NP Prescriptive Privilege.edited

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Nov 24, 2024

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1 NP Prescriptive Privilege Problem One major problem with NP prescriptive privilege in my field of work as a healthcare professional is the constraints and limitations that some regulatory frameworks place on nurse practitioners. Even though NPs get extensive education and training, they may need more than bureaucratic red tape or out-of-date regulations to exercise their prescriptive authority. In addition to impeding the full use of NPs' knowledge and abilities, this problem needs to be revised on the possibility of effective, patient-centered care delivery (Zhang & Patel, 2022). NPs are increasingly valued for their holistic approach to patient care, which includes illness prevention and promotion. Therefore, any restrictions on their prescriptive privilege limit their ability to meet patients' requirements fully. Furthermore, in regulatory frameworks that predominantly reflect a medical paradigm, the unique emphasis on nursing principles and patient-centered care that NPs contribute to the healthcare environment may be devalued (Zhang & Patel, 2022). To maximize the contribution of nurse practitioners to the healthcare system and guarantee that they can fully contribute to the well-being of their patients, these limits on NP prescriptive privilege must be addressed and corrected. This could entail promoting policy modifications that correspond with the changing nature of NP practice and highlighting the unique advantages they offer the medical team. Theories Health Promotion Model (HPM) Nursing theorist Nola Pender created the Health Promotion Model (HPM), a comprehensive framework considering various environmental and individual factors to promote health and prevent sickness. The fundamental principles of the HPM are that interpersonal,

2 situational, cognitive-perceptual, and personal experiences all impact health-promoting behaviors (Turner & Reed, 2023). Essential elements of the model involve individual traits and experiences, which include things like self-efficacy, past relevant behaviors, and perceived advantages and obstacles to action. The HPM also recognizes the influence of moderating variables on health habits, including sociocultural and demographic factors. According to the model, people are more likely to participate in health-promoting behaviors if they think their actions will have a positive impact, see few obstacles in their way, have self-efficacy—the belief that they can act—and if the behavior is consistent with their values and prior experiences (Turner & Reed, 2023). The Health Promotion Model is especially pertinent to nursing practice because it offers a systematic framework for comprehending the complex relationships between health behaviors and informs treatments meant to prevent and promote illness in various populations. Theory of Planned Conduct (TPB) Icek Ajzen's Theory of Planned Conduct (TPB) is a psychological model that explains how intention shapes conduct and how subjective norms, individual attitudes, and perceived behavioral control shape behavior. Fundamentally, the Theory of Planned Behavior holds that a person's desire to carry out a particular behavior precedes that behavior directly (La Barbera & Ajzen, 2020). Three main elements are included in the model: the individual's confidence in their ability to do the behavior, attitudes toward the behavior, and subjective norms reflecting societal and interpersonal influences. How these elements interact determines the degree to which someone intends to carry out an activity. Crucially, the TPB recognizes that these dimensions can be impacted by outside variables like social and environmental effects (La Barbera & Ajzen, 2020). This theory is especially pertinent to investigating how attitudes, social norms, and

3 perceived control influence decisions about extending prescriptive privileges for Nurse Practitioners in healthcare settings because it has been widely used in health-related contexts to understand and predict behaviors. How Theories are Applicable to the Problem The Health Promotion Model (HPM) examines essential variables such as personal traits, perceived advantages and disadvantages, self-efficacy, and sociocultural influences that impact acceptance of nurse practitioners' prescriptive privileges. The HPM provides a sophisticated perspective in comprehending the complications surrounding the expansion of NP prescriptive authority (LaMorte, 2022). It highlights the unique traits and backgrounds of medical professionals, patients, and legislators participating in decision-making. Through the lens of the HPM, the perceived advantages and obstacles to allowing NPs broader prescribing authority can be evaluated, providing insight into the variables affecting change adoption or resistance. Furthermore, the model's emphasis on self-efficacy is relevant because it acknowledges the significance of healthcare professionals' assurance in carrying out the behavior—in this case, promoting increased prescriptive authority. Furthermore, the HPM considers modifying variables, such as socio-cultural elements, that align with healthcare systems' various contexts (Hyer, 2019). Through the HPM, stakeholders can understand the personal and environmental factors that impact NPs' decisions to accept or reject increased prescriptive rights. This understanding can be used to design customized interventions to foster patient-centered and holistic care. Additionally, the Theory of Planned Behavior (TPB), which considers attitudes, subjective norms, and perceived control, sheds light on the psychological elements influencing support or opposition to the extension of Nurse Practitioners' prescriptive privileges. The TPB

