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首页> 外文期刊>Journal of midwifery & women's health >Expansion of nursing practice into primary care continues to generate controversy despite institute of medicine support
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Expansion of nursing practice into primary care continues to generate controversy despite institute of medicine support

机译：尽管有医学方面的支持，将护理实践扩展到基层医疗仍引起争议

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Three articles published in a recent issue of the New England Journal of Medicine (NEJM) examine the expansion of nurse practitioner practice into primary care. Beginning in 2014, sweeping changes anticipated as a result of the Affordable Care Act and its associated mandate to provide health insurance coverage for an estimated 15 million Americans by 2014 and 35 million by 20161 will stress a health care system already grappling with an acute shortage of primary care providers. Despite support from the Institute of Medicine (IOM)~2 and the Robert Wood Johnson Foundation (RWJF),~3 nurse and physician leaders, professional organizations, and policy makers continue to debate and disagree over the role and scope of practice of advanced practice registered nurses (APRNs), which include nurse practitioners (NPs), certified nurse-midwives (CNMs), certified registered nurse anesthetists (CRNAs), and clinical nurse specialists (CNSs). Though the role of CNMs is not specifically addressed in these NEJM articles, nurse-midwifery is regulated by boards of nursing as advanced practice nursing in many states. Thus, it remains imperative for CNMs to engage in discussions about scope of practice at the state and national levels.
机译：在最近一期的《新英格兰医学杂志》（NEJM）上发表的三篇文章探讨了护士执业实践向初级保健的扩展。从2014年开始，由于《平价医疗法案》及其相关授权（预计到2014年为1500万美国人提供医疗保险）和到20161年为3500万美国人提供医疗保险的相关任务，预计将发生巨大变化，这将使已经陷入严重短缺的医疗体系陷入困境初级保健提供者。尽管获得了医学研究所（IOM）〜2和罗伯特伍德·约翰逊基金会（RWJF）的支持，但〜3护士和医师领导，专业组织和决策者仍在就高级实践的作用和范围进行辩论和意见分歧注册护士（APRN），其中包括执业护士（NP），注册护士助产士（CNM），注册护士麻醉师（CRNA）和临床护士专家（CNS）。尽管在这些NEJM文章中并未具体论述CNM的作用，但在许多州，护士护理是由护理委员会管理的高级实践护理。因此，CNM必须在州和国家两级参与有关实践范围的讨论。

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