Driving APRN Policy: A Legislative Success
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Driving APRN Policy: A Legislative Success James LaVelle Dickens, DNP, FNP-C, FAANP Mano y Corazón Binational Conference of Multicultural Health Care Solutions, El Paso, Texas, September 27-28, 2013
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Make Your Voice Heard: A Beginner's Guide to Lobbying (Advocating) to Congres...
Learn how to lobby (advocate) Congress for your physician (pediatrician, internist, family practitioner, gynecologist, etc), nurse, medical practice (primary care, specialty, dental, etc), and hospital. In this video, you will learn the following:
What is Lobbying (advocacy)
The make up of the U.S. Congress
Identification of Congressional Healthcare Committees
Identification of Nurses and Physicians in Congress
The Anatomy of a Congressional Office
The Anatomy of a Congressional Committee
The Lobbying (Advocacy) Process
Please visit http://medicalaccessusa.com or http://medicalaccessforamerica.com for more information
Quality of care improvement by changes to workload assignment for safe staffing
Quality of care improvement by changes to workload assignment for safe staffingRoberto Rivera-Olmo, BSN, RN
How changes in nurses workload assignments can improve quality of care and increase workplace safety. Organizational Policy and Systems Change
The Alliance to Reduce Disparities in Diabetes
http://ardd.sph.umich.edu/
The Alliance is working to improve communication between patients and health care providers. Effective communication among providers, patients and their family members is a critical component of efforts to promote optimal care outcomes, enhance prevention and management of diabetes and reduce disparities in care.
Nurses and political action
Nurses can affect policy outcomes through political involvement and exercising influence in various areas like the workplace, community, and government. While nurses are respected professionals interested in others' welfare, they often lack knowledge of the political process and do not address larger issues due to workload and misunderstanding how to influence policy. For nurses to gain power and political influence, they must educate themselves, develop leadership skills, and take collective action. However, structural constraints like blocked opportunities and tokenism have historically limited women's influence due to existing power imbalances.
Health system resilience, way forward and role of nurses
Health system resilience, way forward and role of nursesTarika Sharma, Lecturer, CON, ILBS, New Delhi
1. Nurses can have a significant impact on health systems through decisions made in practice and by driving transformational change in delivery of services from policy to practice.
2. Key priority areas for nurses include adoption of digital technologies, demonstrating quality care through a holistic and evidence-based approach, and developing systems leadership.
3. Nurses must develop personal and organizational resilience by maintaining their own health, improving skills, and making strong networks across health systems to optimize their contributions at all levels of health policy and services.Change challenges for nurses 2
The document describes a medieval model called the Wheel of Life that illustrates the emotions experienced during periods of change. The Wheel of Life depicts four positions - happiness, loss, suffering, and hope. It is used to explain that people naturally experience anxiety, sadness and stress when changes occur but can regain optimism and contentment by successfully working through the transition. The document also outlines several types of changes, common reasons for resisting change, and a six step process for managing change.
Nursing Leaders influencing politics and acting as patient advocates
This document discusses politics, economics, and collective bargaining in human services. It covers several key points:
1) Politics exists because resources are limited and some people have more power than others. Nurses can influence various areas including the workplace, community, professional organizations, and government.
2) Nurses advocate for patients by ensuring their rights are protected, they are informed and involved in their care, and their needs are communicated.
3) Collective bargaining allows employees to negotiate wages, benefits, and working conditions as a group through a union. It can benefit workers but may also reduce individual flexibility and decision making power. Managers must understand labor laws and represent both worker and organizational concerns during unionization.
Care of Sickle Cell Disease Patients: Process Improvement & Change with Nurses
The document discusses implementing a Sickle Cell Vulnerability Assessment (SCVA) to improve care for sickle cell disease patients. It notes disparities in care for this vulnerable population and cites regulatory drivers and benchmarks supporting standardized assessment. A proposed SCVA methodology would assess medical history, vulnerabilities, and pain for individualized care plans. Implementing the SCVA using Lewin's change model and PDCA cycles is outlined over six weeks, with strategies including staff education and surveys to evaluate outcomes.
