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2 American Association of Colleges of Nursing (AACN). After the transaction has been approved, they must enter into a collaborative agreement with a physician. (Ill. Admin. Primary care, as well as specialty care such as pediatrics, mental health, and cancer care, will necessitate an increase in demand for nurse practitioners. Application is processed where License, DEA number, Board Certification is verified. Nurse leaders can play an important role in helping reduce unnecessary institutional barriers to APRN practice. 312 131 131 457 132 132 746 133 137 891 Journal of the American Academy of Nurse Practitioners, 23(1), 42-50. doi: 10.111/j.1745-7599.2010.00570.x. endstream endobj 831 0 obj <>/Metadata 37 0 R/Pages 36 0 R/StructTreeRoot 39 0 R/Type/Catalog/ViewerPreferences<>>> endobj 832 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC/ImageI]/Properties<>/XObject<>>>/Rotate 0/StructParents 0/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 833 0 obj <> endobj 834 0 obj [/Indexed/DeviceRGB 232 858 0 R] endobj 835 0 obj <> endobj 836 0 obj <> endobj 837 0 obj <> endobj 838 0 obj <> endobj 839 0 obj <>stream 16. Keyword Highlighting By not making a selection you will be agreeing to the use of our cookies. /b375cd9339af2bb12856853d3d172057 28 0 R Larger cities and hospitals will likely pay PMHNPs more than smaller areas. Most employers pay this fee. Even if the nurse practitioner is not a physician attending to patients, she is still considered an attending physician, and the patient must be enrolled in that plan. Sources: 1 AANP National Nurse Practitioner Database, 2022. Location:Nashville, TN and surrounding areas. As a result, nurse practitioners would have the ability to provide inpatient and outpatient care. 2021;69(5):783792. Nurse practitioner state-required collaborative practice agreements: a cross-sectional study in Florida. I recommend that you round routinely with your collaborating physician or a nurse practitioner colleague before applying for privileges to get a sense of the role and responsibilities. (a) The CRNP program must be a definable entity distinguishable from other educational programs and services within the institution. _____I have been approved for the following schedules by the Mississippi State Board of Nursing and 54 54 650 55 55 812 56 56 635 57 annual review). >> Obtain useful information in regards to patient safety, suicide prevention, infection control and many more. J Nurs Regul. 122 746 123 127 891 128 129 952 130 130 Levels of PrivilegesAfter you complete the credentialing procedure, you will be awarded a specific level of hospital privileges. This site uses cookies and other tracking technologies to assist with navigation, providing feedback, analyzing your use of our products and services, assisting with our promotional and marketing efforts, and provide content from third parties. Identify existing institutional barriers to APRN practice; Actively support and target the removal of institutional barriers to APRN practice; Understand and implement the APRN Consensus Model in the regulation of APRNs in their respective institutions; Be knowledgeable about APRN practice restrictions within their state; and. In this case, the treating doctor is responsible for performing the duties. This page was last updated on November 23, 2022. . Most employers pay this fee. Most hospitals mandate that nurse practitioner's notes and orders be signed every 24 hours, even in states where physician collaboration is not required by law. There were also 101 respondents from 19 states (Arizona, Colorado, Connecticut, Hawaii, Iowa, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, New Mexico, North Dakota, Oregon, Rhode Island, South Dakota, Vermont, Washington, and Wyoming) who identified that procedures within APRN scope of practice required physician supervision in their practice setting. endstream endobj 840 0 obj <>stream Are Instagram Influencers Creating A Toxic Fitness Culture? /O 33 5. Despite this, they can still sign workers compensation claims and be designated as primary care providers. It must include the details of the prescribed medication such as the intended patient population, the treatment duration, and the dosage. 12 12 891 13 14 1132 15 16 1171 17 Nurse practitioners provide a wide range of services, including preventive care, health promotion, and diagnosis and treatment of acute and chronic illnesses. 