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Advanced Practice Registered Nursing Scope of Practice

December 9, 2020
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WRITTEN BY Joshua Mueller

Advanced practice registered nurses (APRNs) are nurses with advanced degrees who practice as certified nurse practitioners, certified nurse midwives, certified registered nurse anesthetists, or certified clinical nurse specialists. APRNs in these roles are often primary care providers and can provide acute, gynecological, and pain management care.

In each state, scope of practice (SOP) laws determine which procedures and treatments APRNs may administer. In Missouri, APRNs are required to enter into collaborative practice arrangements (CPAs) with a physician to prescribe, administer, and dispense medications, examine and evaluate patients, and formulate treatment plans. There are about 12,500 APRNs (including 10,000 nurse practitioners) in Missouri, but these restrictions may contribute to healthcare provider shortages in the state, particularly in rural and underserved areas.

HB 84 would modify CPAs in Missouri such that they would only apply to controlled substance prescriptive authority, allowing APRNs to provide healthcare services independent of direct physician oversight.

This bill would also eliminate several regulations surrounding CPAs, including limits on the number of APRNs that may enter into a CPA with a physician, geographic proximity requirements, and requirements that the physician review the services provided by the APRN.

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