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Expanding the scope of practice for advance practice registered nurses in the Veterans Administration: a physician’s perspective

Sharma, Anupama (2016) Expanding the scope of practice for advance practice registered nurses in the Veterans Administration: a physician’s perspective. Master Essay, University of Pittsburgh.

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Abstract

There is wide consensus among the US healthcare professionals regarding the vital role of advanced practice nurse practitioners (APRNs) in healthcare delivery. However, the best way to achieve a formalized integration of APRNs with autonomous role in primary care is heavily contested. Increasing primary care and preventive health focus promoted by the Affordable Care Act (ACA 2010) has made this integration even more imperative due to shortage in primary care workforce. as well as non-uniform geographical distribution of primary care physicians. This has renewed the focus on the APRN scope of practice, despite numerous publications advocating equity of care delivery by APRNs. The established physician groups favor a collaborative/supervised model with limited scope of practice. As the stakeholders argue about the details of the final rule on nurse autonomy, collaborative patient centric care model delivered by blended health care teams is garnering increasing support. The ACA has bolstered this primary care model by rolling out provisions to enhance the nursing role in primary care and proposed bundled payment systems that provide the perfect framework for this change. In 2016 the Veterans Health Administration (VHA) is beginning to implement expanded scope of practice for APRNs to streamline its patient-centric medical home (PCMH) model of care This essay is a focused assessment of the background and potential implications of full practice authority for nurse practitioners in the primary care setting in the Veterans Health Administration (VHA). This topic is of immense public health significance as the demand for primary care services in the United States is expected to increase over the next few years, particularly with the aging and growth of the population and passage of the Affordable Care Act (ACA). VHA, a large public health organization, is not immune to these increasing demands for primary care. Research suggests that NPs and other health professionals are trained to deliver many primary care services and may therefore be able to help increase access to primary care, particularly in underserved areas. VHA has taken the lead in formalizing the APRN role and identifying it as pivotal to meeting increasing healthcare delivery demands it currently faces. This essay attempts to analyze this major policy change in its historical and current perspective.


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Details

Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Sharma, Anupama
Contributors:
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairRohrer, Wesley M.wmrun@pitt.eduUNSPECIFIEDUNSPECIFIED
Committee MemberHoffmann, Rosemary L.rho100@pitt.eduUNSPECIFIEDUNSPECIFIED
Date: 19 December 2016
Date Type: Submission
Publisher: University of Pittsburgh
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Health Policy & Management
Degree: MHA - Master of Health Administration
Thesis Type: Master Essay
Refereed: Yes
Date Deposited: 22 May 2017 16:23
Last Modified: 20 Dec 2018 00:56
URI: http://d-scholarship.pitt.edu/id/eprint/30647

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