Advanced Practice Nursing (APN) capacity to offer direct access to patients and practice to the full extent of their education and clinical competence is limited by a slew of legal, regulatory, and insurance reimbursement constraints. APNs are only permitted to administer drugs if they are part of a documented collaborative protocol developed in collaboration with and authorized by collaborating doctors (Schober et al., 2020). In 1991, the provision for the Joint Protocol was introduced to the original New Jersey Advanced Activity Nurses Act. (It should be noted that federal restrictions, particularly those related to Medicare funding, also limit APN practice.)
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