Review your problem or issue and the study materials to formulate a PICOT question for your capstone project change proposal. A PICOT question starts with a designated patient population in a particular clinical area and identifies clinical problems or issues that arise from clinical care. The intervention used to address the problem must be a nursing practice intervention. Include a comparison of the nursing intervention to a patient population not currently receiving the nursing intervention, and specify the timeframe needed to implement the change process.  Formulate a PICOT question using the PICOT format (provided in the assigned readings) that addresses the clinical nursing problem.

The PICOT question will provide a framework for your capstone project change proposal.

In a paper of 500-750 words, clearly identify the clinical problem and how it can result in a positive patient outcome.

Describe the problem in the PICOT question as it relates to the following:

1. Evidence-based solution
2. Nursing intervention
3. Patient care
4. Health care agency
5. Nursing practice

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. 

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Purpose 

The purpose of this assignment is to identify the scope of practice in one’s state including level of independence of practice, prescribing authority, any limitations of practice, process for obtaining licensure in your state, certification and education requirements for licensure.  Next, students will discuss how the level of independence of practice in their state, i.e., reduced, restricted or full practice, affects patient’s access to care in their local community.  

Activity Learning Outcomes 

Through this discussion, the student will demonstrate the ability to: 

1. Understand NP practice as defined by law (CO2) 
2. Determine legislation as defined by legislation, statutes and regulations (CO2) 
3. Identify barriers to ensuring patient’s rights (CO3) 

Requirements: 

1. Discuss your state NP community in terms of scope of practice. Include the your state’s scope of practice for NPs including: 
   • Level of independence of practice **In California, NPs are required to practice under Standardized Procedure Guidelines. If CA is your intended practice state, please provide details on how Standardized Procedures Guidelines are developed in California and an example of a California SPG.
   • Prescribing authority 
   • Any limitations of practice 
   • Process for obtaining licensure in your state 
   • Certification and education requirements for licensure. 
2. If you live in a restricted or reduced practice state, how has patient care been impacted in your local community from these barriers?  For instance, is the ED used for primary care?  Are the EDs overcrowded with long wait times?  Are there urgent care clinics readily available? Is there adequate access to primary care?  If you live in a full practice, how has independent practice of the APN resulted in improved patient access to healthcare?   
3. How does access to NPs impacts any healthcare disparities? 
4. A scholarly resource must be used for EACH discussion question each week.

DISCUSSION CONTENT 

Scope of practice and NP requirements : Provides relevant evidence of scholarly inquiry of their state’s NP scope of practice. Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion. 

Practice barriers and access to healthcare: Provides relevant evidence of scholarly inquiry of whether their state is a reduced, restricted or full practice state and the impact on the local community with respect to healthcare access. Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion. 

Healthcare disparities: Provides relevant evidence of scholarly inquiry of how access to NPs impacts healthcare disparities. Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion.