People, regardless of political affiliation, often get concerned when they consider how the government’s apparent competing interests may affect matters that are important to them. Healthcare is no exception in this regard. Some people believe that interests that are not good to society can help or hinder local, state, and federal policies and regulations.
Legislators are the ones who give legislative benefits, and their primary goal is to get re-elected. Legislators must consequently boost their chances of re-election, which necessitates political support. When faced with legislative requests, legislators are perceived to be logical and to assess costs and benefits.
However, the costs and benefits to society of enacting certain legislation are not considered in the legislator’s cost-benefit analysis. Instead, the benefits are the additional political support the politician would receive for supporting the law, as well as the political support they would lose as a result of their conduct. Legislators will support legislation if the benefits outweigh the drawbacks (positive political support). (page\s27)
Comparing regulations from various state/regional boards of nursing can be a beneficial exercise. This can help to share insights that may be useful if a state/region changes in the future. Furthermore, nurses may be required to be licensed in multiple states or regions.
All 50 states, the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, and the Virgin Islands have boards of nursing (BONs). Similar entities may exist for different regions as well. BONs’ mission is to protect the public through the regulation of nursing practice. BONs implement state/region regulations for nurses, which include laying out the requirements for licensure and defining the scope of nursing practice in that state/region.
Also Read: Discussion: NURS 6050 Population Health
This is insightful Vanna, nurses have essential responsibilities in the policy-making processes. In other words, their contributions are significant in ensuring that important nurse’s practices are incorporated in the policy document. Nurses are therefore regarded as great resources in the policy review processes. Becoming part of the nursing team within an organization is one of the best approaches of getting involved in the policy review (Dueñas et al., 2016). Nurses have different teams where they interact and contribute towards the policy making processes. There are different teams within a healthcare institution. These teams often operate to ensure that there is the implementation of the best policies that can guide the healthcare practices. Getting involved in the development of these policies often prove to be essential for the nurses as they get to gain skills and knowledge necessary in the management of general healthcare system.
Teams involved in the policy-making processes have to look for the best possible ways to enhance different practices within the healthcare institution. Becoming a member of professional nursing organization is another way that nurses can get involved in the policy review and policy-making processes (Kilbourne et al., 2018). Professional organizations consists of lobbyist who have great experiences at articulating the issues to the state representatives and other leaders who may raise the issue at the national and international levels. Professional nursing organizations also provides an avenue for people to express their thoughts in different healthcare issues. Becoming part of these organizations is critical in ensuring that different aspects of healthcare systems are addressed in line with the standards that have been developed (Dixit & Sambasivan, 2018). Communicating the existence of opportunities for the policy reviewers can be achieved through encouraging peers in the work environment to verbalize the grievances to the persons who are responsible for changing the policy.
References
Dueñas, M., Ojeda, B., Salazar, A., Mico, J. A., & Failde, I. (2016). A review of chronic pain impact on patients, their social environment and the health care system. Journal of pain research, 9, 457. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4935027/
Kilbourne, A. M., Beck, K., Spaeth‐Rublee, B., Ramanuj, P., O’Brien, R. W., Tomoyasu, N., & Pincus, H. A. (2018). Measuring and improving the quality of mental health care: a global perspective. World psychiatry, 17(1), 30-38. Retrieved from: https://doi.org/10.1002/wps.20482
Dixit, S. K., & Sambasivan, M. (2018). A review of the Australian healthcare system: A policy perspective. SAGE open medicine, 6, 2050312118769211. Retrieved from: https://doi.org/10.1177/2050312118769211
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To Prepare:
Review the Resources and reflect on the mission of state/regional boards of nursing as the protection of the public through the regulation of nursing practice.
Consider how key regulations may impact nursing practice.
Review key regulations for nursing practice of your state’s/region’s board of nursing and those of at least one other state/region and select at least two APRN regulations to focus on for this Discussion.
