PEGGY HOCK & KATY MURPHY WACAC SLC MARCH 2013 DEVELOPING A LIST 3/23/2013 1.
Chamberlain.aafp slc 2013
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Advance Practice Nurses in Maine
Independent practice
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Assessing clients Synthesizing & analyzing data, understanding & applying nursing
principles at an advanced level Providing expert teaching & guidance Working effectively with clients, families, health care team Managing clients’ physical & psycho-social health-illness Utilizing research skills Analyzing multiple sources of data, differential diagnosis,
selecting appropriate treatment Independent decisions in solving complex client care problems Diagnosing, prescribing, administering & dispensing therapeutic
measures Recognizing limits of knowledge & experience,
planning for situations beyond expertise, consulting with or referring to other health care providers as appropriate
APRN Scope of Practice
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NPs earned the right to practice independent of physicians in ME in the mid-1990s
NP must complete at least 24 months of supervised work
NPs can now be credentialed as participating providers
NPs can be primary care providers in managed care organizations
A new grad can be supervised by another NP who is independently licensed.
NP History in Maine
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Physician supervision required Physician supervision not required
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1088 NPs in ME in 2012
Most are independently licensed
Fewer than 50 practice independently
APRNs in Maine
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Distribution of NPs and primary care similar Majority of NPs in ME in Primary Care From the ME NP Association web site:
◦ Overall 25% of NPs in rural areas of ME◦ In primary care about 40% rural (most in FM)
Rural distribution of NPs almost identical to FPs
NPs, PAs and Physicians are all leaving primary care at about the same rate (AHRQ and Robert Graham Center data)
Where are the APRNs?
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Increasing numbers of nurse practitioners (NPs) and physician assistants (PAs) working outside of primary care in subspecialty fields
NPs PAs0
20000
40000
60000
80000
100000
120000
TOTALIN PRIMARY CARE
55,625
30,402
52%
43%
Data from 2010 National Provider Identifier File
106,0
73
70,3
83