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4 provides insightful information about the variables influencing support or resistance to extending NP prescriptive authority in healthcare decision-making (Bella, 2021). It highlights how one's intention to support or oppose the expansion is shaped by their attitudes toward the behavior (in this case, supporting or opposing NP prescriptive privileges), subjective norms (like perceived social and professional pressures to conform), and perceived behavioral control (reflecting confidence in endorsing the change). Through an analysis of these elements within the context of the TPB framework, interested parties can thoroughly comprehend the psychological factors that influence the decision-making process concerning NP prescriptive privileges (Bella, 2021). This theory directs actions meant to improve acceptance and execution of increased prescriptive authority for Nurse Practitioners in the healthcare system by addressing perceived behavioral control, changing subjective norms, and cultivating positive attitudes. Differences HPM considers individual traits, self-efficacy, and modifying variables, while TPB emphasizes cognitive determinants such as attitudes, subjective norms, and perceived behavioral control. The holistic approach of Nola Pender's HPM idea considers self-efficacy, individual traits, moderating factors, and perceptions of benefits and limitations (Gonzalo, 2023). Because of its broader focus, HPM can encompass a wide range of factors that go beyond cognitive determinants. Conversely, Icek Ajzen's TPB emphasizes cognitive aspects, highlighting attitudes, subjective standards, and perceived behavioral control. By focusing on these psychological concepts, TPB offers a more focused and efficient examination of intention and ensuing behavior (Chen & Hsieh, 2021). Although HPM is flexible and valuable in various healthcare settings, TPB excels at anticipating and guiding actions in which cognitive factors are crucial. Depending on the research or intervention goals, one may choose between the two theories: HPM offers a

5 more comprehensive perspective. In contrast, TPB provides a more targeted understanding of cognitive determinants in situations like accepting or rejecting Nurse Practitioners' prescriptive privileges in healthcare. Similarities The HPM and TPB share fundamental similarities in their aim to understand and predict health-related behaviors comprehensively. Both views, which acknowledge the critical role of personal beliefs, attitudes, and perceptions in determining behavior, are based on psychological frameworks. They agree on the importance of subjective norms and emphasize the social and interpersonal aspects that play a role in the processes involved in making decisions about health- related activities. Furthermore, both models highlight the importance of personal intention to determine actual conduct, stressing the influence of attitudes and beliefs on these intentions. While TPB focuses more intently on cognitive determinants like perceived behavioral control and HPM more broadly on factors like self-efficacy and modifying variables, their shared emphasis on psychological determinants makes them complementary in offering a comprehensive understanding of the intricate interplay of factors influencing health-related decisions (Chen & Hsieh, 2021). These theories work together to provide a more complex understanding of the psychological processes behind health habits, which is helpful information for academics, legislators, and healthcare providers. How the Theories Impact Advanced Nursing Role The Theory of Planned Behavior (TPB) and the Health Promotion Model (HPM) offer robust theoretical frameworks that direct and educate nursing practice in various healthcare settings, substantially impacting the advanced nursing role. Equipped with a broader range of expertise, advanced practice nurses can thoughtfully incorporate the HPM's tenets into their

