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1. Evidence-based guidelines help shape advanced practiced registered nurses practice by guiding them with the essential tools to be able to provide proper patient care. According to Clarke et al., evidence-based practice is valued by nurse practitioners (NP) because they solely believe how important it is in standardizing patient care (2021). With the usage of evidence-based practice, it improves how APRN can care for patients and provide the highest quality patient care possible. With that being said, I believe physicians and APRNs hold different evidence-based practice standards which is supported by the different scope of practice each has. According to Spetz and Muench, APRN practice in California is governed by the Nurse Practice Act which states that in order for a APRN to work in the state of California, they msut work with standardized procedure to keep regulation and ensure they work under their scope of practice, while physicians in the other hand, are not governed under the Nurses State Act and they standardized procedures do not apply to them (2018). So, physicians such as MD and Do have different scope of practice and are not held to the same evidence-based practice as APRNs. Unfortunately, in the state of California, APRNS are not independent and autonomous as they would like to be compared to physicians. According to Montague, APRNS must follow and practice under a licensed physicians for at least 3 years in order to be eligible to practice as a nurse practitioner (2020). Unlike physicians, APRNS in California has more strict rules and regulations which prevents them from practicing independently. There are collaborative agreements between physicians and APRNS that will define their working relationship. According to NP Advantage, “a collaborative practice agreement is a contract between an NP and a physician that outlines the rights and responsibilities for each” (2023). This states an agreement between the two healthcare providers allowing them to have a professional working relationship. With that being said, it will also come along with a fee for a APRN to be able to work under a physician. Mainly seen in states that do not allow APRNs to practice independently and autonomy, just like California, there is a requirement for APRNs to pay physicians to practice under their name. According to Martin and Alexander, some phycisians require APRNs to pay them a fee when a collaborative agreement is in place in order for the APRN to work with them (2019). In order for APRNs to incorporate consultation and collaboration with their physicians, there must be trust, respect, and equality. According to Schadewaldt et al., the APRN and the physician requires a relationship where they can confidently trust each other in making the right decision for the patient (2013). This is a great way to incorporate and working relationship with each other and to state what their boundaries are and roles when caring for a patient.
2. Advanced Practice Registered Nurses (APRNs) practice is heavily influenced by evidence-based guidelines. These recommendations were created using the most reliable data from scientific and clinical investigations. They give APRNs a foundation for giving their patients high-quality, secure, and efficient care.
Evidence-based guidelines effects on APRN practice:Evidence-based recommendations aid in care standardization and guarantee that APRNs use the most recent and efficient procedures. They are employed to identify, manage, and treat a range of medical disorders. APRNs may make knowledgeable decisions regarding patient care, improve patient outcomes, and raise the standard of care given by following evidence-based recommendations.
Comparison of Evidence-Based Standards for Physicians and APRNs: Both physicians (MDs and DOs) and APRNs are expected to follow evidence-based standards in their practice. While the scope of practice may differ between the two groups, the foundation of evidence-based care remains the same. Physicians and APRNs often collaborate in healthcare settings, and adherence to evidence-based guidelines ensures that all members of the healthcare team are working toward the same goals.
Independence and Autonomy of APRNs: The degree of independence and autonomy of APRNs varies depending on state regulations and institutional policies. In some states and settings, APRNs have full practice authority, meaning they can diagnose, treat, and prescribe medications independently without physician oversight. In contrast, other states may require collaborative agreements or supervision with physicians, especially in specific practice areas. It’s essential to check the regulations in each jurisdiction to understand the level of autonomy granted to APRNs.
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