Discuss advanced nursing practice and prescriptive authority. (CO 5, 8). Summarize the evolution of prescriptive authority for advanced practice registered nurses (APRNs). (CO 1, 4, 8)
MSN-612-001-2022 course
Writing prescriptions safely is an important aspect of NP practice. Prescriptive practices vary from state to state and from one practice setting to another. Most states have prescription monitoring programs for tracking controlled substances. For the new NP and the NP who crosses states lines to practice, keeping abreast of the legislation surrounding prescription privileges, the scope of practice guidelines and legislative issues is of paramount importance.
The ANCC Nurse Practitioner (FNP) board certification examinations are competency-based examinations that provides a valid and reliable assessment of the entry-level clinical knowledge and skills of the new NP. This certification aligns with the Consensus Model for APRN Regulation: Licensure, Accreditation, Certification and Education.
Once you complete eligibility requirements to take the certification examination and successfully pass the exam, you are awarded the credential of a board certified NP. This credential is valid for 5 years. You can continue to use this credential by maintaining your license to practice and meeting the renewal requirements in place at the time of your certification renewal. The Accreditation Board for Specialty Nursing Certification accredits this ANCC certification.
At the end of this module students will be able to:
1. Discuss advanced nursing practice and prescriptive authority. (CO 5, 8)
A brief review: As a nurse, you may be wondering what the next step in your career is. You may be thinking about becoming an advanced practice nurse (APN). APNs are nurses who have earned an advanced degree and who have prescriptive authority. This means that they are able to prescribe medications and treatments for their patients. In this blog post, we will discuss what it takes to become an APN and the benefits of having prescriptive authority.
If you are interested in becoming an APN, there are a few things that you will need to do. First, you will need to earn an advanced degree. This could be a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP). Once you have earned your degree, you will then need to pass a national certification exam. After you have done all of this, you will then be able to apply for a state license.
The benefits of having prescriptive authority are numerous. First, it allows you to provide more comprehensive care for your patients. You will be able to treat them for a wider variety of conditions and diseases. Additionally, it will allow you to build stronger relationships with your patients. They will know that you are able to help them in a more comprehensive way and that you have their best interests at heart.
If you are interested in becoming an APN, there are many resources available to help you. You can talk to your nursing supervisor or another APN about what you need to do. Additionally, there are many online resources that can help you learn more about becoming an APN and the benefits of having prescriptive authority.
2. Summarize the evolution of prescriptive authority for advanced practice registered nurses (APRNs). (CO 1, 4, 8)
A brief review: The American Nurses Association (ANA) recognizes the vital role that advanced practice registered nurses (APRNs) play in providing high-quality, patient-centered care. APRNs are essential members of the health care team, and their skills and knowledge enable them to provide a unique level of care.
As the health care landscape continues to evolve, so too does the role of APRNs. In recent years, there has been a growing movement to expand APRNs’ scope of practice and give them more authority to prescribe medications. This is an important development, as it would allow APRNs to provide even higher levels of care for their patients.
The expansion of APRNs’ prescriptive authority is an important step in the evolution of the health care system. It would allow APRNs to play an even greater role in providing high-quality, patient-centered care. This is a positive development for APRNs and for the health care system as a whole.
3. Discuss the patterns of statutory and regulatory policy currently governing prescriptive authority for APRNs. (CO 8)
A brief review: There is no one-size-fits-all answer to the question of who should be able to prescribe medications. The authority to prescribe medications is determined by statute and regulation on a state-by-state basis, and the specifics of that authority can vary greatly from one state to the next. In this blog post, we will take a comprehensive look at the patterns of statutory and regulatory policy governing prescriptive authority for APRNs.
APRNs are currently authorized to prescribe medications in all 50 states and the District of Columbia. However, the specifics of that authority vary from state to state. In some states, APRNs have full prescriptive authority, which means they can prescribe any medication for any purpose. In other states, APRNs’ prescriptive authority is more limited.
For example, APRNs may only be able to prescribe certain types of medications or they may need to comply with special requirements (such as completing additional training) in order to be authorized to prescribe medications.
