You are the Vice President of Nursing at Good Care Medical Center, a large hospital located in New Jersey. The CEO has formed a committee of various clinicians to consider whether the hospital should expand nursing services to include multiple Advanced Practice Registered Nurses (APRNs). You are tasked with briefing the committee that advocates for the expansion effort. You should discuss the scope of practice rules and regulations regarding APRN’s in New Jersey, including data that will inform the committee’s deliberations. Provide at least one example of another state or provider that has successfully expanded nursing services.
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Introduction: In the following answer, we will discuss the scope of practice rules and regulations regarding Advanced Practice Registered Nurses (APRNs) in New Jersey and provide examples of other states or providers that have successfully expanded nursing services.
In New Jersey, APRNs are licensed and regulated by the New Jersey Board of Nursing. APRNs include Certified Nurse Practitioners (CNPs), Certified Nurse Midwives (CNMs), Certified Registered Nurse Anesthetists (CRNAs), and Clinical Nurse Specialists (CNSs). APRNs are authorized to perform many of the same duties as physicians, such as prescribing medication, ordering and interpreting diagnostic tests, and initiating and managing treatments.
The committee considering the expansion of nursing services should be aware that the scope of practice for APRNs varies by state. In states such as California and Colorado, APRNs have full practice authority, meaning they can practice independently, without physician oversight. Other states, such as Texas and Florida, have restricted practice authority, meaning APRNs must have a collaborative agreement with a physician to provide certain services.
In addition to considering scope of practice regulations, the committee should also review data on the benefits of expanding nursing services. For example, a study of a Veterans Affairs (VA) hospital in North Carolina found that when APRNs were added to the staff, patients experienced shorter wait times, improved access to care, and equivalent or improved clinical outcomes compared to physician-led care.
Another example is the Mayo Clinic, which implemented an APRN-led transitional care model for patients in their Heart Failure Clinic. This model resulted in decreased 30-day readmission rates, fewer emergency department visits, and improved patient satisfaction.
Overall, the committee should carefully consider both the scope of practice regulations and the potential benefits of expanding nursing services when making their decision.