Professional Nursing And State-Level Regulations Assignment

Professional Nursing And State-Level Regulations Assignment

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Respond to at least two of your colleagues* on two different days and explain how the regulatory environment and the regulations selected by your colleague differ from your state/region. Be specific and provide examples.

Discussion: Professional Nursing and State-Level Regulations

A comparison of APRN board of nursing regulations in my state (Pennsylvania) with those one other state (Minnesota) and how they may differ Professional Nursing And State-Level Regulations Assignment

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Hey Molly! Insightful discussion. According to Huynh at el. (2021), the practice of nursing in USA is governed by laws defined in the Nursing Practice Act (NPA), which is then interpreted into regulations by each state and territorial nursing boards with the authority to regulate the practice of nursing care and the power to enforce the laws. In some States, the Board of Nursing (BoN) governs all level of nursing or have individual BON for each level of nursing and is responsible for regulation the NPA enforces laws as defined by state legislative bodies which empower the BON to discipline nurses who violate the nursing laws and regulations. It also describes the prescriptive authority of healthcare providers to prescribe specific medications, including controlled substances. APRNs can prescribe medications, including controlled substances without direct supervision by physician. Other healthcare providers also have varying degrees of autonomy to prescribe medications but must undergo physician supervision or delegation.

In my state Pennsylvania, regulation has evolved to accommodate the bureaucratic, specialized and expansive primary health care needs. It’s now mandatory for a nurse seeking registration in Pennsylvania to have had graduated from an accredited nursing program and passed a rigorous state-administered exam (Phillips, 2021). Qualified Advanced Practice Registered Nurses (APRNs) are allowed to practice in their field of specialty independent of a physician after they complete a three-year, 3,600 hour collaboration agreement with a physician while in Minnesota, are allowed after 2,080 hours of practice with a collaborative agreement with an experienced NP or physician.

References

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Huynh A.P., & Haddad L.M. (2021). Nursing Practice Act. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. https://www.ncbi.nlm.nih.gov/books/NBK559012/.

Phillips, S. J. (2021). 33^rd Annual APRN Legislative Update: Unprecedented changes to APRN practice authority in unprecedented times. Nurse Practitioner, 46(1), 27-55. doi: 10.1097/01.NPR.0000724504.39836.69 Professional Nursing And State-Level Regulations Assignment

A comparison of APRN board of nursing regulations in my state (Pennsylvania) with those one other state (Minnesota) and how they may differ

 Hey Molly Lutgen, this is a good topic, because it governs how Advanced Practice Registered Nurse (APRN) can practice and their code of ethics.

According to Huynh at el. (2021). The practice of nursing in USA is governed by laws defined in the Nursing Practice Act (NPA), which is then interpreted into regulations by each state and territorial nursing board with the authority to regulate the practice of nursing care and the power to enforce the laws. In some state Board of Nursing (BoN) governs all level of nursing or have individual BON for each level of nursing and is responsible for regulating their individual NPA, enforce the laws as defined by state legislative body which empower the BON to discipline nurses who violate the nursing laws and regulations while describing prescriptive authority as the ability of healthcare providers to prescribe specific medications, including controlled substances. APRNs can prescribe medications, including controlled substances without direct supervision by physician. Other healthcare providers also have varying degrees of autonomy to prescribe medications but must undergo physician supervision or delegation.

In my state Pennsylvania, Connolly at el. (2021), shows how nursing regulation has evolved to accommodate the bureaucratic, specialized and expansive primary health care needs, it’s now mandatory for a nurse seeking registration in Pennsylvania to have had graduated from an accredited nursing program and passed a rigorous state-administered exam, qualified Advanced Practice Registered Nurses (APRNs) are allowed to practice in their field of specialty independent of a physician after they complete a three-year, 3,600 hour collaboration agreement with a physician while in Minnesota, are allowed after 2,080 hours of practice with a collaborative agreement with an experienced NP or physician.

References

Huynh A.P, Haddad L.M. Nursing Practice Act. [Updated 2021 Jul 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559012/.

Connolly C, D’Antonio P, Fairman J. Reforming nursing registration: Lessons from pandemics. Nurs Outlook. 2021 May-Jun;69(3):254-256. doi: 10.1016/j.outlook.2020.12.009. Epub 2021 Jan 13. PMID: 33451808; PMCID: PMC8434823. Professional Nursing And State-Level Regulations Assignment

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Discussion – Week 5
COLLAPSE
Professional Nursing and State-Level Regulations