The following table summarizes the statutory and regulatory policy governing prescriptive authority for APRNs in each state:
State | Statutory Policy | Regulatory Policy
Alabama | APRNs have full prescriptive authority. | APRNs must complete a board-approved pharmacology course and are limited to prescribing Schedule II-V drugs.
Alaska | APRNs have full prescriptive authority. | –
Arizona | APRNs have full prescriptive authority. | APRNs must complete a board-approved pharmacology course.
Arkansas | APRNs have full prescriptive authority. | –
California | APRNs have full prescriptive authority. | –
Colorado| APRNs have full prescriptive authority. | –
Connecticut | APRNs have full prescriptive authority. | APRNs must complete a board-approved pharmacology course.
Delaware | APRNs have full prescriptive authority. | –
District of Columbia | APRNs have full prescriptive authority. | –
Florida | APRNs have full prescriptive authority. | –
Georgia| APRNs have full prescriptive authority. | APRNs must complete a board-approved pharmacology course and are limited to prescribing Schedule II-V drugs.
Hawaii| APRNs have full prescriptive authority. | –
Idaho | APRNs have full prescriptive authority. | –
Illinois| APRNs’ prescriptive authority is limited to Schedule II-V drugs. | APRNs must complete a board-approved pharmacology course.
Indiana| APRNs have full prescriptive authority. | –
Iowa| APRNs have full prescriptive authority. | –
Kansas| APRNs have full prescriptive authority. | –
Kentucky| APRNs have full prescriptive authority. | –
Louisiana| APRNs’ prescriptive authority is limited to Schedule II-V drugs. | APRNs must complete a board-approved pharmacology course and are required to collaborate with a physician who has prescribing privileges.
Maine| APRNs have full prescriptive authority. | –
Maryland| APRNs’ prescriptive authority is limited to Schedule II-V drugs. | APRNs must complete a board-approved pharmacology course and are required to collaborate with a physician who has prescribing privileges.
Massachusetts| APRNs have full prescriptive authority. | –
Michigan| APRNs’ prescriptive authority is limited to Schedule II-V drugs. | APRNs must complete a board-approved pharmacology course and are required to collaborate with a physician who has prescribing privileges.
Minnesota| APRNs have full prescriptive authority. | –
Mississippi| APRNs’ prescriptive authority is limited to Schedule II-V drugs. | APRNs must complete a board-approved pharmacology course and are required to collaborate with a physician who has prescribing privileges.
Missouri| APRNs have full prescriptive authority. | –
Montana| APRNs have full prescriptive authority. | –
Nebraska| APRNs have full prescriptive authority. |
4. Describe obstacles to achieving plenary prescriptive authority for APRNs. (CO 8)
A brief review: There are many obstacles to achieving plenary prescriptive authority for APRNs. These include financial, political, and social barriers. In this blog post, we will discuss some of the most common obstacles and how we can overcome them.
One of the most common obstacles is the lack of financial resources. APRNs often do not have the same financial resources as other healthcare professionals. This can make it difficult to obtain the education and training necessary to achieve plenary prescriptive authority.
Another obstacle is the lack of political support. Many APRNs do not have the political clout necessary to lobby for plenary prescriptive authority. This is often due to the fact that APRNs are not as well-known or recognized as other healthcare professionals.
Finally, there is the social obstacle of public perception. Many people still view APRNs as being inferior to other healthcare professionals. This can make it difficult for APRNs to gain the respect and support necessary to achieve plenary prescriptive authority.
Despite these obstacles, it is still possible to achieve plenary prescriptive authority for APRNs. We must continue to fight for financial, political, and social equality. Only then will we be able to overcome the obstacles in our way.
5. Distinguish prescriptive authority among nurse practitioners (NPs), clinical nurse specialists (CNSs), certified registered nurse anesthesiologists (CRNAs), and certified nurse-midwives (CNMs). (CO 5, 8)
A brief review: If you are a nurse practitioner, then you need to be aware of prescriptive authority. This is the right that nurse practitioners have to prescribe medication and other treatments in certain states. In this blog post, we will discuss what prescriptive authority is and how it works. We will also answer some common questions about this topic. So if you want to learn more about prescriptive authority among nurse practitioners, read on!
