There are four areas that nurses act in in an advanced practice role. Those roles include clinical nurse specialists, nurse practitioners, certified nurse midwives, and certified registered nurse anesthetist (Bosse, et al, 2017). There are regulatory boards that regulate nursing practice on a state and federal level. If regulatory boards do not allow APRN’s to practice to the full scope of their abilities, it affects healthcare for all (Bosse, et al, 2017). Each US State has a regulatory board that guides nursing practice for that state. The two states that I will compare for the sake of this discussion are Alabama and Massachusetts. The reason that I picked these two are because I have been licensed in both states individually prior to the development of the Nursing Licensure Compact (NLC).
Prescribing Capabilities
The state of Massachusetts does not require you to take a test or prove any knowledge of regulations regarding Nursing practice prior to issuing you a license via endorsement. I just had to apply and pay a fee. The use of APRNs could assist physicians in having lighter patient loads and improve access to primary care for some patients (Bosse, et al, 2017). One of the abilities that would be needed in aiding APRNs to practice at full capacity is the ability to prescribe medications. In the state of Massachusetts, “CRNAs, CNPs, or PNMHCSs with a minimum of two years of supervised practice may engage in prescriptive practice without supervision upon submission of an attestation to the Board that the CRNA, CNP, or PNMHCS has completed a minimum of two years of supervised practice by a Qualified Healthcare Professional†(Commonwealth of Massachusetts, 2023). With that said, you would not be able to prescribe medications during your first two years of practice. I have witnessed recent graduate CNPs (certified nurse practitioners) unable to work in their specialty due to not having prescribing capabilities. The frustration comes in that they wonder how they are supposed to get the experience they need if no one wants to hire them without those privileges. In the State of Alabama, “Nurse practitioners practicing in Alabama have limited authority to prescribe. They are allowed to do so only with physician collaboration. The name, practice site address and phone number of the collaborating physician must be present on each prescription written by the NP†(ThriveAP, n.d.). NPs must be in practice for at least a year in Alabama before being considered for prescribing capabilities.
Primary Care Provider
The second regulation that I wanted to examine is the ability of the APRN to be a primary care provider. Neither Alabama nor Massachusetts recognize APRNs to be primary care providers. It is the hope of those in practice that legislation will loosen its grip to allow for APRNs to be recognized as Primary care providers (ThriveAP, n.d.). In states where APRNs have full practice abilities, there have been documented benefits to the healthcare system and over health of the population served. There has been a significant decrease in ER visits, decreased admissions to the hospital, and lower cost of care provided by the physicians (Bosse, 2017). It is unclear right now what changes legislation will decide to make in regard to APRNs having more autonomy in the field. As the healthcare staffing shortage continues to increase, the increase in duties that are able to be delegated to APRN’s will likely increase.
002023-12-28 22:59:032023-12-28 22:59:03Reply to discussion week 5
Comparison of Board of Nursing Regulations in Two States
APRNs in Alabama can prescribe medications that are a C3- C5 prescription, and the APRN is required to have a Qualified Alabama Controlled Substance Certification before being allowed to prescribe any controlled substances. In Alabama, to be approved for a QACSC, an NP must be in collaboration practice with a physician who has an unencumbered Alabama Controlled Substance Certification (ACSC). “Be in a collaborative practice agreement with a physician who holds a valid, unrestricted Alabama Controlled Substances Certificate (ACSC)” (ALBOP, n.d). The APRN also must be NP for 12 months with evidence of safe practice to apply for the QACSC. Also, a physician can supervise no more than three full-time APRNs. However, in California, a physician is allowed to supervise 4 full-time APRNs with prescriptive abilities. CA APRNs can prescribe C2-C5 prescriptions, but to prescribe C2 controlled substances, APRNs will need to attend a class on prescribing C2 prescriptions. CA APRNs also must have six months of supervised experience with a physician to prescribe controlled substances.
