The Texas Nurses Association ( Tna )

In the United States, health care accessibility, quality, and affordability continue to be ongoing topics of discussion that effect many Americans on a regular basis. The need for affordable, quality healthcare continues to grow, not only due to a growing elderly population, but also as a result of the Affordable Care Act which has allowed millions of previously uninsured Americans access to health insurance and therefor better access to healthcare services (Patient Protection and Affordable Care Act, 2010). According to the Institute of Medicine (IOM) the projected demand increased for healthcare have led to a call for expansion of primary care services by policy makers (Institute of Medicine, 2010; National Governors Association, 2012). Since Advanced Practice Nurses or Nurse Practitioners (APNs or NPs will be used interchangeably for the purpose of this paper) are one of the fastest growing groups of healthcare providers, and continue to practice and provide care in a range of settings including primary care, it is important to investigate and address any potential barriers to practice. This author believes that allowing APNs to write prescriptions for commonly used controlled substances will help improve timeliness and flexibility in health care delivery; studies have shown that there is a positive impact on high

Controlled medications, also known as “scheduled drugs” are regulated by both the federal and the state laws due to their potential for dependence. Physician assistant (PA) pharmacology education prepares PAs to prescribe controlled medications. According to the SECTION 1. IC 25-27.5-2-14, the public law 102 -2013, identifies several practice changes for physician assistants in Indiana, which are effective from July 2013. The highlights of the new laws are:

State law is made up of two different forms: statues and regulations (Buppert, 2015). Under the established rules and regulations, an ARNP can: (a) monitor and alter drug therapies; (b) initiate therapies for certain diagnosis’; (c) perform additional functions as may be determined by rule; (d) and order diagnostic tests and appropriate therapies (The Florida Legislature, 2016). A practitioner licensed under chapters 458, 459 or 466, must maintain supervision for directing certain course and medical treatment (The Florida Legislature, 2016). Within the context of advanced nursing practice and the Florida Statues chapter 464.003(2), an ARNP may diagnosis, treat, alter medication regimes, diagnose, prescribe and operate, which are approved by a joint committee composed of three members appointed by the Board of Nursing, three members appointed by the Board of Medicine and the State Surgeon General or his/her designee (The Florida Legislature, 2016). On the other hand, the federal government regulates nurse practitioner practice through statutes passed by Congress and regulations (Buppert, 2015). According to Buppert (2015), federal law can override state law, and when federal and state law conflict with one another, federal law usually triumphs. Due to these state and federal statutes and regulations, this can impose a huge threat and impact to NP practice since the BON and the Nurse Practice Act usually help

As a certified registered nurse practitioner (CRNP) practicing in the state of Pennsylvania, the current prescriptive authority limits prescribing narcotics to a 72-hour supply. This includes any Schedule II medication regardless of the patient and their pain regimen. Working under a collaborative practice agreement, the nurse practitioner (NP) can prescribe chemotherapy, treat and prescribe for most symptoms and side effects the oncology patient may encounter, but not treat pain with Schedule II narcotics (Leahy, 2007).

2. Can an APRN be licensed solely within a specialty such as an ER nurse practitioner?

The Arizona State Board of Nursing (AZBN) is an organization that protects the public by ensuring that all nurses holding a license or certificate are competent to practice safely. The board approves education programs and also regulates the practice of nursing (Arizona State Board of Nursing, 2012). The board holds a meeting almost every month to discuss issues and rule on present cases. The purpose of this paper is to identify and discuss agenda items of the attended Arizona State Board of Nursing’s monthly professional meeting.

There have been concerns regarding the identification and credentialing of advanced practiced registered nurses (APRNs). A APRN is a registered nurse who has successfully completed an accredited graduate-level education program, in which the individual is well prepared and successfully passed the nationwide certification examination (APRN Consensus Model, 2008). However, there are still debating issues of who would fall under the APRN category. The National Council of State Boards of Nursing (NCSBN) has identified four APRNs who are deem fit to be called ARPNs; however, only two will be named. They would be certified registered nurse anesthetists (CRNAs) and certified nurse practitioners (CNPs). Whereas, the nurse informatics and the nurse administrations are not considered to be APRNs; although, they are still license registered nurses but they do not provide direct patient care and are not required to take the national certification examination (ARPN Consensus Model, 2008).

