1. APRN PANEL DISCUSSION: STATE OF GEORGIA APRN PRACTICE & EDUCATION Academic Advisory Committee on Nursing/Georgia Association Nursing Deans & Directors 2017 Conference
Desireé Clement, MS, APRN, CNM, FNP-BC
Michelle A. Nelson, PhD, APRN, FNP-BC
MaryJane Lewitt, PhD, APRN, CNM, FACNM
Suzanne Staebler, DNP, APRN, NNP-BC, FAANP, FAAN
UARPN: Shining a Light for Georgia Health

2. 2017 NP STATE PRACTICE ENVIRONMENT & SUPPORT
Several state & national organizations support: APRN Full Scope of Practice
American Association of Nurse Practitioners (2017a, 2017b)
American Nurses Association (2016)
American Association of Retired Persons (2010)
Federal Trade Commission (2014)
Institute of Medicine (2010)
National Council of State Boards of Nursing (2016)
National Governors Association (2012)
US Department of Veterans Administration (2016)
Figure 2. State Practice Environment=23 states (AANP, 2017a, 2017b)

3. GEORGIA POPULATION Population by July, 2016:
10,310,371= Total number of residents
37% = low-income
17% = live in poverty
15.7%= no health insurance < age 65
15% = live in areas without PCPs
1,318,412 = enrolled in Medicaid
State did NOT expand Medicaid
1,519,461= enrolled Medicare
670,617 = veterans (Georgia Department of Community Health, 2016; Kaiser Family Foundation, 2017; U.S. Census Bureau, 2016)
Figure 2. HPSA PCPs, Georgia 2014 (MindingBlindspot.com, n.d.)

4. GEORGIA: AT A GLANCE National: More healthcare providers needed
Growing population Increasing older population
Underserved areas with physician shortages (Xue et al. 2016)
Georgia (GA) issues with healthcare:
Access to care
Rural hospital closures
Physician shortage (Senate Research Office: State of Georgia, 2007)
GA Primary Care Physician (PCP) Shortage:
Only 23,383 physicians hold active state licenses; only >11,000= PCPS(Kaiser Family Foundation, 2017; U.S. Census Bureau, 2016)
By 2020= GA will rank LAST
Number of physicians to citizen’s ratio (Senate Research Office: State of Georgia, 2007)
GA needs more healthcare providers:
NPs: can care for 75% needed primary care services
CNMs: can deliver babies (Senate Research Office: State of Georgia, 2007; Sullivan-Marx, 2008)

5. Licensure at levels of role and population foci
APRN Specialties
Focus of Practice beyond role and population focus
Linked to health care needs
Examples include but are not limited to: Oncology, Older Adults,
Orthopedics, Nephrology, Palliative Care, Emergency
POPULATION FOCI
Family/Individual
Across lifespan
Adult-
Gerontology*
Women’s Health/
Gender Related
Neonatal
Pediatrics*
Psych/Mental
Health
Licensure at levels of role and population foci
APRN ROLES
Nurse
Anesthetist
Nurse
Midwife
Clinical Nurse
Specialist
Nurse
Practitioner

6. Licensure at levels of role and population foci
APRN Specialties
Focus of Practice beyond role and population focus
Linked to health care needs
Examples include but are not limited to: Oncology, Older Adults,
Orthopedics, Nephrology, Palliative Care, Emergency
POPULATION FOCI
Family/Individual
Across lifespan
Adult-
Gerontology
Women’s Health/
Gender Related
Neonatal
Pediatrics
Psych/Mental
Health
Licensure at levels of role and population foci
Across the Continuum
Wellness
Acute care
Clinical Nurse
Specialist (patient, family, system)

7. Licensure at levels of role and population foci
APRN Specialties
Focus of Practice beyond role and population focus
Linked to health care needs
Examples include but are not limited to: Oncology, Older Adults,
Orthopedics, Nephrology, Palliative Care, Emergency
POPULATION FOCI
Family/Individual
Across lifespan
Adult-
Gerontology
Women’s Health/
Gender Related
Neonatal
Pediatrics
Psych/Mental
Health
Licensure at levels of role and population foci PC
PC, AC, CC
(fetus to 2)
Lifespan
PC AC
PC AC
Nurse
Practitioner

8. What is LACE?
LACE is an acronym for the 4 elements of the consensus model:
Licensure
Accreditation
Certification
Education

9. Georgia APRN Roundtable
Convened in May 2015
APRN Associations across the state participate
All APRN Roles represented
Agreed upon legislative priorities
Organizational commitments for collaboration
Legislative training for nurses across the state
Matching of Nurses in legislative districts to begin grass-root advocacy
Working together for improved access to quality healthcare for all Georgians!

