PA003 Regulation

PA003 Regulation

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Western Governors University

D025 Essentials of Advanced Nursing Roles and Interprofessional Practice

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Differences Between a Board of Nursing and Professional Nurse Associations

A Board of Nursing (BON) is a governmental entity established at the state level to uphold and enforce laws that regulate nursing practice. Its legal authority is derived from the state’s Nurse Practice Act, and its primary role is to protect the public by ensuring that only qualified individuals are licensed to practice nursing (Short & Loversidge, 2019; National Council State Board of Nursing, Inc., 2022). BONs set standards for nursing education programs, investigate complaints, impose disciplinary actions, and monitor ongoing compliance with regulatory requirements. Through these functions, the BON safeguards public safety by ensuring that nurses consistently deliver competent and ethical care (Nursing Regulation, 2022).

Professional Nurse Associations vs. Board of Nursing

Unlike BONs, professional nurse associations operate as private, member-driven organizations that advocate for the nursing profession rather than regulate it. These associations—such as the American Nurses Association (ANA)—provide professional development opportunities, continuing education, policy advocacy, networking, leadership training, and support for nursing advancement (American Nurses Association, 2021). Membership is voluntary, and benefits are dependent on dues or subscription fees.

To illustrate the structural differences, the composition of state BONs reflects governmental oversight. For example, the Florida Board of Nursing (FBON) is appointed by the Governor and includes a multi-disciplinary panel of registered nurses, licensed practical nurses, consumer representatives, and at least one individual over the age of 60 (Toney-Butler & Martin, 2021). This diverse composition ensures balanced decision-making that considers both public interest and professional perspectives.

Table 1

Comparison of Boards of Nursing and Professional Nurse Associations**

Medical Necessity: A Federal Regulation of Healthcare

Medical necessity is a federal regulatory standard used primarily by Medicare and other insurers to determine whether a medical service, treatment, or diagnostic procedure is appropriate and eligible for reimbursement. Medicare defines medically necessary services as those that are reasonable and essential for diagnosing or treating illness, injury, or improving the function of a malformed body part (CMS, 2021; Verhovshek, 2019). This concept influences healthcare delivery by shaping what services patients may receive, how quickly they receive them, and whether insurers will cover the associated costs.

Although medical necessity criteria are designed to prevent inappropriate or wasteful care, strict adherence can sometimes delay treatment. Providers may need to supply extensive documentation, obtain prior authorization, or meet specific diagnostic thresholds before a service is approved. These regulatory requirements, while intended to promote high-quality, evidence-based care, can also create administrative burdens and slow the delivery of timely healthcare.

Regulation of Registered Nurses and Advanced Practice Nurse Practitioners in Florida

Registered Nurses (RNs) and Advanced Practice Registered Nurses (APRNs) in Florida practice under the authority of the Florida Nurse Practice Act, which outlines legal standards for safe and professional care. To become licensed, RNs must graduate from a state-approved nursing program and pass the National Council Licensure Examination (NCLEX), demonstrating readiness for entry-level practice. Renewal of licensure occurs every two years and includes mandatory continuing education requirements, ensuring ongoing competency (Florida Board of Nursing, 2022).

APRNs, however, follow an expanded regulatory pathway due to their advanced clinical responsibilities. In addition to RN licensure, APRNs must hold a graduate degree—typically a Master of Science in Nursing or higher—from an accredited program. They must also pass national certification in their specialty area. Florida requires APRNs seeking independent practice to complete 3,000 hours of supervised direct patient care within a collaborative practice agreement before practicing autonomously (Florida Board of Nursing, 2022). These layered requirements ensure APRNs possess specialized knowledge and clinical judgment essential for advanced practice roles.

Impact of Advanced Practice Nurse Practitioners on Healthcare Delivery, Costs, and Access

Advanced Practice Registered Nurses (APRNs) play a significant role in expanding access to healthcare, especially in states like Florida where population growth and physician shortages continue to challenge the healthcare system. APRNs deliver high-quality, cost-effective care and are frequently utilized in primary care settings, rural areas, and underserved communities. Their ability to diagnose, treat, prescribe, and manage chronic conditions enhances efficiency and supports continuity of care (Cleveland et al., 2019).

The growing autonomy of APRNs also contributes to cost savings for healthcare systems. Research indicates that APRN-provided care is often more affordable than physician-delivered care while maintaining comparable outcomes. Increased utilization of APRNs can reduce emergency department overuse, lower wait times, and expand preventive care services. This shift is especially valuable in Florida, where an aging population drives higher demand for chronic disease management and long-term services. By optimizing APRN contributions, the healthcare system can improve accessibility, reduce overall costs, and sustain high-quality patient outcomes.

References

American Nurses Association. (2021). American Nurses Association. ANA. https://www.nursingworld.org/ana/

Cleveland, K., Motter, T., & Smith, Y. (2019). Affordable care: Harnessing the power of nurses. OJIN: The Online Journal of Issues in Nursing, 24(2). https://doi.org/10.3912/ojin.vol24no02man02

CMS. (2021). Centers for Medicare & Medicaid Services. https://www.cms.gov/

Florida Board of Nursing. (2022). Licensing and registration. https://floridasnursing.gov/licensing/

PA003 Regulation

National Council State Board of Nursing, Inc. (2022). Nursing regulation. https://ncsbn.org/boards.htm

Short, N. M., & Loversidge, J. M. (2019). Government response: Regulation. In Health policy and politics: A nurse’s guide (6th ed., pp. 56–84). Jones & Bartlett Learning.

Toney-Butler, T. J., & Martin, R. L. (2021). Florida Nurse Practice Act laws and rules. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK532859/

Verhovshek, J. V. J. (2019). Medical necessity: Why it matters, ways to demonstrate it. AAPC Knowledge Center. https://www.aapc.com/blog/46500-medical-necessity-why-it-matters-ways-to-demonstrate-it/