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NURS 6050 Professional Nursing and State-Level Regulations

NURS 6050 Professional Nursing and State-Level Regulations

NURS 6050 Professional Nursing and State-Level Regulations

State boards of nursing regulate nursing practice based on the Nursing Practice Act (NPA). Maryland Board of Nursing (BON) allows advanced practice registered nurses (APRNs) to practice to the full extent of their education and training (MBON, 2023). However, Pennsylvania nurse practitioners have reduced practice authority. The comparison in these two states is that APRNs in Maryland can evaluate patients, diagnose and order as well as interpret diagnostic tests. Nurse practitioners can also prescribe medications and controlled substances. As such, NPs in Maryland can practice autonomously without supervision from physicians. Conversely, in Pennsylvania, NPs have reduced practice authority implying that they must have collaborative agreements with physicians who guide them in care provision (AANP, 2023). Again, nurses in the state cannot order and interpret diagnostic tests, and initiate and manage treatments.

The National Academy of Medicine and the National Council of State Boards of Nursing (NCSBN) recommend nurse practitioners to practice to the full level of their education and training to improve access to healthcare. However, reduced practice authority affects the ability of APRNs to practice to full authority and improve care delivery (Yang et al., 2021). As such, nurses cannot practice to initiate and manage treatment and prescribe medications. Further, they cannot practice independently since they require collaborative agreement with practicing physicians.

Advanced practice registered nurses (APRNs) can adhere to the two regulations by improving their education and complying with the requirements, especially in Pennsylvania. By enhancing their education, they will ensure that they have specialized in certain areas based on the four roles of APRNs. For instance, nurse practitioners can specialize in geriatric care or oncology, which allows them to practice to the full level of their training and education (AANP, 2023). Through this approach, APRNs can expand access to quality care for patients with different conditions.

References

American Association of Nurse Practitioners (AANP) (2023).  State Practice Environment.

https://www.aanp.org/advocacy/state/state-practice-environment

Maryland Board of Nursing (MBON) (2023). Advanced Practice Registered Nursing: Nurse

            Practitioners. https://mbon.maryland.gov/Pages/adv-prac-nurse-practitioner-index.aspx

Yang, B. K., Johantgen, M. E., Trinkoff, A. M., Idzik, S. R., Wince, J., & Tomlinson, C. (2021).

State nurse practitioner practice regulations and US health care delivery outcomes: a systematic review. Medical Care Research and Review, 78(3), 183-196. DOI: 10.1177/1077558719901216

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APRN practice is typically governed by the Board of Nursing and defined by the Nursing Practice Act. Besides, the method is impacted by various laws and regulations. According to Neff et al. (2018), although the rules may vary from one state to another, they all aim at securing the interest of the public health safety by regulating activities of APRNs health care professionals. They explicitly state that the variation existing between APRNs and related state rules and regulations brings the need for nurses to explicitly understand their scope of practice as defined by the laws and regulations of the said state. In light of this, the paper delves into giving an in-depth explanation of Georgia APRN Board of Nursing regulations, while comparing and contrasting with Ontario’s laws.

In Georgia, the Board of Nursing is the regulatory body for APRNs. These boards are responsible for evaluating applications for nurse licensure, disciplinary actions, issuance, and renewal of nursing licenses. On the other hand, the College of Nurses of Ontario is the governing and regulatory body for APRNs. Although the criteria the two organizations use to give credentials are similar, there are significant differences in the scope of practice in Georgia and Ontario. APRN practice laws in Georgia are the most restrictive in the whole of U.S. The regulations in Georgia require an APRNs to engage in a protocol agreement with a supervising physician actively, so that other supervision requirements are comprehensively mandated. Besides, the regulations do not allow APRNs to write prescriptions for schedule II medications, which lowers the ability of the nurse to order diagnostic tests (Bosse et al., 2017). The prescription laws and regulations in Ontario contradict the ones in Georgia. It is common to find an APRNs in Ontario prescribing medications to patients. The state laws of Ontario allow nurses to prescribe controlled substances provided they have completed approved substance education. The government of Ontario in 2017 recommended changes to the regulations under the Nursing Act 1991 that gave power to APRNs to expand their scope of practice. In essence, the Nursing Act of 1991 is one example of a law that regulates the magnitude of APRNs in Ontario.