What is prescriptive authority?
Prescriptive authority is the right of nurse practitioners to prescribe medication and other treatments in certain states. This right is granted by state legislatures and boards of nursing. In order to have prescriptive authority, nurse practitioners must complete an accredited graduate-level program and pass a national certification exam. They must also complete continuing education courses on prescribing medications safely and effectively.
How does prescriptive authority work?
In states where nurse practitioners have prescriptive authority, they can write prescriptions for medication and other treatments. They must follow the state’s guidelines on how to prescribe these medications safely and effectively. In some states, nurse practitioners may need to collaborate with a physician in order to prescribe certain medications. able to prescribe medication
What are the benefits of prescriptive authority?
There are many benefits of prescriptive authority for nurse practitioners.
6. Discuss the future of prescriptive authority for APRNs. (CO 7, 8)
A brief review: The future of prescriptive authority for APRNs is a hot topic in the nursing community. There has been a lot of discussion about the proposed rule released by the Centers for Medicare and Medicaid Services (CMS), and many nurses are wondering what this means for their careers. In this blog post, we will discuss the proposed rule and what it could mean for the future of prescriptive authority for APRNs. Stay tuned for more information!
The proposed rule would allow APRNs to have prescriptive authority for certain drugs, including controlled substances, without having to collaborate with a physician. This would be a major change from the current rules, which require APRNs to have a written agreement or protocol with a supervising physician in order to prescribe medications.
The proposed rule has caused quite a stir in the nursing community, with many nurses feeling that this could be a major step forward for their profession.
However, there are also some concerns about the proposed rule, including the potential for abuse and the lack of oversight. Only time will tell how this proposed rule will impact the future of prescriptive authority for APRNs, but it is sure to be a hot topic of discussion for many years to come.
7. Describe the purpose of credentialing for providers, institutions, regulators, and the public. (CO 1, 4, 6, 7, 8)
A brief review: What is credentialing? Credentialing is the process of verifying and recording the qualifications of healthcare providers. This includes assessing their education, training, experience, and competence. The purpose of credentialing is to ensure that providers are qualified to provide safe and effective care to patients. Institutions, regulators, and the public all rely on the information collected through the credentialing process.
Credentialing is important for providers, institutions, regulators, and the public because it helps to ensure that healthcare providers are qualified to provide safe and effective care to patients. The process of credentialing helps to ensure that providers have the necessary education, training, experience, and competence to provide care.
The information collected through the credentialing process is used by institutions, regulators, and the public to make decisions about healthcare providers.
8. Evaluate the Consensus Model for APRN Regulation: Licensure, Accreditation, Certification and Education (LACE). (CO 8)
A brief review: There is much debate surrounding the Consensus Model for APRN Regulation. Proponents tout its ability to improve patient care, while opponents argue that it will limit patient access to care. In this blog post, we will evaluate the pros and cons of the Consensus Model and come to a conclusion about whether or not it is good for patients.
The Consensus Model was created by a group of APRN organizations in 2008. It is a set of national guidelines that all states are encouraged to adopt. The Model defines the APRN scope of practice and sets educational requirements. It also establishes a national licensing system for APRNs.
The main goal of the Consensus Model is to improve patient care by ensuring that all APRNs are properly educated and licensed. The Model also seeks to standardize APRN practice across the country. This would allow patients to receive consistent care regardless of which state they live in.
There are several pros to the Consensus Model.
First, it would improve patient care by ensuring that all APRNs are properly educated and licensed.
Second, it would standardize APRN practice across the country, which would allow patients to receive consistent care regardless of which state they live in.
Third, the Model would improve patient safety by reducing the risk of APRNs practicing outside of their scope of practice.
9. Explain the federal and state regulatory impact on the processes of credentialing and privileging required by institutional providers and payers. (CO 8)
A brief review: Credentialing and privileging are two important processes that nurses must be aware of. These processes ensure that nurses are qualified to provide safe and quality care to patients. In this blog post, we will discuss the impact of federal and state regulatory agencies on credentialing and privileging. We will also provide tips for nurses who are seeking to maintain their credentials and privileges.
