Medical Care Research and Review Assignment Paper

Advanced Nursing Practice: Discussion

In the state of California, advanced nurse practitioners are licensed by the California Board of Registered Nursing (BRN). The BRN certifies and licenses nurse practitioners (NPs) upon completing a postgraduate degree (NursePractitionerLicense.com., 2023). Additionally, the applicant must be a holder of a registered nurse (RN) certification in California and have acquired national NP certification. Lastly, an individual must have completed the BRN certification application (NursePractitionerLicense.com, 2023). In California, NPs’ application for certification starts by submitting an RN license issued by the state BRN. Interested parties complete the application process online upon paying application fees of $500. Applicants must have completed a postgraduate NP preparatory program approved by the board. Lastly, the applicant must have a national certification issued by national certifying agencies approved by the board (NursePractitionerLicense.com, 2023). Medical Care Research and Review Assignment Paper

The primary nurse licensure office resource website is the California BRN website.

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The California BRN has adopted a restricted scope of practice for NPs (Lavin et al., 2022). The board requires all NPs to secure a written agreement with a physician in their specialty (McMichael & Markowitz, 2023). Additionally, NPs must collaborate with physicians while making significant treatment decisions. The state’s practice agreement for NPs requires a nurse practitioner to practice in one of the six categories of NP specialties depending on an individual’s national certification (Miec, 2023). In California, NPs obtain a DEA license by applying at the official website of the U.S. Department of Justice. Additionally, NPs apply by calling the DEA Headquarters Registration Unit. An NP can also request the order form’s physical copy from the nearest DEA Registration Field Office. Medical Care Research and Review Assignment Paper

The state of California describes NPs’ controlled-substance prescriptive authority in the Nursing Practice Act (NPA) section 2725 (BRN, 2023). NPs are authorized to order drugs and devices while supervised by a physician or surgeon. Additionally, the NPA under the Uniform Controlled Substance Act allows NPs with a furnishing number to order Schedule II through V Controlled Substances (BRN, 2023). However, the furnishing NP interested in ordering Schedule II Controlled Substances must meet specified educational requirements (BRN, 2023). NPs practicing in the state are allowed to order, prescribe, dispense, and administer various medications, including schedule II-V controlled substances under the supervision of a physician. Medical Care Research and Review Assignment Paper

In California, NP organizations advocate for the expansion of the current NPs’ scope of practice law. Allowing NPs to practice independently would enhance access to high-quality and cost-effective healthcare.

NP regulations include restricted and full scope of practice. Practitioners are allowed to assess, diagnose, order, and prescribe medications to patients independently in states with full practice (Shakya & Plemmons, 2020). Additionally, these states allow NPs to own their practices. On the contrary, states with restricted practice authority require NPs to work under the supervision of physicians while providing treatment (Shakya & Plemmons, 2020). Independent practice in California is hindered by the NPA, which authorizes limited NPs’ scope of practice. Thus, NPs practicing in the state must present a written contract with a physician and collaborate while making treatment decisions. The most surprising part of the research is that NPs practicing in California must be issued with a furnishing number before ordering schedule II-V controlled substances (BRN, 2023). Additionally, it is surprising that NPs with furnishing numbers must undergo special training before ordering Schedule II Controlled Substances (BRN, 2023). Medical Care Research and Review Assignment Paper

References

Board of Registered Nursing. (2023). General Information: Nurse Practitioner Practice. https://www.rn.ca.gov/pdfs/regulations/npr-b-23.pdf

Lavin, R. P., Veenema, T. G., Sasnett, L., Schneider-Firestone, S., Thornton, C. P., Saenz, D., … & Couig, M. P. (2022). Analysis of nurse practitioners’ educational preparation, credentialing, and scope of practice in US emergency departments. Journal of Nursing Regulation, 12(4), 50-62.

McMichael, B. J., & Markowitz, S. (2023). Toward a uniform classification of nurse practitioner scope of practice laws. Medical Care Research and Review, 80(4), 444-454.

Miec. (2023). Nurse Practitioner Expanded Scope of Practice in California. Miec. https://www.miec.com/knowledge-library/nurse-practitioner-expanded-scope-of-practice-in-california/#:~:text=NPs%20can%20apply%20to%20work,primary%20care%2C%20or%20acute%20care

NursePractitionerLicense.com. (2023). California Nurse Practitioner Licensure Steps – 2023. NursePractitionerLicense.com. https://www.nursepractitionerlicense.com/nurse-practitioner-licensing-guides/california-nurse-practitioner-licensu

Shakya, S., & Plemmons, A. (2020). Does scope of practice affect mobility of nurse practitioners serving Medicare beneficiaries? Journal of Labor Research, 41, 421-434 Medical Care Research and Review Assignment Paper

Advanced Nursing Practice
Discussion day 1

Prescriptive authority is granted under state law by the appropriate board. The board granting prescriptive authority may be the medical board, state board of pharmacy, or nursing board for the appropriate state licensure being pursued. The authority to write for a controlled substance is granted at a federal level and is verified through the Drug Enforcement Administration (DEA) by the appropriate state board. Drug Enforcement Agency registration is granted at the federal level and has additional requirements/fees for the registration process.
Finally, the legal landscape for NPs is constantly changing as the status of NPs as providers improves on a national level. Legislative changes may occur annually, bi-annually, or during an emergency legislative meeting at the state or federal level. These legislative sessions and any subsequent changes will significantly impact your scope of practice as a nurse practitioner. Medical Care Research and Review Assignment Paper

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For this Discussion, you examine professional issues for your state (california) , including certification and licensure, scope of practice, independent practice, prescriptive authority, and legislative activities.
Research the following:
• How do you get certified and licensed in your state?
• What is the application process for certification in your state?
• What is the primary nurse licensure office resource website in your state?
• How does your state define the scope of practice of a nurse practitioner?
• What is included in your state’s practice agreement?
• How do you get a Drug Enforcement Agency (DEA) license?
• How does your state describe a nurse practitioner’s controlled-substance prescriptive authority and what nurse practitioner drug schedules are nurse practitioners authorized to prescribe?
• In what legislative and advocacy activities are your state nurse practitioner organization(s) involved?
Post a summary of your findings on your state based on the questions listed above. Explain the types of regulations that exist and the barriers that may impact nurse practitioner independent practice in your state. Be specific. Also, describe what surprised you from your research. Medical Care Research and Review Assignment Paper