How collaborative practice agreements impede the provision of vital behavioral health services
| Autor: | Bethany J. Phoenix, Brendan Martin, Susan A. Chapman |
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| Rok vydání: | 2020 |
| Předmět: |
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Mental Health Services Scope of practice Substance-Related Disorders Psychiatric Nursing Economic shortage 03 medical and health sciences Health services 0302 clinical medicine Nursing Advanced practice registered nurse Physicians Health care medicine Humans Nurse Practitioners 030212 general & internal medicine General Nursing 030504 nursing business.industry Middle Aged Mental illness medicine.disease Mental health Organization and Administration Female 0305 other medical science business Psychology Qualitative research |
| Zdroj: | Nursing Outlook. 68:581-590 |
| ISSN: | 0029-6554 |
| DOI: | 10.1016/j.outlook.2020.04.002 |
| Popis: | Background The critical shortage of behavioral health professionals impairs the ability of the U.S. health care system to respond to the growing demand for services to address mental illness and substance use disorders. Purpose To identify how restrictive state regulations act as barriers to full utilization of psychiatric mental health advanced practice registered nurses (PMH-APRN), whose scope of practice enables them to provide a full range of behavioral health services. Methods A sequential mixed methods study combining interview data (n = 94) from a qualitative study of PMH-APRN practice with a subset of quantitative data (n = 699) from a national APRN survey examining the impact of state-mandated APRN/MD collaborative practice agreements. Discussion Data sources converged to portray challenges to optimal use of APRNs providing psychiatric/mental health services, including high out-of-pocket fees, irregular communication with supervisors, mandated chart reviews, and supervisor turnover. Conclusion Inconsistent and burdensome supervision requirements contribute to cost inflation and may limit patient access. |
| Databáze: | OpenAIRE |
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