Assignment Prompt Discuss the access, cost, and quality of quality environments, as well as recent quality initiatives (See Chapter 24 and Table 24.1). Student is to reflect on the relationship between quality measures and evaluation and role development. In addition, describe this relationship and note how the role of the APN might change without effective quality measures.

Access, Cost, and Quality for APNs

The roles and responsibilities of advanced practice nurses (APNs) reflect their relevance in healthcare. The autonomy of APNs is dependent on the policies and regulations of the state. For instance, states that acknowledge the autonomy of nurse practitioners include Alaska, Colorado, New Mexico, Hawaii, Massachusetts, South Dakota, and Nebraska (Clarke, 2022). In this context, full autonomy means that APNs are permitted to practice fully without being supervised by physicians (Clarke, 2022). APNs are committed to improving the quality of healthcare services and lowering healthcare costs. To accomplish this, they embrace research to achieve evidence-based practice and apply nursing theories. APNs provide patient-centered care depending on the practitioner’s specialty. For example, nurse practitioners are involved in patient assessment, diagnosis, developing nursing care plans, and patient follow-up, whereas Certified Nurse-Midwives provide holistic gynecological healthcare services (Nursingworld.org, n.d.). This paper discusses various aspects of APNs’ practice, including quality initiatives, cost, and access.

Access

Wiesen (2022) reports that in 2020, there were more than 220,000 nurse practitioners and other APNs in the USA. Furthermore, this number is projected to exceed 335,000 by 2030 (Wiesen, 2022). The projected growth in employment opportunities for APNs between 2020 and 2030 is approximately 53 percent (Wiesen, 2022). APNs work in various setups such as healthcare facilities, academia (colleges and universities), and physician offices. As such, APNs are key stakeholders that will promote access to healthcare services.

Purdueglobal.edu (2019) argues that various factors promote the demand for APNs. Firstly, physician shortages have impeded the delivery of primary care to vulnerable populations in rural and urban areas. APNs should be recruited and engaged in addressing this issue. APNs offer comparatively similar primary care services. Secondly, HHS.gov (2022) reports that by 2021, the Affordable Care Act (ACA) had increased healthcare coverage for more than 35 million individuals. An increase in healthcare coverage reflects an increased demand for healthcare services. More APNs should be involved in patient care to avert the possibility of overwhelming healthcare facilities and healthcare providers. Thirdly, findings demonstrate that the elderly population accounts for more than 52 million people in the USA (Purdueglobal.edu, 2019). This population is at a high risk of various medical comorbidities and requires patient-centered holistic care. As such, more APNs should be involved to improve access to care.

Access to healthcare services provided by APNs is impeded by various factors. Most states have not granted APNs full practice authority. States with restricted practice require APNs’ actions and decisions to be supervised by physicians (Clarke, 2022). This limits access to healthcare services provided by APNs because all of their decisions have to be approved by a physician. Examples of states with restricted practice include California, Michigan, Oklahoma, Georgia, North Carolina, and Florida (Clarke, 2022). States with reduced practice limit the scope of practice for APNs. For example, these states may limit the ability of APNs to have their practice or prescribe specific medication (Clarke, 2022). This reduces access to healthcare by limiting the services provided by APNs. Examples of states with reduced practice include Wisconsin, Pennsylvania, Louisiana, Alabama, Ohio, and Illinois (Clarke, 2022). To address this problem, nursing organizations should collaborate with other policymakers, such as members of Congress formulate laws advocating full autonomy in the practice of APNs.

Cost

APNs play a key role in reducing healthcare costs in the USA. It is approximated that an individual spends $12,000 annually on treatment costs in the USA (AMA-ASSN.org, n.d.). These costs range from consultation fees and laboratory tests to medication costs. Findings by Razavi et al. (2021) reveal that APNs play a significant role in lowering treatment costs. According to Razavi et al. (2021), before the enactment of the ACA, APNs offered primary care that cost about 34 percent lower than the services offered by physicians for low-risk patients. Furthermore, regarding medium and high-risk patients, nurses offered primary care services that cost about 28 percent and 21 percent lower than physician-provided services respectively (Razavi et al., 2021). Based on these findings, APNs play an important role in minimizing healthcare costs for patients with various conditions. Notably, low-risk patients benefited significantly from the cost-effective services offered by APNs. Razavi et al. (2021) indicate that the differences in treatment cos