MONA was gratified that many of the elements and recommendations of the Institute of Medicine (IOM) Report on the Future of Nursing are reflected in our ongoing work to advance the nursing profession.  Implementation of IOM Recommendation 1: Remove scope-of-practice barriers is a current focus for MONAAdvanced practice registered nurses should be able to practice to the full extent of their education and training. Changes to our health care system are needed that capture the full economic value of nurses and take into account the growing body of evidence that links nursing practice to improvements in the safety and quality of care.

Advanced practice registered nurses (APRNs) should be called upon to fulfill and expand their potential as primary care providers across practice settings based on their education and competency. By virtue of their regular, close proximity to patients and their scientific understanding of care processes across the continuum of care, nurses have a considerable opportunity to act as full partners with other health professionals and to lead in the improvement and redesign of the health care system and its practice environment.


Did You Know?Status of APRNs in MO: A White Paper

In some medically underserved areas in Missouri if it weren’t for an Advanced Practice Registered Nurse (APRN), the citizens would have no access to healthcare.

The Institute of Medicine (IOM) recommends APRNs practice to the full extent of their education and that state legislatures remove barriers that prevent this. (More info.) The IOM also recommends that the Federal Trade Commission investigate states where regulations are “unduly restrictive.”

Missouri currently ranks an “F+” for utilization and restriction of advanced practice nurses.  Only six states rank lower.  These include Alabama, Florida, Georgia, Michigan, North Carolina, and South Carolina.  (2011 Pearson Report)

Multiple studies have been done comparing the quality of care given by an advanced practice registered nurse compared to a physician.  NO studies have shown advanced practice nurses to be inferior to their physician counterparts.  The studies have shown that advanced practice registered nurses are cost effective, deliver quality care, and increase access to healthcare.  NO studies have shown that physician supervision of an APRN increases safety.

The Veteran’s Administration is the number one employer of APRNs.

Malpractice insurance rates are based upon relative risk and history of claims as a profession.  APRNs liability and malpractice insurance rates are significantly less than their physician counterparts.   (Journal of Medical Licensure and Discipline – Hooker, Nicholson, & Le)