Respond too two peers  in 150-200 words  each with source/citation 
Peer 1 post 
niki post 
 
Factors Supporting the Development of the Advanced Nursing Practice Role
Several factors supported the development of the advanced nursing practice role. A primary driver was the shortage of physicians, especially in primary care and underserved communities, which created a need for qualified healthcare providers capable of delivering comprehensive care. Additionally, the rising prevalence of chronic diseases such as diabetes and cardiovascular disease increased demand for providers skilled in long-term disease management, health promotion, and patient education. Advancements in graduate nursing education strengthened the professionâ€s scientific and clinical foundation, allowing nurses to expand their scope of practice safely. Furthermore, policy changes and reimbursement recognition by Medicare and Medicaid legitimized the NP role and facilitated its integration into the healthcare system.
Barriers to Advanced Nursing Practice
Despite strong evidence supporting advanced nursing practice, multiple barriers remain. Restricted scope-of-practice laws, which vary by state, limit full practice authority for NPs and can reduce access to care. Role confusion and resistance from other healthcare professionals may hinder collaboration and optimal role utilization. In addition, institutional barriers, such as restrictive credentialing policies and inconsistent reimbursement structures, can limit practice autonomy. These barriers highlight the need for continued legislative advocacy, education, and interprofessional collaboration to ensure advanced practice nurses are utilized to the full extent of their education and training.
The National Organization of Nurse Practitioner Faculties (NONPF) competencies provide a comprehensive framework for NP practice. These competencies include domains such as Scientific Foundations, Leadership, Quality, Practice Inquiry, Technology and Information Literacy, Policy, Health Delivery Systems, Ethics, and Independent Practice. Together, they emphasize advanced clinical reasoning, evidence-based practice, leadership, and advocacy, ensuring NPs are prepared to provide high-quality care while contributing to healthcare system improvement.
One competency area in which I excel is Independent Practice. My background as a Registered Nurse in outpatient and community-based settings has strengthened my skills in comprehensive assessment, clinical judgment, and patient education. I am confident in building therapeutic relationships and providing culturally sensitive, patient-centered care.
An area for growth is the Policy competency. While I understand how healthcare policy impacts practice and patient outcomes, I have limited experience with direct policy advocacy or legislative involvement. As I advance in my role, I plan to engage in professional organizations and advocacy initiatives to strengthen my influence on policy decisions affecting advanced nursing practice
 
PEER 2 Amanda  post 
 Amanda Bairos 
Week 2 Discussion
NR581NP-17556
One of the factors that  supported the development of the advanced nursing practice role was influenced by changes in healthcare delivery, population needs, and physician shortages. One of the primary reasons was limited access to healthcare providers, especially in rural and underserved communities. This showed the need for nurses with advanced education was needed to meet growing healthcare demands (Denisco, 2023). 
Despite the growth of advanced nursing practice, several barriers continue to impact role. One major barrier is the difference in state scope of practice. Differences in licensing, authority, and practice autonomy limit the ability of advanced practice registered nurses to practice to the full extent of their education. Some of these regulatory restrictions create inconsistencies in care across states and reduce access to healthcare, particularly in rural and underserved areas (Hamric et al., 2019). Restrictive scope of practice laws have been shown to limit healthcare capability and contribute to provider shortages (Institute of Medicine [IOM], 2011).
One competency area in which I excel is Independent Practice. I have strength in clinical decision making, comprehensive patient assessment, and the application of evidence based interventions as I do this daily in my practice. My nursing background has strengthened my ability to communicate effectively with patients, develop individualized plans of care in aesthetic medicine, and advocate for patient-centered outcomes based on their aesthetic goals. These skills align with the National Organization of Nurse Practitioner Faculties core competencies, which emphasize independent clinical judgment, accountability, and leadership in patient care delivery (NONPF, 2022).
A competency area in which I need growth in is Health Policy and Leadership. While I understand the importance of healthcare policy in shaping advanced nursing practice, I need to develop my skills in advocacy and legislative engagement. Advanced practice nurses play a critical role in influencing health policy and improving the healthcare system and yet many report limited preparation or confidence in this area (Hamric et al., 2019). Growing my knowledge of policy development  will enhance my ability to influence practice environments, and contribute to healthcare reform especially in aesthetic practices. 
 
References:
DeNisco, S. M., & Barker, A. M. (2023). Advanced practice nursing: Essential knowledge for the profession (5th ed.). Jones & Bartlett Learning.
Hamric, A. B., Hanson, C. M., Tracy, M. F., & Oâ€Grady, E. T. (2019). Advanced practice nursing: An integrative approach (5th ed.). Elsevier.
Institute of Medicine. (2011). The future of nursing: Leading change, advancing health. National Academies Press. https://doi.org/10.17226/12956Links to an external site.
National Organization of Nurse Practitioner Faculties. (2022). Nurse practitioner role core competencies. https://www.
 

Application of Course Knowledge: Review the history of the advanced nursing practice role and answer all questions/criteria with explanations and detail.

 

Describe factors that supported the development of the advanced nursing practice role.
Analyze barriers to advanced nursing practice.
Examine either the American Association of Colleges of Nursing Essentials (AACN) or role-specific competencies related to your advanced practice role (e.g., National Organization of Nurse Practitioner Faculties (NONPF), National League for Nursing (NLN), American Organization for Nursing Leadership (AONL), or Public Health Foundation (PHF).
Discuss one domain or competency area in which you excel and one in which you have growth opportunities.

Engagement in Meaningful Dialogue: Engage peers by asking questions, and offering new insights, applications, perspectives, information, or implications for practice:

 

Respond to at least one peer.
Respond to a second peer post.
Communicate using respectful, collegial language and terminology appropriate to advanced nursing practice.

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