NURS 8100 Policy Brief

NURS 8100 Policy Brief

NURS 8100 Policy Brief

The policy proposal the Institute of Medicine (IOM) recommends for furthering healthcare is “Nurses should practice to the full extent of their education and training.” Licensing and practice rules for Advanced Practice Registered Nurses (APRNs) scope of practice varies in each state and is determined not by their education and training but by the state laws. APRNs are essential in today’s healthcare system to solve the increasing shortages of primary care providers in rural and urban areas. Therefore, policy and regulatory changes recommend that all states allow APRNs to practice to the full extent of their education and license with full practice authority. According to the article written by Hudspeth and Klein (2019), IOM got it right in proposing that state legislators, Centers for Medicare & Medicaid Services, and Congress allow APRNs can practice to the full extent of their education and training; therefore,, decreasing the primary care provider shortage.

One of the IOM report messages is that “nurses should practice to the full extent of their education and training.” This message is driven by the need for nurses to transform practice to ensure that all Americans receive healthcare services ( Kershaw, 2019). In addition, nurses should maximize their contribution to the healthcare team. Also, insurance companies and federals should ensure they follow regulations and policies that protect patients’ rights. Several barriers prevent nurses from practicing to the full extent of their education and training. Some obstacles include state laws, federal policies, out-of-date insurance models, and institutional practices and cultures. The healthcare system is evolving. Between the years 1750 and 2000, there have been drastic changes in healthcare. There has been a shift from simple home remedies to complex technological systems. There are actions that the federal state should undertake to ensure the promotion of patient safety and the implementation of nursing recommendations. It provides provision of healthcare services to vulnerable populations. It should ensure the regulation of healthcare markets and support the acquisition of knowledge by nurses(Kershaw, 2019).

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Hudspeth, R. S., & Klein, T. A. (2019). Understanding nurse practitioner scope of practice: Regulatory, practice, and employment perspectives now and for the future. Journal of the American Association of Nurse Practitioners, 31(8), 468-473.

Kershaw, B. (2011). The future of nursing – leading change, advancing Health. The future of  nursing – Leading change, advancing health. Nursing Standard, 26(7), 31- 31.

Hello, it is true that the current shortage in primary care provision may be bridged by advancing knowledge; which

NURS 8100 Policy Brief
NURS 8100 Policy Brief

varies for different states in the united states. The provision that allows for advanced Practice Registered Nurses (APRNs) to exercise their skills and training in healthcare may be more efficient through nurse’s pursuit for further education on the healthcare areas of interest (White et al., 2021). Optimization of contribution of nurses to the healthcare teams require advanced skills acquired through education and training, other than practice.

Barriers to the application of skills and knowledge gained by nurses include restrictions by some institutional cultures, federal and state control as well as insurance models. Recommendations on the utilization of the potential of nurses to bridge the primary care provision gap should be advanced to both federal and state authorities (Davis et al., 2021). Evolving needs in healthcare systems and the increased advocacy for patient best outcome require collaborative approach that includes the utilization of skills amassed by nurses.


Davis, D., Maughan, E. D., White, K. A., & Slota, M. (2021). School Nursing for the 21st Century: Assessing Scope of Practice in the Current Workforce. The Journal of school nursing : the official publication of the National Association of School Nurses37(5), 374–386.

White, K. A., Davis, D., & Maughan, E. D. (2021). Development and validation of an instrument to measure scope of practice in school nurses. Journal of advanced nursing77(7), 3226–3237.

The unpredictability of scope-of-practice regulations across states may hinder advanced practice nurses from giving care they were trained to provide and contribute to innovative health care delivery solutions. Though most nurses are registered nurses, over a quarter million are advanced practice registered nurses (APRNs), who hold master’s or doctoral degrees and have passed national certification examinations. APRNs include nurse practitioners, clinical nurse specialists, nurse anesthetists, and nurse midwives. Although some states have regulations that allow nurse practitioners to see patients and prescribe medications without a physician’s supervision, most states do not. The federal government is well suited to promote reform of states’ scope-of-practice laws by sharing and providing incentives for the adoption of best practices (IOM, 2010).

First recommendation is to remove Scope of Practice Barriers. Advanced practice registered nurses should be able to practice to the full extent of their education and training. To achieve this goal, the committee recommends actions for the following entities: State Legislatures, Congress, Centers for Medicare and Medicaid Services, Office of Personnel Management, Antitrust Division of the Department of Justice, Federal Trade Commission, which has long sought to eliminate anticompetitive behavior in the health care industry, including restrictions on health care providers’ business practices and policies that could operate as a barrier to entry for new competitors (IOM, 2010).

In conclusion, the country has an opportunity to transform its health care system, and nurses are in the forefront and should play a critical role. However, the ability to improve current regulatory, business, and organizational conditions does not rest only with nurses; government, corporations, health care organizations, professional associations, and the insurance industry all have a role to play (IOM, 2010).


Committee for Assessing Progress on Implementing the Recommendations of the Institute of Medicine

Report The Future of Nursing: Leading Change, Advancing Health; Institute of Medicine; National Academies of Sciences, Engineering, and Medicine; Altman SH, Butler AS, Shern L, editors.

Assessing Progress on the Institute of Medicine Report The Future of Nursing. Washington (DC): National Academies Press (US); 2016 Feb 22. 2,

Removing Barriers to Practice and Care. Available from:

Institute of Medicine (US) Committee on the Robert Wood Johnson Foundation Initiative on the Future

of Nursing, at the Institute of Medicine. The Future of Nursing: Leading Change, Advancing Health.

Washington (DC): National Academies Press (US); 2011. 1, Key Messages of the Report.

Available from:

Hi Fidelia, I concur with you that the scope-of-practice regulations hinders the optimization of knowledge in by nurses in healthcare delivery. National certification examination is one of the regulatory criterions available for both registered nurses and advanced practice registered nurses (APRNs) (Phillips, 2022). The restriction on prescription of medicine by nurses in most states hinders the bridging of primary healthcare provision. This calls for the removal of scope barriers and adopting more informed regulatory procedures that distinguished specialize nurses and registered nurses in terms of skills and abilities based on the trainings. This requires both federal and state legislations that allows for a more advanced scope for APRNs and thorough regulation for the practicing nurses (Cuccovia et al., 2021). Organizations also need to advocate for skilled nurses’ involvement in patient treatment in a larger scope as opposed to the current limiting scope in most hospital setups.


Cuccovia, B. A., Heelan-Fancher, L., & Aronowitz, T. (2021). A policy analysis of nurse practitioner scope of practice in Massachusetts. Journal of the American Association of Nurse Practitioners34(2), 410–417.

Phillips S. J. (2022). 34th Annual APRN Legislative Update: Trends in APRN practice authority during the COVID-19 global pandemic. The Nurse practitioner47(1), 21–47.