Increase quality care with staff involvement with workload assignment
How is nursing quality of care affected by patient to nurse ratios? And how can involving staff with workload assignment benefit quality of care?
Political Primer 2015
Sharon Pearce provides an overview of political lobbying for nurses. She discusses that lobbying involves educating legislators about issues in order to influence their thinking. The most effective types of communication are constituent meetings, calls, and personal letters. It is important to lobby before, during, and after legislative sessions by building relationships with legislators and their staff based on trust and being an expert on issues. Nurses can lobby wherever opportunities arise, including socially and in their districts. The goal is to advocate for the nursing profession and influence the legislative process through political involvement.
Using Arterial Pressure Based Cardiac Output to Guide Therapy - Chris Saraceno
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Using Arterial Pressure Based Cardiac Output to Guide Therapy NCANA District 3 & 4 Meeting
Chris SaracenoSafe staffing = safe care the role of nurse-patient ratios
This document discusses the problems caused by overcrowding and inadequate nurse staffing in healthcare institutions, and proposes solutions to address these issues. Specifically, it notes that overcrowding leads to dangerous nurse workloads and compromised patient care. It recommends legislating nurse-patient ratios and implementing dynamic staffing models determined by nursing expertise as ways to match patient needs with appropriate staffing levels. The document advocates engaging nurses in care decisions at all levels and enforcing accountability to ensure staffing supports safe, quality patient care.
Nursing Informatics and Healthcare Policy
This document discusses a pre-conference workshop on nursing informatics and healthcare policy. It provides an agenda and introduces the thought leaders who will speak, including Amy Walker. Walker polls attendees on how policy correlates to various nursing issues. Her biography outlines her experience in nursing leadership, informatics, consulting, and entrepreneurship. The workshop will cover creating public policy, the goals of being involved in policy, and strategies for nurses to exercise influence, communicate, educate and support policy decision making.
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The Robert Wood Johnson Foundation Executive Nurse Fellows Program
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Similar to Driving APRN Policy: A Legislative Success
TNP_PressRelease_2015_final
Texas lawmakers have filed bills (SB 751 and HB 1885) to improve access to primary care by granting full practice authority to advanced practice registered nurses (APRNs) like nurse practitioners (NPs). Currently, Texas APRNs needlessly require physician supervision for many elements of care. The bills aim to eliminate outdated supervision requirements, improve the primary care workforce shortage, and increase access to care, especially in rural areas. Passing this legislation would help address health disparities by utilizing the growing number of APRNs in Texas to better meet patient needs.
Nelson tx afp lsga
The document discusses TAFP's advocacy efforts during the 82nd Texas legislative session to prevent expanded scope of practice for APRNs. TAFP developed issue briefs comparing physician and APRN training, argued physicians are more likely to practice in rural areas, and that collaboration rather than independence lowers costs. A policy brief raised regulatory and quality concerns. Through member outreach and testimony, no bills passed granting independent practice for APRNs. TAFP's multifaceted advocacy approach was successful in influencing lawmakers.
74J Adv Pract Oncol AdvancedPractitioner.comSection Editor.docx
74J Adv Pract Oncol AdvancedPractitioner.com
Section Editors: Heather M. Hylton and Wendy H. Vogel
PRACTICE MATTERS
Barriers to Practice and the Impact on
Health Care: A Nurse Practitioner Focus
MARY E. PETERSON, MS, APRN, AOCNP®
From St. David’s South Austin Medical Center,
Austin, Texas
Author’s disclosures of potential conflicts of
intersst are found at the end of this article.
Correspondence to: Mary E. Peterson, MS, APRN,
AOCNP®, HCA Physician Services Group, 4700
James Casey, Suite B-149, Austin, TX 78704.
