title: Revisiting scope of practice facilitators and barriers for primary care nurse practitioners: a qualitative investigation.
abstract: Revisiting scope of practice (SOP) policies for nurse practitioners (NPs) is necessary in the evolving primary care environment with goals to provide timely access, improve quality, and contain cost. This study utilized qualitative descriptive design to investigate NP roles and responsibilities as primary care providers (PCPs) in Massachusetts and their perceptions about barriers and facilitators to their SOP. Through purposive sampling, 23 NPs were recruited and they participated in group and individual interviews in spring 2011.The interviews were audio recorded and transcribed. Data were analyzed using Atlas.ti 6.0 software, and content analysis was applied. In addition to NP roles and responsibilities, three themes affecting NP SOP were: regulatory environment; comprehension of NP role; and work environment. NPs take on similar responsibilities as physicians to deliver primary care services; however, the regulatory environment and billing practices, lack of comprehension of the NP role, and challenging work environments limit successful NP practice.
authors.affiliation: Columbia University, New York, NY 10032, USA. lp2475@columbia.edu
authors.forename: Lusine
authors.initials: L
authors.lastname: Poghosyan
authors.forename: Angela
authors.initials: A
authors.lastname: Nannini
authors.forename: Arlene
authors.initials: A
authors.lastname: Smaldone
authors.forename: Sean
authors.initials: S
authors.lastname: Clarke
authors.forename: Nancy C
authors.initials: NC
authors.lastname: O'Rourke
authors.forename: Barbara G
authors.initials: BG
authors.lastname: Rosato
authors.forename: Bobbie
authors.initials: B
authors.lastname: Berkowitz
mesh_terms: D000328:Adult; D005069:Evaluation Studies as Topic; D005260:Female; D006291:Health Policy; D006280:Health Workforce / Q000458:organization & administration*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009722:Nurse Practitioners / Q000600:supply & distribution*; D024802:Nurse's Role; D057184:Practice Patterns, Nurses' / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration*; D011787:Quality of Health Care; D014481:United States
keywords: advanced nursing practice; nursing/health-care workforce issues; regulation of nursing practice