Access to quality healthcare is a growing concern in the United States especially in light of healthcare reform coverage expansions made possible by the Patient Protection and Affordable Care Act of 2010. It is estimated that 94% of all Americans will acquire healthcare coverage under the law, an increase of nearly 30 million people (King, 2011). This dramatic influx of patients into the healthcare system has projected to cause an immediate increase in added pressure on an already challenged healthcare workforce (King, 2011). Notably, at a time when healthcare demands are growing, graduate rates from medical schools remain unchanged while advanced practice registered nurse (APRN) graduate rates are rising (Cipher, Hooker, Guerra, 2006). The increased availability of APRNs, along with enhanced delivery of healthcare skills, gives the role a unique advantage in the current state of healthcare. These specialized advanced practice nurses provide services often at a patient’s first (and in some cases, primary) point of contact into the healthcare system (Brassard, 2013). Due to this, many states have started to take action to mitigate the increased healthcare system burden by enhancing the APRN’s scope of practice by broadening prescriptive authority. This has been shown to be one of the fundamental ethical avenues of increasing not only access to healthcare, but also efficiency and quality of care (Ross, 2012).
Those advanced practice nurses who hold a CTP may prescribe medications according to the Ohio Board of Nursing Formulary and as established by the Committee on Prescriptive Governance (CPG) (Napp, 2012). Since enactment, the CPG has met on several occasions to modify the formulary for schedule II drugs to prescribe as well as additional recommendations, rules and procedures for APRN Schedule II prescriptive authority (Napp, 2012). While advocates argue the final version of SB 83 is more restrictive than when it was originally constructed, socio-culturally, it does vastly expand the ability of APRNs to work with patients who are experiencing acute or chronic pain as well as mental health conditions in a more effective and efficient manner (Ross, 2012).
This amendment made great strides to diminish the historical limitations set to the practice provisions of advanced practice nurses. One could argue that political and economic pressures within the state and across the country assisted the bill to passage. It was merely eight years ago that APRNs definitively obtained at least some prescriptive authority to some degree in all 50 states (Christian, Dower, O’Neil, 2007). Thus this bill marks the next significant leap forward for the practice of the APRN profession in the state of Ohio.
Stakeholder Support and Opposition
In the final amended form, Senate Bill 83 took nearly six years of lobbying by supportive bodies including the Council for Ohio Health Care Advocacy group (COCHA) and Ohio Nurses Association to reach final...