Transcript Slide 1

Maryland
Action Coalition
Shannon Idzik, DNP, CRNP
Recommendation #1:
Remove scope-of-practice
barriers.
Advanced practice registered
nurses should be able to practice
to the full extent of their
education and training.
Goals # 1
•
Goal:
– Remove scope-of-practice barriers to conform to the National
Council of State Boards of Nursing (NCSBN) Model Nursing
Practice Act and Model Nursing Administrative Rules (Article
XVIII, Chapter 18).
• Measureable Outcome:
– Elimination of all references to collaboration based on the
model practice act.
• Timeframe:
– April 2013
Goals # 1
•
Leaders:
–
Lorraine Diana and Susan Delean-Botkin
Comparing Current Law and Rule with the APRN Consensus Model Jurisdiction: Maryland
APRN
Requirements
Consensus
Model
Current Law
and Rule
Comment
Title
Advanced practice registered nurse (APRN)
Advanced Practice Nurse
Roles Recognized
Certified registered nurse anesthetist (CRNA)
Certified nurse-midwife (CNM)
Clinical nurse specialist (CNS)
Certified nurse practitioner (CNP)
CRNA
Nurse
Midwife
Nurse
Psychotherap
ist
CRNP
Education
Graduate degree or post-graduate certificate
Yes
Yes
Yes
Yes
Population Foci Available
Family/individual across the lifespan
Adult/gerontology (acute and primary)
Pediatric (acute and primary)
Neonatal
Women’s health/gender related
Psychiatric/mental health
Psych/Mental
Health
All
population
foci available
Certification
Licensure
National Certification
State grants APRN license separate from RN license
Yes
Certification
Yes
Certification
Yes
Certification
Yes
Certification
Practice Autonomy
Independent
Collaborative
Collaborative
Independent
Collaborative
Prescriptive Authority
Independent: pharmacologic and non-pharmacologic
None
Collaborative
None
Collaborative
CRNA and CNS standards of
practice do not mention
prescribing
Goals # 1
•
Leaders:
Lorraine Diana and Susan Delean-Botkin
– Comparing Current Law and Rule with the APRN Consensus Model
Jurisdiction: Maryland
– Recommended changes:
• Titling should be changed to Advanced Practice Registered Nurse (APRN)
• The clinical nurse specialist role should be recognized in place of nurse
psychotherapist
• Nurse midwife and nurse practitioner titles should be changed to certified
nurse-midwife and certified nurse practitioner
• All four roles should be licensed by the BON: CRNA, CNM, CNS and CNP
• All four roles should be authorized to practice and prescribe independently
• All population foci should be listed in BON rule
– Currently starting the very early grass roots “investigation” phase of this.
Goal #2
• Goal:
– Unify APRNs of Maryland by creating a forum (“coalition”) to
share ideas, build consensus, and advance APRNs in the
State of Maryland.
• Measureable Outcome:
– Formation of a Council of Advance Practice Registered Nurses.
• Timeframe:
– Completed
Goal #2
• Leaders: Paul Thurman and Jan Lazear
– Council has been created and named the Council of Advanced Practice Registered
Nurses
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1st meeting was in January
2nd meeting scheduled for end of this month
– Members include local organization and regional representative from national
organizations:
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Nurse Practitioner Association of Maryland (NPAM)
Maryland Academy of Advanced Practice Clinicians (MAACP)
Maryland Association of Nurse Anesthetists (MANA)
American College of Nurse Practitioners (ACNP)
American Academy of Nurse Practitioners (AANP)
National Association of CNS
American Psychiatric Nurse Assoc. (APNA)
American College of Nurse Midwives (ACNM)
National Association of Pediatric NPs (NAPNAP)
Gerontological Advanced Practice Nurses, (GAPNA)
National Association of Neonatal Nurses (NANN)
American Association of Nurse Anesthetists (AANA)
Maryland Association of Nurse Anesthetists (MANA)
APRN BON representative
Goal # 3
• Goal:
– Remove language that restricts APRN scope-of-practice in
regulation, state, or county agency policy, where appropriate.
• Measurable Outcome:
– Where appropriate, “physician” with “physician and/or
advanced practice nurses, consistent with their education and
training, as appropriate.” (provider neutral language).
• Timeframe:
– April 2013
Goal # 3
•
Leader: Veronica Gutchell
– Looking at term “Physician” in COMAR to find places that
is should say “Provider”
• Meeting with research librarians
– SON liaison librarian – Katherine Downton
– Law school research librarian (Maxine Grosshans)
» WESTLAW database
• State administrative codes
• COMAR
• Searched the word “physician”
• 1,298 citations
• 20 reviewed – took 1 hour 10 minutes
• Copied code to excel spreadsheet and gave
brief description of issue in order to keep track
of the issues.
Goal # 3
• Leader: Veronica Gutchell
– Surveyed APRNs by contacting the leadership of the
APRN council groups.
– The following issues were identified from the
responses:
• Workman’s compensation forms for Federal employees
(includes post-office)
• Forms for home and hospital education for the Board of
Education
• Long term care/skilled nursing—cannot be considered the
PCP/attending
• Authorization for pediatric growth hormone therapy
• BGE forms for not turning off electricity
• Psychiatric involuntary commitment and emergency
petition issues
Goal #4
• Goal:
– Remove language that restricts APRN scope-of-practice in the
private sector, where appropriate.
•
Measurable Outcome:
– Where appropriate, “physician” with “physician and/or
advanced practice nurses, consistent with their education and
training, as appropriate.” (provider neutral language).
– Re: BGE, hospitals, granting of admitting privileges to APRNs
• Timeframe:
– April 2013
Goal #4
• Leader: Tonya Appleby
• Progress: Just started
More to come:
• Lobby insurance agencies
• Heading to Congress
• Here we come CMS
• FTC…you’re on standby
• Contact me for more information:
• Shannon Idzik, DNP, CRNP
– Nurse Practitioner Association of Maryland, President
– [email protected]
– 410.706.8129