Policy and State Boards of Nursing Discussion Essay

The most recent regulations promulgated through my state (Texas) board of nursing for advanced practice

Texas Board of Nursing is given authority by the Nurse Practice Authority to regulate advanced practice registered nurses.  The requirement to review the Prescription Monitoring Program (PMP) when prescribing carisoprodol, barbiturate, benzodiazepine, or an opiate is the most recent regulation promulgated by Texas board of nursing. According to Phillips (2021), the authority of APRNs to write prescriptions is delegated by a physician using a prescriptive authority agreement and written protocols.  From March 1,  2020, APRNs have been mandated to review the PMP before prescribing carisoprodol,  barbiturate,  benzodiazepine,  or opiate  (H&S Code §481.0764), except when the patient is receiving hospice c care or has been diagnosed with sickle cell disease or cancer. Policy and State Boards of Nursing Discussion Essay

How the state regulations are supported within my place of employment?

The requirement for APRNs to review Texas PMP is supported in my place of employment. My organization pays fees for PMP- electronic health record (EHR) integration.  The PMP is available online for manual access via the Texas Board of Pharmacy through PMP AWARxE. Also, Physicians have access to the PMP through their EHR. From September 2021, prescribers in Texas started being charged an annual fee for this integrated EHR access. My organization has been paying the annual fee to Appriss (the PMP software vendor) to enable physicians and advanced practice nurses to access the PMP through their EHR within their workflow.

How the states differ in terms of scope of practice and the impact this has on professional nurses across the United States

Individual states have scope of practice regulations and laws on APRN practice and nurses’ scope of practice is established by the board of nursing or by a legislative regulation or statute.  According to Kleinpell et al. (2022), states are grouped as full practice, reduced practice, and restricted practice based on APRN’s scope of practice regulations. in full practice authority states, licensure and practice laws allow APRNs to evaluate patients and make a diagnosis, order and interpret laboratory and diagnostic tests; and commence and manage treatments including writing prescriptions for controlled substances and medications under the state board of nursing’s licensure authority. In reduced practice states, APRNs are required to have collaborative agreements with another health provider, particularly a physician for them to provide patient care while in restricted practice states, APRNs are required to have supervisory agreements for them to practice. Policy and State Boards of Nursing Discussion Essay

The ability of APRNs states in the United States to practice to the full level of their training and education is connected to scope of practice regulations and laws. Park et al. (2020) posit that although nurse practitioners have national certification in their specialty area, scope of practice regulations and laws determine the level of physician collaboration or supervision needed for nurse practitioners and the boundaries within which they are allowed to practice.  The supply of nurse practitioners is substantially associated with cross-state variations in scope of practice regulatory environment

References

Kleinpell, R., Myers, C. R., Likes, W., & Schorn, M.,   (2022). Breaking Down Institutional Barriers to Advanced Practice Registered Nurse Practice.  Nursing Administration Quarterly, 46(2), 137-143. doi: 10.1097/NAQ.0000000000000518

Park, J., Han, X., & Pittman, P. (2020). Does expanded state scope of practice for nurse practitioners and physician assistants increase primary care utilization in community health centers? Journal of the American Association of Nurse Practitioners, 32(6), 447-458. doi: 10.1097/JXX.0000000000000263

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

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Discussion: Policy and State Boards of Nursing
Within the far-reaching and multi-layered realm of policy and reform, government at the state level plays an essential role. Consider the federally enacted PPACA’s individual mandate which sought to increase the number of consumers who receive insurance coverage and, therefore, greater access to care. In a system that is already stretched beyond capacity and confronting a nursing shortage, how can the health care system meet this increased demand? Since state boards of nursing determine scope of practice, it is important to stay up to date and current with the policies and regulations that are created by the state board of nursing. Policy and State Boards of Nursing Discussion Essay

To prepare:

Review the Thomas, Benbow, and Ayars article and the Watson and Hillman article focusing on how states regulate advanced nursing practice and how legislative changes are impacting scope of practice.
Visit your state board of nursing website and/or contact the board to determine how the state board controls advanced practice through regulations.
Determine if your state board has created any new policies or regulations that address changes to scope of practice in response to legislative changes. Policy and State Boards of Nursing Discussion Essay
By Day 3
Post a cohesive response that addresses the following:

What are the most recent regulations promulgated through your state board of nursing for advanced practice?
How are the state regulations supported within your place of employment?
How do the states differ in terms of scope of practice? What impact does this have on professional nurses across the United States? Policy and State Boards of Nursing Discussion Essay