# 1
Molly Lutgen
RE: Discussion – Week 5 (Main Post)
COLLAPSE
Professional Nursing and State-Level Regulations
The National Council of State Boards of Nursing (NCSBN) is an organization where nursing regulatory bodies work together on matters of common interest and concern affecting public health and safety, including licensure regulations. Nursing Regulatory Bodies (NRBs) are jurisdictional government agencies responsible for regulating nursing practice, including the scope of practice which determines the compacity in which an Advanced Practice Registered Nurse (APRN) can practice. Each state has a Nursing Practice Act enforced by NRBs, but it varies from state to state (NCSBN, n.d.).
APRNs are a vital part of the healthcare system in the United States and are educated and certified to assess, diagnose, manage medical conditions, and prescribe medications (NCSBN). Full practice authority (FPA) is the ability of an APRN to practice to the full extent of their training. APRNs’ FPA differs from state to state and is often seen as a barrier to providing efficient, cost-effective, high-quality care, especially with the physician shortages affecting one and five Americans (ANA, n.d.). In states where APRNs have unrestricted practice authority, patients, healthcare systems, and payers significantly benefit due to increased access to lower-cost care (Neff et al., 2018)Professional Nursing And State-Level Regulations Assignment
In my state of Minnesota, APRNs have full practice authority, which includes examination, diagnosis, interpretations of diagnostic tests, treatment plans, and prescribing medications. FPA became effective on January first, 2015. One regulation in Minnesota is before full independent practice and prescribing authority; Nurse practitioners (NP) must practice for 2,080 hours within a collaborative agreement with an experienced NP or physician (Minnesota Board of Nursing, n.d.). Another regulation specific to Minnesota is that APRNs can independently prescribe medications, including controlled substances (Minnesota Board of Nursing, n.d.). In comparison, the state of California has restrictions on full practice authority. APRNs in California must work under a physician, have a written agreement, adhere to standardized procedures, and collaborate with them on treatment decisions. Nurse Practitioners also have to obtain additional certification to prescribe medications under standardized procedures (Montague, 2020).
APRNs with no legal authority to practice within the full scope of their education and training have limited ability to access the healthcare market and compete with other providers. The restrictions on their ability to practice independently also limit patients’ access to quality, cost-effective healthcare. A study revealed that in California, physician demand will meet less than half of the need for primary care in 2030 (Spetz & Muench, 2018). Additional studies have found that in states where Nps can practice and prescribe independently, they are more likely to practice in areas in great need of primary care providers, such as rural and lower socioeconomic areas (Spetz, 2019)Professional Nursing And State-Level Regulations Assignment.
Given the variation in the scope of practice between states, APRNs must clearly understand the laws and regulations in their state of practice. Being an active member or following specific organizations such as the Citizen Advocacy Center (CAC) or American Nurses Association ANA) can help APRNs stay current with nursing trends and regulations. Furthermore, APRNs can actively advocate for policy changes concerning the scope of practice (ANA, n.d.).

References
American Nurses Association. (n.d.). ANA enterprise. https://www.nursingworld.org
Montague, A. (2020). Expanding scope of practice for Nurse Practitioners in California: AB 890 compromises to permit independent practice. California legislative beat. https://sourcrhealthcare.org/.expanding-scope-of-practice-for-nurse-practitioners-in-california-ab-890-compromises-to-permit-independent-practice/.
National Council of State Board of Nursing (NCSBN). (n.d.). https://www.ncsbn.org/index.htm
Neff, D., Yoon, S., Steiner, R. L., Bejleri, I., Bumbach, M. D., Everhart, D., & Harman, J. S. (2018). The impact of nurse practitioner regulations on population access to care. Nursing Outlook, 66(4), 379–385. https://doi.org/10.1016/j.outlook.2018.03.001
Spetz, J. (2019). Expanding the role of Nurse Practitioners in California: The impact on patient access to care, California health care found. & Healthforce at UCSF. https://canweb.org/advacacy/grassrotts-resource-center/ab-890-backround/reports/california-health-care-foundation-report/.
Spetz, J., & Muench, M. (2018). Nurse Practitioners are position too fill the primary care gap, but they face barriers (37 Health Aff. 1466, 1466). https://www-healthaffairs-org.uchastings.idm.oclc.org Professional Nursing And State-Level Regulations Assignment

#2
Caitlin Waters
RE: Discussion – Week 5
COLLAPSE
Kansas and Oklahoma are on opposite spectrums of practicing as an advanced practice registered nurse (APRN). Oklahoma is a restricted practice state, meaning all APRNs must work under the direct supervision of a physician for all of their scope of practice functions. In Oklahoma, APRNs are not independent practitioners. Kansas, however, is a full practice state, meaning they can practice their entire scope of practice with only a collaborating physician. Once a year, the practitioner and collaborating physician must sign an agreement to continue to work in that manner. In Kansas, as an APRN, you are also allowed to diagnose and treat based on your diagnosis entirely; that is not the case in Oklahoma.
In the case of APRNs in Oklahoma, despite gaining your scope of practice through your schooling, you must adhere to the restrictions in your practicing state. Such as you would not be able to perform all of your scope of practice duties in Oklahoma without the supervision of your collaborating physician. In Oklahoma, the physician may also only sign to no more than two APRNs to supervise. In Oklahoma, I would imagine the only way you would be able to adhere to these restrictions is by diagnosing the patient during the visit, taking the subjective and objective information you collected, along with what you think your diagnosis is, and presenting it to the physician. From there, you could make it an official diagnosis to work together on a treatment plan.
I would find it very difficult to have worked as hard as we are working and then some only to be told by the state that I am practicing in that I have restrictions on my ability to provide care for which I put in all this time, money, and education. Professional Nursing And State-Level Regulations Assignment

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References:
Kansas State Board of Nursing. (n.d.). Nurse practice act statutes & administrative regulations – KSBN.KANSAS.GOV. Kansas State Board of Nursing. Retrieved June 27, 2022, from https://ksbn.kansas.gov/wp-content/uploads/NPA/npa.pdf
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Jones & Bartlett Learning.
Oklahoma Board of Nursing. (n.d.). Every effort has been made to ensure that the information provided at this site is correct, but due to the changing nature of the internet, the board disclaims any responsibility for any inaccuracies. Oklahoma Board of Nursing. Retrieved June 27, 2022, from http://nursing.ok.gov/ Professional Nursing And State-Level Regulations Assignment