10. Justify the direct relationship between the processes and documents required for the APRN credentialing process and the decisions for scope of practice or clinical privileges made by the employing institution. (CO 8)
A brief review: The process of credentialing APRNs is directly related to the decisions made by the employing institution about the nurse’s scope of practice or clinical privileges. The specific steps and documents required for the credentialing process ensure that both the nurse and the institution are in agreement about what tasks the nurse is authorized to perform. This allows for a smooth and efficient working relationship, with no surprises or misunderstandings about job duties.
It is important to note that the credentialing process is not a one-time event. APRNs must maintain their credentials by completing continuing education requirements and keeping up with changes in the field. By doing so, they can be sure that their skills are always up to date and that they are able to provide the best possible care to their patients.
Extended
Go to your state board of nursing site and provide information on prescriptive authority for your state. Identify the state in which you live.
Describe what is “full practice authority”. Select a state that is currently pursuing this, but does not have it yet. Provide an overview of that state’s current progress towards this goal.
Describe the differences between Schedule I, II, III, IV and V drugs and who can prescribe them. Give 5 examples of each.
Go to the DEA.gov site and identify the process of obtaining a DEA license, the initial cost and the cost of renewal. How long is each (initial and renewal) good for.
Complete the attached credentialing application with as much information as you currently have and submit it to the assignment site. Do not submit this to an employer.
Identify which of the MSN essentials this assignment meets.
Brief rubric
This criterion is linked to a Learning OutcomePrecriptions
Student provides information on prescriptive authority from their individual state:
a. Identifies the state the information is coming from
b. the process of obtaining a DEA license
c. the cost of the initial application and the cost of a DEA renewal
d. the length of the license period before a renewal is due.
e. The differences between a schedule I, II, III, IV and V drugs with 5 examples of each, and who can prescribe each category in their state.
f. describes what is FPA
g. Provides information on a state’s progress towards achieving FPA.
The NP needs to be equipped to have the knowledge and skills to lead the way in supporting a culture of safety and quality in whatever type of healthcare setting he/she is practicing in. Understanding the tools and process used for quality and safety improvement in order to use them to improve patient care is a vital component for the NP.
Aside from the educational, board certification, and licensure requirements, the NP must obtain several other identifiers to be eligible for reimbursement by a third party payor. Obtaining a national provider number, employer number, being credentialed by private and public insurers are all part of the process that has to be completed prior to that first day on the job.
Interprofessional collaboration occurs when 2 or more professions work together to achieve common goals and is often used as a means for solving a variety of problems and complex issues. The benefits of collaboration allow participants to achieve together more than they can individually, serve groups of people, and grow on individual and organizational levels.
This module provides an overview of interprofessional collaboration in the areas of clinical practice, education, and research; discusses barriers to collaboration; and suggests potential means to overcome them.
At the end of this module students will be able to:
1. Describe the myriad aspects of collaborative practice. (CO 1, 5, 7, 8)
2. Distinguish between multidisciplinary, interdisciplinary, intradisciplinary, and transdisciplinary practices. (CO 1, 2, 4, 5, 6, 7, 8)
3. Identify the status of collaboration in each of the four advanced practice nurse (APN) roles. (CO 1, 2, 3, 5, 6, 7,8)
4. Explain the historic and current barriers to health professional collaboration. (CO 2, 3, 4, 7, 8)
5. Summarize the history of physician-APN, and RN-APN changing relationships.
6. Identify main components of a collaborative agreement.
7. Identify the skills needed to advocate for consumers, families and public policy.
Below is an outline of the items for which you will be responsible throughout the module.
1. From your textbook: Advanced Practice Nursing: Essentials for Role Development, Joel, 5th ed. (MO 1,2,3,4,5,6,7)
Read: Chapter 8, p 129 – 156; Chapter 14, p 239 – 248
2. Review: Collaborative agreement posted in this module, sign and submit it to the assignment site. (MO 1, 6)
3. Participate in the Discussion Board– (MO 1, 2, 3, 4,5,7)
A collaborative practice agreement/Standard Care Agreement is a written contract that establishes a working relationship between the nurse practitioner and the physician. Often this means that the physician will provide supervision and guidance, and be available for consultations with the NP. Below is a link to the American Medical Association and their state law chart: Nurse Practitioner Practice Authority.
https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/specialty%20group/arc/ama-chart-np-practice-authority.pdf
1. Identify a time in which collaboration was not used and that lead to negative consequences for the patient. Discuss the responsibility of the APRN as a patient advocate.
