From the Guidelines
Advanced practice nurses must prioritize practicing within their defined scope and maintaining appropriate professional liability insurance to minimize legal risks and ensure high-quality patient care. When navigating legal issues in the workplace, APNs should be aware of the variations in state laws and regulations regarding their scope of practice, as emphasized in the guidelines for physician assistants and advanced practice registered nurses in emergency departments 1.
Key Legal Considerations
- APNs must practice within their scope as defined by state nurse practice acts, which vary significantly across jurisdictions regarding prescriptive authority, supervision requirements, and independent practice rights.
- Maintaining appropriate professional liability insurance is essential, as APNs face increased liability exposure compared to registered nurses due to their expanded responsibilities.
- Proper documentation in medical records serves as legal protection and ensures continuity of care.
- APNs must obtain informed consent from patients before procedures or treatments, clearly explaining risks, benefits, and alternatives.
- Confidentiality and HIPAA compliance are paramount legal obligations, requiring secure handling of patient information.
Collaborative Practice and Team-Based Care
The principles supporting dynamic clinical care teams, as outlined in the American College of Physicians position paper 1, highlight the importance of collaboration, consultation, and communication between team members. APNs should be aware of their roles and responsibilities within the team and practice to the full extent of their training, skills, and experience.
Licensure, Regulation, and Reimbursement
Licensure and regulation of clinical disciplines play a crucial role in ensuring public safety, and APNs should be aware of the laws and regulations governing their practice. Reimbursement systems should encourage and incentivize team-based care, and APNs should be familiar with the payment models that support coordinated, high-quality care.
Staying Current with Changing Healthcare Laws and Regulations
APNs should stay current with changing healthcare laws and regulations through continuing education, as emphasized in the principles supporting dynamic clinical care teams 1. This includes understanding DEA regulations and state-specific prescriptive authority limitations when prescribing medications. By prioritizing these legal considerations, APNs can practice safely and effectively, minimizing legal risks and ensuring high-quality patient care.
From the Research
Legal Issues of Advanced Practice Nursing in the Workplace
- The empowerment of nurses in advanced nursing practice begins with an understanding of the current legal status of the advanced nurse practitioner, as noted in 2.
- Several studies have analyzed the development of Advanced Practice Nursing (APN) roles around the world, highlighting gaps in scope of practice, education, regulation, and practice climate 3, 4.
- The APRN Consensus Model and LACE (Licensure, Accreditation, Certification and Education) have been developed to standardize APRN regulation, allowing APRNs to practice to the full scope of their education and increasing access to quality health care for all populations 4, 5.
- Despite progress, APNs continue to face challenges such as titling, title protection, regulation development, credentialing, and barriers to practice, which can limit their ability to provide care 3, 6.
- Full Practice Authority (FPA) for Advanced Practice Registered Nurses (APRNs) is essential for mitigating critical mental health services and addressing health disparities, with evidence showing that patients managed by APRNs have better or comparable outcomes to those managed by physicians 6.
- Understanding the historical context and contemporary trends in APRN education and regulation is crucial for effective professional advocacy and driving the profession forward through informed advocacy 5.