Casestudyassignmentinstructions Enter Total Points Possible In Cell C ✓ Solved

CaseStudyAssignment Instructions: Enter total points possible in cell C12, under the rubric. Next enter scores (between 0 and 4) into yellow cells only in column F. Unit 2 - Grading Rubric 150 points Unacceptable Below Average Average Above Average Score Weight Final Score Comments List the name of a State that is representative of each regulatory model Does not identify State with regulatory Model Identifies state with regulatory model but it is inaccurate or incomplete Identifies state with regulatory model but details are missing Identifies state with each regulatory model that is accurate and complete 10% 0.00 Evaluate how each model affects the NPs scope of practice? (include, if applicable, the use of protocols, formulary, written agreements, direct versus indirect supervision, referral policy, patient care, review of medical documentation, and payment reimbursement.

Did not evaluate how each model affects the NPs scope of practice. Eevaluates how each model affects the NPs scope of practice and includes at least 4 of required elements Evaluates how each model affects the NPs scope of practice and includes at least 5 of required elements Eevaluates how each model affects the NPs scope of practice and includes all required elements 20% 0.00 How does model of practice serve as a barrier to access to care? Did not discuss how each model of practice serves as a barrier to access to care Vaguely discussed how each model of practice serves as a barrier to access to care Discussed how each model of practice serves as a barrier to access to care but left out relevant details Thoroughly discussed how each model of practice serves as a barrier to access to care 4 20% 0.80 Compare/contrast the prescriptive privileges of each model and example State Did not compare/contrast NP prescriptive privileges of each model and example State Compared NP prescriptive privileges of one of the models and example States Compared NP prescriptive privileges of two of the models and example States Compared NP prescriptive privileges of all the models and example States 20% 0.00 Compare/ Contrast how each model impacts payer status for the NP Did not compare/ Contrast how each model impacts payer status for the NP Compare/ Contrast how one model impacts payer status for the NP Compare/ Contrast how two models impact payer status for the NP Compare/ Contrast how all of the models impact payer status for the NP 20% 0.00 Resources Does not include any resources (0) or sources utilized are not relevant and credible sources of information(1).

Not all sources utilized are relevant and/or credible and/or does not meet the required number of sources. Supports many opinions and ideas with relevant and credible sources of information; meets the required number and types of resources. Supports opinions and ideas with relevant and credible sources of information; meets or exceeds the required number and types of resources. 10% 0.% 0.80 Appropriate citations are defined for this course as evidence-based on research, published within last 5 years, peer-reviewed, and from a publication or internet site that targets professional healthcare providers and lists references. Course textbook is not used in case studies.

Final Score 30 Percentage 20.00% Total available points = Rubric Score Grade points Percentage Low High Low High Low High 3.5 4.% 100% 2.5 3.% 89.99% 1.7 2.% 79.99% 1.0 1.% 69.99% 0.0 1..99% 11.jpg 12.jpg 13.jpg 14.jpg 1.jpg 2.jpg 3.jpg 4.jpg 5.jpg 6.jpg 7.jpg 8.jpg 9.jpg 10.jpg Template Topic Supervisory Practice Collaborative Practice Independent Practice List the name of a State that is representative of each regulatory model. Evaluate how each model affects the NPs scope of practice? (include, if applicable, the use of protocols, formulary, written agreements, direct versus indirect supervision, referral policy, patient care, review of medical documentation, and payment reimbursement. How does model of practice serve as a barrier to access to care?

Compare/contrast the prescriptive privileges of each model and example State. Compare/ Contrast how each model impacts payer status for the NP. Compare/Contrast how these models may impact NP job satisfaction.

Paper for above instructions

Case Study Analysis of Nursing Practice Regulatory Models

Nurse Practitioners (NPs) play a crucial role in the healthcare system, providing care that varies significantly by the regulatory model in their state. This assignment delves into three primary regulatory models: supervisory practice, collaborative practice, and independent practice. For the purpose of this analysis, California represents supervisory practice, Florida represents collaborative practice, and New York represents independent practice.

Regulatory Models and Their Impact on Nurse Practitioners' Scope of Practice

1. Supervisory Practice (California)
- In California, NP practice is under the supervisory model, which demands NPs to collaborate with a supervising physician. Collaborations can extend to written agreements outlining the authority and responsibilities between the NP and physician. This restrictive model limits NP practices regarding diagnosis and treatment (California Board of Registered Nursing, 2020). Protocols and formulary limitations can hinder NPs from prescribing a full range of medications, impacting patient care (Kuo et al., 2019). Additionally, direct supervision is often required for certain procedures, making it challenging for NPs to operate independently.
2. Collaborative Practice (Florida)
- In contrast, Florida adopts a collaborative practice model, which allows NPs to work alongside physicians with a collaborative agreement. NPs can diagnose and treat patients without direct supervision but are required to adhere to agreed protocols (Florida Board of Nursing, 2021). This model improves the scope of practice for NPs, allowing better access to care as they have more autonomy compared to the supervisory model. Documentation reviews, referral, and payment reimbursement processes are increasingly streamlined, enhancing patient care delivery (Bouchard & Knott, 2021).
3. Independent Practice (New York)
- New York's independent practice model offers the most autonomy to NPs. In states with this model, NPs can practice independently without a supervising physician. They can prescribe medications, manage patient care, and engage in patient education without mandated agreements (NY State Education Department, 2022). This model notably improves NP satisfaction as it fosters a more substantial impact on patient health outcomes through comprehensive care practices (Hain, 2019). Without the need for supervision or collaboration, NPs can respond quickly to patient needs.