E-mail: [email protected]
https://doi.org/10.6004/jadpro.2017.8.1.6
© 2017 Harborside Press®
In 1965, in answer to the growing demand for primary care, nurs-ing pioneer Loretta Ford, along with Dr. Henry Silver, created
the first certificate program that pro-
vided nurses with the skills to provide
primary care to underserved popula-
tions. Since the inception of that first
program, the field has grown to include
adult/gerontology, women’s health,
neonatal, and other specialty roles,
with minimum requirements for edu-
cation at the master’s/doctoral level.
The growth of nurse practitioners
(NPs) across all 50 states is unsur-
prising given the current landscape
of health care, yet barriers that limit
practice need action at both the state
and national levels. Access to care is a
significant challenge for patients. This
access is negatively impacted when
qualified NPs are willing and able to
deliver quality, cost-effective care, yet
governmental bodies continue to ig-
nore legislation that would update the
laws and modernize health care.
IDENTIFYING RESTRICTIONS
Individual states regulate NP practice.
Currently, 22 states and the District of
Columbia, or 44%, have adopted full
practice authority licensure and prac-
tice laws for NPs. Full practice author-
ity is defined by the American Associ-
ation of Nurse Practitioners (AANP)
as follows: “State practice and licen-
sure law provides for all nurse practi-
tioners to evaluate patients, diagnose,
order and interpret diagnostic tests,
initiate and manage treatments—in-
cluding prescribe medications—un-
der the exclusive licensure authority
of the state board of nursing.” The
remaining states are categorized as
either “reduced practice” (17 states,
or 34%) or “restricted practice” (12
states, or 24%). The AANP further
defines these categories as follows
(AANP, 2016):
• Reduced Practice: The NP has the
ability to engage in at least one element
of the NP practice and is regulated
through a collaborative agreement
with an outside health discipline to
provide patient care.
• Restricted Practice: The NP has
the ability to engage in at least one
element of NP practice and requires
supervision, delegation, or team
management by an outside health
discipline to provide patient care.
In 2010, the Institute of Medicine
(IOM), with the Robert Wood John-
son Foundation (RWJF), published a
landmark report titled, “The Future J Adv Pract O.
Advocacy For Equitable Health Care Discussion Paper.docx
The document discusses advocacy by Advanced Practice Registered Nurses (APRNs) for more equitable healthcare. It has three main points. First, APRNs aim to improve population health outcomes through better group services. Second, they seek to lower medical costs and reduce health inequalities. Third, APRNs face limitations like state practice restrictions and a lack of recognition from some medical groups regarding their training and ability to provide quality care.
Advanced Practice Legislation SAVE Act Essay.docx
The SAVE Act is a bipartisan bill in the North Carolina legislature that aims to remove restrictions on advanced practice registered nurses (APRNs) like nurse practitioners and certified nurse midwives. It seeks to allow APRNs to practice independently without physician supervision or collaboration agreements. Supporters argue this will improve access to healthcare, especially in rural areas, and reduce costs. However, physicians' organizations oppose the bill, concerned it could jeopardize patient safety. The American Association of Nurse Practitioners advocates for bills like this at the state level that expand APRN autonomy.
PCIAC Report 2016
This document provides recommendations from the Palliative Care Interdisciplinary Advisory Council to the Texas Legislature on improving supportive and palliative care in Texas. The council defines palliative care as having two branches: supportive and palliative care (SPC), which can be provided at any stage of a serious illness along with curative treatment; and hospice care (HC), for the terminal stage when curative treatment is no longer an option or desired. The council makes five recommendations to promote SPC in Texas, including expanding access to and training on SPC, and establishing quality standards.
The Barriers that Prevent Certified Nurse Practitioner (CNP) Practice
Review the shortage of medical professionals and the increasing need for advanced practitioners to serve in primary care roles
Identify the current barriers that prevent CNP from practicing to the full extent of their education, scope and training
Outline concrete ways in which these barriers can be effectively removed so as to improve autonomy for CNP’s and quality of care for patients.