0000002501 00000 n Hospital privileges also improve the image of nurse practitioners among patients and colleagues. /ImageC NPs have been in practice an average of 9 years. Get fresh tips and insights emailed to you, This content was produced in its entirety for ADVANCE Healthcare Network (1985-2019, now Elite Healthcare) and features original contributions from a qualified and experienced editorial team or was provided to ADVANCE by credible industry experts or qualified healthcare professional(s). /12733094ab32dcca2364aebe5a7375d9 28 0 R Many hospitals mandate that the nurse practitioner desiring privileges send a letter introducing herself to the chair of the department and explaining why privileges are desired. Use the grid below to find, review, and request privileges. J Am Assoc Nurse Pract, 32 (6) (2020), pp. 2 0 obj /Contents [ 45 0 R ] Patients can be confident that they will be treated appropriately, with the goal of making the best possible decision. /ID [ <32FF23BCF6708008BCAFD2B6A8953A2F> However, typically, a patient must be seen by a doctor who then determines if they need to be admitted to the hospital. << 0000003308 00000 n 0000044482 00000 n /Type /Font Even though you have your license, your . On September 29, 2020, California Governor Gavin Newsom signed Assembly Bill 890 into law, launching significant changes to the scope of practice for Nurse Practitioners ("NPs") over. 'j+hrE?Y845=Lf/D>NP7?~uNL0#fi?N4|jMdOfszd(x,Yx;b} ICU+|Der|TWw:6o$u(3:RhICy;341CG49IW#\f iL-gNmU/5Yl:2)=o6]Ku|#w HK J Midwifery Womens Health. >> A hospitalist is critical to the success of a hospitals patient care program. /Fabc39 41 0 R 3. Robert Wood Johnson Foundation (RWJF). Nurse practitioners typically work under the supervision of a doctor, but this may not always be the case. We can make a difference on your journey to provide consistently excellent care for each and every patient. NPs' scope of work varies depending on their specialization area, the population they serve, and the state where they practice. According to the U.S. Bureau of Labor Statistics, there is a great need for nurse practitioners, with job growth projected at 26%, far higher than the average for all jobs. Hastings-Tolsma M, Foster SW, Brucker MC, et al. Devi, S. (2011). advanced practice nursing; advanced practice registered nurse; barriers to practice; institutional practice barriers; nurse leaders. The amount you can earn as a PMHNP will greatly vary based on where you work. >> 0000024987 00000 n Anen T, McElroy D. Infrastructure to optimize APRN practice. Charting Nurs Future. 2. Now some states are different and have referred to them differently. While I am a strong proponent of nurse practitioners being credentialed to provide hospital care, not all nurse practitioners need hospital privileges. 0000001251 00000 n /BaseFont /HPYIKG+Wingdings-Regular /Size 46 Wolters Kluwer Health, Inc. and/or its subsidiaries. /Subtype /Type1 0000023095 00000 n This department will be concerned with health promotion and disease prevention. The law stated that nurse practitioners were subject to the credentialing hospitals bylaws and that a hospital could limit the scope of practice, require monitoring by physicians or require that nurse practitioners co-admit with a physician. Abbreviations: APRN, advanced practice registered nurse; MD, medical doctor; PACU, postanesthesia care unit. m& m& m& m& m& m 14. State law requires a career-long regulated collaborative agreement with another health provider in order for the NP to provide patient care, or it limits the setting of one or more elements of NP practice.Restricted PracticeState practice and licensure laws restrict the ability of NPs to engage in at least one element of NP practice. 141 746 142 172 891 173 176 1047 187 188 0000001138 00000 n Hold an active current Nurse Practitioner license in the State of New . The requirements for conducting a Focused Professional Practice Evaluation (FPPE - MS.08.01.01) and an Ongoing Professional Practice Evaluation (OPPE - MS.08.01.03) also apply to these practitioners. Provide complete physical examinations. 0000013877 00000 n 2020;45(4):311320. Nurse practitioner; actions not prohibited. xc```b``""@ QqQ>"8+Ji!\3o=1[gx,oFM1x;-h_h31bjAX{KE. The form provides written documentation that you have secured one or two physicians who will ultimately be responsible for supervising the care of hospital-based patients. 