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NursingDiscussion postAdvanced practice nursing

DNP 835 Topic 6 DQ 1: barriers to the APN role

Alleviated implies somebody does the alleviating. A barrier named without the actor who could remove it is a complaint; with the actor attached, it is an advocacy target.

Editorial process

Last reviewed · August 15, 2026

01

Barriers to be alleviated — so name who would alleviate them

The prompt's verb is doing more work than it looks. Barriers that need to be alleviated implies an agent, so pair each barrier with whoever has the power to remove it. That single discipline transforms the post, because the barriers sort into levels with different actors and different timescales. Regulatory barriers — scope-of-practice restrictions, supervisory or collaborative agreement requirements, prescriptive authority limits — sit with state legislatures and boards of nursing, and they vary enormously between states, so naming your own state's position is more useful than describing the national picture. Payment barriers sit with payers and with federal rules on direct reimbursement and panel inclusion. Start by establishing which category your state falls into — full, reduced or restricted practice authority — since the barrier you would be alleviating is completely different in each and the advocacy target changes with it. In a restricted state the barrier is statutory and the timescale is years; in a full-practice state it is institutional.

The institutional and cultural barriers are the ones nearest to you and the ones most often omitted, though they are frequently what actually stops a project. Credentialling and privileging processes built for physicians, no seat at the committee where the decision gets made, medical staff bylaws that do not contemplate a DNP leading anything, and a quality-improvement infrastructure that reports to a chief medical officer rather than to nursing. Those are alleviable locally and on a shorter timescale than a statute. Then there is the barrier nobody enjoys naming: the profession's own inconsistency about what the DNP is for, which weakens the case every time it is made differently. Pick two or three barriers across different levels rather than listing everything, and for each say who would have to act and what evidence would move them. Pick barriers you have actually met if you can, since experience carries detail a policy summary does not.

Likely learning objectives

Inferred from the brief — check these against your own rubric.

  • 01
    Distinguish regulatory, payment, institutional and cultural barriers.
  • 02
    Pair each barrier with the actor able to remove it.
  • 03
    Recognise state-level variation in scope of practice.
  • 04
    Identify institutional barriers that are alleviable locally.
Assignment instructionsQuoted verbatim

Read the full question

Review every instruction before using the planning guidance that follows.

DNP 835 Topic 6 DQ 1 What barriers need to be alleviated to increase the APN role in health care change DNP 835 Topic 6 DQ 1 What barriers need to be alleviated to increase the APN role in health care change? The DNP degree empowers nurses to create programs for improving quality outcomes. What barriers need to be alleviated to increase the APN role in health care change?
Course-wide instructions that accompany this question

Important information for writing discussion questions and participation Hi Class, Please read through the following information on writing a Discussion question response and participation posts. Contact me if you have any questions. Important information on Writing a Discussion Question Your response needs to be a minimum of 150 words (not including your list of references) There needs to be at least TWO references with ONE being a peer reviewed professional journal article. Include in-text citations in your response Do not include quotes—instead summarize and paraphrase the information Follow APA-7th edition Points will be deducted if the above is not followed Participation –replies to your classmates or instructor A minimum of 6 responses per week, on at least 3 days of the week. Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article Each response needs to be at least 75 words in length (does not include your list of references) Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count. Follow APA 7th edition Points will be deducted if the above is not followed Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points. Here are some helpful links Student paper example Citing Sources The Writing Center is a great resource Welcome to class DNP 835 Topic 6 DQ 1 What barriers need to be alleviated to increase the APN role in health care change Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to. I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you. Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted. If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations. Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements. Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week. I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course! Name: Discussion Rubric Grid View List View Excellent 90–100 Good 80–89 Fair 70–79 Poor 0–69 Main Posting: Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. 40 (40%) – 44 (44%) Thoroughly responds to the Discussion question(s). Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. No less than 75% of post has exceptional depth and breadth. Supported by at least three current credible sources. 35 (35%) – 39 (39%) Responds to most of the Discussion question(s). Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module. 50% of the post has exceptional depth and breadth. Supported by at least three credible references. 31 (31%) – 34 (34%) Responds to some of the Discussion question(s). One to two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Cited with fewer than two credible references. 0 (0%) – 30 (30%) Does not respond to the Discussion question(s). Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible references. Main Posting: Writing 6 (6%) – 6 (6%) Written clearly and concisely. Contains no grammatical or spelling errors. Adheres to current APA manual writing rules and style. 5 (5%) – 5 (5%) Written concisely. May contain one to two grammatical or spelling errors. Adheres to current APA manual writing rules and style. 4 (4%) – 4 (4%) Written somewhat concisely. May contain more than two spelling or grammatical errors. Contains some APA formatting errors. 0 (0%) – 3 (3%) Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style. Main Posting: Timely and full participation 9 (9%) – 10 (10%) Meets requirements for timely, full, and active participation. Posts main Discussion by due date. 8 (8%) – 8 (8%) Meets requirements for full participation. Posts main Discussion by due date. 7 (7%) – 7 (7%) Posts main Discussion by due date. 0 (0%) – 6 (6%) Does not meet requirements for full participation. Does not post main Discussion by due date. First Response: Post to colleague’s main post that is reflective and justified with credible sources. 9 (9%) – 9 (9%) Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives. 8 (8%) – 8 (8%) Response has some depth and may exhibit critical thinking or application to practice setting. 7 (7%) – 7 (7%) Response is on topic and may have some depth. 0 (0%) – 6 (6%) Response may not be on topic and lacks depth. First Response: Writing 6 (6%) – 6 (6%) Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. 5 (5%) – 5 (5%) Communication is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in standard, edited English. 4 (4%) – 4 (4%) Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited. 0 (0%) – 3 (3%) Responses posted in the Discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited. First Response: Timely and full participation 5 (5%) – 5 (5%) Meets requirements for timely, full, and active participation. Posts by due date. 4 (4%) – 4 (4%) Meets requirements for full participation. Posts by due date. 3 (3%) – 3 (3%) Posts by due date. 0 (0%) – 2 (2%) Does not meet requirements for full participation. Does not post by due date. Second Response: Post to colleague’s main post that is reflective and justified with credible sources. 9 (9%) – 9 (9%) Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives. 8 (8%) – 8 (8%) Response has some depth and may exhibit critical thinking or application to practice setting. 7 (7%) – 7 (7%) Response is on topic and may have some depth. 0 (0%) – 6 (6%) Response may not be on topic and lacks depth. Second Response: Writing 6 (6%) – 6 (6%) Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. 5 (5%) – 5 (5%) Communication is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in standard, edited English. 4 (4%) – 4 (4%) Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited. 0 (0%) – 3 (3%) Responses posted in the Discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited. Second Response: Timely and full participation 5 (5%) – 5 (5%) Meets requirements for timely, full, and active participation. Posts by due date. 4 (4%) – 4 (4%) Meets requirements for full participation. Posts by due date. 3 (3%) – 3 (3%) Posts by due date. 0 (0%) – 2 (2%) Does not meet requirements for full participation. Does not post by due date. Total Points: 100 Name: Discussion Rubric

