Scope of practice issues are essential in health care, and the lines are often starkly drawn. However, coordinated care with an emphasis on patient-centered care, through evidence-based research, is at the heart of how nurses practice. The Department of Veterans Affairs (VA) recognized this, and, at the end of 2016, amended its rules to better reflect both the expertise of advanced practice nurses and the needed backlog and inefficacies of the VA

“Advanced practice registered nurses (APRNs) are valuable members of the VA’s health care system,” VA Under Secretary for Health David J. Shulkin, MD, said. “Amending this regulation increases our capacity to provide timely, efficient, effective and safe primary care; aids the VA in making the most efficient use of APRN staff capabilities; and it provides a degree of much needed experience to alleviate the current access challenges that are affecting the VA.”  

The VA will now allow full practice authority of three roles of APRNs in their employment capacity at the VA. This move is outlined by the following details.

  • The services provided by an APRN under full practice authority in the VA are consistent with the nursing profession's standards of practice for such roles. 
  • Expanding the pool of qualified health care professionals who are authorized to provide primary health care and other related health care services to the full extent of their education, training, and certification, without the clinical supervision of physicians. 
  • Permits the VA to use its healthcare resources more effectively and in a manner that is consistent with the role of APRNs in the non-VA healthcare sector, while maintaining the patient-centered, safe, high-quality health care that veterans receive from the VA.

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