Scope of Practice for NPs in California
1. Discuss your state NP community in terms of scope of practice. Include your state’s scope of practice for NPs, including:
o Level of independence of practice **In California, NPs are required to practice under Standardized Procedure Guidelines. If CA is your intended practice state, please provide details on how Standardized Procedures Guidelines are developed in California and an example of a California SPG.
o Prescribing authority
o Any limitations of practice
o Process for obtaining licensure in your state
o Certification and education requirements for licensure.
2. If you live in a restricted or reduced practice state, how has patient care been impacted in your local community by these barriers? For instance, is the ED used for primary care? Are the EDs overcrowded with long wait times? Are there urgent care clinics readily available? Is there adequate access to primary care? If you live in a full practice, how has an independent practice of the APN resulted in improved patient access to healthcare?
3. How does access to NPs impact any healthcare disparities?
4. A scholarly resource must be used for EACH discussion question each week.
Scope of Practice for NPs in California:
In California, NPs have a level of independence in their practice but are required to work under Standardized Procedure Guidelines (SPGs). These guidelines are developed collaboratively between NPs and physicians.
SPGs outline the specific conditions, treatments, and medications that NPs can independently diagnose, treat, and prescribe. An example of an SPG in California is the “Diabetes Mellitus Management” guideline, which provides specific protocols for NPs to manage diabetes-related care and prescribe medications within their scope of practice.
NPs in California have full prescribing authority, including controlled substances, as long as it is within the scope of their standardized procedures.
Limitations of practice in California include restrictions on performing surgery, anesthesia, and radiology procedures without physician supervision.
The process of obtaining licensure in California involves completing a graduate-level NP program, obtaining national certification in a specialty area, submitting an application to the California Board of Registered Nursing (BRN), and passing the appropriate licensing exam.
Impact of Restricted Practice on Patient Care:
In states with restricted or reduced practice for NPs, patient care can be impacted by barriers that limit NPs’ ability to practice to the full extent of their education and training.
In these states, patients may face challenges in accessing timely and affordable healthcare services, resulting in increased reliance on emergency departments (EDs) for primary care needs.
EDs may become overcrowded with long wait times as patients seek care for non-emergency conditions that could be managed by NPs in primary care settings.
Urgent care clinics may not be readily available or accessible, further limiting options for non-emergent healthcare needs.
Restricted practice can contribute to healthcare disparities by disproportionately affecting underserved populations who may already have limited access to primary care providers.
Impact of NP Access on Healthcare Disparities:
Access to NPs can play a crucial role in addressing healthcare disparities by expanding access to quality healthcare services.
NPs often practice in underserved areas, including rural or low-income communities, where there may be a shortage of primary care providers.
NPs’ ability to provide comprehensive care, including health promotion, disease prevention, and chronic disease management, can help bridge the gap in healthcare services for vulnerable populations.
Studies have shown that increasing the number of NPs in primary care can improve access to care, reduce healthcare costs, and enhance health outcomes, particularly for underserved populations.
References:
California Board of Registered Nursing. (2019). Nurse Practitioner Scope of Practice. Retrieved from https://www.rn.ca.gov/scope/np.pdf
California Association for Nurse Practitioners. (n.d.). Standardized Procedures Guidelines. Retrieved from https://canpweb.org/standardized-procedures-guidelines/
Lin, S., & Gebbie, K. M. (2015). Strengthening Interprofessional Collaboration through Joint Nurse Practitioner/Physician Assistant Practice: The VA Connecticut Healthcare System Experience. Journal of Interprofessional Education & Practice, 1(2), 60-65. DOI: 10.1016/j.xjep.2015.07.001
Morgan, P., Everett, C. M., Humeniuk, K. M., & Shah, N. D. (2019). Primary Care Provider Supply and Health Outcomes: The Impact of Nurse Practitioner Scope-of-Practice Regulations. Medical Care Research and Review, 76(3), 336-350. DOI: 10.1177/1077558717736292