critique
angeliris08
CopyofFullPracticeAuthorityforNPinCAPresentation_FINAL.pptx
Human Trafficking
Monet Dean, Kristi Fisher, Krista Hammond, Ilham Mejahed
Full Practice Authority For NP In California-AB 890 Bill
Name: Sukhjit Dhaliwal
Sumar Abu-Samrah
Janice Dawson
Institution: United States University
10-18-2021
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ASSOCIATION MEMBER INTERVIEW
https://drive.google.com/file/d/1g5dbfxVjOPEL0jqhfqqsybdYoGTdgW8c/view?usp=sharing
Dr. Marketa Houskova Executive Director ANA, Policy Expert, Top Influencer.
(american nurses association - Google zoeken, n.d.)
Dr. Marketa Houskova is one of the biggest influence for the American Nurses Association. It was a surprise to see how quickly she responded and how helpful and passionate she is about nurses expressing their voices and advocating for high quality health care.
References
American nurses association - Google zoeken. (n.d.). American Nurses Association. Retrieved 2021, from https://www.google.com/search?q=american+nurses+association&tbm=isch&ved=2ahUKEwiTnOGs1MrzAhUH5J4KHddBBDAQ2-cCegQIABAA&oq=american+nurses+association&gs_lcp=CgNpbWcQAzIHCCMQ7wMQJzIHCCMQ7wMQJzIFCAAQgAQyBQgAEIAEMgUIABCABDIFCAAQgAQyBQgAEIAEMgUIABCABDIFCAAQgAQyBggAEAUQHjoECAAQGDoGCAAQCBAeOgQIABAeUKUaWLskYPIlaABwAHgAgAGsAYgBgwiSAQM0LjWYAQCgAQGqAQtnd3Mtd2l6LWltZ8ABAQ&sclient=img&ei=BohoYZOBK4fI-wTXg5GAAw&bih=746&biw=1536#imgrc=ggsEiG2uVVm_dM
Interview with the Registered Nurse Leader
As the executive director of the American Nursing Association Dr. Houskova’s:
Mission:
Advance the quality of health care such as access to care and to ethical practice in society through education, legislation, and policy advocacy.
Advocating for Nurse Practitioners to independently practice
https://drive.google.com/file/d/1PSiNh1-wojHYT_o-CnKVikg50kEQ5bTQ/view?usp=sharing
Provider gap. (2021). [ANA]. https://closetheprovidergap.com/
In the interview with Dr. Houskova, she mentioned the supporting the AB 890 act which will allow Nurse practitioners to practice independently without the supervision of a physician (Bill Text - AB-890 Nurse Practitioners: Scope of Practice: Practice without Standardized Procedures., 2019). As the provider grab continues to grow in California because of the shortage of primary care physicians, leaving access to health care difficult. According to the California Health Workforce Commission, after one year of analyzing health care delivery, recommendations were made and one included the full practice authority for NP’s as primary care providers (Expanding the Role of Nurse Practitioners, 2021). In hopes of joining the other 28 states what already changed their legislation allowing nurse practitioners to practice as primary care providers.
