The Effect of Supervision Waivers on Practice Paper

The Effect of Supervision Waivers on Practice Paper

The Effect of Supervision Waivers on Practice Paper

The main objective of the article was to investigate the effects that temporarily waived state practice limitations have on nursing practitioners as well as their perception concerning how beneficial or not beneficial the above limitation/restriction waiver was at the initial surge of the Coronavirus pandemic in Massachusetts. The outcome of this research shows that temporarily waived state practice restrictions increase the performance of nurse practitioners to some extent. There was a significant improvement in practices. In other words, there was increased efficiency in the management of various healthcare practices among nursing practitioners. Overall, nursing practitioners remarked that the suspension of the colocation requirements, supervision costs, and extra physician signatures on pharmaceutical orders had improved the delivery of treatment.

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Strength and Weaknesses

The strengths of the study lie in its application of ethical principles to research. However, the weakness is based on the limited time needed to undertake research projects properly. Nonetheless, this study provides an excellent starting point for future research in this area. Furthermore, it suggests possible solutions to some of the key challenges facing researchers when conducting ethical research. Another strength of the study lies on the design and the methodology that have been used. There are a few key reasons why the strengths of this study lie in its design and data collection processes. First, the study was designed to be effective and efficient, with a clear research question and hypothesis. Second, the data collection process was well-thought-out and executed flawlessly. third, the data analysis was conducted using sophisticated methods that yielded valid and reliable results. Combined, these three factors resulted in a study that provides valuable insights into the topic at hand.

Remarks

The outcome of the study clearly addresses the objectives stated in the introduction. However, there is the need for the incorporation of mix method design to enhance the accuracy of outcomes. There are a few reasons why using a mixed-methods research design can enhance the accuracy of your findings. First, by using both qualitative and quantitative approaches, researcher can triangulate data and cross-check the results for reliability (Manzoor, 2020).). This helps to ensure that any conclusions drawn are based on robust evidence. Second, using a mix of methods allows one to collect data from multiple sources and perspectives. This can provide a more comprehensive understanding of the issue at hand than would be possible with just one method alone.

Reference

Manzoor, A. (2020). Designs of mixed method research. In Cognitive Analytics: Concepts, Methodologies, Tools, and Applications (pp. 95-121). IGI Global. https://www.igi-global.com/chapter/designs-of-mixed-method-research/252022

The Effect of Supervision Waivers on Practice

Description of the purpose

The purpose of this article was to determine the impact temporarily waived state practice restrictions has on NPs and their perception regarding how beneficial or not beneficial this restriction waiver was during the initial surge of COVID-19 pandemic in Massachusetts

Explanation of research design

Research design was done using 391 NPs who participated in this research. This research was a web-based survey of Massachusetts NPs conducted in May and June 2020 using mixed methods of descriptive analysis. The survey included ten open and closed questions aimed at NP specialty, clinical setting, changes in employment, working hours related to pandemic.

Discussion of sample included respondents

Sample composition in the clinical setting during the pandemic included primary care/ ambulatory care, acute inpatient care, telehealth, COVID-19 field hospitals or testing sites, home and community-based care, post-acute care, women’s health, adult-gerontology, unemployed, and others. These respondents were asked if the waiver improved their clinical work during the time this research was done.

Description of data collection methods

Data collection methods was done using an email invitation survey that was sent to the list of distribution of the Massachusetts Coalition of Nurse Practitioners which is advocacy organization with focus on continuing education, practice support, and legislative representation for NPs. The list included members and non-members of MCNPs who participated in past unknown study and may still have eligibility such as retired, students, and those in academics. Eligibility focused on NPs who currently are clinically active. Invitations were sent out via email to 958 NPs, 413 respondents consented, nine ineligibles, and thirteen were blank which left the total number of participants to be 391. Respondents were asked “Do you believe the waiver of supervision requirements has enabled you to improve your clinical work?” Panel of NPs and survey experts from Boston College and other school of nurses reviewed the survey questions.

Summary of findings

Results showed that 25% of respondents acknowledged that the physician’s waiver improved their work as NPs. The NPs that mentioned having improvements in their practice described seeing a positive with being able to practice with the incentives of not having to feel out administrative chart logs explaining the cares the provided and being liberal to conduct their own care without physicians hovering around them. They mentioned improvement in care delivery because of the suspension requirements related to colocation, fees for supervision, and additional physician signatures on medication orders. The rest of the respondents believed that having the waiver did not improve their work as NPs and had no problems practicing under a physician who kept tract of the care they provided.

Strengths of the study (minimum of 1)

This study showed that the waiver overtime can improve the care that NPs provide by giving them more time to work with supervision by a physician. This study highlighted that psychiatric mental health NPs had a higher improvement in the care the provided due to this waiver. This was attributed to the high demand for mental health treatment during the COVID-19 pandemic and the small proportion of physicians available to supervise psychiatric NPs in their practice.