10. ONE Message…
Nurses: Working together for improved access to quality healthcare for all Georgians!

11. Transformational leadership occurs when one or more persons engage with others in such a way that leaders and followers raise one another to higher levels of motivation and morality.
Burns J  Leadership . New York, NY: Harper and Row.
(Burns, 1978)

12. Organizational Leadership
Goal: Move from Transactional to Transformational Leadership
Leaders are visible visionaries
Trust is established and strengthened
Partner organization leaders and members involved in decision making
Transparency

13. Organizational Partners
Coalition of Advanced Practice Registered Nurses (CAPRN)
United Advanced Practice Registered Nurses of Georgia (UAPRN)
Georgia Clinical Nurse Specialists (GACNS)
 Georgia Affiliate of the American College of Nurse-Midwives (GA ACNM)
National Association of Pediatric Nurse Practitioners (NAPNAP) Georgia Chapter
Georgia Nurses Association (GNA)
Georgia Association of Nurses Anesthetists (GANA)
APRN Council of Coastal Georgia
Central Georgia Advanced Practice Registered Nurses (CGAPRN)
Georgia Gerontological Advanced Practice Nurses Association (GAPNA)
Atlanta Nurse Practitioner Facebook Group
CAPRN -  Unites advanced practice nursing organizations across the state of Georgia to improve the healthcare of all Georgians through collaboration, advocacy and legislative initiatives
GACNS - Consistent with the national organization, the NACNS, Atlanta Area CNS Affiliate exists to enhance and promote the unique, high value contribution of the clinical nurse specialist to the health and well-being of individuals, families, groups, and communities, and to promote and advance the practice of nursing in the metro Atlanta Area.
UAPRN – UAPRN serves as a collective voice for all APRNS in Georgia which is dedicated to improving access to healthcare for the citizens of Georgia. We support the advancement of the APRN role by addressing and promoting legislative and practice issues, educates the public regarding advanced nursing practice, promote collaborations of all APRN organizations,
GA ACNM - The Georgia Affiliate of the American College of Nurse-Midwives is our state’s professional organization for Certified Nurse-Midwives (CNMs). Founded as a state chapter of ACNM with national roots dating back to 1929, GA ACNM sets the standard for midwifery excellence in Georgia. Our members care for women throughout their lifetimes, from contraceptive needs through pregnancy and into menopause.
NAPNAP - With more than 8,500 members, the National Association of Pediatric Nurse Practitioners (NAPNAP) is the professional association for pediatric nurse practitioners (PNPs) and all pediatric-focused advanced practice registered nurses (APRNs). Established in 1973, we are the only national organization dedicated to improving the quality of health care for infants, children and adolescents, and to advancing the APRN's role in providing that care.
Georgia Nurses Association - GNA is the state's largest professional nursing association for registered nurses in all practice settings with the purpose of uniting our profession
GANA - The Georgia Association of Nurse Anesthetists advances patient safety and CRNA practice through advocacy, education, and member engagement
APRN Council of Coastal Georgia - provides continuing education programs for nurse practitioners and advanced practice nurses of coastal Georgia, to lobby for professionally related legislative issues, to coordinate community educational efforts, and to provide professional networking opportunities.
Central Georgia Advanced Practice Registered Nurses -  addresses legislative, political, and practice issues of advanced practice registered nurses in the Central Georgia area by promoting the professional role identification of the APRNs of Central Georgia, to include education, community involvement and student support.
GAPNA - represents the interests of all advanced practice nurses who work with older adults. These advance practice nurses are active in a variety of settings across the continuum including primary, acute, post-acute and long-term care.

14. ‘The Tie That Binds’ Common thread in purpose and mission statements
Enhance and promote the APRN role
Addressing and promoting legislative and practice issues
Setting standards for practice excellence
Improving the quality of health care
Uniting our profession
Blest be the tie that binds; Our hearts in Christian love; The fellowship of kindred minds; Is like to that above. John Fawcett 1782
This hymn identifies with the struggles we face as we seek to provide care returning our patients, families, communities, etc. to optimal health and/or helping them to maintain it

15. Unification Engagement in frequent, open and honest discussions
Shared speaking engagements
Collaborative branding – “One Voice”
Coordinated outreach – clinical, academic, legislative, community
Common goals – Ensuring Optimal Healthcare for All Georgians
The need for highly effective coordination and unity of effort can possibly result in a more efficient, favorable and long sought-after outcomes. This requires and can be achieved through understanding the differences between the organizations highlighted in the subtle nuances in purpose mission and goals we have discussed.

