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November 09, 2016

Veterans Affairs Proposed Rule for Advanced Practice Registered Nurses in the Operating RoomA Step Forward or Overstepping?

Author Affiliations
  • 1Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
  • 2Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas
JAMA Surg. Published online November 9, 2016. doi:10.1001/jamasurg.2016.3996

There continue to be ongoing, system-wide changes at Veterans Affairs (VA) medical centers in an effort to address recent issues with wait times and the health care needs of our nation’s veterans. In 2001, the Centers for Medicare and Medicaid Services finalized a rule allowing states the authority to decide whether certified registered nurse anesthetists (CRNAs) require physician supervision or to “opt out” and allow them to practice independently.1 In May 2016, a similar proposed rule was released by the VA to permit full practice authority for advanced practice registered nurses (APRNs)—meaning APRNs would be able to provide health care services within their scope of practice without physician oversight.2 The proposed rule would apply to all types of APRNs, including certified nurse practitioners, CRNAs, clinical nurse specialists, and (possibly in the future) certified nurse midwives.

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