nurse practitioner hospital privileges by state

Find the exact resources you need to succeed in your accreditation journey. This must be performed and dictated within 24 hours of admission. /Subtype /CIDFontType2 Set expectations for your organization's performance that are reasonable, achievable and survey-able. Martin B, Reneau K. How collaborative practice agreements impeded the administration of vital women's services. How does a Nurse Practitioner get hospital privileges?? SlnLge`t```3273P?9@}%lSb< 9`G|@3VP8(}A f3 q 893 9 9 1216 10 10 458 11 11 1083 38 0 obj A nurse practitioner does everything that a doctor can do, but they are not permitted to prescribe medication to patients. Code 1300.430 (a-b)). Nurse practitioners (NPs) are registered nurses who have completed additional education to prepare them to deliver a broad range of services including the diagnosis and treatment of acute and chronic illnesses. s:4"Np/.Iu''w}\?~| I^6u *+m$ABMmLwbV]?7VMgG^#0}pmfN,!R28*y_KQsS&EFh#w|RXa6tHl/t|_h]'iu')XG3?1pvN=YMLZ;L.+"wOg!)gr]?!kxvy3CFFMiioI]:T!K'}r?Zvhlvl|h7Vs)5K{]XYg0Q1F=GjEsQQZ=6}BPr%b:ITKRPH4N1z.-N-Qzd!bC~B EUO&wb>aj~VXJ,B. By not making a selection you will be agreeing to the use of our cookies. Nurse practitioners, who are licensed physicians in addition to receiving training and education, have the same authority as physicians to prescribe medications and diagnose patients. In many states, the nurse practitioner's prescriptive authority includes a collaborative or reduced approach. 30 16 This year, survey respondents were asked to respond to a question re-garding state statutory authority to order home health services. I recommend that you round routinely with your collaborating physician or a nurse practitioner colleague before applying for privileges to get a sense of the role and responsibilities. View them by specific areas by clicking here. Get more information about cookies and how you can refuse them by clicking on the learn more button below. You may be trying to access this site from a secured browser on the server. Nurse leaders can also assist in changing bylaws and restrictive practices that exist. However, there are both pros and cons associated with being an NP with full practice authority. 122 746 123 127 891 128 129 952 130 130 NPs are required to follow the supervision of a physician in order to practice. The term includes a nurse practitioner, nurse midwife, nurse anesthetist, and clinical nurse specialist [ Tex. Nurse practitioners have full practice authority in 25 states, meaning that they do not have to work under the supervision of a doctor. The American Nurses Association defines the scope of practice as the "who, what, where, when, why and how of nursing practice.". Prescription Privileges and Electronic Prescribing New York law authorizes nurse practitioners (NPs) to order, prescribe or dispense medications (including controlled substances) for the treatment of their patients. KS H 2208 : Licensure By The Behavioral Sciences Regulatory Board - Concerns health and healthcare, relates to health professions and facilities,. 0000001897 00000 n 69 1156 70 70 1054 71 71 963 72 72 Occ. 2. A nurse practitioner is generally responsible for providing admission history and physicals, as well as bill for those services, using Current Procedural Terminology (CPT) code 1704. Medicare billing privileges or eligibility for privileges. Lofgren MA, Berends SK, Reyes J, et al. After the transaction has been approved, they must enter into a collaborative agreement with a physician. There were also 101 respondents from 19 states (Arizona, Colorado, Connecticut, Hawaii, Iowa, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, New Mexico, North Dakota, Oregon, Rhode Island, South Dakota, Vermont, Washington, and Wyoming) who identified that procedures within APRN scope of practice required physician supervision in their practice setting. The case for removing barriers to APRN practice. Nurse practitioners are becoming increasingly in-demand, and there will be a shortage of them in the coming years. /b375cd9339af2bb12856853d3d172057 28 0 R There are no prerequisites for nurse practitioners to sign death certificates or handicap parking permits in Texas. Furthermore, they are typically under the supervision of a medical doctor, and their authority over prescription drugs is greatly reduced. 8. 17. No changes to content. According to the U.S. Bureau of Labor Statistics, there is a great need for nurse practitioners, with job growth projected at 26%, far higher than the average for all jobs. Poghosyan L. Federal, state, and organizational barriers affecting nurse practitioner workforce and practice. Hospital and other institutional and organizational barriers can result from a number of policies and practices. Since Physician Assistants (PA) and Advanced Practice Registered Nurses (APRN) are not physicians, are organizations required to credential and privilege them via the requirements found in the Medical Staff (MS) chapter of the accreditation manual? In most facilities, two levels of privileges exist. NPs are not permitted to prescribe more than 30 days worth of controlled substances per year. The supervising physician must be available to the NP for consultation and collaboration. 