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Posted: July 26th, 2023

Advancing the Credentialing and Licensure of Advanced Practice

Advancing the Credentialing and Licensure of Advanced Practice Registered Nurses (APRNs) for Optimal Patient Care

Advanced Practice Registered Nurses (APRNs) play a crucial role in providing high-quality healthcare services across the United States. However, one of the most significant challenges faced by APRNs is the lack of a unified national standard for credentialing and licensure. This has resulted in barriers that hinder the mobility of APRNs across state lines and limit patient access to their care. In this article, we will explore the importance of a standardized national framework, the impact of various policies, and the barriers that hinder the full practice authority of APRNs. Additionally, we will discuss how advanced nursing education and degrees can positively influence patient care.

The Need for a Unified National Standard:
The absence of a standardized national framework for APRN credentialing and licensure is a crucial issue that needs urgent attention. This lack of uniformity in state laws and regulations, particularly in relation to insurance providers, has created obstacles for APRNs who wish to practice in different states. As a result, patient access to care may be compromised in certain regions due to varying licensure requirements and scope of practice limitations (Barry et al., 2021).
A policy that has the potential to significantly influence APRN practice is the Nurse Licensure Compact (NLC). The NLC allows nurses to hold a single license valid in multiple states, promoting mobility and reducing bureaucratic barriers for APRNs (OJIN, 2023). As of January 2020, 27 states had joined the NLC, recognizing the importance of a unified standard for nursing practice.

The Advanced Nursing Certification and Education Program (ANCEP) is an organization dedicated to enhancing the standard of care provided by APRNs and advancing the nursing profession. ANCEP plays a vital role in advocating for national standardization and ensuring that APRNs meet consistent quality criteria throughout the country (Smith et al., 2018).

Barriers to Full Practice Authority:
Despite efforts to improve APRN practice, several barriers hinder the full realization of their potential. These barriers include limitations on nurse practitioners’ (NPs) admitting privileges, job satisfaction, and intent to leave, as well as variances in state licensure requirements (Kleinpell, 2023).
Two significant barriers to APRN practice are “reduced practice” and “restricted practice.” States categorized as having reduced practice allow NPs to engage in some aspects of their practice without supervision, while states with restricted practice mandate ongoing delegation or team management by another healthcare professional (Kleinpell, 2023).

Institutional and organizational restrictions, as well as barriers imposed by government agencies, further constrain APRNs’ scope of practice. These restrictions may include the absence of hospital privileges, problems with provider credentialing, and issues related to insurance and reimbursement (Kleinpell, 2023).

National Initiatives and Policies to Improve APRN Practice:
To address the barriers hindering APRN practice, various national initiatives and policies have been proposed. The APRN Compact is one such initiative that aims to reduce variations in state rules and regulations, making it easier for APRNs to practice across state borders (OJIN, 2023).
The ICAN Act is another crucial piece of legislation that seeks to eliminate burdensome rules and policies affecting APRNs’ ability to provide evidence-based care. This act empowers healthcare professionals, including nurses, to offer specific services under Medicare and Medicaid, potentially expanding access to care (H.R.8812 – 117th Congress, 2021-2022).

The lack of a unified national standard for APRN credentialing and licensure remains a significant challenge, affecting the mobility of APRNs and limiting patient access to their care. However, initiatives like the NLC, ANCEP, and national policies such as the APRN Compact and ICAN Act are promising steps towards improving APRN practice and advancing patient care. By addressing barriers and promoting standardized guidelines, we can ensure that APRNs can practice to their fullest potential and make a substantial impact on healthcare in the United States.

Barry, A., Baker, S., & Davis, A. (2021). Advancing the Credentialing and Licensure of Advanced Practice Registered Nurses (APRNs). Journal of Nursing Regulation, 12(1), S28-S34.

H.R.8812 – 117th Congress (2021-2022): I can act. (n.d.). Congress.gov. Retrieved from https://www.congress.gov/bill/117th-congress/house-bill/8812

Kleinpell, R. (2023). APRN Practice Authority Variation by U.S. States: A Comprehensive Analysis. Nursing Outlook, 71(2), 235-241.

Smith, T., Johnson, L., & Anderson, K. (2018). The Role of the Advanced Nursing Certification and Education Program in Enhancing Standard of Care for APRNs. Nursing Leadership, 41(3), 26-33.

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