The Georgia Board of Nursing through its licensure laws and regulations requires APRNs to hold an active Georgia registered nursing license before an individual can practice as a certified nurse practitioner in the state. On the other hand, APRNs that are considered independently licensed providers are supposed to work under protocol agreements, and Georgia Composite Medical Board controls their prescriptive authority. On the contrary, Ontario state licensure laws and regulations permit all NPs to exercise autonomy in practice. The nurse can assess patients, diagnose, order diagnostic tests, initiate and manage treatments, prescribe all medications, including control substances without a provider’s supervision after qualifying in Approved Substance Education. Allowing APRNs to have full practice access will enable an increase in experience and expand the talents inherent in nurse practitioners. Besides, it will encourage significant innovations in the nursing profession; it also motivates other NPs to spring up in filling the gap created by the shortage of providers in Canada.

In my practice, which is in Georgia, the state practice and licensure laws and regulations are restricting our ability as nurses to engage in at least one element of APRN practice. Besides, this regulation will ensure that all nurse in practice gets certification to practice as an APRN in Georgia. Moreover, the demand of Georgia states laws and regulations will ensure I appreciate career-long supervision, team management, and delegation to another health care provider so that as an APRN, I provide patients with quality care (Milstead & Short, 2019). In my practice, restriction of prescribing schedule III to V drug and substances is limiting the scope of practice of nurses. The prescriptive authority of a supervising physician by submitting a written protocol to the supervising physician and permission is granted, ensuring that nurse managers in my practice engage in supervision mandate. Georgia prescription laws and regulation demands are applicable in my training in the sense that we, the nurses, are required to prescribe both legend drug and Schedules II-V controlled drugs only after certification.

APRNs in Georgia can adhere to licensure laws and regulations by visiting the Georgia Composite Medical Board website after being authorized to complete licensure requirements. Besides, after graduating from a nursing education program, a nurse should look for licensure by endorsement as a registered nurse (Peterson et al., 2015).  Further, a nurse should apply to evaluation. The Georgia Board of Nursing is responsible for evaluating applications for nurse licenses. In regards to prescription laws and regulations, Peterson et al. (2015) assert that APRNs can adhere to this regulation by ensuring that Schedule III and IV controlled substances cannot be filled or refilled more than five times or more than six months after the date the prescription was issued, whichever occurs first. Besides, a nurse should ensure that Schedule II prescriptions cannot be refilled. Under the Georgia State law, there is no expiration for a Schedule II prescription.

References

Bosse, J., Simmonds, K., Hanson, C., Pulcini, J., Dunphy, L., Vanhook, P., & Poghosyan, L. (2017). Position statement: Full practice authority for advanced practice registered nurses is necessary to transform primary care. Nursing Outlook, 65(6), 761–765. doi:10.1016/j.outlook.2017.10.002

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.

Neff, D. F., Yoon, S. H., Steiner, R. L., Bumbach, M. D., Everhart, D., & Harman J. S. (2018). The impact of nurse practitioner regulations on population access to care. Nursing Outlook, 66(4), 379–385. doi:10.1016/j.outlook.2018.03.001

Peterson, C., Adams, S. A., & DeMuro, P. R. (2015). mHealth: Don’t forget all the stakeholders in the business case. Medicine 2.0, 4(2), e4. doi:10.2196/med20.4349

Thank you for pointing out the differences between nursing board regulations in Iowa and Illinois. I wanted to understand why some states allow ARNPs the liberty to practice independently but in other states, they are not allowed. I wondered if the more rural states tended to give more liberty to the nursing profession in this regard. According to the online Family Nurse Practitioner (FNP) program from the Simmons School of Nursing (n.d.), lawmakers are working on expanding the nurse practitioner’s (NP) role to underserved areas because primary care physicians are in such short supply in these areas. More importantly, studies show that when the scope of practice for NPs is expanded, the quality of patient outcomes is not reduced (Ortiz et al., 2018).