A brief review:
Provide 2 peer reviewed references < 5 years old that are from a professional Advanced Practice Journal for your initial post.
Review the posted Collaborative/Standard Care Agreement. Discuss the positive and negative aspects of it in the discussion board.
Provide 2 peer reviewed references < 5 years old that are from a professional Advanced Practice Journal for your initial post.
Make your initial post
Respond to two other classmates’ posts providing 2 peer reviewed references per post that are < 5 years old and from a professional Advanced Practice Journal.
Identify which of the MSN essentials this assignment meets.
Below are the APRN Prescriptive Authority Collaborative Prescriptive Agreements (CAPA) for the state of Kentucky. Students in other states are responsible for their respective state laws.
APRN Prescriptive Authority
APRN are required to establish a collaborative agreement with a physician to prescribe.
KRS 314.011(8) (Links to an external site.) defines APRN prescriptive authority. KRS 314.011 also provides specific information related to the prescribing of controlled substances
KRS 314.042 (Links to an external site.) provides information specific to the CAPA
201 KAR 20:057 (Links to an external site.) provides information related to the CAPA and prescribing standards for controlled substances.
Requirements for APRNs entering into a CAPA with a Physician
There is a common collaborative agreement for Advanced Practice Registered Nurse Prescriptive Authority for Non-Scheduled (legend) Drugs (CAPA-NS) that is required for APRNs by statute. See KRS 314.042 (Links to an external site.)
The law does not mandate a common collaborative agreement for prescribing controlled substance (CAPA-CS) form. An APRN and the collaborating physician may use any form as long as it meets the requirements of KRS 314.042(10) (Links to an external site.)
You can find a sample of a form that meets these requirements on the website of the Kentucky Association of Nurse Practitioners (Links to an external site.)
Required Forms to be submitted to the Board Relating to the CAPA
APRNs need to familiarize themselves with four required CAPA forms:
· CAPA-NS Notification Form
· CAPA-CS Notification Form
· Rescission of a CAPA-NS Form, and
· Rescission of a CAPA-CS Form
Evidence Based Practice
This module focuses on Evidence Based Practice (EBP). Clinical decisions, recommendations, and practice guidelines must focus on the best available evidence as well as the values and perspectives, beliefs, expectations and goals for life and health of the patient. Additional reading are included on the ACNP use of EBP and guidelines for PICOT questions as preparation for the EBP paper due at the end of this module.
Module Objectives
At the end of this module students will be able to:
Describe the relationship between clinical judgment and using the best evidence to make decisions. (CO 5)
Identify and analyze the elements of research methodology that are critical in providing evidence for practice settings. (CO 1, 4, 5)
Demonstrate the ability to access information and evaluate the quality of evidence relevant to practice settings. (CO 1, 4, 5, 6)
Describe tools and strategies for finding the best and most appropriate evidence to improve practice. (CO 1, 3, 4, 5, 6, 8)
Communicate search strategy to others. (CO 1, 5, 6,7, 8)
Identify forces (i.e., ethical, legal, political, cultural, logistical, and economic) that influence research methodology and interpretation of findings in clinical settings. (CO 1, 4, 5, 7, 8)
Module Activities
Below is an outline of the items for which you will be responsible throughout the module.
1. From your textbook: Advanced Practice Nursing: Essentials for Role Development, Joel, 5th ed.
Read: (MO 1,2 6); Chapter 13, p 221-237; Chapter 16, p 266 – 276
2. Review a Advanced Practice Research article of student’s choosing. (MO 1, 4, 5)
3. Submit: Evidence Based Practice Paper (MO 2, 3, 4, 5, 6)
Embedded are the links to the articles and the power point that are a part of this module’s assignments. The article and the power point presentation supplement the reading material.