17. The next step is usually a mandatory interview of approximately 1 hour in length. Examples of these types of barriers include the granting of hospital admitting and other privileges, organizational bylaws, reimbursement, and provider credentialing policies and practices.38 Often the cost of state-mandated collaborative or supervisory services is unregulated and can be cost-prohibitive.911, An integrative review of organization facilitators and barriers to optimal APRN practice identified that other barriers include lack of understanding of the APRN role, lack of professional recognition, poor physician relations, and poor administrator relations.12 Common restrictions involve requirements for physician cosignatures for prescriptive and hospital admission capabilities, the inability of APRNs to be listed as a provider of record or carry their own patient panel, and electronic health records that do not capture APRN care.12 These practices interfere with patient communication and ability of APRNs to provide proper follow-up care, limit patient choice of providers, and render APRN care invisible.1315, Overcoming current barriers affecting APRNs has been identified as a major challenge facing the nursing workforce by the recent Future of Nursing 2020-2030 report.16 Barriers to APRN practice reduce the productivity capacity of these health care professionals. 0000002165 00000 n States by Nurse Practitioner Practice Authority Each state establishes its own NP practice authority regulations. 8. This agreement must outline the specific patients that the NP is authorized to admit and the conditions under which the NP may admit them. stream An advanced nursing practitioner (ANP) is someone who holds a masters or a doctorate degree who diagnoses patients, prescribes medication, and transports patients to the hospital. California - $151,830 New Jersey - $137,010 New York - $133,940 Washington - $130,840 Massachusetts - $129,540 Physician Assistant Salary According to the BLS, the median pay for physician assistants was $121,530 in 2021. /Descent -211 Through leading practices, unmatched knowledge and expertise, we help organizations across the continuum of care lead the way to zero harm. Nurses are now able to provide care in a variety of settings due to technological advances. In order for nurses to provide safe and effective patient care, they must adhere to these guidelines. 4 0 obj Position statement: full practice authority for advanced practice registered nurses in necessary to transform primary care. If no, please comment on how we could improve this response. /d7c4437071eacc1dab71236994084c3f 28 0 R Once you have graduated and taken your boards, you can apply for your state nurse practitioner license. /Font << A majority of respondents (n = 5228; 70.9%) were employed 5 or more years. In addition to the application, a sponsoring physician form may be required. /3c8bbffb169a828b95ac640e1bc217d3 28 0 R Hospital admitting privileges. Certifications from The Joint Commission represent the most stringent, comprehensive and evidence-based proof of the success of your program available. The nurse practitioner can provide compassionate, quality patient care in a variety of settings. 0000051617 00000 n Poghosyan L, Liu J. KS H 2256 : Advanced Practice Registered Nurses - Updates scope of practice requirements for advanced practice registered nurses. 0000015971 00000 n 38-2323. The majority of full-time NPs (56.9%) see three or more patients per hour. Ideally, the sponsoring physician works with you in practice. Online J Issues Nurs. 1 In full practice authority (FPA) states, licensure laws permit APRNs to (1) evaluate patients, (2) diagnose patient problems, (3) order and (3) Rules must be in writing and may include, but need not be limited to: (a) Limitations on the scope of privileges; (b) When this is not possible, you can hire a consulting physician. /ABCpdf 8111 Nurs Econ. Please try again soon. The American Association of Nurse Practitioners (AANP) classifies state laws and regulations impacting APRN practice and identifies the practice environment within the state as full, restricted, or reduced.1 In full practice authority (FPA) states, licensure laws permit APRNs to (1) evaluate patients, (2) diagnose patient problems, (3) order and interpret diagnostic tests, and (4) initiate and manage treatments including prescribing medications and controlled substances under the licensure authority of a state board of nursing.1 Half of the 50 US states (n = 25) are classified as FPA (Figure). Learn how working with the Joint Commission benefits your organization and community. 47 843 48 48 1110 49 49 660 50 50 nihgmH6r. Doctors have a duty to obtain consent from patients before performing any medical procedure in order for them to provide them with accurate information about the treatment they are about to undergo. . 223 223 481 224 224 385 225 65534 1034 ] Find out about the current National Patient Safety Goals (NPSGs) for specific programs. Bosse J, Simmonds K, Hanson C, et al. Yes, an active, permanent, unencumbered Registered Nurse license issued by North Carolina or a multistate privilege to practice issued by another compact state is required for approval to practice as a Nurse Practitioner in North Carolina. Prescribing medicines and writing prescriptions. 