By Day 3 of Week 5
Post a comparison of at least two APRN board of nursing regulations in your state/region with those of at least one other state/region. Describe how they may differ. Be specific and provide examples. Then, explain how the regulations you selected may apply to Advanced Practice Registered Nurses (APRNs) who have legal authority to practice within the full scope of their education and experience. Provide at least one example of how APRNs may adhere to the two regulations you selected. Professional Nursing and State-Level Regulations NRSE 6050
RE: Discussion – Week 5-Main Post
Top of Form
Nurses are expected to be well-versed in state regulations pertaining to their particular field of expertise. Each state has its own unique set of rules and regulations, and the scope of practice will also differ from state to state. In this essay, I’ll go through the distinctions between Missouri’s and Mississippi’s nursing regulations.
It is the responsibility of the APRN to ensure that they are knowledgeable of the rules and regulations of the state in which they are obtaining certification or employment. As an example, APRNs are restricted or limited in their practice in Missouri and Mississippi. If they had complete practice power, they would be able to prescribe any medication their patients needed without having to rely on a partnering physician. Limited NP practice makes it difficult for them to give care in places where primary health care practitioners are scarce (The impact of Nurse Practitioner Regulations on Population Access to Care, 2018). Having patients who aren’t seeking approval would make it easier for doctors to treat them. The APRN should familiarize themselves with the regulating board and the Nurse Practice Act of the state in which they plan to practice.
References:
NursingLicensure.org. (2020a). How to Become a Nurse Practitioner in
Mississippi/ APRN Certification in Mississippi-NursingLicensure.org.
NursingLicensure.Org-A More Efficient Way to Find Nursing License Requirements in
Your State. https://www.nursinglicensure.org/np-state/mississippi-nurse-practitioner/
NursingLicensure.org. (2020b). How to Become a Nurse Practitioner in Missouri/APRN Certification
Requirements in MO-NursingLicensure.org. NursingLicensure.org-A More Efficient Way to Find Nursing License
Requirements in Your State. https://www.nursinglicensure.org/np-state/missouri-nurse-
practioner/#:%7E:text=Missouri%E2%80%99s%20Advanced%20Practice%20Registered%20Nurses%20are%2
0licensed%20as.other%20state%20is%20their%20primary%20state%20of%20residence
Position statement: Full practice authority for advanced practice registered nurse/s is necessary to
transform primary care. (November 2017). ScienceDirect.
https://linkinghub.elsevier.com/retrieve/pii/S002965541730554
The impact of nurse practitioner regulations on population access to care. (2018). ScienceDirect.
https://linkinghub.elsevier.com/retrieve/pii/S00296554173061664
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READINGS
1 Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.
- Chapter 4, “Government Response: Regulation” (pp. 57–84)
2 http://www.nursingworld.org/
3Bosse, J., Simmonds, K., Hanson, C., Pulcini, J., Dunphy, L., Vanhook, P., & Poghosyan, L. (2017). Position statement: Full practice authority for advanced practice registered nurses is necessary to transform primary care. Nursing Outlook, 65(6), 761–765. doi:10.1016/j.outlook.2017.10.002
Note: You will access this article from the Walden Library databases.
5 https://www.ncsbn.org/index.htm
6 Neff, D. F., Yoon, S. H., Steiner, R. L., Bumbach, M. D., Everhart, D., & Harman J. S. (2018). The impact of nurse practitioner regulations on population access to care. Nursing Outlook, 66(4), 379–385. doi:10.1016/j.outlook.2018.03.001
Note: You will access this article from the Walden Library databases.
7 Peterson, C., Adams, S. A., & DeMuro, P. R. (2015). mHealth: Don’t forget all the stakeholders in the business case. Medicine 2.0, 4(2), e4. doi:10.2196/med20.4349
Note: You will access this article from the Walden Library databases.
Professional Nursing and State-Level Regulations NRSE 6050 SAMPLE
Different states tend to have unique regulations for the Advance Practice Registered Nurse but all aims at securing the interest of the public health safety by regulating the activities of the health care professionals (Milstead, 2019). The board of nursing of a state acts on the power derived from the Nurse Practice Act passage that allows them to set and regulate standard for safe nursing practice within its jurisdiction for nurses that have the qualification and for advanced practice including licensure requirements and license renewal as well as any necessary disciplinary actions (Milstead, 2019).
