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NEWS & ANNOUNCEMENTS FOR NURSE PRACTITIONERSCheck your district webpage for information on monthly meetings.President’s Message by Diana Heffner Diana Heffner Assumes NPAM Presidency I am fortunate to be president of NPAM at this time. The presidency is really a group endeavor. We have a president elect, president, and past president who share responsibilities and a dedicated Board of Directors who all pitch in to keep the organization moving forward. Our meetings are very productive with a lot of group input by email in between. Communication has been excellent, with group consensus reached on most issues after constructive discussion. Several of the committees have become active and we hope to see others grow. The membership/public relations committee chaired by Sandi Nettina has been meeting to plan new initiatives, such as the recently completed membership survey. Susan Delean-Botkin joins Deb Baker as co-chair of the legislative committee, which had a very active 2008 legislative session. The conference committee, with the help of Nurse Practitioner Alternatives (NPA), was able to produce a well received one day conference to replace the 4 day conference that is no longer feasible. The return of NPA as our management company will really help us move forward. NPA is run by NP’s who have been active in the organization and have a wealth of experience working with other health care groups. They have insight into the needs of NPAM, are proactive, and have a keen business sense. They make suggestions to assist us to run more efficiently. At the request of the BOD, they have the ability to analyze services, carry out business negotiations, and compose documents. They organize our data so that it is very user friendly. With all this support, we should be able to accomplish a lot this year. We would like to increase membership. I am very pleased to be the facilitator of this great team and anticipate NPAM will continue to increase membership benefits in the coming year. Diana Heffner, NPAM President Recent Wall Street Journal article and Julie Stanik-Hutt's response as ACNP president :April 9, 2008 Julie A. Stanik-Hutt, PhD, CRNP – AC The American College of Nurse Practitioners was pleased to see your report noting that nurse practitioners (NPs) are an enormous asset to this country, providing accessible, affordable, high quality health care to millions of Americans. We are however concerned regarding a number of inaccuracies in your article “Making Room for Dr. Nurse” (April 2, 2008). For more than 40 years master’s prepared nurse practitioners (registered nurses who have completed graduate training in the diagnosis and management of a full spectrum of health problems) have been legally authorized to provide health care in all 50 states and the District of Columbia. 1Today, more than 141,000 NPs are licensed to provide primary and specialty health care, prescribe medications and therapies, and are reimbursed by all types of insurance plans. NPs fill critical gaps in all areas of health care. They are the provider of choice for health promotion and disease prevention services, and are often the only health care provider for rural and underserved populations. In addition, NPs are 3 times more likely to enter family practice than are physicians. 2,3 Many NPs alsohave admitting privileges, and are credentialed to provide care to all types of hospitalized individuals from the smallest neonate to the most critically ill elder. NPs practice completely independently in 23 states and in collaboration with other providers in 20 additional states. Only 8 states require that NPs be supervised by a physician. 4 Research, includingwork done by Ms. Mundinger and others, demonstrates that even without a Doctor of Nursing Practice (DNP) degree, these master’s prepared NPs are already highly qualified and provide excellent health care. 5 – 9Rather than being confused regarding NP’s titles or roles, patients’ confidence in our services is evidenced by the fact that they seek out NPs for the added value we provide, such as focus on the patient with a health problem rather than the pathology in a patient, ease of communication, expertise at patient education for self-care management, willingness to collaborate with other providers, and seamless coordination of comprehensive care services. NPs are not physician practitioners, and since the medical board examination described in the article is based in the practice of medicine, it is not an appropriate measure of any nurses’ professional expertise. NPs knowledge, skills and abilities are better evaluated by one of the existing national board certification examinations. In 2003 the Institute of Medicine called for improvements in the educational preparation of all health care providers. 