Task
In your initial post to the discussion forum, answer the following questions:
1. Briefly discuss your state texas nursing board’s regulation on prescriptive authority and how it aligns with the four IOM recommendations of 2011.
2. Identify and describe the barriers in your particular state (Texas) that impede the APRN’s full scope of practice, and why.
3. As a future APRN, what recommendations would you have for improving healthcare access in your state’s rural community with regards to prescriptive authority restrictions?
4. Finally, discuss the following: “Do all APRNs need hospital privileges? Why or why not?
APA FORMAT AND REFERENCE PAGE
Task In your initial post to the discussion forum, answer the following questions: 1. Briefly discuss your state texas nursing board’s regulation on prescriptive authority and how it aligns with the four IOM recommendations of 2011. 2. Identify and describe the barriers in your particular state (Texas) that impede the APRN’s full scope of practice, and why. 3. As a future APRN, what recommendations would you have for improving healthcare access in your state’s rural community with regards to prescriptive authority restrictions? 4. Finally, discuss the following: “Do all APRNs need hospital privileges? Why or why not? State Law Chart: Nurse Practitioner Prescriptive Authority © 2017 American Medical Association. All rights reserved. State law chart: Nurse Practitioner Prescriptive Authority State Is physician involvement required for NP prescriptive authority? Do NPs have authority to prescribe schedule III-V controlled substances? Do NPs have authority to prescribe schedule II controlled substances? What are the additional educational requirements for NP prescriptive authority? Additional notes Alabama Yes, there must be a standard written protocol. (Ala. Admin. Code 540-X-8-.08 (9); Ala. Admin. Code 610- X-5-.08 (9)). Yes. (AL ST § 20–2–253). Yes, with a special permit approved by the ALBME. (AL ST § 20–2–260, AAC Chapter 540-X-20). Nursing education programs must include some pharmacology. (Ala. Admin. Code 610-X-3-.02 (9)(e)(iii)). Only NPs or CNMs who have completed approved courses including advanced pharmacology and prescribing trends related to controlled substances will receive a certificate to prescribe controlled substances. (AL ST § 20–2– 252). For controlled substances, NPs will be required to have demonstrated safe practice for 12 months prior to application for a controlled substance certificate. If authorized by the collaborative practice agreement, APRNs can prescribe those hydrocodone combinations reclassified from Schedule III to Schedule II. Alaska No. (12 Alaska Admin. Code 44.440). Yes. (12 Alaska Admin. Code 44.445). Yes. (12 Alaska Admin. Code 44.445). 15 hours of advanced pharmacology and clinical management of drug therapy. (www.dced.state.ak.us/occ/p nur.htm)/AAPN application). Prescriptive authority is included in licensure. Arizona No. (A.R.S. § 32-1601 (15)(d)(v); Ariz. Admin. Code R4-19-511). Yes. (Ariz. Admin. Code R4- 19-512). Yes. (Ariz. Admin. Code R4- 19-512). 45 hours in pharmacology and/or clinical management of drug therapy. (http://apps.azsos.gov/public _services/Title_04/4-19.pdf) The state tracks the number of applications for prescriptive authority received. Arkansas Yes, a collaborative agreement is required. (Ark. Code Ann. § 17-87-310 Yes. (Ark. Code Ann. § 17- 87-310 (b); Ark. Admin Code 067.00.3-VIII (D)(2)). No. (Ark. Code Ann. § 17- 87-310 (b); Ark. Admin Code 067.00.3-VIII (D)(2)). 45 contact hours or 3 semester hours in pharmacology. (Board A NP must have 300 hours of precepted experience in the prescription of drugs © 2017 American Medical Association. All rights reserved. 2 State Is physician involvement required for NP prescriptive authority? Do NPs have authority to prescribe schedule III-V controlled substances? Do NPs have authority to prescribe schedule II controlled substances? What are the additional educational requirements for NP prescriptive authority? Additional notes (a)(2); Ark. Admin. Code 067.00.3-VIII (A)(5)). website (www.arsbn.arkansas.gov/Pa ges/default.aspx)/ certificate of prescriptive authority application). before receiving an initial certificate of prescriptive authority. California Yes. (Cal. Bus. & Prof. Code § 2836.1 (a)). Yes. (Cal. Bus. & Prof. Code 2836.1 (f)(1)). Yes. (Cal. Bus. & Prof. Code 2836.1 (f)(1)). 6 months of physician supervised experience, a pharmacology course, and to prescribe schedule II controlled substances, a course on schedule II controlled substances. (Cal. Bus. & Prof. Code § 2836.1 (g)(1)&(2)). The Board assigns each NP with prescriptive authority a “furnishing number,” the number of which have been granted are also tracked by the Board. (Cal. Bus. & Prof. Code § 2836.3(a)). Continuing education is required to prescribe IIs. Colorado Yes. ”Prescribing mentorshop” with physician or APRN required for the first 1,000 hours of practice. (Colo. Rev. Stat. 12-38-111.6 (4.5)(b)(1)(A)). Yes. (Colo. Rev. Stat. 12-38- 111.6 (1)). Yes. (Colo. Rev. Stat. 12-38- 111.6 (1)). 