title: Optimizing full scope of practice for nurse practitioners in primary care: A proposed conceptual model.
abstract: BACKGROUND
  Nurse practitioners (NPs), if utilized to their optimal potential, could play a key role in meeting the growing demand for primary care.
  
  
  OBJECTIVE
  The purpose of this study was to propose a comprehensive model for maximizing NP contributions to primary care which includes the factors affecting NP care and patient outcomes and explains their interrelated impact.
  
  
  METHODS
  We synthesized the results of the published literature to develop a model, which emphasizes NP scope of practice regulations, institutional policies, NP practice environment, and NP workforce outcomes as determinants of NP care and patient outcomes.
  
  
  CONCLUSIONS
  Our model provides a framework to help explain how variations in scope of practice regulations at the state-level and institutional policies within organizations directly and indirectly influence the practice environment of NPs, NP workforce outcomes, and patient care and outcomes.
  
  
  CONCLUSIONS
  Aligning policy change, organizational innovations, and future research are critical to NP optimal utilization and patient care and outcomes.
authors.affiliation: Columbia University School of Nursing, New York, NY. Electronic address: lp2475@columbia.edu.
authors.forename: Lusine
authors.initials: L
authors.lastname: Poghosyan
authors.affiliation: Columbia University School of Nursing, New York, NY.
authors.forename: Donald R
authors.initials: DR
authors.lastname: Boyd
authors.affiliation: Connell School of Nursing, Boston College, Chestnut Hill, MA.
authors.forename: Sean P
authors.initials: SP
authors.lastname: Clarke
mesh_terms: D006801:Humans; D007588:Job Satisfaction; D016294:Models, Nursing; D009722:Nurse Practitioners; D024802:Nurse's Role; D015279:Organizational Culture; D016134:Organizational Policy; D059017:Primary Care Nursing; D011320:Primary Health Care / Q000458:organization & administration*
keywords: Conceptual model; Nurse practitioner; Primary care