Fifty jurisdictions and the District of Columbia have laws pertaining to nurse practitioners’ scope of practice. In general, scope of practice laws regulate the autonomy nurse practitioners are given within their practice to treat patients. State laws fall into two main categories: limited practice and full practice. In limited practice states, the law limits autonomy for nurse practitioners by requiring them to collaborate with, or work under, the supervision of another health care provider. By contrast, full practice states allow nurse practitioners to practice independently.
In total, there are 29 limited practice states. In those states, collaboration, supervision, or a combination of the two are required in performing activities such as prescribing medication, ordering tests, performing examinations, and counseling or educating patients, among other activities.
– States with limited practice authority
In the 22 states where nurse practitioners are given full practice authority, there are no supervision or collaboration requirements. Eight states, however, have transition to practice requirements, which require a transitional period for new nurse practitioners before they are granted full practice authority. That transitional period varies widely, and ranges from 1,000 hours in Colorado, to up to 36 months in Connecticut.
– States with full practice authority
Of note: Nebraska and Maryland transitioned from being limited practice states to full practice states between May 2015 and April 2016.
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