CLEAR

California expands optometrist scope of practice

Two bills signed into law in California expand optometrist scope of practice. Optometrists will be authorized to administer COVID-19 vaccinations and perform COVID testing. The list of allowed drugs and conditions is also expanded to allow optometrists to treat all noncancerous anterior segment conditions, including all types of inflammation and treatment with all antivirals and antifungals. Medical assistants will be allowed to perform subjective refraction procedures.

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New research on nurse independent practice and effect on opioid deaths

New research published by the Mercatus Center at George Mason University shows that allowing nurse practitioners to practice without physician supervision reduced opioid-related deaths by 9.3%.  Specifically, prescription-opioid-related deaths were reduced by 7.6%, and illegal-opioid-related deaths were reduced by 5.5%. The reduction is more pronounced in rural counties, with opioid-related deaths reduced by 14-28%. Contrary to claims that granting nurse practitioners independent practice authority would result in more opioid prescriptions, opioid prescriptions actually decreased. The changes to nurse practitioner authority also increased access to care and treatment options for opioid use disorder.

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Researchers propose framework for reshaping the health workforce

Researchers with Health Affairs Journal have proposed a health workforce policies framework to "ensure that the significant investments of public funds into various health workforce programs are spent effectively and yield improved patient and population health outcomes." The framework focuses on the production of healthcare workers to address population health priorities, workforce distribution and expansion of telehealth to address gaps by specialty and setting, workforce resilience by addressing financial and emotional security and safety of health workers, and maximizing potential by addressing scope of practice and reconfiguration of teams within health systems.

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Delaware grants full practice authority to nurse practitioners

New legislation in Delaware grants full practice authority to nurse practitioners. Twenty-four other states, the District of Columbia, and two US territories have already granted FPA to NPs. The National Academy of Medicine recently released a report with recommendations to allow nurse practitioners "to practice to the full extent of their education and training by removing barriers that prevent them from more fully addressing social needs and social determinants of health and improving health care access, quality, and value."

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Indiana: federal court strikes down abortion law restrictions

A federal judge in Indiana has struck down a ban on using telemedicine for abortion care. Abortion providers will now be able to offer medication abortion via telemedicine and informed consent documentation via virtual care. Patients will no longer have to have an in-person physical exam before a medication abortion, and advanced practice clinicians such as physician assistants and nurse practitioners will have authority to dispense abortion-inducing drugs. Also, doctors will no longer be required to provide patients with certain pre-care information that the judge found to be without scientific evidence and misleading.

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Nova Scotia expands pharmacist scope of practice

The scope of practice of pharmacists in Nova Scotia has been expanded to include checking for ticks and tick bites and prescribing an antibiotic to prevent Lyme disease. The expanded scope of practice is in response to increased incidence of ticks and Lyme disease in Nova Scotia and the associated strain on emergency departments and clinics. Pharmacists must attend a professional education session on tick identification and information on diagnosis and treatment of Lyme disease.

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Michigan expands nurse anesthetist scope of practice

A new law in Michigan will allow certified registered nurse anesthetists to plan and administer anesthesia care without the supervision of a physician. The registered professional nurse must hold a specialty certificate as a nurse anesthetist with three years of experience and maintain appropriate malpractice insurance. The expanded scope of practice only applies to CRNAs practicing collaboratively in a patient-centered care team with a licensed physician immediately available for any emergency situations.

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NCSBN issues study on APRN prescribing of opioid treatment buprenorphine

The National Council of State Boards of Nursing has published a study on Advanced Practice Registered Nurses' participation in medication treatment for opioid use disorder. The study concludes that "requirements that physicians oversee APRN prescribing of buprenorphine may have slowed the growth of the opioid treatment workforce." APRNs are eligible for Drug Enforcement Administration waivers to allow them to prescribe buprenorphine, but physician oversight requirements correlated with fewer waivers being sought in those states.

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Article

Arkansas judge blocks law banning gender-affirming healthcare

A U.S. District judge issued an injunction to temporarily block a law that would ban healthcare practitioners from providing gender-affirming healthcare for transgender youth. The law, passed in April despite the governor's veto, had been set to take effect next week. Supporters of the law claim it protects minors who are too young to make decisions about gender transition medical care. The ACLU filled a challenge to the law on behalf of four families and two medical doctors, saying that banning therapy and treatments such as puberty blockers and hormone replacements would have detrimental effects on the mental, emotional and physical health of transgender people. Concerns have also been raised that the law's limit on scope of practice will discourage medical professionals from working in Arkansas.

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Arkansas grants full practice authority to certified nurse midwives

Act 607 in Arkansas gives certified nurse midwives full practice authority in gynecological, prenatal, delivery, and postnatal care. A certified nurse midwife will no longer need to work under the supervision of a physician. Twenty-seven other states have full practice authority for CNMs. Almost half of Arkansas counties have no obstetrician or gynecological practitioners. The new law aims to increase access to care.

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