Advanced Practice Nursing in the United States of America

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The difference in Licensure, Accreditation, Certification, and Education (LACE) in the States

While the laws governing the practice of APNs are almost similar in various states of the United States of America, they demonstrate some differences. Fundamentally, the differences of APN roles related to the scope of practice, licensure, accreditation, certification, and education (Lugo, O’Grady, Hodnicki, & Hanson, 2007). In the state of Washington, licensure requires one to be a holder of a license as a registered nurse. The requirement is compulsory for all individuals who intend to practice as advanced practice nurses in Washington State. In the state of Illinois, licensure and certification can materialize if one is a holder of a doctorate, masters, or a Ph.D. degree in nursing.

The requirements advanced by the state of Illinois compel individuals to pursue high levels of education and be smart in the field of nursing before receiving accreditation. Betancourt, Green, Carrillo, and Iia (2003) allude that although the state acknowledges the fact that all APNs are nurses, its provisions clarify that registered nurses with high-end skills qualify to be APNs. Consequently, LACE requirements in California dictate that individuals should be holders of RN license before them becoming practicing APNs. Moreover, the state needs accreditation from the certification board so that one qualifies to be an APN in the region. Before commencing work as an APN in California, one has to acquire a license as an active registered nurse.

Restricted Practice for APNs in the States

The states of California, Washington, and Illinois have different rules that govern the operations of their APNs. Although these rules follow a similar pattern, they have differences. Practically, states such as Washington have relaxed rules, which broaden the spectrum of APN operations. On the other hand, California falls among the states that limit the scale of activities that APNs can undertake in various medical facilities. Consequently, the state of Illinois compels APNs to work together with doctors when delivering healthcare services to patients. The restrictions limit the roles of APNs and compel them to undertake their activities under the guidance of a doctor. Avery, Germano, and Camune (2010) assert that the difference in operations emanates from the rules laid down by the various boards that determine the requirements of the healthcare sector in the respective states. In California, the regulations come from the Board of Registered Nursing, whereas in the state of Washington the rules governing APN operations come from the Nursing Commission.

Evidence-based Strategies that Will Lead to Seamless Continuity between APN Practices in the United States of America

The difference in the rules of operation governing APNs in the United States of America is one of the factors that prevent the seamless execution of healthcare. While some states allow the full practice, others limit the operations of APNs to reduced practice. According to Betancourt et al. (2003), the rules applied by different states in the United States of America are perplexing since the same APNs limited by some states exercise full practice in other states. The resultant of the different roles is a disparity in the expertise demonstrated by APNs working in various states.

It is chief to explain that APNs have been engaging in unlimited administration of healthcare and have executed their roles effectively. Therefore, by limiting and restricting them to collaborate with physicians, the state confines the scale of care that patients could receive in the event of their full practice. In the perspective of Avery et al. (2010), various states need to review their rules concerning the roles of APNs and ensure that they rhyme with those in other states. The need to have consistency in the rules transpires because of the absence of seamless service delivery across the various states in the country.

References

Avery, M., Germano, E., & Camune, B. (2010). Midwifery practice and nursing regulation: Licensure, accreditation, certification, and education. Journal of Midwifery& Women’s Health, 55(5), 411-414.

Betancourt, J., Green, A., Carrillo, J., & Iia, A. (2003). Defining cultural competence: A practical framework for addressing racial/ ethnic disparities in health and healthcare. Public Health Reports, 1(118), 293-302.

Lugo, N., O’Grady, E., Hodnicki, D., & Hanson, C. (2007). Ranking state NP regulation: Practice environment and consumer healthcare choice. The American Journal for Nurse Practitioners, 11(4), 8-24.

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