Comparing the State of Georgia, my home state APRN board of nursing regulation to that of the State of Nebraska; the first thing I noticed is that Georgia state regulatory body is the board of nursing while that of Nebraska is the Department of Health and Human Services. The credentialing criteria are similar, but there are some differences in the scope of practice. Georgia state practice regulation has a restrictive tendency; the practice authority allows limited actions for APRN practice requiring supervision by health care provider throughout the APRN’s practice or team management before an APRN such as an NP can provide care to patients (American Association of Nurse Practitioners (AANP), 2018). In the state of Georgia, the practice authority requires a written protocol between the NP and the overseeing physician which specifies medical acts delegated by the physician and demands an instant session with the physician (Scope of Practice Policy, 2019). No wonder at my practice setting an NP is not allowed to initiate care nor partake in a patient discharge process.
On the other hand, Nebraska state and licensure law permit all NPs to exercise autonomy in practice such that they can assess patients, diagnose, order diagnostic tests, initiate and manage treatments, prescribe all medications including control substances without a provider’s supervision after fulfilling the criteria for doing so (Nebraska legislature, n.d). Allowing APRNs to have full practice access will enable an increase in experience and expand the talents inherent in the nurse practitioners and encourage significant innovations in the nursing profession; also motivates other NPs to spring up in filling the gap created by the shortage of providers in America.
In Georgia, an NP can only prescribe a schedule III to V control substance if operating under the prescriptive authority of a supervising physician by submitting a written protocol to the supervising physician and permission is granted (American Medical Association (AMA), 2017). While in Nebraska, an NP may prescribe both legend drug and Schedules II-V controlled substances after the NP has put in first 2000 hours of practice under the supervision of a physician as well as completing 30 hours of education in pharmacotherapeutics and the board does not track the number of the NPs with DEA numbers (AMA, 2017). Both states require that providers should register in the prescription drug monitoring program (PDMP) for Benzodiazepines and opiates but the difference is that APRN in Georgia is practicing under the prescriptive authority of a physician and are not able to delegate access to PDMP unless a nurse who has prescriptive authority (Georgia Department of Public Health, 2018). While in Nebraska, APRN has prescriptive authority; thus, can delegate access to PDMP (Borcher, 2016).
It would be to the perfect interest of patients and the society as a whole for all the APRN in America to have equal full legal authority in all the states as in Nebraska to enable them to practice within the full scope of the education and experience they have earned through rigorous academic and clinical training. According to Doyle et al., (2017), NPs have all it takes to practice to the full scope of education gained; this prompted the IOM to call on states with unjustifiably restrictive regulations on the NPs like Georgia state to amend the law that will authorize NPs to practice to the full scope of their ability across the countries. Also as mentioned earlier, allowing NPs to have full practice authority that would enable them to practice and prescribe independently would assist in addressing the workforce shortage allowing underserved areas to have access to health care as well as all Americans in general (Doyle et al., 2017)
References
American Association of Nurse Practitioners. (2018). Retrieved from https://www.aanp.org/advocacy/state/state-practice-environment
American Medical Association. (2017). Retrieved from https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/specialty%20group/arc/ama-chart-np-prescriptive-authority.pdf
Borcher, K. C., & Houseman, R. (2016). Nebraska and Prescription Drug Monitoring Program. Retrieved from http://www.nebraskahospitals.org/file_download/inline/c0cd1c7d-0de6-477d-b92c-0cee2f87f23d
Doyle, J. M., Zangaro, G. A., Howie, B. A., & Bigley, M. B. (2017). Retrospective Evaluation of the Advanced Nursing Education Expansion Program. The Journal for Nurse Practitioners, 13 (97), 488-495 DOI:10.1016/j.nurpra.2017.04.019
Georgia Department of Public Health. (2018). Retrieved from https://dph.georgia.gov/pdmp
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning
Nebraska legislature (n.d). Retrieved from https://nebraskalegislature.gov/laws/statutes.php?statute=38-2315
Scope of practice policy. (2019). Georgia Scope of Practice Policy: State Profile. Retrieved from http://scopeofpracticepolicy.org/states/ga/#practitioner-nurse-practitioners
RE: Discussion – Week 5
Top of Form
The National Council of State Boards of Nursing (NCSBN) is a non-profit organization that brings together various nursing regulatory bodies to discuss and work on a variety of interests and concerns. They are currently the world leader in nursing regulatory knowledge (National Council of State Boards of Nursing, 2020). The NCSBN represents all 59 nursing regulatory bodies in the United States. They define nursing care safety standards and issue licenses to practice (National Council of State Boards of Nursing, 2020). My home state of North Carolina and Texas are the two APRN regulatory boards I chose for this discussion board.