0000044358 00000 n 28 1078 29 29 939 30 33 891 34 35 Patients applying for disabled license plates or placards may do so with nurse practitioner authorization. 0000022642 00000 n <> /90d2ba19521fc98792541f0fd137c377 28 0 R 3 96.2% of NPs prescribe medications, and those in full-time practice write an average of 21 prescriptions per day. 1 0 obj 0000003082 00000 n /e0d94883a27b514364790c92381ab135 28 0 R 0000001951 00000 n /Fabc7 35 0 R >> xref Nurse Leader. 0000000016 00000 n /Text Drive performance improvement using our new business intelligence tools. /N 10 Washington, DC: AACN. Conversely, if you are employed in a setting where nurse practitioners are not supported or rewarded for the additional skills necessary for the management of hospitalized patients, privileges may not be necessary. Nurse practitioner roles are expanding in a variety of healthcare settings, and with increased access to technology, they can provide care across a broader range of settings. /Info 29 0 R Insurance credentialing for Nurse Practitioner's has some unique challenges. The nurse practitioners have hospital admitting privileges, a move Pear-son acknowledges is "cutting edge." . See how our expertise and rigorous standards can help organizations like yours. Nurse Salary Factors. Virginia gives nurse practitioners a moderate amount of freedom allowing for loose collaboration . /Fabc37 39 0 R The purpose of this article is to review the reported barriers APRNs identified in a recent national survey of more than 7000 APRNs from all 50 states that exist within health care systems and to highlight implications for nurse leaders. From these same 22 FPA states, 352 respondents identified restricted hospital admitting privileges as a barrier to practice. The Joint Commission is a registered trademark of the Joint Commission enterprise. vuuVfdf[R|Xj7?/8;[~=[|5!okwym]{xHn,KKHy-1f=rrkWw/r~l9|}p This is the model recommended by the National Academy of Medicine, formerly called the Institute of Medicine, and the National Council of State Boards of Nursing.Reduced PracticeState practice and licensure laws reduce the ability of NPs to engage in at least one element of NP practice. 2017;(30). In California, nurse practitioners (NPs) have the same privileges as physicians when it comes to admitting patients to the hospital. endobj <>>> Poghosyan L, Boyd D, Clarke SP. /W [ 1 1 0 2 2 750 4 4 1030 5 20. Nurs Outlook. /BaseFont /Times-Roman There is no definitive answer to this question as nurse practitioners regulations vary from state to state. 1270 83 84 530 85 86 891 95 96 1060 J Nurse Pract. According to the National Nurse Practitioner Association, nurse practitioners demand is expected to rise by more than 20% by 2025. 19. 45.6% of full-time NPs hold hospital privileges; 10.9% have long-term care privileges. Can Nurse Practitioners See Patients In The Hospital, The Role Of Nurse Practitioners In Patient Admission, 8 Useful Organic Remedies Worth Considering For An Energy Boost, The Rise of Autism: How Parents Are Coping. 0000002724 00000 n Describes diagnostic tests like x-rays and lab work as part of the order and interpretation process. All rights reserved. If an NP prescribes a Schedule II controlled substance without complying with these guidelines, they may faceDisciplinary action from the Texas Board of Nurse Practitioner. 0000045907 00000 n Click here for complete information about license restrictions by state. 0000004316 00000 n The pharmacy or lab where an APRN works may provide physical exams, medications, and diagnostic tests. In both 2009 and 2011, nursing organizations attempted to change these laws, but were unsuccessful due to protests from physicians. State law may require career-long supervision, delegation, or team management by other health providers, most commonly physicians, for APRNs to provide care.1 In a reduced practice state, collaborative agreements are required, whereas in a restricted practice state, supervisory agreements are required. When an Advanced Practice Registered Nurse (APRN) or PA functions in a limited role, such as an educator, and arenot directing care as a LIP, the Medical Staff requirements would not apply. nearly 50% of NPs now have hospital privileges that allow them to order specialty services as part of . 2016;14(3):198-202. To test the dependability of a survey statistic, a relative standard error (RSE) is used. To initiate the process, call the medical staff affairs office where you are seeking privileges. In most facilities, two levels of privileges exist. <> 4. A designatedNPP can submit Medicare Part B claims for services provided in an inpatient or outpatient setting as of July 1998 under the 1998 Improvement to Medicare Part B. A resume or curriculum vitae, a copy of a DEA certificate (where allowed by state law), malpractice certificate and life support certifications are also required. With your help, we can promote an unbiased and accurate picture of NPs in our country. 