10 They specifically called for educators to improve their graduate’s competencies infive new areas: patient centered care, interdisciplinary teamwork, evidence-based practice, quality improvement, and the application of information technology to enhance care. Nurse educators have incorporated these areas into DNP educational options for nurses. An accurate description of DNP education is available at http://www.aacn.nche.edu/. These practice doctorates are not designed toprepare only future NPs, but all types of advanced practice nurses. Graduates of DNP programs, whether NPs or not, will transform health care through excellence in practice and will collaborate with the thousands of already PhD prepared “Dr. Nurses” who improve practice through research every day. 1. Christian, S., Dower, C. & O’Neill, E. (2007). Overview of Nurse Practitioner Scopes of Practice in the United States – Discussion. Center for the Health Professions, University of California, San Francisco. 2. American Association of Colleges of Nursing (2007). Nurse Practitioner Enrollment and Graduations by National Certification. 3. National Resident Matching Program (2008). Advance Data Tables: 2008 Main Residency Match. 4. Pearson, L.J. (2007). The Pearson Report: A National overview of nurse practitioner legislation and healthcare issues. American Journal for Nurse Practitioners, 11(2), 10-101. 5. Lenz, E., Mundinger, M., Kane, R, Hopkins, S. & Lin, S. (2004). Primary ., are outcomes in patients treated by nurse practitioners or physicians: two-year follow-up. Medical Care Research Review, 61(3), 332-5 6. Horrocks, S., Anderson, E. & Salisbury, C. (2002). Systematic review of whether nurse practitioners working in primary care can provide equivalent care to doctors. British Medical Journal, 324, 819-823. 7. Lambing, A., Adams, D., Fox, D. & Divine, G.(2004). Nurse practitioners' and physicians' care activities and clinical outcomes with an inpatient geriatric population. Journal of the American Academy of Nurse Practitioners, 16(8), 343-52. 8. Ohlman-Strickland, P., Orzano, A., Hudson, L., Solberg, L., DiCiddio-Bloom, B., O'Malley, D., Tallia, A., Balasubramanian, B. & Crabtree, B.(2008). Quality of diabetes care in family medicine practices: influence of nurse-practitioners and physician's assistants. Annals of Family Medicine, 6(1),14-22. 9. Woodburn, J., Smith, K.& Nelson, G. (2007). Quality of care in the retail health care setting using national clinical guidelines for acute pharyngitis. American Journal of Medical Quality, 22(6), 457 – 462. 10. Greiner, A., Knebel, E. (Eds). Health Professions Education: A Bridge to Quality. National Reminder Implementation of Tamper-Resistant Prescription Pads/Paper - April 1, 2008 This is a reminder that effective April 1, 2008, all written Medicaid prescriptions must be executed on tamper-resistant pads/paper in order to be eligible for reimbursement. The Department of Health and Mental Hygiene is in the process of sending out specific information relating to what features will be acceptable for written Maryland Medicaid prescriptions. This information should be out next week. CONGRATULATIONS NPAM!!!! HB 1140/SB 889 - Nurse Practitioners - Authority to Certify officially
passed both the House and Senate tonight on 3rd reader! They will then
go to the Governor's desk for his signature in the coming days. An update
will follow on the amendments, the language that now officially recognizes
nurse practitioners, and when it will go into effect. But we are now being
recognized to do the following:
1. Abilty to sign a form stating that a minor has given birth or is pregnant, so a marriage certificate can be issued
2. Ability to sign a birth certificate
3. Abilty to fill out cause of death and sign a death certificate
4. Ability to write an order for DNR based on the Maryland Institute for Emergency Medical Services (MIEMS) protocol so that patients at home can
have this form and not be resuscitated by emergency personnel.
5. Ability to witness and sign an advance directive for a patient.
6. Ability to document an advance directive that was made orally by the patient before they became incapacitated.
7. Ability to give an oral DNR order to emergency personnel in an outpatient setting
8. Ability to teach epinephrine administration and certify individuals in this skill for a job or volunteer position via the Insect Sting Emergency Treatment Program
9. Ability to certify disability and sign handicapped parking
From the Board of Nursing
The MD BON has started to perform criminal record checks with fingerprinting on all new licensees. In 2008, the BON will begin to phase in this process to renewing licensees as well by sending fingerprint cards and processing information to one-tenth of all renewing nurses each year. Reprocessing, which includes federal and state background checks, will occur every 10 years. The current fee for this process is $62.
Starting April 1, 2007 the BON will no longer issue paper licenses to renewing nurses. A written notice of renewal will be issued, along with directions for employers for verification of license through an online or automated telephone process.
Copies of the Maryland 2007 Nurse Practice Act will be available in February. Each licensed nurse may receive one free copy by writing, faxing, or emailing aalford@dhmh.state.md.us. Include your name, license number, and mailing address. The complete text will also be available through the board website links “Nursing Practice” and “Maryland Nurse Practice Act On-line”.
For more information from the Board of Nursing, www.mbon.org or 410-585-1900. |
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