Regulations for the APRN are determined at the state level through rule-making and legislation. The regulation and other executive agencies such as the Board of Nursing (BON) establish the scope of practice for APRNs at the state level. The prescribing for the APRNs in several states is restricted by the Pharmacy (BOP) oversight and the state laws (Rudner, 2016). The prescriptive authority for the APRNs is limited, depending on the state. However, many states are considering changing the existing prescribing laws. The purpose of this N521 AANP position statement APRNs Essay paper is to identify peer-reviewed journal articles, regulatory position statements or policies that support changes in APRN prescribing practices at the state or national level.
Policies, Regulator Position Statements, and Campaigns
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The position statement by the American Association of Nurse Practitioners® (AANP) advocates and supports the suggested changes for APRNs to have an unlimited prescriptive authority that includes dispensing privileges. AANP further recommends that the regulation of prescribing authority for APRNs should only be done by the state boards of nursing, and according to the training/education, certification, and the role of the APRN (Xue et al., 2015). The process of the nursing board being exclusively involved in the licensing and regulation of the NPs encourages competent practice and public safety. According to the AANP, APRNs are members of nursing state boards and hence have the suitable competence to regulate the prescribing authority of the NPs. AANP supports and advocates for the national certification of the APRNs (Weiland, 2015) N521 AANP position statement APRNs Essay. According to AANP, the ability of the nurse practitioner to prescribe independently is vital to the provision of quality and cost-effective health-care for the diverse populations. Moreover, the National Association of Clinical Nurse Specialist’s (NACNS) Position Statement on Prescriptive Privilege for the Clinical Nurse Specialist supports the changes that support the awarding of independent prescribing and ordering privileges for the nurse practitioners and in this case the Clinical Nurse Specialist (CNS).
The Primary Care Expert Panel also supports the full scope practice of APRNs which includes unrestricted prescriptive authority for the nurse practitioners. In 2010, the Institute of Medicine’s influential Future of Nursing 2010, supported the call for the nurse practitioners to have a full scope of practice, including the prescriptive authority. According to this policy, NPs have the appropriate training, education, and competency to prescribe medications for patients within their specialty (Brom et al., 2018).
The campaign dubbed “The Campaign for Consensus: Uniting APRNs, Promoting Uniformity, and Fostering Collaboration” was by NCSBN held an APRN Summit. The summit aimed to update nursing organizations regarding the status APRN Consensus model. The APRN Consensus Model is the guideline for states to implement uniform regulations when it comes to the roles of APRNs (Brom et al., 2018). Regarding APRN prescribing practices, the campaign by the NCSBN supported the removal of barriers for the APRN scope of practice that included physician collaboration issues during prescriptions and also removal of prescriptive authority limitations. N521 AANP position statement APRNs Essay
The National Governors Association (NGA) report campaign supports the removal of prescriptive limitations and stipulates that APRN have equivalent competency with the physicians and therefore supports change and removal of the scope of practice limitations such as prescriptive restrictions for the APRNs (Weiland, 2015). The Federal Trade Commission (FTC) also published a report in 2014 that supported the position that APRNs are competent and safe independent practitioners. Therefore, the FTC supports the removal of restrictions such as collaborative and supervisory agreements for the APRNs.
Policies such as CARA and SUPPORT Acts have in the past supported the removal of restrictions regarding some prescriptions for NPs. For example, the CARA and SUPPORT Acts enabled the NPs to prescribe Buprenorphine. These policies follow state laws on if an APRN working with a physician through a collaborative or supervisory relationship (Rudner, 2016). Where the state law requires the supervision of the APRN, the physician should not also prescribe buprenorphine. This, therefore, encourages state laws to remove the restriction of APRNs having to be supervised by physicians during the prescription of buprenorphine. The Rules (National Council of State Boards of Nursing, 2011) and the Registered Nurse (APRN) Model Act are the policies that were endorsed to support independent prescribing and ordering privileges for the nurse practitioners (Gadbois et al., 2015). These Acts enabled the Board of Nursing in each specific state to award ordering and prescribing authority to the APRNs through licensing. N521 AANP position statement APRNs Essay.