References
Bill Text - AB-890 Nurse practitioners: scope of practice: practice without standardized procedures. (2019). AB-890 Nurse Practitioners: Scope of Practice: Practice without Standardized Procedures. https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200AB890
Expanding the Role of Nurse Practitioners. (2021, September 11). California Health Care Foundation. https://www.chcf.org/collection/expanding-role-nurse-practitioners/
Based on the interview, describe where this policy challenge is in the legislative process and its implications for the future
In regards to the AB-890 Nurse practitioners: Scope of practice without standardized procedures it has been approved by the governor and filed with Secretary of State as of september 29, 2020
Implications for the Future: 75% of actively practicing Nurse Practitioners provide primary care
Greater health care coverage state wide and increased health care for patients in rural communities
References
Nurse Practitioners in Primary Care. (2017). American Association of Nurse Practitioners. Retrieved 2021, from https://www.aanp.org/advocacy/advocacy-resource/position-statements/nurse-practitioners-in-primary-care
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Policy Challenges
•AB 890 requires a new regulatory board of Advanced Practice Nursing
•There will be two categories of nurse practitioners
•Completion of transition into practice: 3 years equivalent to 4600 hours of practice (California legislative information, 2020)
•Need supportive members on Nurse Practitioner Advisory Committee (NPAC) (California legislative information, 2020)
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Overview for AB 890 Bill
The bill was signed into law in September 2020, allowing California nurse practitioners (NP) to be able to practice independently without the physician's supervision
California is one of the states which are facing a major crisis of physicians shortage, and AB 890 Law seems as a reprieve for this challenge
After years of extensive lobbying, finally the AB 890 Bill was passed by the California legislative assembly. California joined a dozen of other states that have allowed independence practice for the NPs, which is projected to work positively towards bettering the healthcare service delivery (Kuo et al., 2013). Although the law is a major breakthrough to the healthcare service delivery, opposition still exists amid its signing.
References
Kuo, Y., Loresto,Figaro L.,,Jr, Rounds, L. R., & Goodwin, J. S. (2013). States with the least restrictive regulations
experienced the largest increase in patients seen by nurse practitioners. Health Affairs, 32(7), 1236-43.
doi:http://dx.doi.org/10.1377/hlthaff.2013.0072
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Key Stakeholders to the AB 890 Bill
The opposers comprised of The California Medical Association (CMA) the Board of Registered Nursing (BRN) and other coalitions
The proposers included the California Association For Nurse Practitioners, independent media houses and the lobby groups including partisan members of the senate committee
This bill touches on major stakeholders such as the NPs, physicians, lobby groups, media houses, legislative assembly as well as the state and federal governments.These stakeholders comprised of both the proposers and the opposers for the bill.
References
Kuo, Y., Loresto,Figaro L.,,Jr, Rounds, L. R., & Goodwin, J. S. (2013). States with the least restrictive regulations
experienced the largest increase in patients seen by nurse practitioners. Health Affairs, 32(7), 1236-43.
doi:http://dx.doi.org/10.1377/hlthaff.2013.0072
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Proposers views of the AB 890 Bill
Proposers argued that this will increase the care access amid the physician shortage within the state (Sabina et al., 2020)
Allowing nurses to practice independently will create cost savings without compromising the quality of healthcare
There is a big possibility for reaching out more people, especially in the historically underrepresented areas (Knapp et al., 2019).
Intensive lobbying has been utilized to pass information to the relevant influencers in order for the bill to see the light of the day. This has seen the bill pass critical areas and later being signed into law.
Reference
Knapp, K., Yoshizuka, K., Sasaki-Hill, D., & Caygill-Walsh, R. (2019). Co-located retail clinics and pharmacies: An
opportunity to provide more primary care. Pharmacy, 7(3) doi:http://dx.doi.org/10.3390/pharmacy7030074
Sabina, A. M., Breton, M., Touati, N., Maillet, L., Duhoux, A., & Gaboury, I. (2020). Changing nursing practice within
primary health care innovations: The case of advanced access model. BMC Nursing, 19, 1-17.
doi:http://dx.doi.org/10.1186/s12912-020-00504-z
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Opposers views of the AB 890 Bill
The opposers of the bill argued that there is a possibility of undermining the physician-led care
Inadequate training necessary for NP to independently practice
Possibility of creation of a lower tier of care for the low-income patients
Opposers interpreted this bill as something ideally designed to undermine the physicians good job of supervising the NPs during practice.
