NR506NP Week 6 Discussion

Slide 1: Title Slide

Overview:
- This presentation will discuss the scope of practice for Nurse Practitioners (NPs) in Nebraska (NE).
- Focus on levels of independence, prescribing authority, limitations, and certification/education requirements.
- Impact of Full Practice Authority (FPA) on patient access to care in rural areas.

Key Legislation:
- Governor Pete Ricketts signed LB 107 into law on March 5, 2015.
- This legislation granted Full Practice Authority (FPA) to Nurse Practitioners in Nebraska (Sundermeier, 2015).
Definition:
- According to the American Association of Nurse Practitioners (AANP), FPA allows NPs to evaluate patients, diagnose conditions, interpret diagnostic tests, initiate treatment plans, and prescribe medications independently (Dillon & Gary, 2017).

Autonomy in Practice:
- Nebraska NPs have full independence in their scope of practice under FPA.
- They can provide care without physician oversight, particularly critical in rural and underserved areas.
Impact:
- The independence of NPs has significantly improved patient access to care in rural regions of Nebraska.

Full Prescriptive Authority:
- NPs in Nebraska can prescribe both legend drugs and controlled substances as part of their licensure (American Medical Association, 2017).
Responsibility:
- NPs must adhere to prescriptive rules and regulations and commit to ongoing pharmacotherapeutic education (Blair, 2018).

Durable Medical Equipment (DME) Restrictions:
- Unlike other states, Nebraska Medicaid does not authorize NPs to prescribe Durable Medical Equipment (DME) despite CMS guidelines (Nebraska Nurse Practitioners, n.d.).
Impact:
- This restriction presents a barrier to accessing necessary home care equipment, particularly for underserved populations.

Graduate-Level Education:
- NPs must complete an approved graduate-level nursing or NP program, including 30 hours of pharmacotherapeutics education specific to Nebraska (DHHS, 2020).
National Certification:
- After completing their education, NPs must pass a national certifying exam and maintain active board certification (DHHS, 2020).
Approved Certifying Bodies:
- American Association of Critical-Care Nurses (AACN)
- American Association of Nurse Practitioners (AANP)
- American Nurses Credentialing Center (ANCC)
- National Certification Corporation (NCC)
- Pediatric Nursing Certification Board (PNCB)

Rural and Underserved Areas:
- Nebraska has many rural communities classified as geographically isolated by HRSA.
- Full Practice Authority allows NPs to provide essential healthcare services in these areas where physician shortages are prevalent (Dillon & Gary, 2017).
Improved Access:
- FPA enables NPs to meet healthcare demands, reduce travel distances for patients, and prevent gaps in care.

Summary:
- Full Practice Authority in Nebraska empowers NPs to practice independently, improving healthcare access, especially in rural areas.
- Although some limitations exist, such as the DME prescribing restriction, the overall impact of FPA on patient care is positive.
Future Implications:
- Continued advocacy for expanded NP roles, particularly in addressing the remaining practice limitations, is essential for further improving healthcare delivery in Nebraska.