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Medical record documentation is required to record each individual’s health history. This is pertinent information regarding his or her past and present illnesses, laboratory results, treatments including medications, and prognosis. By having these documents, minimize errors and increase patient satisfaction and quality in their care. An increase of APRN’s have soared over the past few years due to the demand in the health care field. According to Barnes, “in 2015, there were approximately 136,060 clinically active NPs in the United States, and it is projected that the supply of NPs will increase substantially in the upcoming years” (Barnes et al., 2017). The need of additional healthcare workers has increased over the years due to the population expanding. NP are essential in providing care because of the way it is delivered. NPs were previously nurses and have been properly trained and educated on communication and hands on care based off experience and school. Nurses have and always will be the patients advocate, which continues to grow in the role of the NP.  According to the Nurse Practitioner Association of Maryland, legislative and clinical practice strongly suggest the NP having clinical practice, professional relationship, and understanding the political system (NPAM, 2015).   

According to the American Association of Nurse Practitioners (AANP), research noted that patients who received their care from NPs had fewer readmissions at the hospital and higher patient satisfaction compared to physicians (AANP, 2020). The goal is to establish a trustworthy relationship with patients to ensure and provide adequate care towards the improvement in his or her wellbeing. By providing this, patients will note higher satisfaction reviews and continue his or her care with the NP.  NPs are leaders, advocates, and provide evidence-based knowledge during care. Placing the patient in the center of their care and treating everyone with sufficient time and attention, again will establish appropriate outcomes towards the patient, but also staff members. Regarding the impact on the physician, having an NP can help with patient care. Physicians can also educate the NP on how to delegate and prioritize the day during patient encounters and tasks that need to be completed.   

In the state of Maryland, APNs are allowed to work independently. Governor Hogan passed this legislative bill in April 2015 called the full practice authority act. According to the Nurse Practitioner Association of Maryland (NPAM), additional requirements for new applicants in Maryland or any other state must provide care with a mentor. The mentor can be a physician or another APN with three years or more clinical experience and is licensed in Maryland. The mentor will be available for the APN when advice is needed within the first 18 months of practicing (Nurse Practitioner Association of Maryland, 2015). This decision is positive because patients can be seen in a timely manner with an educated and trustworthy healthcare professional. Many offices today are booking months in advance, however, now with more healthcare providers, patients can be seen at a reasonable time. Lastly, according to the Maryland Department of Health, telehealth/telemedicine medical services have increased since the pandemic. However, for patients with Medicare, coding is different because only certain services are covered. Services included are chronic care management, the virtual check-in (brief telephone communication); however, coding for telephone calls and telephone audio only services are included in the attached coding guide. This can become confusing and can affect the level of reimbursement if education is not provided to correct this. Although NPs have fewer years of education compared to physicians, the care the two can deliver amongst one another can benefit the patient’s health. By providing empathy and compassion, patients will establish strong relationships and feel trusted with the care provided. Also, effective communication skills and giving proper time, will increase the patient’s gratification. The role of the NP is growing and will shape the future of healthcare.

References:

Barnes, H., Maier, C. B., Altares Sarik, D., Germack, H. D., Aiken, L. H., & McHugh, M. D.

(2017). Effects of Regulation and Payment Policies on Nurse Practitioners' Clinical          Practices. Medical care research and review : MCRR, 74(4), 431–451.         https://doi.org/10.1177/1077558716649109

Maryland Primary Care Program. Maryland Department of Health Maryland Primary Care Program Billing Reference Guide. (2022, January 21). Retrieved April 8, 2022, from https://health.maryland.gov/mdpcp/Documents/MDPCP%20Advance%20Care%20Planning%20and%20COVID-19%2021May20.pdf

Nurse Practitioner Association of Maryland. (2015). The Legislative and Clinical Practice Environment in Maryland. https://www.npamonline.org/page/34.

State Practice Environment. American Association of Nurse Practitioners. (2020).

https://www.aanp.org/advocacy/state/state-practice-environment.