Development and Adoption of the White Paper: Increasing Access to Health Care for Louisiana Residents by Utilizing Nurse Practitioners to the Fullest Extent of Their Education and Training

Louisiana’s primary care provider (PCP) shortage is becoming increasingly evident and is projected to accelerate over the next decade. A growing body of evidence has linked the shortage of PCPs and decreased access to primary care services as contributing factors to poor health outcomes. Research findings illustrate Nurse Practitioners (NPs) provide safe, quality, and cost-effective care. Use of Louisiana NPs to the fullest extent of their education and training (full practice authority) is a readily available, viable, cost-effective resource and may be one solution to the growing need for PCPs. Use of NPs in this capacity is often impeded by an antiquated legislative mandate, one that requires NPs to enter into a collaborative practice agreement (CPA) with a physician. The complexities of initiating and maintaining such an agreement represent a barrier to full practice authority, which inadvertently decreases access to primary care services. This DNP Synthesis Project resulted in the creation of a white paper comprising evidence-based rationales for the removal of the CPA. A summary of the background and significance of the problem, a proposed solution, the benefits of CPA removal, and a call to action for all stakeholders was addressed. The white paper was presented for organizational adoption to the Board of Directors of the Louisiana Association of Nurse Practitioners (LANP). Upon adoption, the paper was electronically posted to the LANP website to reach a broader audience. Further propagation was accomplished through presentations conducted at various organizational meetings throughout the state. Additionally, the white paper was submitted via electronic communication to Representatives and Senators currently serving on the state’s Health and Welfare committee. Finally, the tenants of the white paper were used as the foundation for bill authorship. Two bills were written addressing removal of the CPA and have been dropped, one in the House and one in the Senate, for consideration during the 2016 Louisiana Legislative session. Keywords: Nurse Practitioner, Scope of Practice Barriers, Physician Opposition, Full Practice Authority, Louisiana, Access to Care, Collaborative Practice Agreement, Whit