Optimizing full scope of practice for nurse practitioners in primary care: A proposed conceptual model

Lusine Poghosyan, Donald R. Boyd, Sean P. Clarke

Research output: Contribution to journalArticlepeer-review


Background: Nurse practitioners (NPs), if utilized to their optimal potential, could play a key role in meeting the growing demand for primary care. Purpose: The purpose of this study was to propose a comprehensive model for maximizing NP contributions to primary care which includes the factors affecting NP care and patient outcomes and explains their interrelated impact. Method: We synthesized the results of the published literature to develop a model, which emphasizes NP scope of practice regulations, institutional policies, NP practice environment, and NP workforce outcomes as determinants of NP care and patient outcomes. Discussion: Our model provides a framework to help explain how variations in scope of practice regulations at the state-level and institutional policies within organizations directly and indirectly influence the practice environment of NPs, NP workforce outcomes, and patient care and outcomes. Conclusion: Aligning policy change, organizational innovations, and future research are critical to NP optimal utilization and patient care and outcomes.

Original languageEnglish (US)
Pages (from-to)146-155
Number of pages10
JournalNursing outlook
Issue number2
StatePublished - Mar 1 2016


  • Conceptual model
  • Nurse practitioner
  • Primary care

ASJC Scopus subject areas

  • General Nursing


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