02

Turn the brief into deliverables

  1. 01
    Two or three barriers drawn from different levels.
  2. 02
    The actor who could remove each one.
  3. 03
    Your own state's scope-of-practice position.
  4. 04
    The evidence that would move each actor.
03

Regulatory, institutional, then the quieter ones

01

Regulatory barriers

Set out scope-of-practice and authority restrictions and where they sit.

02

Payment barriers

Describe reimbursement and panel-inclusion constraints.

03

Institutional barriers

Identify local structures that exclude the APN from decisions.

04

What would move each actor

Say what evidence or argument each decision-maker responds to.

04

Where scope-of-practice restrictions are documented

Recommended databases

  • Your state board of nursing
  • AANP scope of practice resources
  • PubMed Central
  • CINAHL

Search sequence

  1. 1.
    Establish your own state's scope-of-practice category before writing anything.
  2. 2.
    Find outcome evidence used in scope-of-practice policy debates.
  3. 3.
    Check your organisation's bylaws for who may lead a quality initiative.
  4. 4.
    Look for a study of institutional rather than regulatory barriers.
05

Reference shortlist

These are authoritative starting points, not a ready-made bibliography. A qualified reviewer must confirm that each source fits the assignment and supports the claim beside which it is cited.

Nothing here is cleared for citation until you have read it.

  1. 01

    SCOPE OF PRACTICE

    Nursing Fundamentals, NCBI Bookshelf · 2023

    Sets out how scope of practice is defined and constrained, which is the regulatory barrier in its formal form.

  2. 02

    Provision of evaluation and management visits by nurse practitioners and physician assistants in the USA from 2013 to 2019: cross-sectional time series study

    BMJ · 2023

    Evidence on the care actually delivered by nurse practitioners, which is the kind of data scope-of-practice advocacy runs on.

  3. 03

    Policy Advocacy and Nursing Organizations: A Scoping Review

    Policy, Politics & Nursing Practice · 2021

    On how nursing organisations pursue policy change, which is the route by which a regulatory barrier gets alleviated.

  4. 04

    Expanding knowledge and roles for authority and practice boundaries of Emergency Department nurses: a grounded theory study

    International Journal of Qualitative Studies on Health and Well-being · 2019

    On expanding authority and practice boundaries for nurses in a specific setting, which is the institutional barrier close up.

06

Review before submission

Common mistakes

  • Listing barriers with no actor attached to any of them.
  • Describing the national scope-of-practice picture rather than your state's.
  • Omitting institutional barriers, which are the ones you could act on.
  • Treating physician opposition as the only barrier worth naming.

Submission checklist

  • Does each barrier have someone who could alleviate it?
  • Have you named your own state's regulatory position?
  • Is at least one barrier alleviable locally?
  • Did you say what evidence would move each actor?

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