Implementing Evidence-Based Health Policy: A Focus on Pennsylvania’s Nurse Practitioner Full Practice Authority Legislation

Abstract

Background: The ability of nurse practitioners to practice to the full scope of their education and training would improve access to healthcare for Pennsylvania's patients. Previous attempts to gain full practice authority in Pennsylvania have been unsuccessful. Evidence-based health policy principles including; use of a strong unified voice, clear, concise messaging, health policy knowledge, strong relationships with legislators, coalitions of stakeholders, and utilization of the media and research, have been shown to have a significant impact on policy change initiatives. The purpose of this scholarly project was to implement evidence-based health policy tools during the reintroduction of Pennsylvania's nurse practitioner (NP) full practice authority bill. Methods: Using evidence-based health policy principles as a framework, policy strategies were developed. To create a unified message, an evidence-based health policy campaign manual and presentation was developed for the 18 regions of the Pennsylvania Coalition of Nurse Practitioners (PCNP). The manual included the following items: copies of the talking points, roles of the regional representatives, sample letters to legislators, and contact information for the regional representatives and campaign committee. A presentation explaining the legislation, talking points and evidence-based health policy advocacy was prepared and delivered by the regional representatives during the February to April 2015 regional meetings. Nurse practitioners were individually encouraged to meet with their district legislators to increase bill sponsorship and eventually a favorable vote. Talking points were provided to NPs to use during these visits or during phone calls. Draft letters were distributed to NPs that they could hand write or email legislators. As a grassroots movement, members were encouraged to attend the PCNP's Lobby Day to advocate for Pennsylvania's full-practice authority bill on May 12, 2015. Results: The presentation and manual was delivered to 16 regional groups with a total of 547 NP attendees. At introduction on March 9th, House bill 765 had 20 co-sponsors, expanding to 36 cosponsors after Lobby Day. Within the Senate, there were 20 co-sponsors of Senate bill 717 when it was introduced by Senator Vance on April 10th, increasing to 21 co-sponsors after Lobby Day. A total of 227 NPs and students attended Lobby Day. Six coalitions were established: one nursing organization, three community groups, and two healthcare organizations. Discussion: As the Pennsylvania full practice authority bill progresses, evidence-based health policy strategies should continue to be the foundation of the campaign. These strategies supported increased participation in health policy and legislator sponsorship of the bills during this campaign. The strategic plan must include knowledge dissemination to nurse practitioners. NPs are the front-line infantry in this legislative battle and must become more comfortable in the legislative arena. Grassroots strategies and establishing a unified, consistent voice is critical. All of these strategies can be intertwined into other states campaigns for nurse practitioner full practice authority.