In 2010 the Institute of Medicine (IOM) issued The Future of Nursing: Leading Change, Advancing Health, which called for the removal of laws, regulations, and policies that prevent advanced practice registered nurses (APRNs) from providing the full scope of health care services they are educated and trained to provide.
Today state practice acts, institutional rules, and federal statutes and regulations that require physician oversight or otherwise limit APRN practice continue to reduce access to care, create disruptions in care, increase the cost of care, and undermine efforts to improve the quality of care. This brief outlines the debates surrounding the regulation of APRN practice, the patchwork of laws and regulations that restrict patients' access to APRN services, and the human and economic toll that accompanies these practice restrictions. The brief also debunks common myths about APRNs and highlights progress toward removing practice barriers.
A growing body of research suggests that in states where APRNs enjoy full practice authority, the quality of care they deliver compares to the level of care provided in states that limit independent practice. Yet despite notable progress, much work remains.