The first aspect of North Carolina nursing regulation that I investigated was the education and certification requirements. Nurse practitioners must provide certification evidence from a national credentialing body, according to 21 NCAC 3.0805. (NC Board of Nursing, 2020a). A nurse practitioner education program with 400 didactic and preceptorship hours must be completed. Health assessment and diagnosis, pharmacology, pathophysiology, disease management, prevention services, client education, and role development are all required courses (NC Board of Nursing, 2020a, para. #1).
I then researched the continuing education requirements for APRNs in North Carolina. According to 21 NCAC 36.0807, 50 hours of continuing education are required each year to maintain practice approval. The ANCC or ACCME, other credentialing bodies, or practice relevant courses must provide 20 of the hours (NC Board of Nursing, 2020b, para. #1). If the APRN prescribes controlled substances, one hour of continuing education must be devoted to substance use acts.
Texas APRN educational requirements, on the other hand, are approved by the State of Texas accrediting board. The program must be at the Master’s level of nursing education, according to Rule 219.1, and the director and faculty must all comply with the Nurse Practice Act and Board of Nursing regulations (Texas Board of Nursing, 2018). The education program should have uniform standards, and it should promote safe and effective advanced practice nursing as a developmental guide, as well as provide criteria for evaluating new APRNs (Texas Board of Nursing, 2018).
Texas APRNs are required to complete 20 hours of professional development, or they can obtain, maintain, or renew national nursing certification approved by the Texas Board of Nursing (Texas Board of Nursing, 2019). Pharmacotherapeutics must receive 5 additional contact hours. Competencies must be obtained during the two-year period preceding license renewal (Texas Board of Nursing, 2019).
APRNs are subject to licensure and continuing education requirements because they must demonstrate and maintain educational competence. Both states have misconduct regulations, and failing to adhere to competent care can result in unsafe practice, patient harm, and being seen in front of the nursing board, with the possibility of having a license revoked. With advanced practice licensure comes autonomy, which comes with the expectation and responsibility for professionals to stay current and competent when practicing at all times.
APRNs can comply with these regulations by staying current on education and practices related to the care they provide. They can also join professional organizations, which provide access to journals and opportunities for continuing education. The American Association of Nurse Practitioners (AANP) is an excellent example of a professional organization that offers APRNs advocacy, CE hours, journal subscriptions, and other benefits (American Association of Nurse Practitioners, n.d.). Additionally, APRNs can become certified and gain expertise in their field.
References
American Association of Nurse Practitioners. (n.d.). Membership. https://www.aanp.org/membership
National Council of State Boards of Nursing. (2020). About U.S. nursing regulatory bodies. https://www.ncsbn.org/about-nursing-regulatory-bodies.htm
NC Board of Nursing. (2020a). Education and certification requirements for registration as a nurse practitioner. http://reports.oah.state.nc.us/ncac/title%2021%20-%20occupational%20licensing%20boards%20and%20commissions/chapter%2036%20-%20nursing/21%20ncac%2036%20.0805.html
NC Board of Nursing. (2020b). Continuing education (CE). http://reports.oah.state.nc.us/ncac/title%2021%20-%20occupational%20licensing%20boards%20and%20commissions/chapter%2036%20-%20nursing/21%20ncac%2036%20.0807.html
Texas Board of Nursing. (2018). Advanced practice registered nurse education. https://www.bon.texas.gov/rr_current/219-1.asp
Texas Board of Nursing. (2019). Requirements for APRNs. https://www.bon.texas.gov/education_continuing_education.asp#E
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ADDITIONAL INSTRUCTIONS FOR THE CLASS
Questions for Discussion (DQ)
Initial responses to the DQ should address all aspects of the questions, incorporate at least one scholarly source, and be at least 250 words in length.
