Advanced Practice Registered Nurses’ Views of the APRN Compact: Survey Findings From Five U.S. States

Background

The 2022 National Nursing Workforce study projected a worsening nursing shortage in the wake of the COVID-19 pandemic. An International Council of Nurses report also identified the shortage of nurses as a global health emergency. In response, policymakers and researchers are now exploring interstate licensure compacts as a long-term policy option to mitigate healthcare workforce crises and improve access to care through increased workforce mobility.

Purpose

To assess and quantify the interest and possible concerns of advanced practice registered nurses (APRNs) regarding the APRN Compact licensure model.

Methods

This study is an aggregate report of findings from state-based online surveys conducted by the National Council of State Boards of Nursing from 2021 to 2023. APRN responses from Arizona, Maryland, Montana, West Virginia, and Wyoming are included. The survey instrument contained 12 questions, which included respondents’ demographics (e.g., license type, APRN practice experience) and opinions about adopting the APRN Compact.

Results

A total of 8,453 APRNs completed the survey for an overall response rate of 26%. At the time of the survey, 46% of respondents held an active APRN license in at least one state other than the state in which they were surveyed. Eighty-six percent of respondents supported the APRN Compact, 4% opposed it, and the remaining 10% did not specify an opinion. Of the 7,409 respondents who expressed their support or opposition, 96% reported a favorable opinion of the APRN Compact. Increased patient access to high-quality healthcare was the most frequently cited reason for supporting the APRN Compact, whereas the 2,080 hours of experience requirement was the most frequently cited concern. The high support rate for the APRN Compact was consistent across practice patterns, provider roles, experience, and state of residency. Eighty-four percent of respondents indicated that they would apply for an APRN Compact license if it becomes available.

Conclusion

The majority of responding APRNs would welcome the APRN Compact, would apply for the multistate license, and reasoned that the Compact would increase patient access to high-quality care.