6 patient care strategies (Miller, 2020). The proactive role of advanced practice nurses is well aligned with this approach, which places a heavy emphasis on promoting health and preventing sickness. These nurses can customize interventions to each patient's needs by considering individual features, modifying variables, and self-efficacy. This allows for a more thorough and individualized approach to patient care. For instance, when it comes to NPs' prescription rights, the HPM can help NPs navigate patients' attitudes, beliefs, and perceptions around medication adherence, ultimately leading to improved patient outcomes. Similarly, the TPB is beneficial in defining the function of advanced nursing, especially for those in leadership and teaching roles. By offering insightful information about the cognitive factors influencing health-related decision-making, this theory enables advanced practice nurses to create focused treatments and instructional initiatives. Advanced practice nurses can foster a more knowledgeable and cooperative healthcare environment by comprehending and resolving the attitudes, subjective norms, and perceived behavioral control of both patients and healthcare staff (Wang, Liu, Zhao, Xiao, & Peng, 2021). Using TPB concepts in the context of NP prescription privileges enables a more nuanced knowledge of the perspectives held by doctors, regulatory agencies, and patients, allowing APRNs to negotiate and participate in the changing healthcare decision-making environment. Ultimately, by offering frameworks that support patient-centered, evidence-based, and culturally sensitive care, the HPM and TPB strengthen the advanced nursing role by enabling advanced practice nurses to successfully navigate the complex dynamics of healthcare decision-making and encourage positive behavior change.

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7 References Bella, W. F. (2021). Factors Determining the Behavioral Intention to Use a Web-Based Appointment System: An Application of the Theory of Planned Behavior (TPB) - ProQuest. Retrieved November 24, 2023, from www.proquest.com website: https://www.proquest.com/openview/0fa96212851713acaedd48828820727e/1?pq- origsite=gscholar&cbl=18750&diss=y Chen, H.-H., & Hsieh, P.-L. (2021). Applying the Pender’s Health Promotion Model to Identify the Factors Related to Older Adults’ Participation in Community-Based Health Promotion Activities. International Journal of Environmental Research and Public Health , 18 (19), 9985. https://doi.org/10.3390/ijerph18199985 Gonzalo, A. (2023, July 2). Nola Pender: Health Promotion Model (Nursing et al.). Retrieved from Nurseslabs website: https://nurseslabs.com/nola-pender-health-promotion-model/ Hyer, S. (2019). Factors Influencing Nurse Practitioners’ Weight Management Factors Influencing Nurse Practitioners’ Weight Management Practices in Primary Care Practices in Primary Care . Retrieved from https://stars.library.ucf.edu/cgi/viewcontent.cgi?article=7510&context=etd La Barbera, F., & Ajzen, I. (2020). Control interactions in the theory of planned behavior: Rethinking the role of subjective norm. Europe’s Journal of Psychology , 16 (3), 406–411. https://doi.org/10.5964/ejop.v16i3.2056 LaMorte, W. (2022, November 3). The Health Belief Model. Retrieved from Boston University School of Public Health website: https://sphweb.bumc.bu.edu/otlt/MPH- Modules/SB/BehavioralChangeTheories/BehavioralChangeTheories2.html Miller, P. (2020). Surgical Palliative Care—Where Are We in 2020? The American Surgeon , 86 (11), 1436–1440. https://doi.org/10.1177/0003134820965951

8 Turner, A. R., & Reed, S. M. (2023). Theory Analysis: The Health Promotion Model and Motivation in Physical Activity. Research and Theory for Nursing Practice , RTNP–2022-0085.R1. https://doi.org/10.1891/RTNP-2022-0085 Wang, J., Liu, W., Zhao, Q., Xiao, M., & Peng, D. (2021). An Application of the Theory of Planned Behavior to Predict the Intention and Practice of Nursing Staff Toward Physical Restraint Use in Long-Term Care Facilities: Structural Equation Modeling. Psychology Research and Behavior Management , Volume 14 , 275–287. https://doi.org/10.2147/prbm.s293759 Zhang, P., & Patel, P. (2022, September 19). Practitioners and prescriptive authority. Retrieved from PubMed website: https://www.ncbi.nlm.nih.gov/books/NBK574557/

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