Successful comments are substantive (i.e., they contribute something new to the conversation, they engage others in the discussion, and they contain at least one scholarly source).
One- or two-sentence comments, simple affirmations of agreement or “excellent post,” and off-topic responses will not be considered substantive. Responses should be at least 150 words in length.
I invite you to incorporate the week’s readings into your comments (where applicable).
Weekly Involvement
The obligatory DQ’s initial responses do not count toward participation and are scored separately.
Along with the DQ responses, you must post at least one response to peers (or to me) on three distinct days, for a total of three responses.
No scholarly source/citation is required for participation posts (unless you cite another author’s work).
As part of your weekly involvement, you must see the weekly announcement and confirm your viewing in the comments section. These notifications are provided to ensure that you are aware of all of the tasks that are due during the week.
APA Style and Writing Prowess
Familiarize yourself with the APA format and practice correctly applying it. It is used for the majority of writing assignments associated with your degree. For APA paper templates, citation examples, and recommendations, visit the Writing Center in the Student Success Center, accessible via the Resources option in LoudCloud. Points will be removed for ineffective use of the APA format or for the complete absence of the APA format (if required).
All sources of information must be cited! Cite the source whenever possible. Additionally, paraphrasing requires a citation.
I strongly advise you to use the sixth edition of the APA Publication Manual.
Utilization of Direct Quotes
At the Masters’ level, I discourage excessive use of direct quotes in DQs and assignments and deduct points accordingly.
It is crucial for you to be able to critically assess and comprehend information from journal articles and other sources as Masters’ level students. Simply restating another’s words does not demonstrate comprehension or critical analysis of the material.
It is preferable to paraphrase and cite your sources.
Policy LopesWrite
Please ensure that you have got your report and Similarity Index (SI) percentage BEFORE submitting your assignment to LopesWrite.
Please examine your report after you have got it. This report will highlight common grammar, punctuation, and spelling mistakes. Spend a few more minutes reviewing rather than being penalized for these errors.
Examine your parallels. Did you overlook a citation? Were you unable to adequately paraphrase? Is the majority of your paper composed of someone else’s opinions rather than your own?
For advice on how to improve your paper and SI score, visit the Writing Center in the Student Success Center, accessible via the Resources option in LoudCloud.
Policy on Late Arrivals
The university’s late assignment policy is a 10% penalty PER DAY LATE. This also holds true for late DQ responses.
Kindly contact me if you anticipate submitting an assignment late. I am happy to accommodate special requests with enough notice. We may be able to arrange you an extension if extenuating circumstances exist.
If you do not contact me prior to submitting an assignment late, GCU’s late policy will apply.
I will not accept projects that are more than two weeks late unless an extension has been agreed upon.
Assignments are not accepted after the last day of class, per policy. Any assignment submitted after 12:00 a.m. on the final day of class will not be graded.
Communication
Communication is critical. There are several methods to contact me:
This is an excellent location to address questions about course content or assignments. If you have a question, it’s likely that one of your peers does as well. This is the class’s public forum.
This is a private forum where you may ask me questions or send me messages. At the very least, this will be checked once every 24 hours.
Rubric Detail
Select Grid View or List View to change the rubric’s layout.
Content
Name: NURS_6050_Module03_Week05_Discussion_Rubric
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List View
Excellent Good Fair Poor
Main Posting
Points Range: 45 (45%) – 50 (50%)
Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.
Supported by at least three current, credible sources.
Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
Points Range: 40 (40%) – 44 (44%)
Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.
At least 75% of post has exceptional depth and breadth.
Supported by at least three credible sources.
Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
Points Range: 35 (35%) – 39 (39%)
Responds to some of the discussion question(s).
