title: The impact of managed care on nursing regulations in nine western states.
abstract: With the recent increase in health care service delivery across state lines, national organizations have perceived the need for standardization of nursing practice. In 1995, the Pew Commission recommended that states standardize entry-into-practice requirements and adopt inter-state licensure by endorsement. Over the past two years, the National Council of Nursing has been in the process of developing approaches which would allow nursing licenses to be recognized across state lines. These recommendations and activities suggest that nursing regulation may be moving towards national standardization. This paper presents qualitative data from State Boards of Nursing in nine western states. A review of the priorities and activities of the nine boards indicates that the apparent movement towards standardization of nursing regulations is misleading. States continue to have distinctive approaches to nursing regulation based on unique political context and historical development of nursing regulatory agencies, population growth rates in the respective states, and access to rural health care. While managed care may be resulting in standardization of payment approaches and services purchased, it has not substantially impacted each state's unique nursing regulations and educational approaches.
authors.affiliation: University of Colorado at Colorado Springs, Graduate School of Public Affairs, USA. jrobins@micron.net
authors.forename: J E
authors.initials: JE
authors.lastname: Robinson
mesh_terms: D006302:Health Services Research; D008008:Licensure, Nursing; D008329:Managed Care Programs / Q000331:legislation & jurisprudence / Q000592:standards*; D009505:Nevada; D015205:Northwestern United States; D013023:South Dakota; D014589:Utah