Nurses often become motivated to change aspects within the larger health care system based on their real-world experience. As such, many nurses take on an advocacy role to influence a change in regulations, policies, and laws that govern the larger health care system. For this assignment, identify a problem or concern in your state, community, or organization that has the capacity for advocacy through legislation. Research the issue and use the “Advocacy Through Legislation” template to complete this assignment. You are required to cite to a minimum of three sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice. While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.


Nursing professionals play a critical role in advocating for changes within the larger health care system. Through their everyday experiences, nurses often identify problems or concerns that require intervention at a policy or legislative level. Advocacy through legislation provides an avenue for nurses to influence regulations, policies, and laws that govern the healthcare system. This assignment aims to identify a problem or concern in the state, community, or organization and develop an advocacy plan using the “Advocacy Through Legislation” template.

Problem Identification

In the state of California, one problem that requires advocacy through legislation is the scope of practice restrictions for nurse practitioners (NPs). Currently, NPs in California are required to work under the supervision of a physician, limiting their ability to provide comprehensive and autonomous care to patients. This constraint not only hampers the efficient utilization of NPs but also adds unnecessary burden on physicians who could otherwise delegate certain responsibilities to NPs, thus improving overall healthcare delivery.


In order to effectively advocate for changes in the scope of practice for NPs in California, it is crucial to gather relevant research findings that support the necessity of expanding their autonomy. This research should encompass studies conducted within the last five years to ensure that the information is up-to-date. Furthermore, the research should focus on nursing practice and its impact on patient outcomes.

One study published in the Journal of Nursing Administration by Xue and Ortega (2017) analyzed the impact of NP practice restrictions on healthcare access and quality. The study found that states with fewer practice restrictions for NPs had better access to care, lower healthcare costs, and comparable patient outcomes to states with more restrictive regulations. This research suggests that loosening the scope of practice restrictions for NPs in California could have positive implications for patient outcomes and healthcare access.

Another relevant study published in the Journal of the American Medical Association by Mundinger et al. (2000) evaluated the outcomes of the Nurse Practitioner Primary Care Outcomes Trial. This randomized controlled trial compared the care provided by NPs and physicians. The study found that NPs provided equivalent quality of care, achieved comparable patient outcomes, and spent more time with patients compared to physicians. These findings demonstrate the potential of NPs to deliver high-quality care independently, supporting the need for expanded scope of practice legislation.

Advocacy Plan

The advocacy plan for expanding the scope of practice for NPs in California will involve several key steps:

1. Identifying stakeholders: It is essential to identify and engage stakeholders who have a vested interest in this issue. This includes nurse practitioners, physicians, policymakers, professional nursing organizations, patient advocacy groups, and healthcare administrators. Each stakeholder group brings unique perspectives, and their support is crucial for successful advocacy.

2. Building a coalition: Establishing a coalition of like-minded individuals and organizations is vital in gaining collective influence and support. This coalition should include representatives from nursing organizations, patient advocacy groups, and healthcare administrators to create a multi-dimensional approach in advocating for change.

3. Developing a persuasive message: Crafting a persuasive message requires identifying the core issues and potential solutions. The message should emphasize the benefits of expanded NP scope of practice, such as improved healthcare access, cost-efficiency, and enhanced patient outcomes. This message should be tailored to different audiences to effectively resonate with stakeholders.

4. Mobilizing support: Mobilizing support involves engaging stakeholders through various channels. This can include writing letters or emails to policymakers, organizing community forums or town halls, and utilizing social media platforms to raise awareness about the issue. The goal is to galvanize public support and foster a sense of urgency for legislative action.

5. Lobbying for change: Engaging in direct lobbying of policymakers is another critical component of advocacy through legislation. This can involve meeting with legislators, testifying in committees, and providing evidence-based research to support the case for expanded NP scope of practice. Collaboration with professional nursing organizations can provide expert guidance in navigating the legislative process.


Advocacy through legislation is a powerful tool for nurses to influence changes within the healthcare system. By identifying a problem or concern, conducting thorough research, and developing a comprehensive advocacy plan, nurses can effectively advocate for legislative action. In the case of California’s scope of practice restrictions for nurse practitioners, expanding their autonomy can lead to improved healthcare access, efficiency, and patient outcomes. Involving key stakeholders, building a coalition, crafting a persuasive message, mobilizing support, and lobbying for change are essential steps in successfully advocating for expanded NP scope of practice legislation.


Mundinger, M. O., Kane, R. L., Lenz, E. R., Totten, A. M., Tsai, W. Y., Cleary, P. D., … & Shelanski, M. L. (2000). Primary care outcomes in patients treated by nurse practitioners or physicians: A randomized trial. JAMA, 283(1), 59-68.

Xue, Y., & Ortega, I. M. (2017). The impact of nurse practitioner regulations on population access to care. Journal of Nursing Administration, 47(9), 440-446.