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NURSE PRACTITIONERS AND PRACTICE BARRIERS

PRESENTED BY:

Bosede O. Adedire

COPPIN STATE UNIVERSITY

CONTENT
 Introductory statement
 Statement concerning the challenge
 Review of the literature concerning Nurse
Practitioners and practice challenge
 Discussion of the prevalence of the problem
 Resources/agencies that have taken initiatives/efforts
to address this challenge
 Discussion of barriers that exist which may impede
independent practice of Nurse practitioners
 Conclusion which summarizes nurse practitioners
implications

INTRODUCTION

 Nursing practice has been guided and monitored by other
advance health care professionals and political rulings
 Advance Practice Nurses has been given the privilege to
practice as independent primary care providers (PCP)
 There is a general knowledge that there are obstacles to
practice autonomy of advance practice nurses.

STATEMENT OF THE PROBLEM
 There are several road blocks to Nurse practitioner’s

autonomy to successfully practice independently as primary
care provider.

 The scope and practice of Nurse Practitioners as independent
providers are still evolving from state to state.
.

REVIEW OF LITERATURE
Cheater, F. M. (2010). Improving primary and community health services
through nurse-led social enterprise. Quality in Primary Care, 18(1), 5-7.
Muxworthy, H & Bowllan, N. (2011). Barriers to practice and impact on care:
An analysis of the psychiatric mental health nurse practitioner role. Journal of
the New York State Nurses Association, 1 & 2, 8-14.
Gilliss, C. L. (2011). The nurse as social entrepreneur: Revisiting our roots and
raising our voices. Nursing Outlook, 59(5), 256-257. doi:
10.1016/j.outlook.2011.07.003
Weiland, S. (2008). Reflections on independence in nurse practitioner practice.
Journal of the American Academy of Nurse Practitioners, 20(7), 345-352.
Wilson, A., Whitaker, N., & Whitford, D. (2012). Rising to the challenge of
health care reform with entrepreneurial and intrapreneurial nursing initiatives:
The Online Journal of Issues in Nursing Vol. 17, No. 2. doi:
OJIN.Vol17No02Man05

PREVALENCE OF THE CHALLENGE
 The prevalence of the challenge of NP’s autonomy as
independent health care provider differs from state to state.
 The problem is resolving in some states while some other
states still have restrictive policies

BARRIERS TO NP’S INDEPENDENT PRACTICE

 Decentralized policy for NP practice set by different states

 Health plans formulary, and recognition of services provided
by nurse practitioners
 Reimbursement is not comparable to other health care
providers and fear on the part of NPs to take on the new role

 The degree of competition from other health care professionals
create hindrance to NP’s independent practice

 Lack of hospital privileges
 The consumer perceptions and understanding of nurse
practitioner contributions and duties as independent care
providers

RESOURCES/AGENCIES THAT HAVE TAKEN EFFORTS
TO ADDRESS THIS CHALLENGE

 Institute of Medicine of the National Academies
 American Association of Nurse Practitioners.
 U.S. Census Bureau, Statistical Abstract of the
United States. Reflections on independence in
nurse practitioner practice.

CONCLUSION

 A national perspective approach is needed to resolve barriers

to independent practice of NPs
 Barriers to independent practice of NPs has implication for
practice and the society as a whole
 Sustained obstacles to independent practice of NPs may in
the long run impede access to health care for the vulnerable
population.

References

American Association of Nurse Practitioners. (2013). Fact sheet: Medicare
reimbursement. Retrieved from www.aanp.org/legislation-regulation/federallegislation/medicare/68-articles/325-medicare-reimbursement
Cheater, F. M. (2010). Improving primary and community health services through nursesocial enterprise. Quality in Primary Care, 18(1), 5-7.
Churchman, J. J., & Doherty, C. (2010). Nurses' views on challenging doctors' practice in
acute hospital. Nursing Standard, 24(40), 42-48.
Coddington, J., Sands, L., Edwards, N., Kirkpatrick, J., & Chen, S. (2011). Quality of health
provided at a pediatric nurse-managed clinic. Journal of the American Academy of Nu
Practitioners, 23(12), 674-680. doi: 10.1111/j.1745-7599.2011.00657.x
Gilliss, C. L. (2011). The nurse as social entrepreneur: Revisiting our roots and raising our
voices. Nursing Outlook, 59(5), 256-257. doi: 10.1016/j.outlook.2011.07.003
Institute of Medicine of the National Academies. (2010). The future of nursing leading change
advancing health. Retrieved from www.iom.edu/Reports/2010/The-Future-of-Nursing
Leading-Change-Advancing-Health.aspx
Lee, S. (2011). In support of the abolishment of supervisory and collaborative clauses. The
Journal for Nurse Practitioner, 7(9), 764-769.
Muxworthy, H & Bowllan, N. (2011). Barriers to practice and impact on care: An analysis
the psychiatric mental health nurse practitioner role. Journal of the New York State Nurs
Association, Volume 42, Numbers 1 & 2, 8-14.

Naylor, M. D., & Kurtzman, E. T. (2010). The role of nurse practitioners in
reinventing primary care. Health Affairs, 29, 893-899.
U.S. Census Bureau, Statistical Abstract of the United States. (2012). Washington,
DC, 2011. Retrieved from: http://www.census.gov/compendia/statab/.
Weiland, S. (2008). Reflections on independence in nurse practitioner practice.
Journal of the American Academy of Nurse Practitioners, 20(7), 345-352.
Wilson, A., Whitaker, N., & Whitford, D. (2012). Rising to the challenge of health
care reform with entrepreneurial and intrapreneurial nursing initiatives: The
 
 

Online Journal of Issues in Nursing Vol. 17, No. 2. doi: OJIN.Vol17No02Man05