Barriers to Access to Care

Each regulatory model presents barriers to access to care. In California, the requirement for supervisory agreements can limit the availability of services in rural areas where physicians may be scarce (Harrison et al., 2022). The supervision requirement can lead to longer wait times for patients seeking NP services.
Florida's collaborative model, while more autonomous than California's, still mandates collaboration agreements. This requirement may deter some NPs from establishing practices or collaborating, creating gaps in service delivery, especially during physician shortages (Duchsherer et al., 2020).
In New York, where NPs practice independently, access to care is typically less restricted. However, some argue that complete independence may lead to uneven quality in care without physician oversight, particularly in complex medical situations (Fowler et al., 2019).

Prescriptive Privileges: Comparison and Contrast

The prescriptive privileges vary significantly under each model:
- California: In the supervisory model, NPs can prescribe medications, but with restrictions. NPs must have a supervising physician sign off on medical orders, limiting their autonomy (California Code of Regulations, 2020).
- Florida: The collaborative model provides NPs with prescriptive authority, where they can prescribe without a physician's signature, as long as it's within the framework of the collaborative agreement (Florida Board of Nursing, 2021).
- New York: NPs have full prescriptive authority, allowing them to prescribe medications autonomously, which enhances their ability to provide holistic care without delays from physician agreements (NY State Education Department, 2022).

Influence of Regulatory Models on Payer Status for NPs

Payer status is significantly affected by the regulatory models. In California, due to the supervisory model, reimbursement rates can be lower, as some insurance companies may prefer direct physician involvement (Harrison et al., 2022). The need for physician supervision can create complications in establishing billing practices.
In Florida, NPs receive better reimbursement opportunities due to collaborative agreements that allow for complete workflows integrated into healthcare systems (Kuo et al., 2019). This model promotes NP services, therefore improving payer considerations.
New York presents the most favorable conditions concerning payer status. Since NPs can practice independently, they can engage directly with insurance programs, often receiving better reimbursement rates due to their increased autonomy (Fowler et al., 2019).

Job Satisfaction Considerations

Job satisfaction among NPs correlates highly with their regulatory model. In California, NPs often report lower job satisfaction due to the restrictions imposed on their practice (Hain, 2019). The necessity for constant physician involvement can lead to frustrations and reduced autonomy.
Conversely, the collaborative model in Florida has shown that job satisfaction increases as NPs experience enhanced roles in patient care without restrictive oversight (Bouchard & Knott, 2021). NPs can work to the top of their license, leading to fulfilling practices.
Finally, in New York, where the independent practice model takes precedence, job satisfaction among NPs tends to be the highest. The increased autonomy and ability to make clinical and operational decisions create a fulfilling work environment conducive to the highest patient care standards (Duchsherer et al., 2020).

Conclusion

In summary, the regulatory model of Nurse Practitioners in each state profoundly influences their practice scope, patient access, prescriptive privileges, payer status, and job satisfaction. States like New York illustrate the benefits and improvements that independent practice can yield in advancing healthcare delivery, while others like California highlight the restrictions that can challenge service access. Balancing autonomy and patient safety through optimal regulatory frameworks remains pivotal for enhancing healthcare systems across the U.S.
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References

- Bouchard, M., & Knott, L. (2021). The impact of collaborative practice agreements: A review of the literature. Journal of Nursing Administration, 51(12), 628-634.
- California Board of Registered Nursing. (2020). Nurse Practitioner Handbook.
- California Code of Regulations. (2020). Article 6. Nurse Practitioners.
- Duchsherer, J., et al. (2020). Barriers to NP autonomy in practice: Implications for policy change. Nursing Economics, 38(4), 200-205.
- Florida Board of Nursing. (2021). Advanced Practice Role in Florida.
- Fowler, J., et al. (2019). The associates of practice autonomy on job satisfaction among nurse practitioners. American Journal of Nursing, 119(7), 34-41.
- Hain, D. J. (2019). The impact of practice restrictions on nurse practitioners. The Nurse Practitioner, 44(12), 10-13.
- Harrison, K., et al. (2022). The effects of NP supervisory agreements on access to care. Health Affairs Journal, 41(2), 215-223.
- Kuo, Y. F., et al. (2019). Impact of nurse practitioners on health care delivery: A systematic review. JAMA Internal Medicine, 179(6), 963-975.
- NY State Education Department. (2022). Nurse Practitioners: Full Practice.
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