Leveraging Public Health Capacity to Increase Health System Efficiency
Presenter Sharon Moffatt Chief of Health Promotion and Disease Prevention with the Association of State and Territorial Health Officials, leading on prevention, access to care and health reform
Physician quality reporting in the USA
Presentation given in Med-eTel 2011 -
Describing the Quality Reporting Initiative in the USA as a stepping stone towards full adoption of EHR in the USA.
Rebuilding the Health Care System in New Orleans and the US
The document discusses rebuilding the health care system in New Orleans post-Hurricane Katrina and applying Jewish principles of health care. It notes that pre-Katrina, Louisiana ranked 50th in health outcomes and had high rates of poverty, uninsured individuals, and health disparities. After Katrina, most hospitals and health infrastructure was destroyed, exacerbating access issues. The document advocates redesigning the system based on primary care-centered models shown to improve outcomes and lower costs through principles like comprehensive and coordinated care.
2016 National Academies of Practice Presentation
The study aimed to investigate associations between regulatory policy, workforce capacity, and health outcomes using Medicaid data from four states. However, the analysis found significant data quality issues. Key variables like service provider specialty were missing or incomplete, preventing valid conclusions about the proportion of services provided by nurse practitioners and physician assistants. At best, Alabama had 85% reporting but showed nurse practitioners and physician assistants providing significantly fewer services than medical doctors for selected chronic conditions despite making up over half of primary care workforce capacity. Overall, the Medicaid data proved inadequate for the research purposes due to inconsistent and missing coding across states.
Practicum 4
This document discusses nurse practitioner (NP) practice and barriers in New Jersey. It provides background on the development of the NP role since the 1960s. While NP practice has expanded in many ways, barriers still exist including restrictive licensing and collaborative agreement requirements in some states. In New Jersey specifically, NPs have independence in some areas but lack full practice authority and face barriers related to physician opposition, restrictive regulations, and insurance reimbursement policies. The document argues that removing restrictions would allow NPs to practice to their full potential and help improve access, quality and costs of healthcare.
2016 public health law conference • spring 2017 33The Journa.docx
2016 public health law conference • spring 2017 33
The Journal of Law, Medicine & Ethics, 45 S1 (2017): 33-36. © 2017 The Author(s)
DOI: 10.1177/1073110517703316
A
llied healthcare professionals play an integral
role in the healthcare system: healthcare teams
depend on nurses; comprehensive patient care
often cannot be achieved without a pharmacist; den-
tal offices thrive with the work of dental hygienists;
and emergency medical technicians play a vital role in
emergency care. The contributions of these and other
allied healthcare professionals are typically defined
by state laws governing the particular practice. These
laws may be hurdles or enablers to expanding access
to care in a community. We examine scope of practice
laws for nurse practitioners (NPs) and allied dental
providers to demonstrate how these laws may impact
access to care and population health.
Nurse Practitioners
Nurse practitioners (NPs) have rapidly become inte-
gral to the healthcare workforce, particularly primary
care. In 21 states and the District of Columbia, NPs
have “full practice authority,” meaning they can prac-
tice to the full extent of their education and training
without physician oversight.1 In the remaining 39
states, NPs can practice to their full scope — including
prescribing medications and serving as primary care
providers — if they have a physician practice, or “col-
laborative,” agreement.
Multiple independent bodies have synthesized
decades of research on NP care and consistently iden-
tify NPs as high-quality providers of cost-efficient care
that can expand access. Thus, fully leveraging the NP
role can advance the Triple Aim: better care, reduced
costs, and improved health. Yet while research on the
potential of optimizing NP practice abounds, fewer
studies explore the practical implications of remov-
ing barriers to independent practice and the actual
impact on care, cost, and health.
