Date of Award

Spring 3-9-2024

Document Type

Scholarly Project

Degree Name

Doctor of Nursing Practice (DNP)

First Advisor

Dr. David Liguori, DNP, APNC, NP-C

Second Advisor

Dr. Bandi Davini, DNP, APRN-BC


This policy analysis investigates the benefits of full practice authority (FPA) for Nurse Practitioners (NPs) in the Southwestern United States, using Arizona as an FPA model and California and Tennessee as comparison states. The PICO question that directed the project is: for NPs practicing as advanced practice nurse practitioners within the Southwestern United States region (P), does a comprehensive policy recommendation for FPA for NP-led clinics in the secondary education space (I) compared to existing variable approaches within the region (C) improve access to care and direct or indirect patient outcomes as endorsed by the literature (O)? A comprehensive literature review revealed that the United States is experiencing a significant primary care provider shortage. Although NPs are educationally prepared, tested, certified, and licensed to provide comprehensive patient care, California and Texas continue regulatory restrictions on NP scope of practice. These practice restrictions exacerbate the care shortage, especially in rural and primary health professional shortage areas. Furthermore, the literature search revealed consistent support of FPA by critical stakeholders, such as the American Association of Nurse Practitioners, the American Nurses Association, and the Consensus Model. Policy briefs advocating for evidence-based recommendations for FPA are presented for dissemination to the legislative bodies, professional organizations, and the state boards of nursing. Eliminating practice barriers allows NPs to practice to the fullest extent of their education and training. This results in greater access to care, reduced healthcare costs, increased quality of care, and works to lessen health disparities.


Scholarly project submitted to the University of St. Augustine for Health Sciences in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice.

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.