0000028719 00000 n Wolters Kluwer Health, Inc. and/or its subsidiaries. This Standards FAQ was first published on this date. 0000043711 00000 n Kleinpell, Ruth PhD, RN, FAAN, FAANP; Myers, Carole R. PhD, RN, FAAN; Likes, Wendy PhD, DNSc, APRN-BC, FAANP; Schorn, Mavis N. PhD, CNM, CNE, FACNM, FNAP, FAAN. Kapu AN, Steaban R. Adding nurse practitioners to inpatient teams: Making the financial case for success. 34 0 obj 5. Admitting and discharging patients may be within the scope of practice for Nurse Practitioners provided that these functions are included in the CPA between the Nurse Practitioner and supervising physician and the hospital has policies and procedures allowing Nurse Practitioners to perform these functions. Wolters Kluwer Health Now some states are different and have referred to them differently. Nurs Outlook. A number of state and regulatory barriers to practice were identified including restricted hospital admitting privileges (n = 2446; 32.8%), restricted home health approval (n = 2485; 33.3%), requiring a physician signature to order durable medical supplies (n = 2273; 30.4%), requiring physician cosignature on APRN orders (n = 1708; 22.9%), restricted health insurance credentialing of APRNs (n = 1465; 19.6%), requiring physician supervision for procedures within an APRN scope of practice (n = 1227; 16.4%), and the requiring of a physician signature on pre- and postoperative assessments conducted and written by an APRN (n = 829; 11.1%), among others (Table 1).18 Even among APRNs working in FPA states, similar barriers were reported. Schirle L, Norful AA, Rudner N, Poghosyan L. Organizational facilitators and barriers to optimal APRN practice: an integrative review. In addition, you will be responsible for working with ancillary services such as physical therapy, coordinating patients care to achieve a timely yet appropriate discharge, and then discharging the patient. startxref Registrants for the in-person conference will also receive access to the on-demand package at no extra charge! Most hospitals do not permit admission to medical residents, NPs, or PAs, so their inability to write admission orders would create significant logistical and financial problems for many hospitals and physician groups, including hospitalists. There are a number of benefits to this. 0 School health Women's health Their range of health care services (scope of practice) and privileges (authority granted to a provider) depends on laws in the state that they work. Levels of PrivilegesAfter you complete the credentialing procedure, you will be awarded a specific level of hospital privileges. 0000004316 00000 n 0000000012 00000 n Overcoming BarriersBarriers to obtaining hospital privileges are significant but definitely surmountable. 2021-2022 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing. /CIDSystemInfo << /ItalicAngle 0 2020;65(4):487495. To understand credentialing and privileging, it is helpful to first look at the genesis of such requirements and examine how laws, regulations, agency policies, and common law affect whether or not a nurse practitioner (NP) is able to practice in a specific setting and under what conditions (Fig. xc```b``""@ Their medical skills allow them to diagnose and treat illnesses, prescribe medication, and perform other tasks that a regular registered nurse cannot perform. 3. You need to know all the details about NP practice in your statefrom signature authority to the number of CE hours required for licensure and beyond. Some state laws require career-long regulated collaborative agreements with other health providers for APRNs to provide care, or 1 or more elements of APRN practice are limited.1 Currently, 15 US states are classified as reduced practice states (Figure). According to data from the U.S. Bureau of Labor Statistics, California is the highest paying state for nurse practitioners. The requirements for conducting a Focused Professional Practice Evaluation (FPPE - MS.08.01.01) and an Ongoing Professional Practice Evaluation (OPPE - MS.08.01.03) also apply to these practitioners. 2018;14(7):559565. Patients can collaborate with one or more physicians by collaborating with nurses and specialists, such as doctors. /Fabc37 39 0 R 0000002614 00000 n Learn about the development and implementation of standardized performance measures. Your ResponsibilitiesA nurse practitioners responsibilities in an acute-care setting include an admission history and physical examination. endobj As identified in the Future of Nursing 2020-2030 report, until all APRNs are permitted to practice to the full extent of their education and training, significant and preventable gaps in access to care will continue.16. _____I have been approved for the following schedules by the Mississippi State Board of Nursing and Data is temporarily unavailable. The Application ProcessBefore you apply for hospital privileges, carefully consider the associated responsibilities, benefits and drawbacks. QqQ>"8+Ji!