Expansion of APRN Practice Authority During COVID-19
The COVID-19 pandemic can create circumstances in which APRNs have been granted expanded professional rights. Specifically, new regulations were needed to face the pandemic in a less restrictive manner. APRNs were able to provide services more readily via telehealth, resulting in a smaller burden of in-person visits (Kleinpell et al., 2021).
Furthermore, APRNs were able to proceed with patient care without requiring physicians to perform chart reviews. Other measures that required a physician’s approval, such as expediting orders, were also more accessible. Last but not least, APRNs acquired more opportunities to provide care by assisting patients with home care and direct care services.
Determining When Regulations Should Change in Emergency Situations
Regulations should be adjusted, and waivers should be provided in an emergency as soon as the circumstances become critical and facilities are unable to keep up with the burden. Hence, when a health crisis leads to adverse outcomes, such measures should be employed immediately. Needless to say, this implies that facilities have contingency plans in place to address disruptions to workflow. APRNs should be trained for such situations to be prepared to demonstrate resilience.
Decision-Making Authority for Emergency Practice Waivers
The board of trustees, as well as all the physicians and nurses, are to participate in decision-making. Specifically, individuals who directly work with patients and are aware of ways to make processes more efficient are to report potential ideas for change, while the board of trustees is to approve both planned changes and urgent ones.
Post-Crisis Considerations Regarding Expanded Practice Privileges
Once the crisis is abated, certain privileges are to be kept, and others are to be withdrawn. For example, if regulators assess the benefits of nurses’ engagement in telehealth and determine that the outcomes are positive, the decision can be maintained. However, since the urgency has diminished, implementing additional physician supervision may be helpful, as per the existing regulations. Furthermore, the nurses’ opinions should be considered when deciding which changes to implement permanently.
References
Kleinpell, R., Myers, C. R., Schorn, M. N., & Likes, W. (2021). Impact of COVID-19 pandemic on APRN Practice: Results from a national survey. Nursing Outlook, 69(5), 783–792.