Barriers to NP Practice That Impact Healthcare Redesign
As healthcare reform evolves, nurse practitioners (NP) will play key roles in improving health outcomes of diverse populations. According to the Institute of Medicine (IOM) 2011 report, The Future of Nursing: Leading Change Advancing Health, nurses should be change advocates by caring for populations within complex healthcare systems. The IOM reports asserts, "advanced practice registered nurses (APRNs) should be able to practice to the fullest extent of their education and training" (IOM, 2011, s8). However, existing barriers in the healthcare arena limit APRN practice. This article will discuss some of these barriers and provide suggestions for possible ways to decrease the barriers.
In 1965, to meet the demands of underserved populations, Loretta Ford and Henry Silver began the first certificate program that provided nurses with the skills to deliver primary care to children in community settings. In the 1970's NP education moved from a certificate program to programs that offered bachelors or masters degrees. In addition, the population focus was not only pediatric and families, but also began to include adult/gerontology, women's health, neonatal, and other specialty roles. These early nursing pioneers revolutionized advanced practice nursing. Present-day NPs assume various roles that include caring for ethnically diverse, underserved populations within an aging society and across many healthcare settings. The rapid growth of NPs since the initial certificate programs has been astounding and contemporary NPs have emerged as leaders in healthcare (Sullivan-Marx, McGivern, Fairman, & Greenberg, 2010). The NP role in the 21 century looks much different than it did in 1965.
Today, NP practice is impacted by four significant policy and regulation initiatives 1) the Consensus Model for APRN Regulation: Licensure, Accreditation, Certification and Education (APRN Joint Dialogue Group, 2008); 2) the Doctor of Nursing Practice movement; 3) the IOM report (2011); and 4) the Patient Protection and Affordable Care Act (PPACA). Despite many positive expansions to the NP role, there continues to be many barriers requiring attention of national and state leaders in order to achieve the Triple Aim of healthcare: 1) better care; 2) better health; and 3) lower healthcare cost (Berwick, Nolan, & Whittington, 2008). The next part of this paper will discuss some of the barriers to NP practice.
Abstract and Introduction
Abstract
As healthcare reform evolves, nurse practitioners (NP) will play key roles in improving health outcomes of diverse populations. According to the Institute of Medicine (IOM) 2011 report, The Future of Nursing: Leading Change Advancing Health, nurses should be change advocates by caring for populations within complex healthcare systems. The IOM reports asserts, "advanced practice registered nurses (APRNs) should be able to practice to the fullest extent of their education and training" (IOM, 2011, s8). However, existing barriers in the healthcare arena limit APRN practice. This article will discuss some of these barriers and provide suggestions for possible ways to decrease the barriers.
Introduction
In 1965, to meet the demands of underserved populations, Loretta Ford and Henry Silver began the first certificate program that provided nurses with the skills to deliver primary care to children in community settings. In the 1970's NP education moved from a certificate program to programs that offered bachelors or masters degrees. In addition, the population focus was not only pediatric and families, but also began to include adult/gerontology, women's health, neonatal, and other specialty roles. These early nursing pioneers revolutionized advanced practice nursing. Present-day NPs assume various roles that include caring for ethnically diverse, underserved populations within an aging society and across many healthcare settings. The rapid growth of NPs since the initial certificate programs has been astounding and contemporary NPs have emerged as leaders in healthcare (Sullivan-Marx, McGivern, Fairman, & Greenberg, 2010). The NP role in the 21 century looks much different than it did in 1965.
Today, NP practice is impacted by four significant policy and regulation initiatives 1) the Consensus Model for APRN Regulation: Licensure, Accreditation, Certification and Education (APRN Joint Dialogue Group, 2008); 2) the Doctor of Nursing Practice movement; 3) the IOM report (2011); and 4) the Patient Protection and Affordable Care Act (PPACA). Despite many positive expansions to the NP role, there continues to be many barriers requiring attention of national and state leaders in order to achieve the Triple Aim of healthcare: 1) better care; 2) better health; and 3) lower healthcare cost (Berwick, Nolan, & Whittington, 2008). The next part of this paper will discuss some of the barriers to NP practice.