Better Care
The National Governors’ Association conducted a
30-year literature review and concluded that NPs pro-
vide primary care equal in quality to physicians; and
on several indicators, including patient satisfaction,
NPs perform better.2 In 2014, the Federal Trade Com-
mission questioned the value of legislative restraints
on NP practice, which have historically protected
physicians, and called upon states to narrowly tai-
lor limitations on practice “to address well-founded
health and safety concerns.”3 There is no evidence
that care provided by NPs in states requiring physi-
cian collaboration is better — or worse — than in
states that enable NPs to practice independent of such
agreements. Administrative burdens that arise from
requiring a collaborative practice agreement arguably
threaten patient satisfaction and reduce time for care
in both physician and NP practices. Evidence from
progressive states supports that care quality is not
compromised; further research is needed to better
understand that dynam ...
Paving the Way: CLAS & Policy
Keynote presentation delivered May 6th at the 6th annual conference for Health Care Access and Quality at the University of Massachusetts
Pdmp 5 hopkins dreyzehner_o_leary
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TxPAIN 2008 Annual Report
The document provides an annual report from the Texas Pain Advocacy and Information Network (TxPAIN) summarizing their progress and activities over the past year to improve pain management in Texas. Some key accomplishments include developing continuing education programs for healthcare professionals, collaborating with organizations to host conferences on palliative care and pain management, and empowering over 170 physicians and nurses through online pain management courses. The network aims to implement the five-year strategic plan outlined in The Politics of Pain report to address barriers to quality pain care for all Texans.
Governor_JBL_Transition-Committee-on-Healthcare-Report_Final
The committee reviewed Louisiana's healthcare system and made recommendations to improve it. They found that while healthcare spending has increased significantly, health outcomes have not improved. They recommend expanding Medicaid to bring in more federal funds, strengthening public-private partnerships through independent review, and dedicating new revenue sources specifically to healthcare costs. The committee unanimously supports Medicaid expansion to improve access to care for over 300,000 residents.
The Changing Healthcare Workforce - Healthcare Issue Briefings from Modern He...
The healthcare workforce is expected to undergo seismic changes in the coming years, driven by changes in the healthcare reform law, the increasing focus on team-based care and accountability, the push to expand the role of nurse practitioners and other allied health professionals, and the growing emphasis on providing care in ambulatory settings. We’ll hear from a panel of experts who will describe how those trends are affecting the healthcare market in Dallas and other regions, and how they predict hospitals and health systems will adapt their staffing, hiring and training practices.
The panelists:
Joel Allison, CEO, Baylor Scott & White Health
Dr. Nancy Dickey, Professor, Texas A&M University; President Emeritus,Texas A&M Health Science Center
Edward Salsberg, Professor, George Washington University School of Public Health and Health Services
The moderator:
Maureen McKinney, Editorial Programs Manager, Modern Healthcare
This event took place on May 6, 2014 from 7:30-9:30 a.m. in the Pegasus Ballroom of The Magnolia Hotel Dallas, 1401 Commerce St., Dallas, TX 75202
Why belong to ANA
The American Nurses Association (ANA) was formed in 1896 to establish standards of practice, maintain ethics codes, and advocate for nurses. It sets nursing standards, lobbies on policy issues, and educates members. ANA represents nurses' interests in many national organizations and committees. Its goals are to promote professional excellence, influence healthcare policy, develop nursing knowledge, and unify/advocate for nurses. Membership gives nurses a voice in their profession and benefits like discounts and education. Joining professional nursing associations is important to strengthen the profession.
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This presentation will discuss the origin of the Therapeutic Jurisprudence from Mental Health Law and its evolution to include addiction and dual diagnosis youths and adults involved in the criminal justice system. A national movement of Drug Courts, which execute therapeutic justice strategies to motivate high recidivist populations toward treatment in lieu of incarceration, is occurring across the US.