References:

Ortiz, J., Hofler, R., Bushy, A., Lin, Y., Khanijahani, A., & Bitney, A. (2018, June 15). Impact of nurse practitioner practice regulations on rural population health outcomes. Healthcare (Basel, Switzerland), 6(2), 65. https://doi.org/10.3390/healthcare6020065
Simmons School of Nursing. (n.d.). Where can nurse practitioners work without physician supervision? Retrieved from https://online.simmons.edu/blog/nurse-practitioners-scope-of-practice-map/

An Advanced Registered Nurse Practitioner (ARNP) is a certified registered nurse who has completed national certification for a specialized area (Arizona Board of Nursing, 2020) such as Psychiatric Mental Health Nurse Practitioner (PMHNP). This nurse will compare the regulations from two of the places she has lived in, Alaska and Arizona

According to Ariz. Rev. Ann § 32-1601(20) (ARNP) has full independent authority and practice under licensure authority of the State Board of Nursing instead of a licensed physician (NCSL Scope of Practice Policy, 2021). The same is true in Alaska, (ARNP) have full independence to practice without the supervision of a physician according to Alaska Admin. Code §12-44.400. This means that both states allow (ARNP) to
1. Examine a patient and establish a medical diagnosis by client history, physical examination, and other criteria.
2. For a patient who requires the services of a health care facility: Order and interpret laboratory, radiographic, and other diagnostic tests, and perform those tests that the RNP is qualified to perform.
1. Admit the patient to the facility,
2. Manage the care the patient receives in the facility, and
3. Discharge the patient from the facility.
3.
4. Prescribe, order, administer and dispense therapeutic measures including pharmacologic agents and devices if authorized under R4-19-511, and non-pharmacological interventions including, but not limited to, durable medical equipment, nutrition, home health care, hospice, physical therapy, and occupational therapy.
5. Identify, develop, implement, and evaluate a plan of care for a patient to promote, maintain, and restore health.
6. Perform therapeutic procedures that the RNP is qualified to perform.
7. Delegate therapeutic measures to qualified assistive personnel including medical assistants under R4-19-509.
8. Perform additional acts that the RNP is qualified to perform and that are generally recognized as being within the role and population focus of certification. (ARIZONA STATE BOARD OF NURSING, 2017)
One key difference is in the prescribing and dispensing authority within each state. Arizona requires that evidence of a minimum of 45 contact hours of education within the three years immediately preceding the application be submitted, covering one or both of the following topics consistent with the population focus of education and certification: Pharmacology, or Clinical management of drug therapy (ARIZONA STATE BOARD OF NURSING, 2017). While Alaska requires the applicant to provide evidence of completion of 15 contact hours of education in advanced pharmacology and clinical management of drug therapy within the two-year period immediately before the date of application (DIVISION OF CORPORATIONS, BUSINESS AND PROFESSIONAL LICENSING, 2021)

NURS 6050 Professional Nursing and State-Level Regulations

References:

Arizona Board of Nursing. (2020, July 24). Arizona Board of Nursing Scope of Practice APRN Questions & Answers SCOPE OF PRACTICE Nurse Practitioners. Retrieved from Arizona Board of Nursing: https://www.azbn.gov/sites/default/files/2020-11/FAQs%20Final%20Questions-%20NP%207.24.20%20%281%29.pdf
ARIZONA STATE BOARD OF NURSING. (2017, July 1). RULES OF THE STATE BOARD OF NURSING. Retrieved from ARIZONA STATE BOARD OF NURSING: https://www.azbn.gov/sites/default/files/2018-12/rulesjuly12017final.pdf
DIVISION OF CORPORATIONS, BUSINESS AND PROFESSIONAL LICENSING. (2021). Statutes and Regulations Nursing Nursing. DEPARTMENT OF COMMERCE, COMMUNITY, AND ECONOMIC DEVELOPMENT (p. 23). State of Alaska.
NCSL Scope of Practice Policy. (2021). State Overview: Arizona. Retrieved from NCSL Scope of Practice Policy: https://scopeofpracticepolicy.org/states/az/

