Over 100 people attended the Advanced Practice Nurse Summit in Des Moines on July 30th, 2013.  Rich discussion among small groups and with summit speakers identified some common themes around limitations to practice for ARNPs in Iowa.  As identified in the Future of Nursing report by the Institute of Medicine, all groups agreed that one of the top barriers to their practice was the lack of authorization from the Medicare program to perform admission assessments as well as certification of patients for home health care services and for admission to hospice and skilled nursing facilities.

Within Iowa, ARNPs that work in hospital settings are limited by facility by-laws and their lack of membership on medical staff.  UnityPoint Health – Des Moines has formed its own Advanced Practice Nurse Council, and they are in the process of updating the facility’s by-laws.  Their medical staff recently voted to allow all nurse practitioners to have co-admitting privileges.  Another common theme was the lack of knowledge about the capabilities of nurse practitioners by physicians, registered nurses and the general public.  Some next steps for the Iowa Action Coalition include:

• Develop Q&A document about the role of advanced practice nurses
• Create talking points and presentations targeted toward boards of directors
• Develop tool kit for changing facility by-laws
• Provide editorials for local newspapers
• Provide a list of references regarding the quality of care delivered by advanced practice nurses

Attached below are some important references from the summit:

• “Removing Barriers to Advanced Practice Registered Nurse Care: Hospital Privileges” from AARP Public Policy Institute
• “Removing Barriers to Advanced Practice Registered Nurse Care: Home Health and Hospice Services” from AARP Public Policy Institute
• “The Role of Nurse Practitioners in Meeting Increasing Demand for Primary Care” from the National Governor’s Association, which includes a good literature review of the quality of care provided by APRNs
• Dr. Rita Frantz’s presentation from 7/30/2013
• Agenda for the 7/30/2013 summit