2018;14(7):559565. Individual agreements will dictate the family nurse practitioner's prescriptive scope in that practice. Since Physician Assistants (PA) and Advanced Practice Registered Nurses (APRN) are not physicians, are organizations required to credential and privilege them via the requirements found in the Medical Staff (MS) chapter of the accreditation manual? Barriers to NP practice that impact healthcare redesign. Some nurse practitioners may work independently in clinics or hospitals without doctor supervision. << New Jersey Nurse Practitioners are also legally allowed to admit patients and obtain hospital privileges, but the authorization is not within the legal statue (The Nurse Practitioner, 2012). %PDF-1.4 Currently, 22 states and the District of Columbia have approved "full practice" status for nurse practitioners, a provision that allows them to assess, diagnose, interpret diagnostic tests, and prescribe medications independently. %%EOF Hain D, Fleck LM. Patients assistants (PAs) currently have privileges and are responsible for issuing orders in addition to admissions. /fdb78615b0b97d405802f5f16a80ad78 28 0 R 30 16 NPs hold prescriptive privileges, including controlled substances, in all 50 states and D.C. Complete and submit the Autonomous Practice Application for Nurse Practitioner to: ^^It is the responsibility of the individual organization to determine, based on law/regulation, if the APRN or PA meet the following definition of a Licensed Practitioner: "An individual who is licensed and qualified to direct or provide care, treatment, and services in accordance with state law and regulation, applicable federal law and regulation, and organizational policy. 0 3 Some error has occurred while processing your request. According to data from the U.S. Bureau of Labor Statistics, California is the highest paying state for nurse practitioners. Consider involvement in state and national organizations positioned to make policy changes impacting APRN practice. 2018;27(21/22):40004017. In addition, you will be responsible for working with ancillary services such as physical therapy, coordinating patients care to achieve a timely yet appropriate discharge, and then discharging the patient. Here's some states where there's action on this front: Connecticut: In Connecticut, the state Senate voted earlier this month to allow nurse practitioners to practice independently of . 199 200 891 201 204 775 205 206 1067 207 stream 2017;65(6):761765. AS HEALTH CARE PROFESSIONALS, advanced practice registered nurses (APRNs) contribute to promoting health and providing care for patients in a variety of health care settings. Abbreviations: APRN, advanced practice registered nurse; DNP, do not resuscitate; EKG, electrocardiogram; FPA, full practice authority; MD, medical doctor; PCP, primary care physician. <<7FDC303F19327345BB923EC94941E706>]/Prev 323822/XRefStm 1540>> Other reported barriers even in FPA states included a physician signature was required for certain medications, APRNs were restricted from ordering rehabilitation services postdischarge, inability to order do-not-resuscitate orders, among others, based on institutional regulations rather than state regulations (Table 2).18, Understanding the context for advanced practice nurses is important for nurse leaders to ensure that all individuals are practicing at the top of their license. UNIVERSITY HOSPITAL AND HEALTH SYSTEM UNIVERSITY OF MISSISSIPPI MEDICAL CENTER 2500 North State Street, Jackson MS 39216 CLINICAL PRIVILEGES- FAMILY NURSE PRACTITIONER Name: Page 1 Initial Appointment Department _____ . 0000006214 00000 n It is also helpful to round with a collaborating physician for the first 3 to 6 months after you obtain privileges. s:4"Np/.Iu''w}\?~| I^6u *+m$ABMmLwbV]?7VMgG^#0}pmfN,!R28*y_KQsS&EFh#w|RXa6tHl/t|_h]'iu')XG3?1pvN=YMLZ;L.+"wOg!)gr]?!kxvy3CFFMiioI]:T!K'}r?Zvhlvl|h7Vs)5K{]XYg0Q1F=GjEsQQZ=6}BPr%b:ITKRPH4N1z.-N-Qzd!bC~B EUO&wb>aj~VXJ,B. There is a shortage of NPs in primary care, but NP roles in specialty fields are on the rise. Advanced Practice Registered Nurses Alcohol and Drug Counselors Audiologists Chiropractic Physicians Clinical Pastoral Therapists Dentists Dietitian/Nutritionists Dispensing Opticians Electrologists Licensed Registered Respiratory Therapists Licensed Certified Respiratory Therapists Licensed Laboratory Personnel Marital & Family Therapists /Length 122 Kleinpell R, Cook ML, Padden DL. Join AANP today and support the movement to remove practice barriers and secure full and direct access to NP services. Nurse leaders can also assist in changing bylaws and restrictive practices that exist. More than 88 percent of family nurse practitioners and adult nurse practitioners accept Medicare patients, and more than 80 percent of both groups accept Medicaid patients. Easy access to healthcare can be an in issue throughout the United States. What Does a Nurse Practitioner Do? Yes No This must be performed and dictated within 24 hours of admission. * The sum of all percentages is greater than 100% because some NPs have more than one certification.