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Implementation of Full Practice Authority for Nurse Practitioners in Massachusetts: Impact of Organizational Climate
Jana Zwilling1, Monica O'Reilly-Jacob
1Author Affiliations: Clinical Associate Professor (Dr Zwilling), University of North Dakota College of Nursing & Professional Disciplines, Grand Forks; and Assistant Professor (Dr O'Reilly-Jacob), Boston College Connell School of Nursing, Chestnut Hill, Massachusetts.
Objective:
The aim of this study was to examine the relationship between nurse practitioner (NP) organizational climate and the implementation of full practice authority (FPA) for NPs.
Background:
In 2021, Massachusetts passed FPA for NPs. Most NPs did not experience changes to their practice. It is unknown whether NP organizational climate impacts implementation of FPA.
Methods:
A Web-based survey was distributed to NPs in Massachusetts.
Results:
Response rate was 50.3% (N = 147). Practice remained unchanged for most. Organizations with more favorable climates experienced more rapid implementation of FPA, resulting in improved efficiency (P = 0.049) and timeliness (P = 0.007) of care. Nurse practitioners outside hospital systems were more likely to report favorable organizational climates and positive change to their practice after FPA.
Conclusions:
Organizations that facilitate implementation of FPA are likely to experience improvement in efficiency and timeliness of patient care. Nursing leadership, especially within hospital-based organizations, can help achieve these benefits by improving the organizational climate for NPs.
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