Discussion Grading Criteria: Agreeing and disagreeing do not mean just voicing one’s opinion.

In this assignment I need a peer response for the main discussion, that show below.

The peer’s responses

Discussion Grading Criteria: Agreeing and disagreeing do not mean just voicing one’s opinion. The focus of the discussions should remain on the ideas posed in the readings. Agreeing and disagreeing mean making scholarly arguments from the literature that may support your own ideas. Faculty expects you to support your ideas from the readings or similar scholarly writing about the topic in nursing literature. Always cite your source(s) and reference in APA format.

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Remember the post and responses should include scholarly writing about the topic in nursing literature.

Note por the professor:

Hello class,

Please refer to your APA format in your postings. The journal name and volume is italicized font. Ex.

The American Nursing Journal,7(9),,,,

Please update your APA to reflect doi

Amely Perez Cicili

Advanced Family Practicum III

The application of national health reform with millions of people receiving health insurance service is increasing the current challenges facing primary care. A major issue focuses on how to rise capacity while improving superiority and cost efficacy. Policy makers and researchers are suggesting innovative approaches to guarantee the system is ready as more people are gaining access (Barnes & Novosel, 2018). While some strategies seek to increase the number of primary care providers (PCPs), others seek to encourage efficient use of existing providers. As providers, Nurse Practitioners have faced some challenges in their scope of practice. Three of these challenges are the autonomy in practice, the teamwork with physicians, and limited prescriptive authority.

State and organizational policies generate misunderstanding around NP roles. In some states, regulations require NPs to collaborate or be supervised by physicians, whereas in other states, these regulatory requirements have been removed by policy makers. Similarly, some organizations restrict NP practice or fail to provide necessary support so NPs can maximally contribute their advanced skills to teams. On the other hand, teamwork between NPs and physicians in primary care has received care due to their overlapping scopes of practice and the fact that lack of agreement exists between them about their respective roles. On the contrary, when patient care suffers, fragmented teamwork and poor collaboration and communication between team members are often found to be contributing factors (Poghosyan, Shang, Liu, et al.,2015).

Limited right for prescription and referral challenged the development of APN scope of practice. Some people believe that only a physician should be allowed to diagnose, refer, or treat any medical condition. Independent prescribing by a NP does not require collaboration with a physician and is a key element of scope of practice for NPs, as well as being part of the APRN Consensus Model, which seeks to achieve uniformity of state regulation of APRN practice. However, regardless of the existence of the consensus model, there are extensive disparities among the states with respect to prescriptive authority. In some states, prescriptive authority is granted at the time of APRN licensure; in others, the APRN must apply separately for these privileges. (Gardner, Chang, & Duffield, 2012).


Barnes, H., Novosel, L. M. (2018). A scoping review of nurse practitioner workforce data: Part Two of a four-part series on critical topics identified by the 2015 Research Agenda Roundtable. Journal of the American Association of Nurse Practitioners. Advance online publication. doi:10.1097/JXX.0000000000000069.

Gardner, A., Chang, C., & Duffield, A. D. (2012). Delineating the practice profile of advanced practice nursing: a cross-sectional survey using the modified strong model of advanced practice. J Adv Nurs, 69 (9), pp. 1931-1942. Google Scholar

Poghosyan, L., Shang, J., Liu, J., Liu, N., et al. (2015). Nurse practitioners as primary care providers: creating favorable practice environments in New York State and Massachusetts. Health Care Manag Rev;40(1):46–55. doi: 10.1097/HMR.0000000000000010. [PubMed] [CrossRef] [Google Scholar]