Advanced practice registered nurses practice is distinct state by state and the APRN scope of practice and regulative criteria vary from nurses with same qualifications and titles in each state (Milstead & Short, 2019). In comparing APRNs in Texas and New Mexico, there are differences in regulations based on the respective nursing boards and the scope of practice authority. In Texas, the APRN board of nursing regulations mandates nurse practitioners to restricted practice. The NPs can only engage in one element of practice and should be on career-long supervision of a physician. APRNs should also have registered nurse license, graduate degree and have national certification. The Texas Board of Nursing also mandates APRNs to meet the Nurse Practice Act and all its requirements (Texas Board of Nursing, 2021). In New Mexico, Nurse practitioners are under the Nurse Practice Act and must register with the Prescription Monitoring Unit. The APRNs have full practice authority and can prescribe drugs and controlled substances. The APRNs are also regulated by the state Board of Nursing and should have national certification and graduate degree qualification (NMNPC, 2020). The implication is that certified family nurse practitioners (FNPs) as a specialty in APRN may also have variations based on states. In Texas, family nurse practitioners must have supervising physicians to provide patient care. However, in New Mexico FNPs are allowed to practice independently to the full extent of their training and education.

The regulations impact APRNs who have legal authority to practice to the full level of their education and experience as they set guidelines for those practicing with the profession to protect their titles and the public (Laureate Education, 2018). APRNs comply with the regulations by ensuring that they update their licenses, meet the requirements for continuing education and training and enhancing patient safety and competence in their nursing practice.

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References

Laureate Education (Producer). (2018). The Regulatory Process [Video file]. Baltimore, MD:

Author.

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.).

Burlington, MA: Jones & Bartlett Learning.

New Mexico Nurse Practitioner Council (2020). Practice Regulations.

https://www.nmnpc.org/page/PracticeRegs

Texas Board of Nursing. (2021) Practice-APRN Scope of Practice.

https://www.bon.texas.gov/practice_scope_of_practice_aprn.asp

Professional Nursing and State-Level Regulations

Boards of Nursing (BONs) exist in all 50 states, the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, and the Virgin Islands. Similar entities may also exist for different regions. The mission of BONs is the protection of the public through the regulation of nursing practice. BONs put into practice state/region regulations for nurses that, among other things, lay out the requirements for licensure and define the scope of nursing practice in that state/region.

It can be a valuable exercise to compare regulations among various state/regional boards of nursing. Doing so can help share insights that could be useful should there be future changes in a state/region. In addition, nurses may find the need to be licensed in multiple states or regions.

Resources

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

WEEKLY RESOURCES

To Prepare:

  • Review the Resources and reflect on the mission of state/regional boards of nursing as the protection of the public through the regulation of nursing practice.
  • Consider how key regulations may impact nursing practice.
  • Review key regulations for nursing practice of your state’s/region’s board of nursing and those of at least one other state/region and select at least two APRN regulations to focus on for this Discussion.

By Day 3 of Week 5

Post a comparison of at least two APRN board of nursing regulations in your state/region with those of at least one other state/region. Describe how they may differ. Be specific and provide examples. Then, explain how the regulations you selected may apply to Advanced Practice Registered Nurses (APRNs) who have legal authority to practice within the full scope of their education and experience. Provide at least one example of how APRNs may adhere to the two regulations you selected.

By Day 6 of Week 5

Respond to at least two of your colleagues* on two different days and explain how the regulatory environment and the regulations selected by your colleague differ from your state/region. Be specific and provide examples.

*Note: Throughout this program, your fellow students are referred to as colleagues.

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The Maryland Board of Nursing governs the advanced practice registered nurses (APRNs) in Maryland. They are the ones that set the guideline for APRN licensure,  their educational scope, and their practice scope. Compared to the neighboring state of Virginia,  the regulation of APRNs is quite similar, but they have critical differences in several areas. One significant difference between the two states is the requirement that is needed for APRN licensure. In Maryland, APRNs must have a current RN license and a master’s degree. They also need to have been certified in their specialty. APRNs that practice in Virginia are usually required to have finished a minimum of 500  hours of field practice in their specialty.