Alignment with AANP’s Prescriptive Privilege Statement
The policies, position statements, and campaigns regarding the changes in APRN prescribing practices for APRNs align with the AANP’s Prescriptive Privilege Statement. For example, the National Association of Clinical Nurse Specialist’s (NACNS) Position Statement on Prescriptive Privilege for the Clinical Nurse Specialist supports the changes that support awarding of independent prescribing and ordering privileges for the nurse practitioners specifically the Clinical Nurse Specialist (CNS) (Gadbois et al., 2015). Similarly, campaigns by the National Governors Association (NGA) report, NCSBN report, and the Institute of Medicine’s influential Future of Nursing 2010 support the removal of prescriptive limitations and by arguing that APRNs have the required competency, training and education to practice to the full scope that including removing practice limitations such as prescriptive restrictions. Prescription of drugs, treatments, devices, and modalities is a key element of the APRN role and fundamental to APRN practice. Limiting the prescriptive authority for the APRNs unreasonably restricts the ability of the APRNs to offer comprehensive health care services (Park et al., 2018).
All these positions and initiatives through various policies, campaigns and position statements regarding changes in the prescriptive authority of APRNs are in line with the AANP’s Prescriptive Privilege Statement. According to the AANP, APRNs should practice according to the role, training, education, and certification. This calls for the removal of restrictions that hinder APRNs from prescribing independently. AANP also advocates for the national certification of the APRNs to remove the state restrictions that limit autonomous prescriptive authority for APRNs in some states (Park et al., 2018). In line with the AANP’s Prescriptive Privilege Statement, the discussed policies, campaigns, and position statements support changes that advocate for the ability of APRNs to prescribe without limitations, prescribed controlled substances, medical equipment, and devices (Park et al., 2018) N521 AANP position statement APRNs Essay.
The discussed policies, position statements, and campaigns support the changes that support the removal of restrictions in APRN prescribing practices for APRNs. These changes include allowing APRNs to prescribe independently without supervision and the authority to prescribe controlled substances, and medical equipment in their specialty. The position from the sources is in line with the AANP’s Prescriptive Privilege Statement.
Brom, H. M., Salsberry, P. J., & Graham, M. C. (2018). Leveraging health care reform to accelerate nurse practitioner full practice authority. Journal of the American Association of Nurse Practitioners, 30(3), 120–130. https://doi.org/10.1097/JXX.0000000000000023.
Gadbois, E. A., Miller, E. A., Tyler, D., & Intrator, O. (2015). Trends in state regulation of nurse practitioners and physician assistants, 2001 to 2010. Medical care research and review: MCRR, 72(2), 200–219. https://doi.org/10.1177/1077558714563763 N521 AANP position statement APRNs Essay
Park, J., Athey, E., Pericak, A., Pulcini, J., & Greene, J. (2018). To What Extent Are State Scope of Practice Laws Related to Nurse Practitioners’ Day-to-Day Practice Autonomy? Medical Care Research and Review, 75(1), 66–87. https://doi.org/10.1177/1077558716677826
Rudner N. (2016). Full Practice Authority for Advanced Practice Registered Nurses is a Gender Issue” OJIN: The Online Journal of Issues in Nursing, 21(2).
Weiland, S. A. (2015). Understanding nurse practitioner autonomy. Journal of the American Association of Nurse Practitioners, 27(1), 95-104. doi:10.1002/2327-6924.12120.
Xue, Y., Ye, Z., Brewer, C., Spetz, J. (2015). Impact of state nurse practitioner scope-of-practice regulation on health care delivery: Systematic review. Nursing Outlook, 64(1), 71-85. doi:10.1016/j.outlook.2015.08.005 N521 AANP position statement APRNs Essay
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