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Leading with Purpose

Dr. April Kapu

Vanderbilt's April Kapu Named AANP President-Elect

More than one billion Americans visit nurse practitioners annually. As providers scramble to care for an aging baby boomer population on the heels of an unprecedented pandemic, the need for advanced care practitioners has skyrocketed.

In June, leadership of the industry's largest professional organization - the American Association of Nurse Practitioners (AANP) - will fall to president-elect April Kapu, DNP, RN, ACNP-BC, FAANP, FCCM, FAAN, of Vanderbilt. With 118,000 members, the AANP represents the largest nurse practitioner community nationwide.

A certified acute care nurse practitioner and professor of clinical nursing for Vanderbilt University School of Nursing, Kapu also serves as the associate chief nursing officer for advanced practice nursing at Vanderbilt University Medical Center, providing professional practice support for more than 1,200 Advanced Practice Registered Nurses.

NMN: You've had a dynamic career in both the academic and private realms. How has that shaped you as an educator, leader and APRN advocate?

Kapu: I have been fortunate to grow within a healthcare organization that employs over 1,300 advanced practice professionals across our hospitals and clinics. My executive leadership and healthcare management growth and development have come from working with world-class healthcare executives from nursing, medicine, pharmacy and other health disciplines. Through my doctoral work and now as a clinical professor, my educational opportunities have provided the underpinning to scholarly research and a better understanding of the patient care and health policy issues that our country faces today.

How has the national nursing shortage affected APRNs?

There are 3.8 million RNs in the U.S. and nurse practitioners comprise just over 7 percent of the total workforce. Building a robust nursing workforce is critically important as our nation builds back from COVID and plans for the future. More than 10,000 baby boomers become Medicare eligible every day and an increasing number of Americans live with chronic disease.

In the last several years, the federal government, state legislatures and healthcare systems have been steadily updating policy to make full use of the knowledge and skills of nurse practitioners. For example, the federal government has recently authorized NPs to prescribe medication to help treat substance use disorder. Since then, every state, including Tennessee, has made it easier for patients to get access to these lifesaving treatments. Removing barriers between NPs and their patients is one way to make sure we make the most of the workforce.

Cam you share some insights on the ongoing discussion about a push for autonomy for APRNs?

Many, if not most, APRNs currently practice autonomously. The issues have mainly centered on outdated collaborative practice agreements and supervisory agreements required by various states, as well as supporting the state board of nursing to be the sole regulatory body for the practice of advanced practice nursing as a profession. Closing the gap between the level of care that NPs are prepared to deliver and the level of care that some state laws allow them to deliver must be addressed.

In about half the country, patients have full and direct access to nurse practitioners' services. These states are referred to as Full Practice Authority States, meaning that under their license, they are authorized to practice to full extent of their education, clinical training and board certification. In the remaining states, outdated state laws make it illegal for NPs to directly provide the care they were educated and nationally certified to provide. States with Full Practice Authority have been demonstrated to have better ability to recruit and retain NPs in rural and underserved communities and maintain high care quality while decreasing healthcare costs and improving access to care.

How do you envision the role of APRNs in today's rural communities?

More than 80 million Americans live in Health Professional Shortage Areas - or areas where there are more than 3,500 patients for a single primary care provider. This lack of access means no prevention, screening, immunizations, or primary care for infections, sickness, and inadequate healthcare access. Over the last few years, NPs have increased from 18 percent to a quarter of the rural primary care workforce. At the School of Nursing, more than 40 percent of graduates choose to work in rural or underserved communities. With 30,000 new NPs entering the healthcare workforce each year, NPs are adding high-quality providers and increasing access to care.

Has your experience overseeing the APRN division of VUMC's COVID unit changed the way you view patient care?

Over and over again, APRNs stepped up to lead during this pandemic. Whether it was in the early days battling for personal protective equipment or now administering vaccines, APRNs have been, and continue to work, on the frontlines of COVID day in and day out. Working in our COVID command center this past year, APRNs have led in the development of our COVID ICU. as well as our hotline, COVID assessment clinics, vaccination stations and many efforts we have launched to provide care to our patients and our communities.

What efforts has VUSN made to expand their offerings/programs and to better incorporate APRNs on both the educational and patient care sides?

APRN students should seek out the best education for their masters and doctorate programs and look for accredited schools, as well as the critical elements of a robust academic program. According to the 2022 U.S. News and World Report, Vanderbilt University School of Nursing is ranked No. 1 for our psych mental health NP program, No. 2 in the country for our acute and family NP programs, and No. 6 for our doctoral program. Speaking from my vantage point as an employer of NPs, I am thrilled with the level of preparedness of Vanderbilt's graduate students and their readiness to step into an entry-level role in advanced practice care, especially during a time when our country needs to expand access to primary care more than ever.

Reflecting on your career, what achievements have meant the most to you?

Being part of the build for Vanderbilt's generous and comprehensive advanced practice infrastructure has been a defining part of my career. Many APRNs seek us out as an employer because of the excellent environment for advanced practice, education and research. My work in education as faculty with VUSN has only deepened my passion for the APRN role and its importance in expanding access in a healthcare setting. AANP has allowed me to grow in professional advocacy and support of nurse practitioners worldwide.



AANP Leadership, April Kapu



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AANP, American Association of Nurse Practitioners, April Kapu, Vanderbilt University School of Nursing, VUSN
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