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  • Rand Corporation Recommends "Full Practice Authority" for ALL APRNs in the VA



    A major independent assessment of the Veterans Health Administration (VHA) issued in September recommends that the VHA recognize nurses to their Full Practice Authority in order to improve care for the nation’s Veterans. The assessment, ordered by Congress as part of the Veterans Access, Choice and Accountability Act and conducted by the RAND Corporation, is being reviewed by the House Veterans Affairs Committee at a hearing on Oct. 7 – and is a significant new impetus for the VHA to publish an APRN Full Practice Authority rule now.

    Within the VHA healthcare system assessment’s section on increasing productivity within existing resources, the first recommendation is to “formally grant Full Practice Authority for all advanced practice nurses (APNs) (that is, nurse practitioners, clinical nurse specialists, nurse anesthetists, and nurse midwives) across VA, superseding individual state laws governing scope of practice where applicable.” The report states, “Allowing full nursing practice authority is often raised as a key approach to addressing physician workforce shortages and access problems in non-VA contexts….” Referencing both the Institute of Medicine report The Future of Nursing: Leading Change, Advancing Health and current AANA backed legislation (HR 1247, the “Improving Veterans Access to Care Act”) the report says that allowing APRNs to practice as Full Practice Providers may favorably improve Veterans access to care and produce cost savings for the VA.

    Underscoring one significant reason for AANA and CRNAs to continue engaging their own legislators on this issue, the report also says that the proposal “could face strong political resistance from physician advocates within and outside the VA,” adding that “physician reluctance to accept the role of nonphysician practitioners remains a persistent cultural barrier that will require sustained and intensive attention by VA leadership and beyond to overcome.” It adds, “Physician organizations often state that substituting APNs for physicians may put patients at risk for poorer outcomes despite a lack of evidence to support this claim.”


    To read the healthcare portion of the VHA independent assessment, see: http://www.va.gov/opa/choiceact/docu...pabilities.pdf (the APRN Full Practice Authority proposal begins on p. 266 of the document). To support Veterans access to quality care by backing Full Practice Authority for CRNAs and other APRNs, see www.Veterans-Access-To-Care.com and urge your Veteran colleagues and friends to do the same.