对执业护士的持续限制:对马萨诸塞州早期实施全职执业权的定性研究
Monica O'Reilly-Jacob1, Rosebud Mayanja-Sserebe2, Jana Zwilling3
1School of Nursing, Columbia University, New York, NY.
Nursing outlook
|July 27, 2024
概括
执业护士 (NP) 在马萨诸塞州面临实施全职执业权限 (FPA) 的障碍,原因是雇主沟通缺口和外部政策. 国家计划领导了实施工作,但要成功地整合FPA,需要对联邦和纳税人的政策进行调整.
科学领域:
- 医疗保健政策 医疗保健政策
- 护理实践的护理实践
- 医疗服务研究 医疗服务研究
背景情况:
- 马萨诸塞州于2021年1月颁布了护士执业人员 (NP) 的全职执业权限 (FPA).
- 联邦公积金立法对非公积金护理的影响在很大程度上仍未得到审查.
研究的目的:
- 调查护士从业人员对马萨诸塞州早期全面实践权威实施的看法.
- 确定FPA采用初期阶段的挑战和成功.
主要方法:
- 使用感应性主题分析进行定性描述性研究.
- 基于网络的调查分发给马萨诸塞州的NP (2021年10月至12月).
- 分析了144个NP的开放式调查答复 (50.3%的响应率).
主要成果:
- 出现了四个关键主题:FPA实施的障碍,最低限度的雇主沟通,NP主导的倡议和成功的实施努力.
- 内部和外部障碍严重阻碍了FPA的推出.
- 国家计划积极推动了FPA的实施,一些举措被证明是有效的.
结论:
- 持续的外部政策,包括对雇主的财政激励,阻碍了FPA后的NP实践范围的变化.
- 联邦和付款人政策 (例如,事件到计费) 与州FPA法律的协调对于有效实施至关重要.
- 进一步的政策调整是必要的,以充分实现NP的全面实践权威的好处.
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