University of Massachusetts Boston, Boston, MA.
Department of Nursing, University of Massachusetts Boston, Boston, MA.
J Am Assoc Nurse Pract. 2021 Oct 13;34(2):410-417. doi: 10.1097/JXX.0000000000000657.
Nurse practitioner (NP) practice has evolved since inception of the role in 1965. Educational requirements have been standardized requiring a master's degree, yet variation in NPs scope of practice exists across the United States. As the population ages and more Americans have health insurance coverage, the demand for health care continues to increase. Shortages of clinical providers and changes in hospital models of care continue to burden the health care system. Nurse practitioners have been found to provide safe, high-quality patient care and are a potential solution to ease the burden on our health care system. Nurse practitioner scope of practice restrictions limit the ability for NPs to practice independently. The purpose of this article was to analyze the advanced practice registered nurse's (APRNs) scope of practice policy in Massachusetts (MA) where APRNs just recently obtained full practice authority. Legislation to remove NP scope of practice restrictions in MA had been presented several times but was met with resistance from physician advocacy groups stating that NPs lack the education requirements to practice independently. A recent report from the MA Health Policy Commission demonstrates the impact that NPs have on lowering health care costs and servicing individuals in underserved areas of the state. During the pandemic, restrictions on NP scope of practice in MA were temporarily removed. It was realized that if NPs can practice independently during a pandemic, then they certainly are competent to practice independently at other times. A reassessment of NP scope of practice to allow for full authority should be completed nationally.
自 1965 年护士从业者(NP)角色创立以来,其实践已经发展。教育要求已经标准化,需要硕士学位,但美国各地的 NP 实践范围存在差异。随着人口老龄化和更多美国人拥有医疗保险,对医疗保健的需求持续增加。临床提供者的短缺和医院护理模式的变化继续给医疗保健系统带来负担。已经发现护士从业者能够提供安全、高质量的患者护理,并且是缓解我们医疗保健系统负担的潜在解决方案。护士从业者的实践范围限制限制了 NPs 独立实践的能力。本文的目的是分析马萨诸塞州(MA)的高级实践注册护士(APRNs)实践范围政策,APRNs 最近刚刚获得了完全实践权限。在 MA 取消 NP 实践范围限制的立法已经提出了几次,但遭到了医师倡导团体的反对,他们表示 NPs 缺乏独立实践的教育要求。MA 卫生政策委员会的一份最新报告表明,NP 对降低医疗保健成本和为该州服务不足地区的个人产生了影响。在大流行期间,MA 对 NP 实践范围的限制被暂时取消。人们意识到,如果在大流行期间 NPs 能够独立实践,那么他们在其他时候肯定也有能力独立实践。应该在全国范围内重新评估 NP 实践范围,以允许完全授权。