The scope of practice for APRNs in the two states is also different. APRNs that practice in Maryland have the full right to carry out the diagnosis of patients, treat them, and give them prescriptions for drugs without needing an oversight physician (Mastarone et al., 2019). While in Virginia, APRNs are guided in their practice by the collaborative agreement, where physicians are the ones that outline what they are supposed to practice. Even though APRNs in Virginia can write a prescription for drugs for the patient,  they carry out this in accordance with the directives of the physicians (Mastarone et al., 2019).

To adhere to the regulations stipulated in the two states, it is the responsibility of APRNs to ensure they familiarize themselves with the specific requirements and guidelines that give direction on how to practice each of their states. To satisfy license criteria, APRNs in Maryland must be certified in their specialization (Auerbach et al., 2020). An APRN practicing in Virginia must work closely with the physician to comply with the scope of practice.

Different states tend to be regulated by different entities. There are differences in terms of the scope of practices as well as the regulatory standards for nurses as well in different states (Milstead & Short, 2019). However, it is interesting to note that they usually have similar standards with regards to their education requirements. For example, in the state of Michigan, nurse practitioners (NP) cannot operate as primary care providers without having a physician being present. This means that an NP working in the state of Michigan cannot operate independently and must have a physician present to oversee as well as to order any kind of work that the NP does. At the same time, NPs in Michigan are allowed to prescribe certain medications to patients. The medications that the NPs are not allowed to prescribe, they can still do so if the task were to be delegated by a physician. For example, some of the medications that the NP cannot prescribe without referring to the physician would include various types of opioids as well as antianxiety and antipsychotic pills.

Considering another state, it would be useful to look at the state of Arizona. In Arizona, the NPs have the scope of practice and authority to work independently without having a physician to oversee or delegate their work. Other than that, Arizona also recognizes NPs as being primary care providers (NCSLSOP, 2023. This is something that can be contrasted with Michigan in which the NPs are not considered to be primary care providers and they must work under a physician at all times. Nevertheless, the NPs must ensure that they are operating and practicing within the various regulations and guidelines that their state board of nursing have laid out for them. The state board of nursing not only regulates the nurse practitioners but also the registered nurses as well as other nurses, such as licensed practice nurses and other types of nurses. This is why if a nurse decides to move to a new state after having practiced in one state, it is important for the nurse to research what the guidelines and regulations are in the new state.

For instance, as noted earlier, NPs in the state of Arizona can work independently of a physician. Nevertheless, it is important for the nurses to ensure that they are working as per their scope of practice that defines their specialty. Nurses who specialize in oncology, for example, would not be able to work in respirology and vice versa. The nurses have to register for their particular specialty and then only practice within that particular one. In a similar manner, it is important for the nurses to note that just because one state allows the nurses to work in a particular manner does not mean that all other states would require the same. This is why it is the responsibility of the nurses to ensure that they are aware of what their scope is within a particular state and how they can operate safely and according to the laws and regulations that are related to their state and scope of practice. The nurses must also ensure that they are following all licensure rules and that they do not overstep their scope of practice or specialty.

Hello Millicent,

Thank you for sharing your post. Although 98% of NPs have graduate degrees, only about 27 states and the District of Columbia allow them to practice independently to the full extent of their education and training without collaborating with a physician. In the state of Michigan, similar to the state of Illinois, APRNs have a legal and ethical obligation to consult, refer or transfer patients when health care needs are beyond their scope of practice.  APRNs will continue to collaborate with physicians and all members of the interdisciplinary team to provide the best care for patients (SOM, n.d.). NPs are still very valuable to the growing number of patients and demands for health care providers. Like many states with limited autonomy, NPs are still able to provide patients with counseling and education services, health maintenance, disease prevention, and treatment for common and chronic illnesses (Korbecka, 2018). Current and past research has found that patients who are under the care of NPs have fewer unnecessary hospital readmissions, fewer potentially preventable hospitalizations, higher patient satisfaction and fewer unnecessary emergency room visits than patients under the care of physicians. According to research conducted by Mundinger, et al. (2000), that compared outcomes of patients seen by an NP versus a physician. Eligible participants were interviewed by mail, phone calls or home visits and the result showed no significant differences in self-reported health status; satisfaction; disease-specific physiologic measures; or use of specialist, emergency room or hospital care between the two groups. More state should adopt the full practice act for NPs to meet the demands of today’s growing need for providers. All NPs must also practice within the scope of their specialty.

