The U.S. Department of Veterans Affairs issued a final rule that grants three types of advanced practice registered nurses full practice authority.
Here are five things to know:
1. The rule applies to certified nurse practitioners, clinical nurse specialists and certified nurse-midwives. However, the VA did not include certified registered nurse anesthetists in this list.
2. The VA passed the final rule to include three classes of APNs to increase VA healthcare access to medically-underserved areas and reduce the wait time for veterans when making appointments.
3. The VA decided not include CRNAs in the final rule because it reported the VA does not have access problems in anesthesiology. The VA noted its decision "does not stem from CRNAs' inability to practice to the full extent of their professional competence."
4. The American Medical Association commended the VA for addressing the need for physicians and nurse anesthetists' collaboration to ensure patient safety. The organization is "disappointed" with the final rule allowing APNs to practice without a physician's clinical oversight.
In a statement the AMA said, "This part of the VA's final rule will rewind the clock to an outdated model of care delivery that is not consistent with the current direction of the healthcare system. Providing coordinated, physician-led, patient-centered, team-based patient care is the best approach to improving quality care for our country's veterans, especially given the highly-complex medical care that veterans often require."
5. There is a comment period to assess whether there are access issues or other circumstances not previously considered that may lead to the VA include CRNAs in future legislation. The VA will publish the rule, which is effective 30 days after publication, in the Federal Register on Dec. 14, 2016.