医学研究所（IOM）在其2010年关于护理未来的报告中建议，在为根据《平价医疗法案》（ACA）获得医疗服务的数百万美国人提供护理方面，高级实践注册护士（APRNs）应发挥重要作用。IOM还建议APRNs应充分运用其教育和培训所学进行执业。然而，许多州都制定了法律，限制APRNs，特别是执业护士（NPs）在提供诸如初级保健等基本卫生服务方面的全面执业权。这些法律对独立执业以及医疗补助和医疗保险报销设置了限制，这使得护士无法“有效应对快速变化的医疗环境和不断发展的医疗体系”。美国不到一半的州采用了全面执业权许可和执业法律（见APRN执业权一览）。本文讨论了通过在全国范围内授予APRNs全面执业权来满足数百万美国人的初级保健需求的方法，并提供证据支持这些从业者能够独立提供的高水平护理。