\3o=1[gx,oFM1x;-h_h31bjAX{KE. AS HEALTH CARE PROFESSIONALS, advanced practice registered nurses (APRNs) contribute to promoting health and providing care for patients in a variety of health care settings. /ProcSet [ /PDF NPs have been in practice an average of 9 years. If an NP prescribes a Schedule II controlled substance without complying with these guidelines, they may faceDisciplinary action from the Texas Board of Nurse Practitioner. 0000001138 00000 n Yes, an active, permanent, unencumbered Registered Nurse license issued by North Carolina or a multistate privilege to practice issued by another compact state is required for approval to practice as a Nurse Practitioner in North Carolina. 66 66 891 67 67 895 68 68 891 69 /PageMode /UseNone More than 88 percent of family nurse practitioners and adult nurse practitioners accept Medicare patients, and more than 80 percent of both groups accept Medicaid patients. Nurse practitioners' job satisfaction and intent to leave current positions, the nursing profession, and the nurse practitioner role as a direct care provider. >> may email you for journal alerts and information, but is committed Since that time, many states have enacted similar legislation. . The application is generally 10 to 15 pages long and includes a variety of questions about practice setting and education. 1 0 obj | vuuVfdf[R|Xj7?/8;[~=[|5!okwym]{xHn,KKHy-1f=rrkWw/r~l9|}p To initiate the process, call the medical staff affairs office where you are seeking privileges. Stay up to date with all the latest Joint Commission news, blog posts, webinars, and communications. Join AANP today and support the movement to remove practice barriers and secure full and direct access to NP services. 722 63 63 693 64 64 794 65 65 885 2015;13(2):5056. 38-2321. (II) If an advanced practice nurse or physician assistant has been granted clinical privileges by a hospital, the hospital may not modify or revoke those privileges without providing certain procedural rights to provide fairness of process, as determined by the governing body of the hospital, to the advanced practice nurse or physician assistant. In addition to accreditation, certification, and verification, we provide tools and resources for health care professionals that can help make a difference in the delivery of care. /Encoding /WinAnsiEncoding A letter in your file detailing how you will deal with referrals and consult with other specialists is required in Alaska. Nurse leaders should: As outlined in Table 2, these barriers might include requiring health care professionals to send consultative or procedural notes to the provider who referred the patient, including APRNs, or eliminating the option to decline accepting a referral based on the referring health care provider type. endobj AANPs interactive State Practice Environment map provides an overview of NP licensure for all 50 states, Washington, D.C. and U.S. territories. For example, a total of 437 respondents from 22 FPA states (Alaska, Arizona, Colorado, Connecticut, Hawaii, Idaho, Iowa, Maine, Maryland, Minnesota, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Dakota, Oregon, Rhode Island, South Dakota, Vermont, Washington, and Wyoming, along with the District of Columbia) reported that home health approval was restricted and was a barrier to practice. Respondents identified working in outpatient settings (n = 4445; 59.5%), inpatient settings (n = 1430; 19.1%), or both (n = 1596; 21.4%).18. Not permitting APRNs to practice to the full extent of their licensure and education decreases the types and amounts of health care services that can be provided for people who need care.16 As noted in the Future of Nursing 2020-2030 report, these barriers also have significant implications for addressing the disparities in access to health care between rural and urban areas. During the credentialing process, a group of physicians in the department of medicine reviews your qualifications and decides whether to grant privileges. | Most hospitals mandate that nurse practitioner's notes and orders be signed every 24 hours, even in states where physician collaboration is not required by law. AANP is closely tracking the policy response to the COVID-19 pandemic. 