Reference
Kuo, Y., Loresto,Figaro L.,,Jr, Rounds, L. R., & Goodwin, J. S. (2013). States with the least restrictive regulations
experienced the largest increase in patients seen by nurse practitioners. Health Affairs, 32(7), 1236-43.
doi:http://dx.doi.org/10.1377/hlthaff.2013.0072
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Strategies to Inform and Lobby Legislators
•Dr. Houskova (personal communication, October 12, 2021) discussed
several ways she and other leaders of the ANA have and are advocating for provisions of the AB 890:
Letters were written to CA governor Gavin Newsom
Letters written to the Board of Registered Nursing
Attend Board of Registered Nursing meetings
Attend meetings of the new NPAC
Attend meetings with the
APRNs have a special position to be active in politics by facing the challenges of full practice but also to advocate and inform others of nurse's values (Patton et al., 2019). “Standing still…is the beginning of a dying process” (Patton et al., 2019).
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Through the California Association For Nurse Practitioners, mobilization was done with a coalition of more than 80 organizations, who advocated for the bill assent to access to quality health care
Formation of Provider Gap coalition that provided research-based evidence to vital stakeholders such as lawmakers, independent media houses, as well as the public about the many merits of the AB 890 Bill
Non-legislative Strategies That Were Used Or Plan To Be Used To Support The AB 890 Bill
The California Association For Nurse Practitioners has been in the frontline for quite long in finding interested groups that can assist them in one way or the other for legislative purposes.
References
Sabina, A. M., Breton, M., Touati, N., Maillet, L., Duhoux, A., & Gaboury, I. (2020). Changing nursing practice within
primary health care innovations: The case of advanced access model. BMC Nursing, 19, 1-17.
doi:http://dx.doi.org/10.1186/s12912-020-00504-z
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The Legislative Process And Its Implications For The Future
Already the AB 890 is signed into law
Waiting for the full implementation of the program by 2023
Future nurse practitioners working independently
This will lead to increased access to healthcare services
There is a projected Improved patient healthcare outcomes
Although the legislative process took sometime, the expected benefits might outweigh the risks considering the looming physician shortages within the California state.
Reference
Sabina, A. M., Breton, M., Touati, N., Maillet, L., Duhoux, A., & Gaboury, I. (2020). Changing nursing practice within
primary health care innovations: The case of advanced access model. BMC Nursing, 19, 1-17.
doi:http://dx.doi.org/10.1186/s12912-020-00504-z
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•California Legislative Information Assembly Bill 890. (2020). AB-890 Nurse practitioners: scope of practice: practice without standardized procedures. (2019-2020). Retrieved October 12, 2021 from https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201920200AB890
•Patton, R.M., Zalon, M.L., & Ludwick, R. (2019). Nurses making policy: from bedside to boardroom (2nd ed.). Springer Publishing Company.
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References
Bill Text - AB-890 Nurse practitioners: scope of practice: practice without standardized procedures. (2019). AB-890 Nurse Practitioners: Scope of Practice: Practice without Standardized Procedures. https://leginfo.legislature.ca.gov/f
Expanding the Role of Nurse Practitioners. (2021, September 11). California Health Care Foundation. https://www.chcf.org/collection/expanding-role-nurse-practitioners/
Nurse Practitioners in Primary Care. (2017). American Association of Nurse Practitioners. Retrieved 2021, from https://www.aanp.org/advocacy/advocacy-resource/position-statements/nurse-practitioners-in-primary-care
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References:
Kuo, Y., Loresto,Figaro L.,,Jr, Rounds, L. R., & Goodwin, J. S. (2013). States with the least restrictive regulations experienced the largest increase in patients seen by nurse practitioners. Health Affairs, 32(7), 1236-43. doi:http://dx.doi.org/10.1377/hlthaff.2013.0072
Knapp, K., Yoshizuka, K., Sasaki-Hill, D., & Caygill-Walsh, R. (2019). Co-located retail clinics and pharmacies: An opportunity to provide more primary care. Pharmacy, 7(3) doi:http://dx.doi.org/10.3390/pharmacy7030074
Sabina, A. M., Breton, M., Touati, N., Maillet, L., Duhoux, A., & Gaboury, I. (2020). Changing nursing practice within primary health care innovations: The case of advanced access model. BMC Nursing, 19, 1-17. doi:http://dx.doi.org/10.1186/s12912-020-00504-z
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