Nurse practitioners' perception of temporary full practice authority during a COVID-19 surge: A qualitative study.

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Publisher: Elsevier B.V.
Document Type: Report; Brief article
Length: 355 words

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Keywords COVID-19; Nurse practitioner; Advanced practice nurse; Regulation; Scope of practice; Survey Abstract Background At the beginning of the COVID-19 pandemic in the United States, 22 state governors temporarily waived physician supervision of nurse practitioners to expand access to health care during the state of emergency. Objective We examined the nurse practitioner perception of the simultaneous scope of practice changes and the exigent pandemic demands during the initial COVID-19 surge in Massachusetts. Methods Qualitative descriptive design using content analysis of open-ended responses to a web-based survey of Massachusetts nurse practitioners conducted in May & June 2020. Results Survey response rate was 40.6 percent (N = 389). Content analysis identified four themes including: 1) State waivers enabled more control over practice and more expedited care, 2) State waiver did not change practice either because of pre-established independence or employers not changing policy, 3) Perception of nurse practitioner role as both versatile and disposable and 4) Telehealth increased access to care and created an autonomous setting. Conclusions Although findings suggest fewer barriers in some areas, the temporary removal of state-level restrictions alone is not sufficient to achieve immediate full scope of practice for nurse practitioners. There is a need for regulatory frameworks that optimize the capacity of the advanced practice nursing workforce to respond to global health emergencies. US-based policymakers and healthcare organizations should revise outdated scope of practice policies and capitalize on telehealth technology to utilize the full extent of nurse practitioners. Likewise, nursing leaders should be a voice for nurse practitioners to more effectively and safely maximize the nurse practitioner contribution during emergency responses. In countries where the role is under development, regulators can leverage these findings to establish modernized nurse practitioner scope of practice policies from the outset. Author Affiliation: (a) Boston College, Connell School of Nursing, 140 Commonwealth Avenue, Chestnut Hill, MA, 02467, USA (b) Brandeis University, The Heller School for Social Policy and Management, 415 South Street, Waltham, MA, 02454, USA * Corresponding author. Article History: Received 13 September 2021; Revised 16 November 2021; Accepted 17 November 2021 Byline: Monica O'Reilly-Jacob [monica.oreilly@bc.edu] (a,*), Jennifer Perloff (b), Roya Sherafat-Kazemzadeh (b), Jane Flanagan (a)

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Gale Document Number: GALE|A689867780