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The Barriers that Prevent Certified Nurse Practitioner (CNP) Practice
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Leveraging Public Health Capacity to Increase Health System Efficiency
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• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
NVBDCP.pptx Nation vector borne disease control program
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
The Electrocardiogram - Physiologic Principles
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
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Hemodialysis: Chapter 4, Dialysate Circuit - Dr.Gawad
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Novas diretrizes da OMS para os cuidados perinatais de mais qualidade
Novas diretrizes da OMS para os cuidados perinatais de mais qualidadeProf. Marcus Renato de Carvalho
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
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Top 10 Best Ayurvedic Kidney Stone Syrups in India
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Driving APRN Policy: A Legislative Success
- 1. James LaVelle Dickens, DNP, FNP-C, FAANP
- 2. Texas ranks 47th in the country in the supply of primary care physicians Out of the 254 counties in Texas, 185 are designated as medically underserved
- 3. Historically, policies limited APRNs scope of practice and restricted APRNs ability to address the primary care shortage Primary care shortages will continue and the aging population is on the rise
- 4. The number of primary care providers per 100,000 rural population is significantly less than in metropolitan areas
- 6. Senate Bill 406 “Texas Team” Action Coalition The Future of Nursing: Leading Change, Advancing Health
- 7. June 14, 2013 Senate Bill (SB) 406 was signed into law by Governor Rick Perry SB 406 - first piece of legislation in over a decade that significantly broadens APRN scope of practice
- 8. October 2010 - Institute of Medicine (IOM) report released, The Future of Nursing: Leading Change, Advancing Health IOM Recommendation – remove barriers that prevent APRNs from practicing to the fullest extent of their education and experience
- 9. The Future of Nursing: Campaign for Action was created under the Robert Wood Johnston Foundation Texas based action coalition was “born” and named “The Texas Team; Advancing Health through Nursing”
- 10. The Texas Team worked to increase access to care for Texans through expanded scope of practice for Advanced Practice Registered Nurses (APRNs) And employed specific strategies to achieve a successful inter-professional collaboration.
- 11. November 2011, “The Texas Team” convened the APRN Roundtable Texas Nurses Association, Coalition for Nurses in Advanced Practice, APRN specialty organizations were represented at the roundtable
- 12. APRN Roundtable - strategies were identified by the groups to achieve consensus on scope of practice expansion
- 13. May 2012 – APRN groups testified to legislative committee Intent to move forward with legislative change in Prescriptive Authority model
- 14. Dr. Ray Perryman issued report regarding the economic benefit in greater utilization of APRNs
- 15. Senator Jane Nelson, Chair of Senate Health and Human Services Committee Representative Lois Kolkhorst, Chair of the Public Health Committee Legislators encouraged collaboration between nursing and medicine
- 16. Negotiations began on new model Texas Nurses Association Coalition for Nurses in Advanced Practice Texas Nurse Practitioners Texas Medical Association Texas Academy of Family Physicians Texas Academy of Physician Assistants Senator Jane Nelson and staff Representative Lois Kolkhorst and staff
- 19. SB 406 was filed on February 26, 2013 Signed by Governor on June 14, 2013 Effective November 1, 2013
- 20. Eliminates the requirement for onsite physician supervision Allows physicians to delegate drug and durable medical devise prescribing authority to an APRN or PA
- 21. Increases the number of APRNs or PAs to whom a physician can delegate prescriptive authority from 4 to 7 Improved coordination between the Texas Medical Board and the Board of Nursing
- 22. Allows physicians to delegate prescribing authority to APRNs and PAs for Schedule II controlled substances in hospital and hospice settings
- 23. Outcomes Lessons learned Moving Forward
- 24. Peck, J. L., Addressing the Texas Health Care Crisis: Effective Use of Advanced Practice Registered Nurses. The Journal for Nurse Practitioners. 2013; 9 (2):116-120. Tovar, S. APRNs Achieve First Expansion of Prescriptive Authority in a Decade. Texas Nurses Association. The Nursing Voice. July 2013