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Full Practice Authority

Twenty-two states and the District of Columbia currently allow nurse practitioners to exercise full practice authority by practicing independent of physician supervision.

A nurse who is able to practice to the full extent of their licensure and training is said to have full practice authority. Unfortunately, many states have instituted laws and regulations that prevent nurses from carrying out functions they are legally licensed and fully trained to perform. In the case of advanced practice nurses, like nurse practitioners, these regulations usually take the form of unnecessary physician supervision and collaboration requirements.

With millions of Americans enrolling in health coverage and the nation facing a shortage a shortage of primary care providers, policy makers need to institute polices that maximize the potential of all available health care providers. Research shows permitting nurses to exercise full practice authority increases access and lowers costs.

Research on Full Practice Authority

The research is clear and shows that full practice authority increases access to health care while decreasing the cost of health care. 

  • Full practice authority leads to a greater supply of nurse practitioners (Reagan et al., 2013) and a general increase in access to care. (Strange, 2014).
  • Full practice authority decreases emergency department visits (Traczynski and Udalova, 2014) and lowers avoidable hospitalizations. (Oliver et al., 2014).
  • Full practice authority encourages more nurse practitioners to practice in primary care settings (Westat, 2015), including placing more nurse practitioners in community and rural settings. (Buerhaus et al., 2015).
  • Full practice authority for nurse practitioners increases the savings that can be achieved from retail clinics for low-acuity conditions. (Spetz et al., 2013).
  • Full practice authority for nurse practitioners is linked to lower costs for well-child health examinations. (Traczynski and Udalova, 2014).

In 2010, the Institute of Medicine published their Future of Nursing Report, which recommended states adopt policies and regulations that allow nurses to practice to the full extent of their licensure and training. The National Nurse-Led Care Consortium is committed to advancing full practice authority throughout the United States.

Full Practice Authority Resources

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TCPI Power Packs

TCPI Power Packs

As the only professional nursing organization involved in the Transforming Clinical Practice Initiative (TCPI) we were part of a collective of 10 professional associations charged to assist over 140,000 clinicians in improving how care is delivered by providing technical assistance support for integrating quality and process improvements, and by building on and spreading existing change methodologies, practice transformation tools, published literature, and technical assistance programs.

In collaboration with other SANs we developed a number of Power Packs to spread the transformational work undertaken by clinicians and practices nationally.

Each Power Pack presents a specific service delivery challenge and the steps taken by the spotlighted practice to address the challenge. Power Packs provide a set of change tactics and resources from the SANs and other professional associations that clinicians can use to address a similar challenge within their own practices.