0000025341 00000 n American Association of Nurse Practitioners. Types of changes and an explanation of change type: /Font << This form needs to be completed and signed by one or two physicians. startxref 2014;19(2):2. Position Summary. Correspondents must contact their own professional advisors for such advice. advanced practice nurse (APN) throughout the Nurse Practice Act. 11. Primary care and specialty care, such as pediatrics and mental health, are expanding as a result of an aging population, resulting in increased demand for NPs. 25 25 602 26 26 1072 27 27 947 28 Get new journal Tables of Contents sent right to your email inbox, Creative Commons Attribution-Non Commercial-No Derivatives License 4.0, http://www.aacn.nche.edu/education/pdf/APRNReport.pdf, https://www.aanp.org/advocacy/state/state-practice-environment, https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-19-2014/No2-May-2014/Barriers-to-NP-Practice.html, https://www.rwjf.org/en/library/research/2017/03/the-case-for-removing-barriers-to-aprn-practice.html, https://www.unitedhealthgroup.com/content/dam/UHG/PDF/2018/UHG-Primary-Care-Report-2018.pdf, Breaking Down Institutional Barriers to Advanced Practice Registered Nurse Practice, Articles in PubMed by Ruth Kleinpell, PhD, RN, FAAN, FAANP, Articles in Google Scholar by Ruth Kleinpell, PhD, RN, FAAN, FAANP, Other articles in this journal by Ruth Kleinpell, PhD, RN, FAAN, FAANP, The Advanced Practice Clinical Nurse Specialist, Full Practice Authority for Nurse Practitioners, AACN Essentials as the Conceptual Thread of Nursing Education, Creating a Healing Environment: An Innovative Educational Approach for Adopting Jean Watson's Theory of Human Caring, International Nursing: Caring in Nursing LeadershipA Meta-ethnography From the Nurse Leader's Perspective, Privacy Policy (Updated December 15, 2022). Are Instagram Influencers Creating A Toxic Fitness Culture? In Texas, nurse practitioners are required to have a collaborative agreement with a physician in order to practice, but there are no specific regulations regarding which type of physician they must collaborate with. 1270 83 84 530 85 86 891 95 96 1060 1).This article provides a brief overview of federal, state, and local laws that impact NP . There is a simple reason for this change. APRNs, including nurse practitioners (NPs), certified registered nurse anesthetists (CRNAs), clinical nurse specialists (CNSs), and certified nurse-midwives (CNMs), face barriers to practice that impede their ability to provide care commensurate with their educational training. 0000004685 00000 n Scope of practice guidelines for advanced nursing professions vary by state. Nurs Outlook. KS H 2256 : Advanced Practice Registered Nurses - Updates scope of practice requirements for advanced practice registered nurses. << There are also institutional strategies that can improve the APRN role, thus also improving patient care. endstream endobj 840 0 obj <>stream (a) The CRNP program must be a definable entity distinguishable from other educational programs and services within the institution. These strategies include involving APRNs in the credentialing and privileging process within the organization; creating an APRN practice committee or formal structure to support APRN hiring, orientation and onboarding, and competency assessment; ensuring tests or medications ordered or assessments conducted within the APRN scope of practice do not require a physician oversight or cosignature; developing institutional support for billing and reimbursement to capture optimal APRN revenue, continued practice development, and involvement in key organizational committees or workgroups; and APRN outcome assessment. In addition, even in states where nurse practitioners can practice without a collaborating physician, notes and orders must be co-signed. /Encoding /WinAnsiEncoding /Filter /FlateDecode 0000032118 00000 n Admissions and orders for long-term care require MD signature, All new hire physicians and work compensation injuries must be co-signed by MD, Can pronounce death but unable to sign death certificate, Collaborating/supervising physician practice/population restriction, Documentation requirements related to reimbursement for medical direction of anesthesia (eg, Tax Equity and Fiscal Responsibility Act [TEFRA]), Payment requirement to collaborating/supervising physician, Pharmaceutical companies require MD signature for samples, Pronouncing death prohibited (including fetal death), Social Security disability forms not honored without MD signature, Unable to bill for EKGs, so these have to be sent to collaborating MD, Unable to clear child for hearing aids without MD signature, Unable to obtain informed consent for procedures, Unable to order imaging for patients with abnormal mammogram, Unable to order skilled care/visiting nurse, Unable to perform pulmonary function tests, Unable to practice telemedicine outside of state (New Hampshire), Unable to refer to pulmonary rehabilitation, Unable to sign an emergency psychiatric hold, Unable to sign for pulmonary rehabilitation, Unable to sign return to play after concussion, Visiting Nurse Service will not