Standards for Nurse Practitioner Practice in Retail-based Clinics
It is the position of the American Association of Nurse Practitioners® (AANP) that primary care nurse practitioners (NPs) can play a significant role in making retail-based clinics (also known as convenient care clinics) a viable health care option to patients who might not otherwise receive needed care in a timely manner. To do this, a number of standards must be met to assist the NP in maintaining the high quality of care that NPs provide. Multiple studies have demonstrated that NPs provide health care that is equal to, or superior to, that of physicians providing the same care for the same problems. Likewise, patient satisfaction ratings for NPs are found to be very high.i The combination of high-quality nursing and medical care provided by NPs is an effective model for care in retail-based clinics.
Recognizing that primary care NPs are advanced practice, licensed independent practitioners, the following standards should be maintained in retail-based clinics utilizing NPs as their primary providers of care:
- NPs utilized in retail-based clinics must meet all regulatory requirements for certification and education and be recognized to practice as an NP in the state in which the clinic functions.ii,iii
- NPs must be consulted regarding the development of retail-based primary care clinics, their policies, practice guidelines and operational procedures.
- NPs must be an integral part of management activities in establishing and running retail-based primary care clinics.
- The functions of the clinic should be based on the NP’s full scope of practice and should not limit the ability of NPs to conduct appropriate assessments and provide appropriate evidence-based treatments and referrals to other health care providers, institutions and agencies.
- The NP must be provided with resources to maintain appropriate health and medical records for all patients seen in the clinic and to provide appropriate information to other health care providers within the framework of HIPAA regulations.
- The facility must be adequately equipped to appropriately provide primary care services, including but not limited to the provision of patient privacy and the maintenance of OSHA, CLIA and ADA standards.
- NPs must be permitted to establish an ongoing program for quality assurance through appropriate peer review and established quality measures.
- NPs must be able to maintain high standards of professionalism in all activities undertaken in the retail-based clinic environment.
- NPs employed by retail-based clinics must receive competitive salaries or equivalent payment for services and benefits, including opportunities to attend professional meetings and continuing education activities.
The implementation of these standards will facilitate the provision of high-quality primary care services to patients seen by NPs in the retail-based setting.
Summary
Retail-based clinics are a potentially viable resource for the provision of necessary primary care services in many communities throughout the United States. In order to facilitate their functioning at the highest quality level, NPs must be involved in all aspects of forming and running these clinics.
i American Association of Nurse Practitioners (2013), Documentation of Quality of Nurse Practitioner Practice. Austin, Texas: American Association of Nurse Practitioners.
ii American Association of Nurse Practitioners (2013), Scope of Practice for Nurse Practitioners. Austin, Texas: American Association of Nurse Practitioners.
iii American Association of Nurse Practitioners (2013), Standards of Practice for Nurse Practitioners. Austin, Texas: American Association of Nurse Practitioners.