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1.Identify and describe practice barriers for APNs in your state and discuss these barriers on a state and national level. In 2010 the Institute of Medicine (IOM) released the report, “The Future of Nursing: Leading Change, Advancing Healthadvocating for an expanded scope of practice for APN’s (IOM, 2011). The role of Advanced Nurse Practitioners (APN) has expanded over the years and has become one of todays most sought after healthcare professions. However, despite the many advancements in the role of APN’s, there are still many barriers at the state and national level, hindering APN’s ability to practice to the full extent of their license. In 2015 the IOM reviewed theprogress made after release of The Future of Nursing report upon which many barriers were discovered. Some of the barriers to expansion of APN’s scope of practice include, opposition by physicians and physician organizations, regulatory restrictions on nursing practice, lack of diversity in the nursing workforce, lack of data collection on nursing workforce, and lack of doctorate-trained nurses (IOM, 2015).Michigan is one of the 12 restrictive states which is making it difficult for APN to practice to the fullest extent of their education and training (Hain & Fleck, 2015). According to the IOM report (2011), overly restrictive scope-of-practice regulations in some states is one of the most serious barriers to accessible care (IOM, 2011). Restrictive practice prevents APN from engaging in at least one element of NP practice and requires supervision, delegation, or team management by anoutside health discipline to provide patient care (AANP, 2016). APN’s in the state of Michigan can prescribe nonscheduled drugs but require oversight by physicians to prescribe schedule 2 through 5 drugs. Furthermore, a practice barrier for APN’s at a national level is physician and NP integration. APNhave an important role in healthcare and can help meet the growing demand from primary care however, this some physician related barriers have made this difficult. For instance, some