3 semester hours or 4 quarter hours in pathophysiology, pharmacology, and physical assessment. (3 Code Colo. Regs 716-1 Ch. XV (2.1)). The Board tracks and assigns an identifier to all NPs with prescriptive authority. (Colo. Rev. Stat 12-38-111.6 (4.5)(f)(II)(7)). Remote communication with the physician or APRN mentor is permissible as long as the communication is synchronous (e.g. not email). Connecticut Yes. The NP must collaborate with a physician for 3 years and no less than 2,000 hours. (Conn. Gen. Stat. § 20-87a(b)). Yes. (Conn. Gen. Stat. § 20- 94b). Yes. (Conn. Gen. Stat. § 20- 94b). 30 hours of education in pharmacology for advanced nursing practice required for NP licensure. (Conn. Gen. Stat. § 20-94a (3)). Legend drug authority is included in licensure, but to prescribe controlled substances, the NP must apply for a Controlled Substance Registration. The state does not track how many NPs have CSRs. Delaware Yes, a collaborative agreement is required to Yes. (CDR 24-1900 (8.18); CDR 24-1700 (27.4)). Yes. (CDR 24-1900 (8.18); CDR 24-1700 (27.4)). Coursework in advanced health assessment; diagnosis Legend drug prescriptive authority is included in © 2017 American Medical Association. All rights reserved. 3 State Is physician involvement required for NP prescriptive authority? Do NPs have authority to prescribe schedule III-V controlled substances? Do NPs have authority to prescribe schedule II controlled substances? What are the additional educational requirements for NP prescriptive authority? Additional notes apply for prescriptive authority – for the first 2 years and 4,000 hours of practice. and management of problems within clinical specialty; advanced pathophysiology; and advanced pharmacology/ pharmacotherapeutics. (http://dpr.delaware.gov/boar ds/nursing/apnprescauth.sht ml). APRN Rx authority is subject to biennial renewal, with varying requirements based on time of practice: APRNs not in clinical practice for more than the past 2 years must complete 24 contact hours of CE (12 in pharmacotherapeutics and 12 in the clinical management of patients) within 1 year prior to applying for renewal. APRNs not in clinical practice for more than the past 5 years must complete 45 hours of pharmacotherapeutics CE within 1 year prior to application in addition to the advanced practice nursing refresher program. licensure, unless an applicant declines. The Board does not track the number of who decline legend drug prescriptive authority, but does track the number with Delaware controlled substance registrations. In the event no advanced practice refresher program is available, the applicant must complete 600 hours of supervised clinical experience in the appropriate advanced practice role and population focus, with a qualified preceptor within 1 year prior to licensure by reinstatement. D.C. No. (D.C. Code §§ 3- 1201.02 (2)(C); 3-1206.04 (1)). Yes. (CDCR 17-5909, 5910). Yes. (CDCR 17-5909, 5910). None. Legend drug authority is included in licensure, but NPs must obtain a D.C. http://dpr.delaware.gov/boards/nursing/apnprescauth.shtml http://dpr.delaware.gov/boards/nursing/apnprescauth.shtml http://dpr.delaware.gov/boards/nursing/apnprescauth.shtml © 2017 American Medical Association. All rights reserved. 4 State Is physician involvement required for NP prescriptive authority? Do NPs have authority to prescribe schedule III-V controlled substances? Do NPs have authority to prescribe schedule II controlled substances? What are the additional educational requirements for NP prescriptive authority? Additional notes Controlled Substances Registration to prescribe controlled substances. Florida Yes. NPs must maintain a written collaborative agreement for prescriptive authority. (Fla. Admin. Code 64B9-4.010). Yes. (Fla. Stat. § 464.012). Only psychiatric NPs are allowed to Rx psychiatric medication to children under 18. No. (Fla. Stat. § 464.012). 7- day limit of Schedule II controlled substances, except for psychiatric controlled substances, for which there is no limit. Only psychiatric NPs are allowed to Rx psychiatric medication to children under 18. None. Those NPs whose protocols permit them to dispense medications must register with the Board of Nursing (Fla. Stat. § 465.0267 (2)(a)). A joint committee of NPs, physicians and pharmacists under the nursing board will recommend the formulary for controlled substances. NPs must complete 3 AMA PRA Category 1 credit hours in prescription of controlled susbtances. Georgia Yes. Physicians may delegate the authority to prescribe medications to NPs pursuant to a written protocol agreement. (O.C.G.A. 43-34- 25 (b)). Yes. (O.C.G.A. 43-34-25 (d)). No. (O.C.G.A. 43-34-25 (k)). To be licensed, NPs must complete a post-basic educational program for NPs that includes advanced pharmacology in its curriculum or as a separate course. (Ga. Admin. Code 410-12-.03