Healthcare Policy Aprns Reducing Cost

ABC/123 Version X Institutional Policy Analysis Policy Type Summary of the Policy (in your own words) Explain if the policy is effective and provide a rationale Describe the financial outcomes of the policy Provide examples of policy violations National APRNs' ability to practice is determined on a state-by-state basis, there is no specific policy in regards to practice scope (Kleinpell et al. 2014).

Given that nurses are credentialed on a state versus a federal basis and the healthcare system is largely regulated by the states versus federal policy, this seems inevitable in terms of how healthcare laws in the U.S. are structured. Healthcare costs increase due to a failure to take full advantage of APRN's expanded yet lower-cost care alternatives.

N/A National APRN's roles in institutional leadership are not defined or restricted according to federal policy (Hain & Fleck 2014) States are allowed to set regulations regarding the scope of practices, as articulated by licensing boards (Bakanas 2013). Nurses often struggle to attain positions of leadership which can limit their earnings and institutional power. N/A State State policies regarding the practice scope of APRNs vary, with some of the 50 states allowing full and autonomous operation while others prohibiting it (Kleinpell et al.

2014) There is a lack of an evidence-based rationale for prohibiting APRNs for operating at the full scope of their practice competencies. APRNs can offer more cost-effective care than physicians for many diseases according to current research (Kleinpell et al. 2014). N/A State Given that states limit scope of practice of APRNs, APRNs often cannot assume positions of leadership on teams with physicians (Bakanas 2013). This is extremely counter-productive given that limiting nurse leadership results in a lack of representation of a viable healthcare perspective.

This limits the voice of APRNs to offer alternative points-of-view to the medical paradigm and may drive up healthcare costs. N/A Institutional Within some institutions if the state allows, APRNs are subsuming more and more patient care and taking the place of physicians (Kleinpell et al. 2014). Empirical studies support the contention that APRNs provide comparable care to physicians (Kleinpell et al.

2014) Using APRNs could save institutions financially as well as provide high-quality care, given the lack of evidence that only physicians can provide primary care such as diagnoses and prescriptions for common ailments (Kleinpell et al. 2014). N/A Institutional APRNs are allowed to attain leadership positions even in teams where physicians are present if they are allowed to practice autonomously in the state (Bakanas 2013). Empirical studies support the contention that APRNs provide comparable care to physicians (Kleinpell et al. 2014). This should be reflected in the leadership of the organization.

Even in states where APRNs can practice independently, many physicians oppose this on an institutional level; this can limit the ability of nurses to potentially offer cost-saving alternatives to physician-directed care as well as savings on salaries of individuals in leadership positions, since nurse leaders are still paid less than physicians (Bakanas 2013). N/A The International Council of Nursing defines "an advanced practice nurse as a registered nurse who has acquired the expert knowledge base, complex decision-making skills and clinical competencies for expanded practice" (Kleinpell et al. 2014).

However, within the United States, there is often a conflict between institutional practices and state and federal laws. Overall, there has been increasing emphasis on expanding the capacities of APRNs to dispense care to patients as a way of defraying institutional costs. According to evidence-based research, APRNs are capable of providing care comparable to that of physicians at lower cost and patients often express preference for the APRN patient-focused nursing model of care (Kleinpell et al. 2014). A number of states within the U.S.

still restrict the ability of nurses to practice independent of physician oversight and nursing practice, scope, and credentials are governed by state laws (Kleinpell et al. 2014). In states where nurses are allowed to practice autonomously, the sole leadership capacity of physicians is being phased out at many institutions but there is still substantial push-back regarding this loss of power by many practitioners. Physicians claim "nurses do not know enough or have enough experience to be able to refer properly or carry out consults.

Physicians will not respond to calls for consults from nurses in the same way that they respond to calls from physicians. If the unnecessary referrals are made, we will be wasting the time and money of the receiving physician, the patient, and the hospital" even though there is no evidence patients are at risk (Bakanas 2013).

Research by the Institute of Medicine (IOM) has "highlighted the importance of promoting the ability of APRNs to practice to the full extent of their education and training and to identify further nurses' contributions to delivering high-quality care" and as an important component of reducing healthcare costs given that the evidence suggests that APRNs dispense healthcare of equal quality and with the same.