Scope of Practice and Patient’s Healthcare Accessibility in Maryland

Scope of Practice and Patient’s Healthcare Accessibility in Maryland

Scope of Practice for Nurse Practitioners in Maryland

Nurse practitioners (NPs) have full practice authority in Maryland; they are allowed to assess, diagnose, order and interpret diagnostic studies and prescribe or order treatments. This independence allows NPs to practice independently as the first-contact practitioners without the supervision of physicians. In order to become licensed, NPs are required to finish a graduate-level NP program, pass a national certification examination by an accredited certifying body, and submit an application to the Maryland Board of Nursing. It is required for certification and licensure renewal so that NPs can keep abreast with new trends in the practice of health care (DePriest et al., 2020).

Prescribing Authority

Maryland allows NPs to prescribe medications and for controlled substances as well. NPs need to acquire a DEA number to prescribe controlled substances and uphold federal and state laws (Zhang & Patel, 2023). This authority enables NPs to oversee the full patient care, especially in regard to chronic and acute illnesses. Prescribing independence expands the authority of NPs to provide timely and appropriate care to clients.

Limitations of Practice

However, there are still constraints that affect NPs’ practice in Maryland, especially their comparatively lower payment rates than those of physicians offering similar services. Certain healthcare organizations may also have internal rules stating that certain procedures performed by NPs must be supervised by physicians, thus restricting NPs’ independence (McMenamin et al., 2023). Such barriers can influence sustainable and expanded NP practices, hence the importance of advocacy in addressing them.

Process for Obtaining Licensure in Maryland

To obtain licensure for NPs in Maryland, the NP must graduate from a master’s or doctoral degree program in nursing, take and pass the national certification examination and then apply for a license from the Maryland Board of Nursing. Renewal of license requires the NPs to update their clinical practice and to acquaint themselves with advances in the health care delivery systems (Abbie Jacobs RN, 2022).

Certification and Education Requirements for Licensure

To obtain NP certification in Maryland, candidates must first complete a graduate program that can take at least two years to complete, including a heavy emphasis on clinical experience. Following education, NPs are required to undertake a certification examination from a body of credentialing recognized nationally, such as the American Nurses Credentialing Center (ANCC) (Chekijian et al., 2020). This is a legal requirement for practicing as an NP and requires renewal through continued professional development, meaning NPs are trained to practice modern advances in medicine.

Impact of Full Practice on Patient Care in Maryland

The expansion of the full practice authority for NPs in Maryland has increased patient access to healthcare through increased numbers and scope of practice in rural and underrepresented regions. NPs can offer primary care at patients’ homes without the supervision of doctors and minimize patients’ reliance on emergency departments. This independence enables NPs to practice in different healthcare facilities, thus enhancing the quality of patients’ care and offloading the load on other healthcare facilities (Martin et al., 2023).

Healthcare Disparities and NP Access

NPs in Maryland favour serving speciality key roles in bridging health needs in Maryland, especially in areas of the latter. In situations where there are low numbers of physicians, NPs provide primary medical care, thus decreasing the gap in health experiences and benefiting the general population (Kueakomoldej et al., 2022). Independent practice of NPs implies improving the accessibility of high-quality healthcare, which is essential for attaining health disparities at the state level.

Conclusion

The full practice authority that Maryland offers to NPs improves patients’ access to health care tremendously. It has also been seen that NP’s independent practice has benefited the healthcare sector and minimized the disparities irrespective of the difficulties faced, such as reimbursement problems and institutional constraints. Thus, it is crucial to persistently advocate for NP practice rights as they directly impact the ability of all Maryland’s citizens to obtain comprehensive and quality care.

References

Abbie Jacobs RN, B. (2022, February 28). How to become a nurse practitioner in Maryland – MD: APRN Certification and jobs. GraduateNursingEDU.org. https://www.graduatenursingedu.org/maryland/#:~:text=You%20must%20complete%20a%20Board,nurses%20may%20be%20found%20here.

Chekijian, S. A., Elia, T. R., Horton, J. L., Baccari, B. M., & Temin, E. S. (2020). A Review of Interprofessional Variation in Education: Challenges and Considerations in the Growth of Advanced Practice Providers in Emergency Medicine. AEM Education and Training, 5(2). https://doi.org/10.1002/aet2.10469

DePriest, K., D’Aoust, R., Samuel, L., Commodore-Mensah, Y., Hanson, G., & Slade, E. P. (2020). Nurse practitioners’ workforce outcomes under the implementation of full practice authority. Nursing Outlook, 68(4), 459–467. https://doi.org/10.1016/j.outlook.2020.05.008

Kueakomoldej, S., Turi, E., McMenamin, A., Xue, Y., & Poghosyan, L. (2022). Recruitment and retention of primary care nurse practitioners in underserved areas: A scoping review. Nursing Outlook, 70(3). https://doi.org/10.1016/j.outlook.2021.12.008

Martin, B., Buck, M., & Zhong, E. (2023). Evaluating the Impact of Executive Orders Lifting Restrictions on Advanced Practice Registered Nurses During the COVID-19 Pandemic. Journal of Nursing Regulation, 14(1), 50–58. https://doi.org/10.1016/s2155-8256(23)00068-6

McMenamin, A., Turi, E., Schlak, A. E., & Lusine Poghosyan. (2023). A Systematic Review of Outcomes Related to Nurse Practitioner-Delivered Primary Care for Multiple Chronic Conditions. Medical Care Research and Review, 80(6). https://doi.org/10.1177/10775587231186720

Zhang, P., & Patel, P. (2023). Practitioners and prescriptive authority. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK574557/

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The purpose of this assignment is to identify the scope of practice in one’s state, including the level of independence of practice, prescribing authority, any limitations of practice, the process for obtaining licensure in your state, certification, and education requirements for licensure. Next, students will discuss how the level of independence of practice in their state, i.e., reduced, restricted, or full practice, affects patients’ access to care in their local community.

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Activity Learning Outcomes
Through this discussion, the student will demonstrate the ability to:

Understand NP practice as defined by law (CO2)
Determine legislation as defined by legislation, statutes, and regulations (CO2)
Identify barriers to ensuring patient’s rights (CO3)
Due Date: Wednesday by 11:59 pm MST of Week 6
Initial responses to the discussion topic must be posted by Wednesday 11:59 pm MT. Two additional posts to peers and/or faculty are due by Sunday at 11:59 pm MT. Students are expected to submit assignments by the time they are due.

A 10% late penalty will be imposed for discussions posted after the deadline on Wednesday of week 6, regardless of the number of days late. NOTHING will be accepted after 11:59 pm MT on Sunday (i.e. student will receive an automatic 0).

Total Points Possible: 100
Preparing the Discussion
Discuss your state NP community in terms of scope of practice. Include your state’s scope of practice for NPs, including:
Level of independence of practice **In California, NPs are required to practice under Standardized Procedure Guidelines. If CA is your intended practice state, please provide details on how Standardized Procedures Guidelines are developed in California and an example of a California SPG.
Prescribing authority
Any limitations of practice
Process for obtaining licensure in your state
Certification and education requirements for licensure.
If you live in a restricted or reduced practice state, how has patient care been impacted in your local community by these barriers? For instance, is the ED used for primary care? Are the EDs overcrowded with long wait times? Are there urgent care clinics readily available? Is there adequate access to primary care? If you live in a full practice, how has an independent practice of the APN resulted in improved patient access to healthcare?
How does access to NPs impact any healthcare disparities?
A scholarly resource must be used for EACH discussion question each week.
Category Points % Description
DISCUSSION CONTENT
Scope of practice and NP requirements