The effects of state-level scope-of-practice regulations on the number and growth of nurse practitioners

Impact of state nurse practitioner scope-of-practice regulation on health care delivery: Systematic review

“…Consistent evidence has shown that the number of NPs and growth of the NP workforce were highest in states with greater practice authority. Evidence from four studies indicates that states with more favorable NP practice environments have higher per capita NPs (Auerbach, 2000;Kuo et al, 2013;Reagan & Salsberry, 2013;Stange, 2014). By 2010, states with full SOP regulations had an average of 25 more NPs per 100,000 population (95% confidence interval [1.2, 48.3]) compared with states with the most restrictive SOP regulations (Kuo et al, 2013).…”

“…One study found that growth of the NP workforce from 2001 to 2008 was significantly higher in states with full SOP regulations: 100% growth in states with full SOP regulations, 92% in states with reduced regulations, and 73% in states with restrictive regulations (Reagan & Salsberry, 2013). Another study found that growth in the number of NPs per capita was 14.8% higher in states with the least restrictive SOP regulations compared with states with the most restrictions between 2006 and 2010 (Kuo et al, 2013).…”

Nurse practitioner and physician assistant staffing in the patient-centered medical homes in New York State

“…State laws vary widely in the level of physician oversight required for NPs, with some states allowing NPs to practice independently, whereas others limit NPs' authority to diagnose, treat, and prescribe medications to patient without supervision. The empirical evidence suggests that restrictive scope of practice regulations reduced the number and growth of NPs (Reagan & Salsberry, 2013). Proponents of the PCMH have long advocated for NPs and PAs to practice to the top of their license to ensure the effectiveness and efficiency of team-based care (Carrier, Yee, & Stark, 2011;Iglehart, 2014).…”

The Impact of Establishing a Full Scope of Practice for Advanced Practice Registered Nurses in the State of Indiana

“…Nine studies examined the relationship between SOP regulations and provider counts. Graves et al (2016) found that states with full SOP (practice and prescription) had 25 percent more NPs, while Reagan and Salsberry (2013) found 27 percent more NPs in states that allowed full practice and prescription authority. Kuo et al (2013) found an additional 18 NPs per 100,000 population in states with moderate SOP regulations compared with states with full SOP.…”

“…Reagan andSalsberry, 2013 2008 Cross-sectional nationally representative study. The study did not have data on NPs from the following states: AK, AR, DE, HI, NH, SC, VT, WI, and WY.…”