Nurse Scope of Practice

Giving nurse practitioners authority to practice to the full extent of their education and training can ease the shortage of primary care providers. This can also help family caregivers by expanding options for care recipients to receive primary care services in the setting of their choice (e.g., medical offices, community health centers, adult day centers, at home). When the first Scorecard was released in 2011, just 14 states allowed patients to benefit from the full range of care nurse practitioners are educated and trained to provide. The number of states has now doubled to 28. 

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This indicator gives states credit for policies that allow nurse practitioners to practice to the fullest extent of their education and training.  Scope of practice includes three levels of authority: (a) Under full practice authority, the NP is permitted to evaluate patients, diagnose, order, and interpret diagnostic tests, initiate and manage treatments, and prescribe medications; (b) Reduced practice requires a collaborative practice agreement with a physician specifying the scope of practice allowed; and (c) Restricted practice requires a physician to oversee all care provided by the NP.

Scoring:  States that permit full scope of practice received 1.0 point, states that permit reduced scope of practice received 0.5 points, and states that have restricted practice received 0 points.  

Current year 2023 data from AARP Public Policy Institute analysis of nurse practitioner state practices, American Association of Nurse Practitioners, Nurse Practitioner State Practice Environment. Reference year 2019 data from same source.  

American Association of Nurse Practitioners (AANP), Nurse Practitioner State Practice Environment (Austin, TX: American Association of Nurse Practitioners, 2019, 2022),  


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