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Practice environment for nurse practitioners in California. Identifying barriers
A L Anderson1, C L Gilliss, L Yoder
1Department of Family Health Care Nursing, University of California, San Francisco (UCSF), School of Nursing 94143-0606, USA.
The Western Journal of Medicine
|October 1, 1996
Summary
Nurse practitioners face barriers in primary care practice, including lack of prescriptive authority and physician support. Addressing these challenges can enhance nurse practitioner effectiveness and utilization in healthcare.
Area of Science:
- Health Services Research
- Nursing Practice
- Primary Health Care
Background:
- Nurse practitioners (NPs) possess primary health care knowledge and skills that are often underutilized.
- Barriers to NP practice limit their ability to fully contribute to patient care.
- California has the largest population of NPs in the United States.
Purpose of the Study:
- To identify the specific barriers experienced by nurse practitioners in California.
- To determine the incidence of these barriers in a large, representative NP sample.
- To compare current barriers with previously identified national barriers.
Main Methods:
- A statewide survey was administered to all certified nurse practitioners in California in January 1995.
- A total of 2,741 out of an estimated 3,895 (70%) NPs returned the survey.
- The survey included questions on legal/social barriers and an open-ended response section.
Main Results:
- 65% of California NP respondents reported providing primary care.
- Key barriers identified include lack of prescriptive authority, insufficient physician support, reimbursement issues, and limited public awareness.
- These barriers are comparable to those reported in national data from 1992.
Conclusions:
- Barriers to nurse practitioner practice in California persist and mirror national trends.
- Enhancing NP utilization requires addressing issues like prescriptive authority and physician collaboration.
- Promoting interprofessional dialogue and recognizing NP contributions are crucial for improving primary care.