Continued restrictions on nurse practitioners: A qualitative study of the early implementation of full practice authority in Massachusetts

IF 4.1 2区医学 Q1 NURSING

Nursing Outlook Pub Date : 2024-07-26 DOI:10.1016/j.outlook.2024.102249

Monica O’Reilly-Jacob PhD, APRN, FAAN , Rosebud Mayanja-Sserebe MPH, RN , Jana Zwilling PhD, APRN, FNP-C

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引用次数: 0

Abstract

Background

In January 2021, the Commonwealth of Massachusetts granted nurse practitioners (NPs) full practice authority (FPA). Little is known about how care delivery changed after FPA legislation.

Purpose

To understand the NP perception of early implementation of FPA in Massachusetts.

Methods

Qualitative descriptive design using inductive thematic analysis of open-ended responses to a web-based survey of NPs in Massachusetts from October to December 2021.

Findings

Survey response rate was 50.3% (N = 144). Inductive thematic analysis of open-ended responses identified four themes, including: (a) internal and external barriers obstructed FPA implementation, (b) employer communication about scope-of-practice changes was minimal, (c) NPs led initiatives to implement FPA, and (d) some efforts effectively implemented FPA.

Discussion

Almost 1 year after FPA was passed, external policies persisted that financially incentivized employers to not change NP scope-of-practice. Concerted efforts are needed to ensure that federal and payer policies, such as incident-to billing, are aligned with state law to encourage the implementation of FPA.

查看原文本刊更多论文

对执业护士的持续限制：对马萨诸塞州全面执业权早期实施情况的定性研究。

背景：2021 年 1 月，马萨诸塞州联邦授予执业护士（NPs）全面执业权（FPA）。目的：了解护士对马萨诸塞州早期实施 FPA 的看法：方法：采用定性描述设计，对 2021 年 10 月至 12 月期间对马萨诸塞州 NP 进行的网络调查的开放式回答进行归纳主题分析：调查回复率为 50.3%（N = 144）。对开放式回复的归纳主题分析确定了四个主题，包括：（a）内部和外部障碍阻碍了 FPA 的实施，（b）雇主对执业范围变化的沟通微乎其微，（c）NPs 主导了实施 FPA 的倡议，以及（d）一些努力有效地实施了 FPA：讨论：FPA 通过近一年后，外部政策仍然存在，这些政策在经济上激励雇主不改变 NP 的执业范围。需要共同努力，确保联邦政策和支付方政策（如事故到账单）与州法律保持一致，以鼓励实施 FPA。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nursing Outlook 医学-护理

CiteScore

6.20

自引率

7.00%

发文量

109

审稿时长

25 days

期刊介绍： Nursing Outlook, a bimonthly journal, provides innovative ideas for nursing leaders through peer-reviewed articles and timely reports. Each issue examines current issues and trends in nursing practice, education, and research, offering progressive solutions to the challenges facing the profession. Nursing Outlook is the official journal of the American Academy of Nursing and the Council for the Advancement of Nursing Science and supports their mission to serve the public and the nursing profession by advancing health policy and practice through the generation, synthesis, and dissemination of nursing knowledge. The journal is included in MEDLINE, CINAHL and the Journal Citation Reports published by Clarivate Analytics.