In Iowa, where I reside and plan to practice in the future, nurse practitioners are allowed to practice to the full scope of their role. They can practice independently without any supervision (iowa.gov,2022). The Iowa Board of Nursing website lists the scope and practice of the Advanced Registered Nurse Practitioner (ARNP) in Iowa. This website gives guidelines the practice of the ARNP but does differ to the national certifying body for the standards of care and guidelines (iowa.gov, 2022). The 2 choices for ARNPs to choose for credential exams are the American Academy of Nurse Practitioners (AANP) and the American Nurses Credentialing Center (ANCC). For the sake of my discussion, I am choosing to go with the guidelines the AANP sets out for the practice (and documentation) for the nurse practitioner. 

           The AANP sets clearly lays out the scope of practice guidelines. The categories include assessment with subcategories of obtaining a thorough social, family, and medical history. This indicates documentation standards for a ARNP. This includes using the full education and experience of the ARNP to adjust for age and population (AANP.org, 2022). Further categories include performing a thorough and appropriate assessment, ordering and monitoring appropriate diagnostic procedures, identifying risk factors, and evaluating social determinants. By setting a standard, it indicates the care that should be provided, and documenting is a professional responsibility of all healthcare providers (Rutherford, 2019). 

           Documenation and proving the care we provide is critical in reimbursement which is closely associated with quality metrics that both commercial and government payers utilize to monitor provider’s care (Rutherford, 2019). The reimbursement is associated with the auditing of the care provided, and documentation is the only proof of how we cared for each patient. 

           We all have heard it from day 1 of our nursing education. “If it’s not charted, it wasn’t done.” This still rings true as we all advance in our educational journey and careers. The risk of documenting something that was not done is just as great as our responsibility and liabitly increase. Fraudulently documenting something was done or charge for something not given can incur large fines and even criminal convictions (Rutherford, 2019).  Correct documentation is imperative to patient care in this age of information sharing. Whether that mean our responsibility to payers, or our responsibility to our patients and their safety. 

References:

American Academy of Nurse Practitioners {AANP.org} (2022) Standards of Practice for Nurse Practitioners. https://www.aanp.org/advocacy/advocacy-resource/position-statements/standards-of-practice-for-nurse-practitioners

Rutherford, M.M. (2019) The business of advanced practice nursing in Dunphy, L.M, Winland-Brown, J.E., Porter, B.O., and Thomas, D.J. (Eds.), Primary care: The art and science of advanced practice nursing. (5th ed., pp 1327-1347). F.A. Davis Company, Philadelphia.

Weinberg, K.R.{iowa.gov} (2022) Advanced Registered Nurse Practitioner- Role & Scope. https://nursing.iowa.gov/practice/advanced-registered-nurse-practitioner-role-scope