In California, the APRN has free range to deal with patients after collaborating with the physician with whom they have a collaboration agreement. Regarding standardized procedures, an APRN is considered independent once a physician signs off the procedure. “Standardized procedures must be developed collaboratively by nursing, medicine, and administration in the organized health care system where they will be utilized. Once the physician signs off on the standardized procedure, nurse and facility (if applicable) the practice is considered independent. The “standardized procedure” is agency specific and must meet certain requirements including collaborative development by nursing, medicine and administration within the agency” (AMA, 2017). However, in Alabama APRN is not considered independent for any procedures. They must be monitored by a physician, and a physician must monitor them for at least 10% of their scheduled hours. “The collaborating physician must be present at least 10% of the NP’s scheduled hours and must visit each collaborative practice site at least quarterly. (Ala. Admin. Code 540-X-8-.08 (4); Ala. Admin. Code 610-X-5- .08 (4))†(AMA, 2017). “Written standard protocols must · specify the specialty practice area of the NP and the collaborating physician; · identify all cites where the NP will practice within the protocol; identify the physician’s principal practice site; be maintained at each practice cite; · include a formulary of drugs, devices, medical treatments, tests, and procedures that may be prescribed, ordered, and implemented by the NP; · include a pre-determined plan for emergency services; · specify a plan for quality assurance management with established patient outcome indicators for evaluation of the NP, and include review of at least 10% of medical records, plus all adverse outcomes (Ala. Admin. Code 540-X-8-.08 (9); Ala. Admin. Code 610-X-5-.08 (9))” (AMA, 2017).
Application to Advanced Practice Registered Nurses
These regulations make it hard for APRNs to grow to their full potential; however, rules make patient care safe, which is the most crucial aspect. Being able to open your own business is ultimately restricted to needing a physician to oversee all their work, which may be frustrating. Still, it is necessary to cut down on mistakes that APRNs might make. Instead of seeing the physician as a burden, see them as a mentor guiding the APRN to becoming a better service to humanity in their practice. “Nurse practitioners in California have been fighting to break free of physician oversight for years. The biggest pushback came from physicians. During legislative debate, the California Medical Association said nurse practitioners have less training than physicians, so allowing them to practice independently could lessen the quality of care and even pose a risk to patients” (Ibarra, 2022). It is a fact that APRNs have less training than physicians, and the need to have someone to advise them in the right direction is essential. Nursing’s first goal should be patient safety, so seeing as the patients would be getting the best possible outcome through the collaborative practice agreement should give APRNs peace of mind regarding patient safety.
Examples of How APRNs Adhere to Regulations
APRNs can adhere to the regulations required by their board by first doing their research, ensuring all their ducks in a row, and ensuring that they are following all the necessary procedures and rules to perform procedures in that state. Having a mentor can keep an APRN in the right direction and on the straight and narrow road. Ultimately, calling the Board of Nursing in that state if there is any misunderstanding on the APRN’s part to make sure they fully grasp the concepts of the regulation. It is the APRN’s responsibility to know the rules and regulations for the state they are practicing in and adhere to the standards of care.
Conclusion
In conclusion, APRNs are required by law to make sure they are aware and practice based on the rules and regulations provided by the board of nursing. The professional aspect is vital because APRNs in some states must work with a physician through an agreement signed and legally binding by the two individuals. Knowing the legal aspects of the contract according to state law is very important to maintain licensure and compliance.
002023-12-28 22:55:182023-12-28 22:55:18Reply to discussion week 5
Using the slides on pages 4, 5, 6, 7, 8, and 9 of the attached prospectus PowerPoint, create themes on the literature review slide, page 10, and write 2-3 sentences with 2-3 in-text citations from current (2019 +) empirical studies to support each theme as it relates to the research study.
REGULATION FOR NURSING PRACTICE STAFF DEVELOPMENT MEETING
Nursing is a very highly regulated profession. There are over 100 boards of nursing and national nursing associations throughout the United States and its territories. Their existence helps regulate, inform, and promote the nursing profession. With such numbers, it can be difficult to distinguish between BONs and nursing associations, and overwhelming to consider various benefits and options offered by each.
Both boards of nursing and national nursing associations have significant impacts on the nurse practitioner profession and scope of practice. Understanding these differences helps lend credence to your expertise as a professional. In this Assignment, you will practice the application of such expertise by communicating a comparison of boards of nursing and professional nurse associations. You will also share an analysis of your state board of nursing.
RESOURCES
Be sure to review the Learning Resources before completing this activity.Click the weekly resources link to access the resources.
Assume that you are leading a staff development meeting on regulation for nursing practice at your healthcare organization or agency.
Review the NCSBN and ANA websites to prepare for your presentation.
The Assignment: (8- to 9-slide PowerPoint presentation)
Develop a 8- to 9-slide PowerPoint Presentation that addresses the following:
Describe the differences between a board of nursing and a professional nurse association.
