Proposed Rule ARPN Full Practice Authority In Veteran Hospital Care

SEPTEMBER 15, 2016

Advanced Practice Registered Nurses Full Practice Authority

The U.S. Department of Veteran Affairs (VA) recently proposed a rule which would allow Advanced Practice Registered Nurses (APRN) full practice authority when they are acting within the scope of their VA employment. Full practice authority means that APRNs would be able to evaluate patients, diagnose, order and interpret tests, prescribe medications and manage treatments. There are several types of APRNs: Certified Nurse Practitioner, Clinical Nurse Specialist, Certified Registered Nurse Anesthetist and Certified Nurse Midwife; each must be nationally certified to be employed by the VA.

The rule was proposed to ostensibly improve veteran access to care and resources.

THE VA SEEKS TO INCREASE VETERAN CARE AND RESOURCES AVAILABLE

Under current law, APRNs are not permitted full practice authority and must be supervised by a physician when administering certain treatments and care. Supporters of the proposed rule argue that the quality of healthcare provided is often lacking due to a shortage of personnel. Hence, if APRNs were allowed full practice authority, then veterans would have greater access to healthcare.

When a federal agency proposes a rule, it must provide a period for public comment. After the period for public comment closes, the agency must base its decision on whether or not to adopt the rule as policy and consider comments it received. If commentary provides new data that causes the agency to amend the rule substantially, then it must provide a new comment period based on the supplemental proposed rule.

THE GEORGIA COMPOSITE MEDICAL BOARD FEELS A PHYSICIAN-NURSE TEAM APPROACH IS BEST

While the proposed rule to allow APRNs full practice authority in the course of VA employment has received positive support from the American Nursing Association, the Georgia Composite Medical Board (GCMB) has not agreed. The GCMB states in its comment to the VA proposed rule that the rule would allow APRNs to provide services without clinical oversight of a physician and, under current Georgia law, APRNs already have the capacity to perform many of the actions that would be granted under the new VA rule.

Citing a team-based care approach, the GCMB argues that eliminating the doctor/nurse team would create a dangerous level of care and place veterans at increased.

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