- On March 14, 2023, Utah granted full-practice authority to nurse practitioners (NPs), which eliminated the state-mandated contract with a physician for licensure.
- Utah NPs had limited prescriptive authority, which was reversed when Senate Bill 36 was signed — ensuring NPs were not limited in any of the four elements of advanced nursing practice in Utah.
- Data demonstrates that care provided by NPs is comparable to physicians, costs less, and patients have fewer hospitalizations and emergency department visits.
On March 14, Gov. Spencer Cox signed Senate Bill 36 into law, making Utah the 27th state to allow nurse practitioners full-practice authority. This is a clear message about improving access and decreasing disparities in healthcare.
Full-practice authority for NPs ensures patients have full and direct access to high-quality patient care and helps break barriers to cost-effective preventive care. Explore what this legislation means for nursing professionals in Utah and the impact it will have on patient care.
What Full-Practice Authority Means for Nurse Practitioners in Utah
Senate Bill 36 changes the scope of practice for Utah NPs and completes the effort to modernize licensure laws for professional practice in the state.
"We applaud Utah for recognizing the need to update laws and make the most of their healthcare workforce," said American Association of Nurse Practitioners (AANP) President April Kapu, DNP, APRN, in a press release.
Kapu continues, "In the last two and a half years, four other states have taken similar action. These changes will help Utah attract and retain nurse practitioners and provide patients access to high-quality care. We thank Governor Cox and the legislature for prioritizing patients and taking action to improve healthcare in the Beehive State."
There are three levels of practice authority under which NPs practice depending on the state law: full practice, reduced practice, and restricted practice. According to the AANP, there currently are 11 states where NPs practice under restricted authority.
Prior to Senate Bill 36 being signed into law, nurse practitioners in Utah had reduced-practice authority which meant:
- As an advanced practice registered nurse (APRN), nurse practitioners were limited in their APRN practice. In Utah, under Code 58-31b-803, NPs were limited in their prescriptive authority, including for controlled substances.
- NPs were required to have a state-mandated contract with a physician as a condition of licensure.
Now that Senate Bill 36 has been signed into law, nurse practitioners in Utah have full-practice authority, which means:
- The state-mandated contract with a physician as a condition of licensure was eliminated.
- NPs are not limited in any of the four elements of APRN practice, which include:
- Ordering and interpreting diagnostic tests
- Initiating and managing treatments, including prescription medications and controlled substances
Full-practice authority creates an opportunity for APRNs to enjoy more autonomy within their field. Utah's full-practice authority will also help the state attract and retain more nurse practitioners, which in turn increases access to high-quality healthcare and better patient outcomes.
Full-practice authority also helps increase the demand for nurse practitioners and opens more employment opportunities in hospitals, clinics, and offices. Independent practice increases the opportunity for innovative career options, such as clinic owner, health coach, mobile testing, or online store owner.
What Utah NP Full-Practice Authority Means for Patient Care
Several studies have compared care provided by nurse practitioners to care provided by physicians. A 2020 study published in Health Services Research examined utilization costs and clinical outcomes between nurse practitioners and medical doctors in a Veterans Administration database. The researchers found those patients assigned to a nurse practitioner were less likely to use primary care and specialty services and had a lower total number of hospitalizations.
A 2019 study compared the use of physicians, nurse practitioners, and physician assistants (PAs) on the cost of caring for complex patients. They found that when NPs and PAs provided primary care for complex patients with diabetes, they used less acute care services and incurred lower total costs than physicians.
While NPs excel at caring for complex, chronic patients, data also demonstrates that patient outcomes in NP-led medical emergency teams experienced lower hospital mortality and a higher likelihood of discharge home.
Data continues to show that patient care outcomes, satisfaction, and costs improve with full-practice authority for nurse practitioners. Nurse practitioners also help expand access to care, especially in primary care, which affects nearly 81 million people who live in areas where there's a primary care shortage.
Several factors limit healthcare access, not the least of which is a lack of health insurance. High medical costs, a shortage of medical professionals, and language barriers are other challenges faced by patients who need medical care. The consequences of limited healthcare include a reduced life expectancy, increased use of emergency departments, and poor health.
The nature of an NP's clinical expertise and emphasis on managing health and preventing disease addresses many of the challenges that patients face. A comprehensive approach to providing healthcare is an essential part of reducing barriers and improving patient outcomes.
NPs are uniquely positioned to address ongoing shortages in primary care, specialty care, and mental healthcare.
What Utah NP Full-Practice Authority Means for Nurses
Nurses considering a career as a nurse practitioner will find they are in demand across the U.S. With full-practice authority, Utah presents an opportunity for nurses looking to advance in the industry. However, it is important to understand the laws that govern the scope of practice in each state.
Find out more about how to become an NP.
Chuan‐Fen Liu, eta l. (2020). Outcomes of primary care delivery by nurse practitioners: Utilization, cost, and quality of care. National Library of Medicine
Gupta S, et al. (2021). Comparison of clinical outcomes between nurse practitioner and registrar-led medical emergency teams: a propensity-matched analysis. Critical Care
Joyce M. (2021). Three ways nurse practitioners can improve healthcare in your state. National Nurse-Led Care Consortium
Kleinpell R, et al. (2022). Breaking down institutional barriers to advanced practice registered nurse practice. Nursing Administration Quarterly
Morgan PA, et al. (2019). Impact of physicians, nurse practitioners, and physician assistants on utilization and costs for complex patients. Health Affairs
State practice environment. (2022). American Association of Nurse Practitioners
Utah code. (2022). Utah State Legislature
Utah's new law will improve patients' health care access. (2023). American Association of Nurse Practitioners
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New York and Kansas Nurse Practitioners Granted Full-Practice Authority
Nurse Practitioner Practice Authority: A State-by-State Guide
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