Slade Eric P, DePriest Kelli, Commodore-Mensah Yvonne, Samuel Laura, Hanson Ginger C, D'Aoust Rita
Johns Hopkins School of Nursing, Baltimore, MD, USA.
Research Triangle Institute International, NC, USA.
Med Care Res Rev. 2025 Feb;82(1):68-78. doi: 10.1177/10775587241282163. Epub 2024 Oct 29.
State full practice authority (FPA) laws are designed to permit NPs to practice autonomously from physicians. Little is known regarding how FPA laws affect NPs' practice autonomy in daily practice. This study used nationwide survey data from 20,830 NPs to estimate how NPs' practice autonomy differs between NPs in FPA and non-FPA states. NPs in states with FPA laws were more than twice as likely as NPs in non-FPA states to practice in clinic settings with no onsite physicians and were twice as likely to not have a physician collaborator. Associations between FPA laws and four other indicators of practice autonomy were positive but smaller in magnitude. States with FPA laws more than 10 years experienced larger changes in nurse practitioner (NP) autonomy compared with states with FPA laws in effect less than 10 years. FPA laws may promote the development of autonomous NP practice sites, thereby expanding access in underserved populations.
全面执业权限（FPA）法律旨在允许执业护士独立于医生开展执业活动。关于FPA法律如何影响执业护士在日常执业中的自主权，目前所知甚少。本研究使用了来自20830名执业护士的全国性调查数据，以估计FPA州和非FPA州的执业护士在执业自主权方面有何不同。拥有FPA法律州的执业护士在没有现场医生的诊所环境中执业的可能性是非FPA州执业护士的两倍多，且没有医生合作者的可能性也是其两倍。FPA法律与其他四个执业自主权指标之间的关联呈正向，但幅度较小。与实施FPA法律不到10年的州相比，实施FPA法律超过10年的州在执业护士（NP）自主权方面经历了更大的变化。FPA法律可能会促进自主执业护士执业地点的发展，从而扩大为服务不足人群提供的医疗服务。
