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Understanding nurse practitioner scope of practice

Regulatory, practice, and employment perspectives now and for the future

Hudspeth, Randall S. PhD, MBA, MS, APRN-CNP, FRE, FAANP1; Klein, Tracy A. PhD, ARNP-CNP, FRE, FAANP, FAAN (Assistant Professor, Principal Consultant)2

Journal of the American Association of Nurse Practitioners: August 2019 - Volume 31 - Issue 8 - p 468–473
doi: 10.1097/JXX.0000000000000268
Health Policy

ABSTRACT The nurse practitioner (NP) role has existed for 50 years. During the past 10 years, a national effort to use NPs to the full extent of their education based on the 2008 Consensus Model for Advanced Practice Registered Nurse Regulation and the 2010 Institute of Medicine Report on the Future of Nursing continues to result in variable scopes of practice (SOP) between states. Subsequently, NPs have a lack of clarity on SOP because it relates to population foci and practice setting. Review and analysis of state-based statutes and rules with the current literature focused on NP SOP, including documents by the National Council of State Boards of Nursing, was conducted. Clarification and understanding of SOP is essential for safe practice and optimum access to care. Inconsistent SOP regulation continues to exist between states, and NPs can be in employment situations that place them in a position to possibly breech their SOP. Although practice is not setting specific, NP licensure is based on NP education and certification that is competency based within population foci, and credentialing by employers should align with these parameters. Continuing to work toward a more common NP SOP between states and achievement of full practice authority means periodic reassessment of NP education and practice models. Practice mobility is essential for continued advancement of the NP profession and increased access to care by the public.

1RSHudspeth Consulting, LLC, Boise, Idaho,

2Washington State University, Pullman, Washington

Correspondence: Randall S. Hudspeth, PhD, MBA, MS, APRN-CNP, FRE, FAANP, RSHudspeth Consulting, LLC, Boise, ID 83704. Tel: 208 860 9338; E-mail:

Competing interests: The authors report no conflicts of interest.

Authors' contributions: R.S.H. did the literature search, wrote the initial manuscript, and references. T.A.K. edited the manuscript, added content, and references.

Received January 15, 2019

Received in revised form May 28, 2019

Accepted June 04, 2019

© 2019 American Association of Nurse Practitioners
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