Do transition to practice hour requirements make a difference in adverse action and medical malpractice payment reports: An analysis from the National Practitioner Data Bank.

BACKGROUND

The transition to practice (TTP) hour requirement presents a barrier to full practice authority (FPA) for nurse practitioners (NPs). Since 2015, the predominant method of granting FPA entails a TTP hour requirement.

PURPOSE

Adverse action reports (AARs) and medical malpractice payment reports (MMPRs) of NPs were compared in states with FPA on initial licensure and states with FPA requiring a TTP hour period using data from the National Practitioner Data Bank (NPDB). The relationship of TTP hours to AARs and MMPRs was also evaluated.

METHODOLOGY

A secondary analysis was obtained from a review of retrospective data in the NPDB. States examined were those that grant FPA on initial advanced practice registered nurse licensure and states that require a TTP hour requirement as part of their criteria for granting FPA.

RESULTS

In a 5-year period, postimplementation of FPA or 5-year postexpiration of the TTP requirement in 23 states, plus the District of Columbia, revealed that states with FPA granted on initial licensure demonstrated a lower incidence of AARs and MMPRs at the 5-year period compared with states that require a TTP hour period. No relationship existed between the amount of TTP hours and the incidence of AARs and MMPRs.

CONCLUSION

Transition to practice hours remains a barrier to NPs achieving FPA. It is important for nursing to continue to build the body of evidence that refutes or supports the need for TTP hours.

IMPLICATIONS

These data can be used when lobbying at the state level in the remaining states seeking FPA.