Limitations of the study (minimum of 1)

The study was limited by the timing of the survey and the temporal nature of the waiver which impacted the results. Limitations on this study also stems from the fact that some of the respondents were not properly surveyed because of the burden it would have added as they were on the frontlines of care during the pandemic. The brief survey made it difficult to collect different important fact which may impact the NPs perception of being able to practice with a temporal waiver. Some of these factors are size of practice, composition of provider, colocation of supervising physician, region of practice, practice provider, rurality, care complexity, NP level of experience, degree type etc.

Recommendations regarding potential application for future practice that are insightful and appropriate.

Recommendations for future practice will be to implement another waiver that can measured where NPs are practicing outside of the pandemic or in situation where surveys can be appropriately conducted without adding extra burden or stress to the work that NPs are doing in the practice. Longer waivers and more incentives such as adding more pay to what the NP receives can improve the willingness for NPs to practice in rural America and to provide more care that will shorten the gap in healthcare disparity in rural America in comparison to urban America.

Reference

O’Reilly-Jacob, M., & Perloff, J. (2021). The Effect of Supervision Waivers on Practice: A Survey of Massachusetts Nurse Practitioners During the COVID-19 Pandemic. Medical care, 59(4), 283–287. https://doi.org/10.1097/MLR.0000000000001486

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The Effect of Supervision Waivers on Practice

Description of the purpose

The purpose of this article was to determine the impact temporarily waived state practice restrictions has on NPs and their perception regarding how beneficial or not beneficial this restriction waiver was during the initial surge of COVID-19 pandemic in Massachusetts

Explanation of research design

Research design was done using 391 NPs who participated in this research. This research was a web-based survey of Massachusetts NPs conducted in May and June 2020 using mixed methods of descriptive analysis. The survey included ten open and closed questions aimed at NP specialty, clinical setting, changes in employment, working hours related to pandemic.

Discussion of sample included respondents

Sample composition in the clinical setting during the pandemic included primary care/ ambulatory care, acute inpatient care, telehealth, COVID-19 field hospitals or testing sites, home and community-based care, post-acute care, women’s health, adult-gerontology, unemployed, and others. These respondents were asked if the waiver improved their clinical work during the time this research was done.

Description of data collection methods

Data collection methods was done using an email invitation survey that was sent to the list of distribution of the Massachusetts Coalition of Nurse Practitioners which is advocacy organization with focus on continuing education, practice support, and legislative representation for NPs. The list included members and non-members of MCNPs who participated in past unknown study and may still have eligibility such as retired, students, and those in academics. Eligibility focused on NPs who currently are clinically active. Invitations were sent out via email to 958 NPs, 413 respondents consented, nine ineligibles, and thirteen were blank which left the total number of participants to be 391. Respondents were asked “Do you believe the waiver of supervision requirements has enabled you to improve your clinical work?” Panel of NPs and survey experts from Boston College and other school of nurses reviewed the survey questions.

Summary of findings

Results showed that 25% of respondents acknowledged that the physician’s waiver improved their work as NPs. The NPs that mentioned having improvements in their practice described seeing a positive with being able to practice with the incentives of not having to feel out administrative chart logs explaining the cares the provided and being liberal to conduct their own care without physicians hovering around them. They mentioned improvement in care delivery because of the suspension requirements related to colocation, fees for supervision, and additional physician signatures on medication orders. The rest of the respondents believed that having the waiver did not improve their work as NPs and had no problems practicing under a physician who kept tract of the care they provided.

Strengths of the study (minimum of 1)

This study showed that the waiver overtime can improve the care that NPs provide by giving them more time to work with supervision by a physician. This study highlighted that psychiatric mental health NPs had a higher improvement in the care the provided due to this waiver. This was attributed to the high demand for mental health treatment during the COVID-19 pandemic and the small proportion of physicians available to supervise psychiatric NPs in their practice.

Limitations of the study (minimum of 1)

The study was limited by the timing of the survey and the temporal nature of the waiver which impacted the results. Limitations on this study also stems from the fact that some of the respondents were not properly surveyed because of the burden it would have added as they were on the frontlines of care during the pandemic. The brief survey made it difficult to collect different important fact which may impact the NPs perception of being able to practice with a temporal waiver. Some of these factors are size of practice, composition of provider, colocation of supervising physician, region of practice, practice provider, rurality, care complexity, NP level of experience, degree type etc.

Recommendations regarding potential application for future practice that are insightful and appropriate.

Recommendations for future practice will be to implement another waiver that can measured where NPs are practicing outside of the pandemic or in situation where surveys can be appropriately conducted without adding extra burden or stress to the work that NPs are doing in the practice. Longer waivers and more incentives such as adding more pay to what the NP receives can improve the willingness for NPs to practice in rural America and to provide more care that will shorten the gap in healthcare disparity in rural America in comparison to urban America.

Reference

O’Reilly-Jacob, M., & Perloff, J. (2021). The Effect of Supervision Waivers on Practice: A Survey of Massachusetts Nurse Practitioners During the COVID-19 Pandemic. Medical care, 59(4), 283–287. https://doi.org/10.1097/MLR.0000000000001486

mlr-59-283.pdf