Date of Award

January 2019

Document Type

Open Access Thesis

Degree Name

Doctor of Nursing Practice (DNP)


Yale University School of Nursing

First Advisor

Lisa Summers


Nurse practitioners (NP) play a vital role in the United States health care system. Nurse practitioners belong to a category of Advanced Practice Registered Nurses (APRN). APRNs in Washington State, licensed as Advanced Registered Nurse Practitioners (ARNP), are able to practice without the requirement of physician supervision or oversight. This facilitates NP practice ownership. NPs are qualified, autonomous, clinicians that can help address the primary and mental health care needs in Washington State. Washington State, unlike Oregon, does not require third-party insurers to reimburse NPs the same rate for the same services provided by a physician. This has financial implications for NP-owned practices. This project included working with a project mentor on a survey of ARNPs and ARNP practice owners in Washington State, development of an advocacy strategy and political endorsement process, and draft parity language for the 2019 Washington legislative session.


This is an Open Access Thesis.

Open Access

This Article is Open Access