Describe the board for your specific region/area.
Who is on the board?
How does one become a member of the board?
Describe at least one state regulation related to general nurse scope of practice.
How does this regulation influence the nurse’s role?
How does this regulation influence delivery, cost, and access to healthcare?
If a patient is from another culture, how would this regulation impact the nurse’s care/education?
Describe at least one state regulation related to Advanced Practice Registered Nurses (APRNs).
How does this regulation influence the nurse’s role?
How does this regulation influence delivery, cost, and access to healthcare?
Has there been any change to the regulation within the past 5 years? Explain.
Include Speaker Notes on Each Slide (except on the title page and reference page)
BY DAY 7 OF WEEK 6
Submit your Regulation for Nursing Practice Staff Development Meeting Presentation.
SUBMISSION INFORMATION
Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.
To submit your completed assignment, save your Assignment as WK6Assgn+LastName+Firstinitial
Then, click on Start Assignment near the top of the page.
Next, click on Upload File and select Submit Assignment for review.
Rubric
NURS_6050_Module03_Week06_Assignment_Rubric
NURS_6050_Module03_Week06_Assignment_Rubric
CriteriaRatingsPts
This criterion is linked to a Learning OutcomeBoards of Nursing vs. Professional Nurse AssociationsDevelop a 8- to 9- slide PowerPoint presentation that addresses the following:· Describe the differences between a board of nursing and a professional nurse association.· Describe the members of the board for your specific region/area.· Who is on the board?· How does one become a member of the board?· Speaker notes are included on every slide and are used to explain and elaborate the significant points on each slide.
25 to >22.0 pts
Excellent
Using sufficient evidence, the response accurately and thoroughly describes the differences between a board of nursing and professional nurse associations. …Response provides a complete and accurate description of who is on a board of nursing. …Response provides a detailed and thorough explanation of how one becomes a member of the board of nursing. …Speaker notes are included on every slide and are used to explain and elaborate the significant points on each slide.
22 to >19.0 pts
Good
Using sufficient evidence, the response accurately describes the differences between a board of nursing and professional nurse associations. …Response provides an accurate description of who is on a board of nursing. …Response provides an accurate explanation of how one becomes a member of the board of nursing. …Speaker notes are included on every slide and are used to explain the significant points on each slide.
19 to >17.0 pts
Fair
Description of the differences between a board of nursing and professional nurse associations is inaccurate or incomplete. …Description of who is on a board of nursing is incomplete or inaccurate. …Explanation of how one becomes a member of the board of nursing is vague or inaccurate. …Speaker notes are incomplete or lack sufficient elaboration.
17 to >0 pts
Poor
Description of the differences between a board of nursing and professional nurse associations is inaccurate or incomplete. …Description of who is on a board of nursing is incomplete or inaccurate. …Explanation of how one becomes a member of the board of nursing is vague or inaccurate. …Speaker notes are missing.
25 pts
This criterion is linked to a Learning OutcomeThe Impact of State Regulation on Nurse PracticeDescribe at least one state regulation related to general nurse scope of practice.• How does this regulation influence the nurse’s role?• How does this regulation influence delivery, cost, and access to healthcare?• If a patient is from another culture, how would this regulation impact the nurse’s care/education?• Has there been any change to the regulation within the past 5 years? Explain.• Speaker notes are included on every slide and are used to explain and elaborate the significant points on each slide.
30 to >26.0 pts
Excellent
Response includes an accurate and thorough description of how one state regulation is related to general nurse scope of practice. …Response accurately and thoroughly explains how the regulation influences the nurse’s role. …Response accurately and thoroughly explains how the regulation(s) influences delivery, cost, and access to healthcare. …Response accurately and thoroughly explains how the regulation impacts the nurse’s care/education to provide care for other cultures. … Changes fully explained. …Presentation includes speaker notes that explain and elaborate the significant points of the presentation.
26 to >23.0 pts
Good
Response includes an accurate description of how one state regulation is related to general nurse scope of practice. …Response accurately explains how the regulation influences the nurse’s role. …Response accurately explains how the regulation(s) influences delivery, cost, and access to healthcare. …Response accurately explains how the regulation impacts the nurse’s care/education to provide care for other cultures. …Changes partially explained. …Presentation includes speaker notes that explain the points of the presentation.