^ Indicates a primary care certification. A number of barriers to APRN practice prior to the pandemic were identified, with most respondents (n = 6334; 84.8%) identifying that practice barriers limited the ability to provide care during the pandemic. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. %PDF-1.5 Learn about the development and implementation of standardized performance measures. Following the Covid-19 pandemic, NPs have begun temporarily gaining full practice power through the use of reduced/restricted practices. They are authorized to diagnose, order and interpret diagnostic tests, and prescribe medication and other treatment. 5 1144 6 6 1301 7 7 1343 8 8 0000024163 00000 n These are generally held every 1 to 2 months. Their ability to provide compassionate and high-quality care to patients is demonstrated by the wide range of settings where they are available. You need to know all the details about NP practice in your statefrom signature authority to the number of CE hours required for licensure and beyond. /CIDSystemInfo << The doctor will then write an order for admission and the patient will be admitted by the hospital staff. % Entry-level nurse practitioners in the state earn over $50 hourly and average about $107,310 yearly. stream 3 2022 AANP National Nurse Practitioner Workforce Survey Preliminary Analysis. The entire application process, from inception to the granting of privileges, generally takes 3 to 6 months, although reports of 1 year are not unusual. American Association of Nurse Practitioners. Yet, barriers to APRN practice exist, including regulatory, state, and institutional barriers, that hinder their ability to practice to the full extent of their education, licensure, and certification. Please enable scripts and reload this page. Whereas not every state requires certification for NP licensure, most hospitals mandate national certification. In Texas, nurse practitioners (NPs) can admit patients to the hospital. Organizational requirements. US nurse practitioners push for more responsibilities. American Association of Nurse Practitioners National Nurse Practitioners sample survey: Update on acute care nurse practitioner practice. 0000004685 00000 n Reflects new or updated requirements: Changes represent new or revised requirements. State practice environment. Duplicate copies usually are not acceptable. J Gen Intern Med. endobj Issues and Answers: Medicare, Money and More. In the event of admission, the hospitalist will coordinate with other doctors and hospital staff to ensure that you receive the best possible treatment. (2015) After ten business days, the patient will require a prescription from a physician, dentist, chiropractic, podiatrist, physician assistant, or advanced nurse practitioner to continue treatment. 2016;31(7):771777. /ImageI ] A physician assistant, certified nurse practitioner, clinical nurse specialist, or certified nurse-midwifery physician may admit patients to hospitals in Ohio under new legislation that took effect on May 20, 2014; however, NPs working in restricted states are not permitted to prescribe, diagnose, or treat patients without first In Illinois, nurse practitioners will be able to diagnose patients, order diagnostic tests, provide therapy and education for patients who require it, and prescribe drugs. Evidence of a license in good standing as a nurse practitioner and current Virginia RN license OR RN license with multi-state privilege. /Parent 27 0 R /Subtype /CIDFontType2 They are also capable of providing healthcare in a variety of settings, including hospitals, clinics, and home health care facilities. /StemV 80 Plus, you'll have limitless opportunities for networking and fun with colleagues. J Clin Nurs. The Nurse Practitioner prescribing laws by state vary based on collaborative practice, full authority, or required supervision. Overcoming BarriersBarriers to obtaining hospital privileges are significant but definitely surmountable. 138 138 577 139 139 986 140 140 457 141 Practice settings included urban (n = 3094; 42.2%), suburban (n = 2326; 31.7%), and rural (n = 1914; 26.1%). >> Keep us informed at the Report Now page.