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Continued restrictions on nurse practitioners: A qualitative study of the early implementation of full practice
Monica O'Reilly-Jacob1, Rosebud Mayanja-Sserebe2, Jana Zwilling3
1School of Nursing, Columbia University, New York, NY.
Background:
In January 2021, the Commonwealth of Massachusetts granted nurse practitioners (NPs) full practice authority (FPA). Little is known about how care delivery changed after FPA legislation.
Purpose:
To understand the NP perception of early implementation of FPA in Massachusetts.
Methods:
Qualitative descriptive design using inductive thematic analysis of open-ended responses to a web-based survey of NPs in Massachusetts from October to December 2021.
Findings:
Survey response rate was 50.3% (N = 144). Inductive thematic analysis of open-ended responses identified four themes, including: (a) internal and external barriers obstructed FPA implementation, (b) employer communication about scope-of-practice changes was minimal, (c) NPs led initiatives to implement FPA, and (d) some efforts effectively implemented FPA.
Discussion:
Almost 1 year after FPA was passed, external policies persisted that financially incentivized employers to not change NP scope-of-practice. Concerted efforts are needed to ensure that federal and payer policies, such as incident-to billing, are aligned with state law to encourage the implementation of FPA.
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