State responses to COVID-19 - Potential benefits of continuing full practice authority for primary care nurse practitioners

Sep 21, 2026

During the COVID-19 pandemic, federal and state governments removed scope of practice restrictions on nurse practitioners, enabling them to provide care without those limits. The manuscript supports policymakers in granting full practice authority beyond the pandemic by summarizing evidence on benefits of eliminating state-level scope of practice barriers and outlining recommendations for policy, practice, and research. A thorough literature review finds improved access and care quality, better patient outcomes, and potential cost reductions.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Article history

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UCSF UC San Francisco Previously Published Works Title State responses to COVID-19: Potential benefits of continuing full practice authority for primary care nurse practitioners Permalink [https://escholarship.org/uc/item/6rs9t0tr](https://escholarship.org/uc/item/6rs9t0tr) Journal Nursing Outlook, 70(1) ISSN 0029-6554 Authors Poghosyan, Lusine Pulcini, Joyce Chan, Garrett Ket al. Publication Date 2022 DOI 10.1016/j.outlook.2021.07.012 Peer reviewed [eScholarship.org](eScholarship.org) Powered by the California Digital Library University of California Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID- 19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content- immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. State responses to COVID-19: Potential beneﬁts of continuing full practice authority for primary care nurse practitioners Lusine Poghosyan, PhD, MPH, RNa,\#,*, Joyce Pulcini, PhD, PNP-BC, FAANPb,\#, Garrett K. Chan, PhD, NP, CNSc,\#, Lynne Dunphy, PhD, FNP-BC, FAANd,\#, Grant R. Martsolf, PhD, MPH, RNe,\#, Karen Greco, PhD, ANP-BC, FAANPf,\#, Barbara A. Todd, DNP, ACNP-BC, FAANPg,\#, Sandra C. Brown, DNS, APRN, FNP-BCh,\#, Margaret Fitzgerald, DNP, FNP-BC, NP-Ci,\#, Amy L. McMenamin, BSN, RN, CENj, P. Ann Solari-Twadell, PhD, MPA, RNk,\# aColumbia University School of Nursing, New York, NY bGeorge Washington University School of Nursing, Ashburn, VA cUniversity of California, San Francisco, CA dFlorida Atlantic University, Boca Raton, FL eUniversity of Pittsburgh School Nursing, Pittsburgh, PA fNurse Practitioner, Oregon City, OR gHospital University of Pennsylvania, Philadelphia, PA hSouthern University and A&M College, Baton Rouge, LA iFitzgerald Health Education Associates, North Andover, MA jColumbia University School of Nursing, New York, NY kLoyola University Chicago Marcella Niehoff School of Nursing, Maywood, IL A R T I C L E I N F O | Article history:
Received 1 April 2021
Received in revised form
21 July 2021
Accepted 29 July 2021
Available online August 7, 2021 . | | --- | | Keywords:
Full practice authority Scope of practice Nurse practitioner Covid-19
Primary care | A B S T R A C T Background: During the COVID-19 pandemic, federal and state governments removed the scope of practice restrictions on nurse practitioners (NPs), allowing them to deliver care to patients without restrictions. Purpose: To support policy makers’ efforts to grant full practice authority to NPs beyond the COVID-19 pandemic, this manuscript summarizes the existing evidence on the beneﬁts of permanently removing state-level scope of practice barriers and outline recommendations for policy, practice, and research. Methods: We have conducted a thorough review of the existing literature. Findings: NP full scope of practice improves access and quality of care and leads to better patient outcomes. It also has the potential to reduce health care cost. Discussion: The changes to support full practice authority enacted to address COVID-19 are temporary. NP full practice authority could be part of a longerterm plan to address healthcare inequities and deﬁciencies rather than merely a crisis measure. *Corresponding author: Lusine, Poghosyan, Columbia University School of Nursing, 560 W 168th St, New York, NY, 10032 . E-mail address: [lp2

FAQs

What change to nurse practitioner scope of practice occurred during COVID-19?

Federal and state governments removed scope of practice restrictions on nurse practitioners, allowing them to deliver care without those limitations.

What is the purpose of the manuscript?

To support policymakers by summarizing evidence on benefits of permanently removing state-level scope of practice barriers and to provide recommendations for policy, practice, and research beyond the pandemic.

What benefits does the review associate with full practice authority?

Improved access and quality of care, better patient outcomes, and potential reductions in health care costs.

Sep 21, 2026

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