One or two criteria are not addressed or are superficially addressed.
Is somewhat lacking reflection and critical analysis and synthesis.
Somewhat represents knowledge gained from the course readings for the module.
Post is cited with two credible sources.
Written somewhat concisely; may contain more than two spelling or grammatical errors.
Contains some APA formatting errors.
Points Range: 0 (0%) – 34 (34%)
Does not respond to the discussion question(s) adequately.
Lacks depth or superficially addresses criteria.
Lacks reflection and critical analysis and synthesis.
Does not represent knowledge gained from the course readings for the module.
Contains only one or no credible sources.
Not written clearly or concisely.
Contains more than two spelling or grammatical errors.
Does not adhere to current APA manual writing rules and style.
Main Post: Timeliness
Points Range: 10 (10%) – 10 (10%)
Posts main post by day 3.
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Does not post by day 3.
First Response
Points Range: 17 (17%) – 18 (18%)
Response exhibits synthesis, critical thinking, and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are fully answered, if posed.
Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of learning objectives.
Response is effectively written in standard, edited English.
Points Range: 15 (15%) – 16 (16%)
Response exhibits critical thinking and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in standard, edited English.
Points Range: 13 (13%) – 14 (14%)
Response is on topic and may have some depth.
Responses posted in the discussion may lack effective professional communication.
Responses to faculty questions are somewhat answered, if posed.
Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.
Points Range: 0 (0%) – 12 (12%)
Response may not be on topic and lacks depth.
Responses posted in the discussion lack effective professional communication.
Responses to faculty questions are missing.
No credible sources are cited.
Second Response
Points Range: 16 (16%) – 17 (17%)
Response exhibits synthesis, critical thinking, and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are fully answered, if posed.
Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of learning objectives.
Response is effectively written in standard, edited English.
Points Range: 14 (14%) – 15 (15%)
Response exhibits critical thinking and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in standard, edited English.
Points Range: 12 (12%) – 13 (13%)
Response is on topic and may have some depth.
Responses posted in the discussion may lack effective professional communication.
Responses to faculty questions are somewhat answered, if posed.
Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.
Points Range: 0 (0%) – 11 (11%)
Response may not be on topic and lacks depth.
Responses posted in the discussion lack effective professional communication.
Responses to faculty questions are missing.
No credible sources are cited.
Participation
Points Range: 5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days.
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days.
Total Points: 100
Name: NURS_6050_Module03_Week05_Discussion_Rubric
Initial Discussion – Week 5 J. Pryor
Top of Form
An Advanced Registered Nurse Practitioner (ARNP) is a certified registered nurse who has completed national certification for a specialized area (Arizona Board of Nursing, 2020) such as Psychiatric Mental Health Nurse Practitioner (PMHNP). This nurse will compare the regulations from two of the places she has lived in, Alaska and Arizona
According to Ariz. Rev. Ann § 32-1601(20) (ARNP) has full independent authority and practice under licensure authority of the State Board of Nursing instead of a licensed physician (NCSL Scope of Practice Policy, 2021). The same is true in Alaska, (ARNP) have full independence to practice without the supervision of a physician according to Alaska Admin. Code §12-44.400. This means that both states allow (ARNP) to
- Examine a patient and establish a medical diagnosis by client history, physical examination, and other criteria.
- For a patient who requires the services of a health care facility: Order and interpret laboratory, radiographic, and other diagnostic tests, and perform those tests that the RNP is qualified to perform.
- Admit the patient to the facility,
- Manage the care the patient receives in the facility, and
- Discharge the patient from the facility.
- Prescribe, order, administer and dispense therapeutic measures including pharmacologic agents and devices if authorized under R4-19-511, and non-pharmacological interventions including, but not limited to, durable medical equipment, nutrition, home health care, hospice, physical therapy, and occupational therapy.
- Identify, develop, implement, and evaluate a plan of care for a patient to promote, maintain, and restore health.
- Perform therapeutic procedures that the RNP is qualified to perform.
- Delegate therapeutic measures to qualified assistive personnel including medical assistants under R4-19-509.