Combined, they will assist students in organizing ideas, increase the understanding of the content from the assigned chapter and clarify information for the student.
Today’s health care environment demands all APNs play a role in conducting, translating, integrating, and utilizing research in daily practice.
Additional Lecture Materials
Students are to research and read an Evidence Based Research Paper in their chosen NP track. ie. JAANP, Each edition of this monthly online journal features peer-reviewed articles written to help NPs stay informed and enhance patient outcomes.
Additionally, JAANP provides helpful information surrounding issues encountered in daily practice — for example, workplace fatigue or topics related to practice management.
This article on EBP(evidence based practice) discusses a study of interviews of Acute Care Nurse Practitioners and the associated barriers and facilitators to the use of EBP in their day to day practice.
Link to 7th ed APA Purdue on line writing labhttps://owl.purdue.edu/owl/research_and_citation/apa_style/apa_style_introduction.html
This is to be a full 4-5 page paper MINIMUM/MAXIMUM, (not including the title, abstract and reference page) in 7th edition, student APA format.
Online link to 7th ed APA resource
https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_style_introduction.html (Links to an external site.)
Instructions:
Submit a 4-5 page, 7th ed. student APA paper, not including title and references.
1. Select a PEER reviewed EBP Research paper from a professional advanced practice journal related to your APN track. i.e. FNP, AGACNP, PSYCH article ….that is < 5 years old.
2. Evaluate the paper using the following criteria.
Identify your APN track.
What method did you use to find the article? (Cochran library, Silver Platter etc.)
Journal name and year of article publication.
Title and all authors.
Identify the topic and question under study (PICOT if given)
Subjects – how many and how were they identified?
What were the research methods used in the study? Methodology
What did the finding show?
Interpret the finding. (i.e. p value and sign levels.) What does this mean?
What is the significance of the findings for professional practice in your specific APN track ?
3. Submit your paper to your ePortfolio site.
Submit a link at the bottom of your paper to the ePortfolio site for your instructor.
4. Submit the paper to the Canvas assignment site.
Submit a link to the article at the bottom of the paper
Identify which of the MSN essential(s) this assignment meets.
This criterion is linked to a Learning OutcomeProject Identification
-Identifies APN track -Identifies an EBP article from a professional Advanced Practice journal in the students APN track. – Identifies the title and all authors of the article -Student identifies the search method used to find the article? (Cochran library, Silver Platter etc.) -Identifies Journal name and year of article publication.
At the end of this module students will be able to:
1. Identify the APRN options for certification. (CO 1)
2. Describe the value, quality, and accountability context surrounding advanced practice registered nurse (APRN) practice. (CO 7, 8)
3. Describe APRN performance expectations in general and those specific to specialty practice. (CO 1, 6, 7, 8)
4. Demonstrate the ability to design a model for assessing structures, processes, and outcomes within a framework of national standards. (CO 7, 8)
5. Plan actions to enhance the APRN impact in patient care, education, research, administration, and advocacy or policy. (CO 1, 2, 3, 4, 5, 7, 8)
6. Describe the differences between an employee and an independent contractor. (CO 8)
7. Discuss liability concerns for an independent contractor if a negligence case arises. (CO 8)
8. Categorize the types of terms contained in employment and independent contractor agreements. (CO 8)
9. Explain a covenant not to compete. (CO 8)
10. Assess possible exposure to charges of fraud and abuse. (CO 8)
Module 6: Lecture Materials — Legal and Contractual Considerations
As healthcare becomes increasingly complex and challenging, the value of certification as a mark of excellence is more important than ever. Achieving board certification demonstrates to patients, employers and the public that a nurse’s knowledge reflects national standards and a deep commitment to patient safety.
Below are the resources needed to begin your AACN certification process.
Additional Lecture Materials
Resource
AACN Certification-1.docx
https://www.onlinefnpprograms.com/faqs/aprn-certification-organizations/ (Links to an external site.)
APRN Certification Options-(MO 1)
https://www.onlinefnpprograms.com/faqs/aprn-certification-organizations/Links to an external site.