To prepare:
- Review the Thomas, Benbow, and Ayars article and the Watson and Hillman article focusing on how states regulate advanced nursing practice and how legislative changes are impacting scope of practice.
- Visit your state board of nursing website and/or contact the board to determine how the state board controls advanced practice through regulations.
- Determine if your state board has created any new policies or regulations that address changes to scope of practice in response to legislative changes.
By Day 3
Post a cohesive response that addresses the following:
- What are the most recent regulations promulgated through your state board of nursing for advanced practice?
- How are the state regulations supported within your place of employment?
- How do the states differ in terms of scope of practice? What impact does this have on professional nurses across the United States?
Learning Resources
Required Readings
Chen, A. S., & Weir, M. (2009). The long shadow of the past: Risk pooling and the
political development of health care reform in the States. Journal of Health Politics,
Policy & Law, 34 (5), 679-716.
The authors provide an analysis of varying state health care policies, with a
basic premise that health care risk is either “pooled”—shared, or
“actuarial”—segmented by risk level. Most states have taken a segmented
approach to health care, and therefore, have not solved health care issues
such as rising costs and access to care. The authors maintain that federal
action is needed to create a uniformed approach to health care.
Junghee, L. (2009). Cultural, social, and political influences on state-level indigent
health care policy formation. Journal of Policy Practice, 8 (2), 129–146.
This article provides details on a 50-state study of Medicaid spending. The
authors concluded that political and economic factors can positively predict
individual state Medicaid spending, and that actual need has a negative
impact on spending. In conclusion, a uniform, federal structure may be the
only method to ensure equal access to Medicaid.
Mills, A., Engelhard, C. L., & Tereskerz, P. M. (2010). Truth and consequences-
insurance-premium rate regulation and the ACA. New England Journal of Medicine
363 (10), 899-901.
O’Connor, J. C., MacNeil, A., Chriqui, J. F., Tynan, M., Bates, H., & Eidson, S. K.
(2008). Preemption of local smoke-free air ordinances: The implications of judicial
opinions for meeting national health objectives. Journal of Law, Medicine & Ethics,
36 (2), 403– 412.
Sommers, B. (2010). Enrolling eligible children in Medicaid and CHIP: A research
update. Health Affairs, 29 (7), 1350.
The enrollment and retention of eligible children in Medicaid and Children’s
Health Insurance Program (CHIP) is a health care concern. The article
concludes that some state processes have mitigated this issue but other
requirements, such as providing citizenship documentation, may have a
detrimental effect. Therefore, these concerns should be incorporated into the
implementation on PPACA of 2010.
Thomas, M. B., Benbow, D. A., & Ayars, V. D. (2010). Continued competency and
board regulation: One state expands options. Journal of Continuing Education in
Nursing, 41 (11), 524-528.
The authors use the changes instituted by the state of Texas in regard to the
licensing of nurses to illustrate the need to adapt state licensing
requirements to the changing diversity and scopes of practice among
nurses.
Watson, E., & Hillman, H. (2010). Advanced practice registered nursing: Licensure,
education, scope of practice, and liability issues. Journal of Legal Nurse Consulting,
21 (3), 25-29.
The expanded role of the advanced practice nurse has led to changes in
licensure, education, certification, and scope of practice definitions. The
author points out that this expanded role has led to increased liability and
accountability concerns as well.
Yue, L., Harrington, C., Spector, W. D., & Mukamel, D. B. (2010). State regulatory
enforcement and nursing home termination from the Medicare and Medicaid programs.
Health Services Research, 45 (6 pt 1), 1796-1814. doi:10.1111/j.1475-
6773.2010.01164.x
Those nursing homes receiving Medicare and Medicaid funding are subject
to strict quality and safety regulations. This article examines the
consequences of enforcing those federal quality standards.
Optional Resources
Wieck, K. L., Oehler, T., Green, A., & Jordan, C. (2004). Safe nurse staffing: A win-win
collaboration model for influencing health policy. Nursing Education Perspectives, 31(3),
160-166.
