Physician Practice

VA plans to increase independence of advanced practice RNs

Physician Practice Insider, June 14, 2016

The Department of Veterans Affairs (VA) announced a proposed rule that would permit full practice authority for all advanced practice RNs (APRN) working for the VA. APRNs would be allowed to provide patient care to the full extent of their education and abilities without the oversight of a physician. The proposed rule would override any existing state restrictions on the scope of practice of APRNs for those working within the VA health system. The VA believes the proposed rule will increase veterans’ access to healthcare and help the agency use its resources more effectively, particularly in areas affected by a shortage of qualified healthcare professionals.

The proposed rule outlines additional professional qualifications that would be required of APRNs within the VA. APRNs would be divided into four categories under the proposed rule: certified nurse practitioner, certified registered nurse anesthetist, clinical nurse specialist, and certified nurse-midwife.

However, the proposed rule has received mixed reactions from the medical community. The American Medical Association (AMA) strongly criticized the expansion of the independence of APRNs in the VA The AMA states that although it supports the VA’s efforts to find solutions to providing healthcare for veterans, it believes the proposed rule will undermine delivery of care within the VA health system. The AMA urges the VA to maintain the physician-led, team-based model of patient care. Others, including the American Association of Nurse Anesthetists (AANA), support the policy change. The AANA says that patients in the VA health system routinely experience prolonged wait times to access services, which leads to poorer outcomes and increased costs. The proposed rule would bring the VA’s policies in line with those of the military, the AANA said in a statement, and is also endorsed by the Military Officers Association of America, the Air Force Sergeants Association, and the AARP.

The proposed rule is open for public comments until July 25.

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