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Background The impact of the COVID-19 pandemic on Advanced Practice Registered Nurse (APRN) practice is not well known. Purpose This study aimed to describe state practice barriers and explore the effects of the COVID-19 pandemic on APRN practice. Methods A descriptive study design used a 20-item web-based survey open from June 1 through September 23, 2020. Findings A total of 7,467 APRNs responded from all 50 states, including nurse practitioners (n = 6,478, 86.8%), certified registered nurse anesthetists (n = 592, 7.9%), certified nurse-midwives (n = 278, 3.7%), and clinical nurse specialists (n = 242, 3.2%). A number of barriers to practice prior to the pandemic were identified. Most respondents (n=6334, 84.8%) identified that practice barriers limited the ability of APRNs to provide care during the pandemic. Discussion Barriers to APRN practice continue to restrict aspects of patient care and patient access to care, even in states with FPA, during the COVID-19 pandemic and with state executive orders waiving practice restrictions. The study findings can be used to advocate for policy changes to support APRN practice authority.

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CNE participation is influenced by personal, professional, and organizational factors. In the absence of state mandates, policy changes are needed to promote CNE and overcome persistent barriers to participation.