Should the State of Utah Adopt the APRN Compact?

Providing healthcare to underserved and rural communities is a challenge. Solutions to this challenge include the use of technology and the inclusion of advanced practice registered nurses (APRNs). Ongoing research shows that healthcare provided by APRNs is equal to that provided by physicians. Additionally, telehealth and telemedicine networks can expand the reach of providers into rural and underserved areas. However, their extended reach frequently crosses state borders requiring multistate licensure. Seeking licensure in each state is cumbersome, redundant, and expensive. An APRN compact addresses this issue by creating a contractual structure between member states allowing recognition of licenses issued by other member states. The member states extend permission to practice privileges to the APRNs from other member states. The National Council of State Boards of Nursing (NCSBN) has developed two versions of an APRN compact. Neither version has gained enough support to enact the compact. This study analyzed version two of the compact. While the compact defers much of the practice environment to that prescribed by the laws in each of the member states, it specifies that member states will grant prescriptive authority for noncontrolled medications and independent practice to APRNs governed by the compact. In Utah, these requirements do not conflict with the Utah Nurse Practice Act (UTNPA). The UTNPA already grants prescriptive authority to APRNs and does not require collaborative agreements between APRNs and physicians. However, these two requirements are controversial and mobilize opposition to the compact in many states. A survey of active APRNs in Utah indicates a lack of support for introducing additional restrictions or transitions to practice requirements to facilitate passage of a future version of the compact. Combining the analysis of the compact with the poll data suggests that if the NCSBN cannot gain passage of version two of the compact, removing the contentious provisions from the compact would be more acceptable to Utah APRNs than imposing additional restrictions.