Reference:

Korbecka, A. M. (2018). Independent practice by Aprns . LWW. Retrieved March 31, 2023, from https://journals.lww.com/ajnonline/fulltext/2018/05000/independent_practice_by_aprns.3.aspx

Links to an external site.

 

Lenz, E.R., Mundinger, M.O., Kane, R.L., Hopkins, S.C., & Lin, S.X. (2004). Primary care outcomes in patients treated by nurse practitioners or physicians: Two-year follow-up. Medical Care Research and Review 61(3), 332-351.

Nursing. SOM – State of Michigan. (n.d.). Retrieved March 31, 2023, from https://www.michigan.gov/lara/bureau-list/bpl/health/hp-lic-health-prof/nursing

Rubric Detail

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Name: NURS_6003_Module01_Week01_Discussion_Rubric

Excellent Good Fair Poor
Main Posting
45 (45%) – 50 (50%)

Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.

Supported by at least three current, credible sources.

Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

40 (40%) – 44 (44%)

Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.

At least 75% of post has exceptional depth and breadth.

Supported by at least three credible sources.

Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

35 (35%) – 39 (39%)

Responds to some of the discussion question(s).

One or two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Post is cited with two credible sources.

Written somewhat concisely; may contain more than two spelling or grammatical errors.

Contains some APA formatting errors.

0 (0%) – 34 (34%)

Does not respond to the discussion question(s) adequately.

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only one or no credible sources.

Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.

Main Post: Timeliness
10 (10%) – 10 (10%)
Posts main post by day 3.
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
Does not post by day 3.
First Response
17 (17%) – 18 (18%)

Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.

15 (15%) – 16 (16%)

Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.

13 (13%) – 14 (14%)

Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

0 (0%) – 12 (12%)

Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.

Second Response
16 (16%) – 17 (17%)

Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.

14 (14%) – 15 (15%)

Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.

12 (12%) – 13 (13%)

Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

0 (0%) – 11 (11%)

Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.

Participation
5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days.
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days.
Total Points: 100

Also Read: NURS 6050 Politics and the Patient Protection and Affordable Care Act

I believe the Texas legislators would give attention to the needs of the community. According to my research there has been a shortage of physicians in Texas and in other states. American Medical Association stated that the state will likely to have a shortage of 125,000-160,000 physicians by the year of 2025. The population in Texas is rising resulting in an increased growth of elderly population and uninsured that is affecting the central region. In primary care, there are 114 Texas counties are considered full primary care health professionals’ shortages, 7 counties are considered partial shortage areas, and 25 counties that don’t have any current physicians. According to the Texas Medical Association, Texas has only 204.6 physicians for a 100,000 population and the national average is 245.5 per 100,000. The T.L.L. Temple foundation funded a public health study and data analysis that can improve the shortages of physicians. In their study, they found out the following below:

  • Allowing APRNs to have Full Practice Authority would benefit Texas financially and in public health improving the accessibility to the health care and healthcare economy in Texas by removing the restrictions. It would improve the shortage by 2,376 primary care providers or 32% and reduce psychiatric provider shortage by 13%. It can increase the opportunity of 4,000 new jobs and save Texas at the same time up to $47.7 million in the first biennium alone.
  • Removing physician delegation will reduce the cost of healthcare in Texas and can benefit the Medicaid by having a saving of $12.8 million AF and $5.1 million GR and the Teacher Retirement System would save around $4.6 million.
  • Removing the collaborative agreement will not affect the patient’s safety. APRNs are safe as MDs/DOs when examining National Practitioner Data Bank medical negligence or malpractice. APRNs represent 2% of all medical negligence which is claimed in Texas and in nationals while physicians are responsible for 98% malpractice insurance claims.