The scope of practice for APRNs in Texas are quite dynamic in range. It evolves through experience, acquisition of knowledge, evidence-based practice, technology development and changes in the health care delivery system. The standards of Nursing practice in rule is 217.11. The scope of practice is determined by advanced practice education in a role and specialty if applicable, legal implications such as Board rules, and scope of practice statements as published by national professional specialty and advanced practice nursing

It is composed of actively practicing physicians, other prescribers, pharmacists, nurses, administrators, quality improvement managers, and other health care professionals and staff who participate in the medication-use process. The P&T committee should be responsible for overseeing policies and procedures related to all aspects of medication use within an institution. The P&T committee is responsible to the medical staff as a whole, and its recommendations are subject to approval by the organized medical staff as well as the administrative approval process. The P&T committee’s organization and authority should be outlined in the organization’s medical staff bylaws, medical staff rules and regulations, and other organizational policies as appropriate. Other responsibilities of the P&T committee include medication-use evaluation (MUE), adverse-drug-event monitoring and reporting, medication-error prevention, and development of clinical care plans and guidelines. The hospital’s internal policies follow all national standards for how the P&T committee should

Attending the Texas Nurses Association District 8 annual meeting was educational, remarkable, and inspirational. Meeting the new officers for the coming year and the recognition for outgoing officers had a sense of camaraderie, which envelops nursing. The legislative updates and highlights included a significant bill to APRN’s, House Bill 1415. Although left pending in committee, this bill will allow APRN’s full practice authority. TNA has partnered with coalitions to assist in the passing of this bill. While there has been opposition to this bill by physician based associations, the impact of the passage and implementation of this bill is beneficial to the state, medical community and most importantly, our patients.

Also, she mentioned the law regarding practicing as an APRN in TN. According to the Tennessee’s Nursing Practitioner Supervision Laws, a nurse practitioner is required to be supervised by a physician. It is mandatory for the physicians to visit the site and review the charts that APRN has been working. Nurse practitioners can prescribe controlled substances in TN. She practices with a collaborating physician, and he is available for the clinical resources. I inquired about inter-professional role conflict between APRN and physician since this is a typical situation in the clinical setting. She thought about it before starting the current position, but she felt all the physicians are helpful and understand of APRN’s role. However, she emphasized the need for more independence and autonomy for the better

In order to meet the growing demand for primary care, nurse practitioners need prescriptive authority to provide quality, safe, and cost-effective healthcare to patients. The development of nurse practitioners, plus physician shortages in primary care, leads to an increasing need for nurse practitioners and access to health care. However, nurse practitioners currently face prescription regulations for controlled substances, which limits their scope of practice. The regulation of nurse practitioners prescribing controlled substances diminishes comprehensive health care services by increasing the wait time for patients and liability claims for physicians. The number of nurse

Nneka, I absolutely agree with you that an independent prescriptive authority gives the APN the right to prescribe without any limitations, such as medical devices, health and medical services, durable medical goods, prescription and controlled drugs some of the state that issue independent prescriptive authority includes Alaska, Arizona, Idaho etc. In the state of GA, where I currently practice as a Registered Nurse, Georgia’s APRN practice laws are some of most restrictive in the nation and their APRN practice regulations do not align with national trends. Georgia Secretary of State websites state that NPs need a Nurse Protocol Agreement to be granted prescriptive authority which is a written document mutually agreed upon and signed by an

The number of APRNs is increasing across the country. With fewer restrictions on their practice, more opportunities to those who are suffering from addiction/abuse can be easily utilized. This can help nurses save lives, decrease overdose deaths and prevent further diseases such as HIV and Hepatitis (HIV Prevention and Treatment Strategies can help address the overdose crisis, 2015). One of the primary issues facing this epidemic is the limited number of available treatments. Increasing the number of providers that are certified in substance abuse will lead to an increase in accessible treatment for patients in need. Until something is done with legislation, more people will die each day because of the lack of care that can be provided. With

The future advanced practice registered nurses (APRN) ultimate goal is to prevent acute and chronic illnesses and to manage chronic disease processes outside the hospital settings. Overall, long-term antibiotic therapy is a