- Perform additional acts that the RNP is qualified to perform and that are generally recognized as being within the role and population focus of certification. (ARIZONA STATE BOARD OF NURSING, 2017)
One key difference is in the prescribing and dispensing authority within each state. Arizona requires that evidence of a minimum of 45 contact hours of education within the three years immediately preceding the application be submitted, covering one or both of the following topics consistent with the population focus of education and certification: Pharmacology, or Clinical management of drug therapy (ARIZONA STATE BOARD OF NURSING, 2017). While Alaska requires the applicant to provide evidence of completion of 15 contact hours of education in advanced pharmacology and clinical management of drug therapy within the two-year period immediately before the date of application (DIVISION OF CORPORATIONS, BUSINESS AND PROFESSIONAL LICENSING, 2021)
References:
Arizona Board of Nursing. (2020, July 24). Arizona Board of Nursing Scope of Practice APRN Questions & Answers SCOPE OF PRACTICE Nurse Practitioners. Retrieved from Arizona Board of Nursing: https://www.azbn.gov/sites/default/files/2020-11/FAQs%20Final%20Questions-%20NP%207.24.20%20%281%29.pdf
ARIZONA STATE BOARD OF NURSING. (2017, July 1). RULES OF THE STATE BOARD OF NURSING. Retrieved from ARIZONA STATE BOARD OF NURSING: https://www.azbn.gov/sites/default/files/2018-12/rulesjuly12017final.pdf
DIVISION OF CORPORATIONS, BUSINESS AND PROFESSIONAL LICENSING. (2021). Statutes and Regulations Nursing Nursing. DEPARTMENT OF COMMERCE, COMMUNITY, AND ECONOMIC DEVELOPMENT (p. 23). State of Alaska.
NCSL Scope of Practice Policy. (2021). State Overview: Arizona. Retrieved from NCSL Scope of Practice Policy: https://scopeofpracticepolicy.org/states/az/
MAIN POST RE: Discussion – Week 5
APRN Board Regulations in Texas and California
In the present healthcare environment, the role of nurses as a crucial element of the system is increasingly recognized. As such registered nurses often rely on Advanced Practice degrees in pursuit of independent provision of care. According to Schober (2018) their ability to promote accessible and safer care is acknowledge internationally, and new opportunities for nurses arise. In order to meet the requirements of independent practice, the usual procedure comprises a postgraduate degree that helps nurses reach a new level of expertise on the solid foundation obtained previously. Having complete the stage of education, advanced practice nurses are able to commence the new phase of their careers. However, in the case of the United States, the exact nature of advanced nursing practice may vary across different states.
For example, Texas is one of the territories where APRN practitioners benefit from the independent practice opportunities. More specifically, this state’s Nursing Practice Act introduces a possibility of independent work for an advanced practice nurse who meets the primary requirements. In order to obtain this status, an educated professional needs to complete licensing and certification procedures that will provide them with the required credentials (Texas Board of Nursing, 2021). The situation is different in California where advanced practice nurses cannot work without a physician’s supervision as per the Nursing Practice Act. Major changes are projected for the near future, as APRNs will be released from compulsory supervision in 2023 (California Board of Professional Nursing, 2021). However, the present-day situation remains the same. Another key difference between Texas and California consists of the APRN’s prescriptive authority. In the first case, while nurses can be independent practitioners, their prescriptive authority is to be delegated by a physician. In California, the lack of independence translates into the compulsory participation of a physician or a surgeon in all prescriptions.
References
California Board of Professional Nursing. (2021). Nursing Practice Act. Retrieved September 24, 2021, from https://www.rn.ca.gov/practice/npa.shtml
Schober, M. (2018). Global emergence of nurse practitioner/advanced practice nursing roles. Journal of the American Association of Nurse Practitioners, 30(4), 182–184.
Texas Board of Nursing. (2021). Nursing Practice Act. Retrieved September 24, 2021, from https://www.bon.texas.gov/pdfs/law_rules_pdfs/nursing_practice_act_pdfs/NPA2021.pdf
