Care Coordination and the Expansion of Nursing Scopes of Practice. (28th April 2014)

• Record Type: Journal Article
• Authors: Yang, Y. Tony; Meiners, Mark R.
• Is Part Of: Journal of law, medicine & ethics. Volume 42(2014)Supplement 1
• Page Start: 93
• Page End: 103
• Publication Date: 2014-04-28
• Subjects: Medical laws and legislation -- United States -- Periodicals; Medical care -- Law and legislation -- United States -- Periodicals; Medical ethics -- Periodicals; Jurisprudence -- Periodicals; Legislation, Medical -- Periodicals; Legislation, Nursing -- Periodicals; Ethics -- Periodicals; Forensic Medicine -- Periodicals; Nursing -- Periodicals; Medicine -- Periodicals; Societies -- Periodicals; Medical care -- Law and legislation; Medical ethics; Medical laws and legislation; United States; Periodicals; 344.73041
• DOI: 10.1111/jlme.12122
• Languages: English
• ISSNs: 1073-1105

Abstract

Abstract : Nurse practitioners can ease increased pressure on primary care shortage while providing a cost‐effective and high‐quality alternative to certain physician services. However, scope‐of‐practice laws are restrictive and their modification remains a source of controversy. Clearly, there is a need for new thinking around the scope of practice debate. This article conducted a review of literature and laws concerning the nursing scope of practice, as well as the outcomes of nurse‐led care coordination models. It also examined different manifestations of the controversy that arises in scope of practice debates. We argue that improved care coordination is necessary to improve outcomes and "bend the cost curve downward." Allowing nurse practitioners and other providers to practice to the full extent of their licenses will result in improved care coordination. This can be accomplished by expanding nursing and other providers' scopes of practice. But any health care reform strategy, particularly with respect to chronic care management, must also serve to activate the patient herself as the keystone in the coordinated care process. Focusing first on the patient's need for coordinated care may be what is necessary to move beyond the existing impasse between physicians and nurses on scope of practice expansion.