23 to >20.0 pts
Fair
Description of one or more state regulations that are related to general nurse scope of practice is incomplete or inaccurate. …Explanation of how the regulation(s) influences the nurse’s role is vague or inaccurate. …Explanation of how the regulation(s) influences delivery, cost, and access to healthcare is vague or inaccurate. …Explanation of how the regulation(s) influences the nurse’s care/education for other cultures is vague or inaccurate. …Change is vague. …Presentation includes speaker notes that are incomplete or lack appropriate explanation.
20 to >0 pts
Poor
Description of one or more state regulations related to general nurse scope of practice is vague and inaccurate or is missing. …Explanation of how the regulation(s) influences the nurse’s role is vague and inaccurate or is missing. …Explanation of how the regulation(s) influences delivery, cost, and access to healthcare is vague and inaccurate, or is missing. …Explanation of how the regulation(s) influences the nurse’s care/education for other cultures is vague or inaccurate or missing. …Change was not discussed. …Speaker notes are missing.
30 pts
This criterion is linked to a Learning OutcomeDescribe at least one state regulation related to Advanced Practice Registered Nurses (APRNs).• How does this regulation influence the nurse’s role?• How does this regulation influence delivery, cost, and access to healthcare?• Has there been any change to the regulation within the past 5 years? Explain.Speaker notes are included on every slide and are used to explain and elaborate the significant points on each slide.
30 to >26.0 pts
Excellent
Using sufficient evidence, response includes an accurate and thorough description of how one state regulation is related to Advanced Practice Registered Nurses (APRNs). …Response accurately and thoroughly explains how the regulation influences the nurse’s role. …Response accurately and thoroughly explains how the regulation(s) influences delivery, cost, and access to healthcare. … Changes fully explained. …Presentation includes speaker notes that explain and elaborate on the significant points of the presentation.
26 to >23.0 pts
Good
Using sufficient evidence, response includes an accurate description of how one state regulation is related to Advanced Practice Registered Nurses (APRNs). …Response accurately explains how the regulation influences the nurse’s role. …Response accurately explains how the regulation(s) influences delivery, cost, and access to healthcare. …Changes partially explained. …Presentation includes speaker notes that explain the points of the presentation.
23 to >20.0 pts
Fair
Description of one or more state regulations that are related to Advanced Practice Registered Nurses (APRNs) is incomplete or inaccurate. …Explanation of how the regulation(s) influences the nurse’s role is vague or inaccurate. …Explanation of how the regulation(s) influences delivery, cost, and access to healthcare is vague or inaccurate. …Change is vague. …Presentation includes speaker notes that are incomplete or lack appropriate explanation.
20 to >0 pts
Poor
Description of one or more state regulations related to Advanced Practice Registered Nurses (APRNs) is vague and inaccurate or is missing. …Explanation of how the regulation(s) influences the nurse’s role is vague and inaccurate or is missing. …Explanation of how the regulation(s) influences delivery, cost, and access to healthcare is vague and inaccurate, or is missing. …Change was not discussed. …Speaker notes are missing.
30 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting—Paragraph Development and OrganizationSpeaker notes make clear points that support well developed ideas, low logically, and demonstrate continuity of ideas.Sentences are carefully focused– neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction and conclusion are provided which delineate all required criteria.
5 to >4.0 pts
Excellent
Speaker notes and sentences follow writing standards for flow, continuity, and clarity. …A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.
4 to >3.0 pts
Good
Speaker notes and sentences follow writing standards for flow, continuity, and clarity 80% of the time. …Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive.
3 to >2.0 pts
Fair
Speaker notes and sentences follow writing standards for flow, continuity, and clarity 60%- 79% of the time. …Purpose, introduction, and conclusion of the assignment is vague or off topic.
2 to >0 pts
Poor
Speaker notes and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. …Purpose, introduction, and conclusion of the assignment is incomplete or missing.
5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting: English Writing StandardsCorrect grammar, mechanics, and proper punctuation.
5 to >4.0 pts
Excellent
Uses correct grammar, spelling, and punctuation with no errors.
4 to >3.0 pts
Good
Contains a few (1-2) grammar, spelling, and punctuation errors.
3 to >2.0 pts
Fair
Contains several (3-4) grammar, spelling, and punctuation errors.
2 to >0 pts
Poor
Contains many (≥5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting: The presentation follows correct APA format for parenthetical/in-text citations, and reference list.