16. Academic Support
Resource for faculty and students in all aspects of the APRN role
Presentations (live and electronic) for professional development courses
Events inclusive of Monthly Pharmaceutical Dinners, Legislative Bootcamps, Networking and Mentoring Mixers, Professional State-wide Conferences, APRN of the Day, and Member Appreciation Dinners
Legislative Updates, Initiatives and Agendas
Mentoring and Preceptor opportunities

17. APRN Legislative efforts in Ga
Prescriptive Authority Coalition
Lessons learned
Moving forward

19. Moving Forward Educate on role of APRNs Communicate Have a presence
Highlight practice
APRN Study Committee
Provide Solutions

20. APRN PANEL: CONTACT INFORMATION
Desireé Clement, MS, APRN, CNM, FNP-BC
Emory University, Nell Hodgson Woodruff School of Nursing Faculty, Specialty Program Coordinator, Dual FNP + Midwifery Programs
Factors Influencing Georgia Legislators’ Decision-making on Nurse Practitioner Scope of Practice (Vanderbilt University DNP Project completion Summer 2017)
Office:
Michelle Nelson, PhD, APRN, FNP-BC
United APRNs of Georgia, State President
Georgia State University, Byrdine F. Lewis School of Nursing & Health Professions, Faculty
Office:
Mary Jane Lewitt, PhD, APRN, CNM, FACNM
Georgia Coalition of APRNs (CAPRN), Chair
Emory University, Nell Hodgson Woodruff School of Nursing Faculty
Office:
Suzanne Staebler, DNP, APRN, NNP-BC, FAANP, FAAN
Georgia Nurses Association (GNA), APRN Director
Emory University, Nell Hodgson Woodruff School of Nursing Faculty, Specialty Program Coordinator, NNP Program
Office:

21. How Can You Support APRNs in Georgia?
Contact us to come speak at your school to students & faculty.
Encourage students & faculty to become involved by joining APRN and/or nursing professional organizations such as:
UAPRN of Georgia
GNA
Encourage support of APRN issues in Georgia by staying informed and receiving legislative updates from the grassroots organization for all APRNs:
Georgia Coalition of APRNs
Attend state-wide APRN events:
Upcoming 2ND Annual UAPRN State Conference, Atlanta, GA Sept (offering CEUs; student rates available) annual-state-conference#!info

22. REFERENCES
American Association of Nurse Practitioners [AANP]. (2017a). Georgia. Retrieved from
American Association of Nurse Practitioners [AANP]. (2017b). State practice environment [Image file]. Retrieved March 11, 2017 from regulation/state-legislation/state-practice-environment
American Association of Retired Persons [AARP]. (2010). AARP 2010 Policy supplement: Scope of practice for Advanced Practice Registered Nurses. Retrieved from
American Nurses Association [ANA]. (2016). Determining scope of practice for Advanced Practice Registered Nurses (APRNs). Retrieved from
APRN Consensus Work Group & National Council of State Boards of Nursing [NCSBN] APRN Advisory Committee. (2008). The Consensus Model for APRN Regulation: Licensure, Accreditation, Certification, Education. Retrieved from
Burns J  Leadership . New York, NY: Harper and Row.
Canfield-Davis, K., Jain, S., Wattam, D., McMurtry, J., & Johnson, M. (2010). Factors of influence on legislative decision making: A descriptive study-updated August Journal of Legal, Ethical and Regulatory Issues, 13(2), Retrieved from
Federal Trade Commission [FTC]. (2014). Policy perspectives: Competition and the regulation of advanced practice nurses. Washington, DC: Federal Trade Commission. Retrieved from
Georgia Department of Community Health. (2016). Annual report FY2016. Retrieved from
Henry J. Kaiser Family Foundation [KFF.org]. (2017). The Kaiser Family Foundation: State health facts. [Data Source]. Retrieved February 12, 2017 from
Institute of Medicine of the National Academies [IOM]. (2010). The future of nursing: Focus on scope of practice [Report Brief]. Washington, DC: National Academy of Science. Retrieved from Nursing/Nursing%20Scope%20of%20Practice%202010%20Brief.pdf

23. REFERENCES
MindingBlindspot.com. (n.d.). GA+BHPSAs.png (816 X1056) HPSA PCPs, Georgia 2014 [Image file]. Retrieved from
National Council of State Boards of Nursing [NCSBN]. (2016). Major components of the Consensus Model by state. Retrieved from
National Governors Association [NGA]. (2012). The role of nurse practitioners in meeting increasing demand for primary care. Retrieved from
Senate Research Office: State of Georgia. (2007). Final report of the Senate study committee on the shortage of doctors and nurses in Georgia. Retrieved from senate_shortage_report_2007.pdf
Sullivan-Marx, E. M. (2008). Lessons learned from advanced practice nursing payment. Policy, Politics, & Nursing Practice, 9(2), doi:
U.S. Census Bureau. (2016). Census Bureau’s March Supplement to the Current Population Survey (CPS), Quick facts: Georgia. Retrieved from
US Department of Veterans Affairs. (2016). VA proposes to grant full practice authority to Advanced Practice Registered Nurses. [News Release]. Retrieved from
Xue, Y., Ye, Z., Brewer, C., & Spetz, J. (2016). Impact of state nurse practitioner scope-of-practice regulation on health care delivery: Systematic review.  Nursing Outlook, 64(1), doi: /j.outlook