take orders, only take MD referrals, Anesthesia or emergency airway management requires MD supervision, Discharges from the PACU or other units require MD signature, Laboratory or imaging results only given to collaborating/supervising physician (not to APRN), MD has to repeat all physical examinations and sign all notes, Orders for blood products requires MD signature, Orders for durable medical supplies require an MD signature, Pre- and postoperative assessments require MD signature, Prescriptions require an MD signature (or cosignature), Procedures essential to anesthesia (eg, regional/peripheral nerve blocks, invasive line placement) require MD supervision, Procedures essential to quality care and within APRN scope require MD supervision, Referral or consultation declined by other providers (only because you are an APRN). Anen T, McElroy D. Infrastructure to optimize APRN practice. 0000023756 00000 n 0000194677 00000 n Currently, there is a limited scope of practice for NP in Texas. /N 10 6. Barriers to practice and the impact on healthcare: a nurse practitioner focus. In this case, the treating doctor is responsible for performing the duties. xref 97 119 891 120 120 312 121 121 457 122 Nurse Practitioner - Hospital: Nurse Practitioner - Neonatal: Podiatry: Medical Specialties A-M. Allergy and Immunology . State law requires career-long supervision, delegation or team management by another health provider in order for the NP to provide patient care. 0000002450 00000 n /Source (WeJXFxNO4fJduyUMetTcP9+oaONfINN4+d7JkdepJGYv1GjCAXXZLJA5HEtThBppB9khgm8VtCFmyd8gIrwOjQRAIjPsWhM4vgMCV\ /Ordering () 141 746 142 172 891 173 176 1047 187 188 Others work together with doctors as a joint health care team. 7. A nursing degree is required if you work in a specialized graduate program. Get fresh tips and insights emailed to you, This content was produced in its entirety for ADVANCE Healthcare Network (1985-2019, now Elite Healthcare) and features original contributions from a qualified and experienced editorial team or was provided to ADVANCE by credible industry experts or qualified healthcare professional(s). Interpret lab results and X-rays. 870 0 obj <>stream >> This includes initiation, alteration and cessation of prescription drugs. 429-437, 10.1097/JXX.0000000000000270. Sources: 1 AANP National Nurse Practitioner Database, 2022. Once this letter is received, an application is sent to the nurse practitioner. Alternative privileges are granted by the State Board of Medical Examiners to practitioners who do not have hospital privileges and permit these practitioners to perform surgery and special procedures or administer anesthesia services in an office setting. 0000024676 00000 n 3. Nurse practitioners in Texas can prescribe prescriptive medicine through written agreements with a physician. We help you measure, assess and improve your performance. Robert Wood Johnson Foundation (RWJF). At around the same time, Oregon also passed legislation allowing NPs to seek hospital privileges. /O 33 0000044482 00000 n The ability of nurse practitioners to provide high-quality patient care without the interference of a physician is an important step forward in the delivery of patient care. The hospital may require a fee of $100 to $500 to process your application for privileges. The pharmacy or lab where an APRN works may provide physical exams, medications, and diagnostic tests. The hospital may require a fee of $100 to $500 to process your application for privileges. Please try again soon. The doctor will then write an order for admission and the patient will be admitted by the hospital staff. endobj Nurse practitioner; licensed on or before August 30, 2015; requirements; transition-to-practice agreement; contents. They may also prescribe medications and perform certain procedures, such as suturing. stream In both 2009 and 2011, nursing organizations attempted to change these laws, but were unsuccessful due to protests from physicians. J Nurs Adm. 2017;47(9):465469. 15. /BaseFont /Times-Roman Nurse Practitioner Scope of Practice by State 28 1078 29 29 939 30 33 891 34 35 0000003308 00000 n However, typically, a patient must be seen by a doctor who then determines if they need to be admitted to the hospital. /StemV 80 Yes No Consider involvement in state and national organizations positioned to make policy changes impacting APRN practice. Published September 2011. 0s-5Wo Learn how working with the Joint Commission benefits your organization and community. The amount you can earn as a PMHNP will greatly vary based on where you work. Many nurse practitioner programs do not educate students to provide hospital care, and these skills need to be developed. Your insurance company will be able to approve a referral from your personal physician and ensure that you are admitted to the hospital as soon as possible. The qualifications of a nurse practitioner and the competence of a collaborating physician are at the heart of Ohio law, allowing them to treat patients independently. 