State policy change and organizational response: Expansion of nurse practitioner scope of practice regulations in New York State

Abstract

Background: In January of 2015, New York (NY) implemented a new policy, Nurse Practitioners Modernization Act, which removed the required written practice agreement between physicians and experienced nurse practitioners (NPs).

Purpose: We examined NP work environment in NY before (2012) and after (2018) the implementation of the new policy.

Methods: Cross-sectional survey data on work environments were collected from NPs in NY in 2012 and 2018. Work environment was measured with the Nurse Practitioner Primary Care Organizational Climate Questionnaire. In 2012, 278 and in 2018, 348 NPs completed the tool. Regression analyses were used to examine the relationship between the study year and work environment.

Findings: Controlling for individual and organizational characteristics, NPs reported significantly better work environments in 2018. Positive changes were observed both for experienced and less experienced NPs.

Discussion: Removing state-level policy restrictions on NPs may promote a better work environment within health care organizations.

Keywords: Nurse practitioner; Organizational climate; Primary care; Scope of practice; State policy change; Work environment.