0000042320 00000 n . 0000007652 00000 n 1. Once you have graduated and taken your boards, you can apply for your state nurse practitioner license. DISCLAIMER: The material contained in this is offered as information only and not as practice, financial, accounting, legal or other professional advice. 830 0 obj <> endobj /Type /Font /Root 31 0 R Verification of education or training will also be required. Regardless, the concept of admitting privileges is that your doctor would be able to admit you with some paperwork and a quick phone call. 3 96.2% of NPs prescribe medications, and those in full-time practice write an average of 21 prescriptions per day. /Fabc6 34 0 R NPs must have a written agreement with a supervising physician in order to admit patients. Larger cities and hospitals will likely pay PMHNPs more than smaller areas. Through leading practices, unmatched knowledge and expertise, we help organizations across the continuum of care lead the way to zero harm. In reduced practice states, practice and licensure laws reduce the ability of APRNs to engage in at least one of the 4 elements of APRN practice. State law requires a career-long regulated collaborative agreement with another health provider in order for the NP to provide patient care, or it limits the setting of one or more elements of NP practice.Restricted PracticeState practice and licensure laws restrict the ability of NPs to engage in at least one element of NP practice. J Am Assoc Nurse Pract, 32 (6) (2020), pp. /289a552e0d4400188146c4b0372efb63 28 0 R National Academies of Sciences, Engineering, and Medicine. . New Jersey Nurse Practitioners are also legally allowed to admit patients and obtain hospital privileges, but the authorization is not within the legal statue (The Nurse Practitioner, 2012). Information. Drive performance improvement using our new business intelligence tools. /XObject << advanced practice nursing; advanced practice registered nurse; barriers to practice; institutional practice barriers; nurse leaders. Updates on the quest for full practice authority. The APRN Consensus Model was enacted to provide guidance for states to adopt uniformity in the regulation of APRN roles, licensure, accreditation, certification, and education. Review only, FAQ is current: Periodic review completed, no changes to content. 0000004862 00000 n Identify existing institutional barriers to APRN practice; Actively support and target the removal of institutional barriers to APRN practice; Understand and implement the APRN Consensus Model in the regulation of APRNs in their respective institutions; Be knowledgeable about APRN practice restrictions within their state; and. 0000024987 00000 n stream The form provides written documentation that you have secured one or two physicians who will ultimately be responsible for supervising the care of hospital-based patients. endobj Nurse practitioners in New Hampshire are allowed to practice independently, free of physician supervision. The remaining 11 states are classified as restricted (Figure). It is also helpful to round with a collaborating physician for the first 3 to 6 months after you obtain privileges. m& m& m& m& m& m For years, nurse practitioners have been working in this capacity without formal regulation, which is why this change is so significant. Diagnosing, treating, and managing diseases. 0000038275 00000 n The nurse practitioners have hospital admitting privileges, a move Pear-son acknowledges is "cutting edge." . After ten business days, the patient will require a prescription from a physician, dentist, chiropractic, podiatrist, physician assistant, or advanced nurse practitioner to continue treatment. A resume or curriculum vitae, a copy of a DEA certificate (where allowed by state law), malpractice certificate and life support certifications are also required. Nurs Econ. your express consent. Code 301.152 . 2016;64(2):146155. 13. 0000001738 00000 n 35 0 obj Entry-level nurse practitioners in the state earn over $50 hourly and average about $107,310 yearly. When an Advanced Practice Registered Nurse (APRN) or PA functions in a limited role, such as an educator, and arenot directing care as a LIP, the Medical Staff requirements would not apply. Devi, S. (2011). The hospitalist must assess your condition, order tests and interventions, and coordinate care with other medical professionals. /1f12c52f8985e00d5fdf413c2fab942d 28 0 R Kleinpell R, Cook ML, Padden DL. Washington, DC: American Association of Colleges of Nursing & National Organization of Nurse Practitioner Faculties; 2008. Yes, any provider recognized by state law and providing services as a 'Licensed Practitioner (LP)^^ or providing a medical level of care and decision-making (e.g. 10. (Ala.

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