Advanced Practice Nursing Role
Advanced Practice Nursing Role
This is an assignment and does not need to be in essay format, however all questions answered can be mixed within a paragraph or two and flow together. Please see attachment and keep the module sections divided. About one page of length per module section is ok. These questions are for Advanced Practice Nursing (APRN) practicing in Texas– this is important because the laws may differ from state to state.
Minimum of 2 references per section. References need to be provided in APA format.
Module 1.2
Can Advanced Practice Nurses (APRN) practice with any type of population focus or speciality? Does the Texas BON regulate where APRN’s can practice? Does the Texas BON regulate what type of practice APRN’s can participate in? Does Medicaid or Medicare influence where APRN’s can practice or what type of practice? Does the Texas Board of Medicine regulate what type of practice APRN’s can participate in?
Compare and contrast the differences between the various APRN credentialing organizations? Does an APRN need to be credentialed? What purpose does credentialing serve?
Do APRN’s need to be certified? If so, why? What purpose does APRN certification serve? What are some types of APRN certification? Who certifies APRN’s?
Module 1.3
Why is there a need for the consensus model? What is the purpose of the consensus model? If you move from state to state as a APRN to work, what do you need to ask yourself in order to stay out of trouble? How did the consensus model come about?
Is Texas compliant with the consensus model? If so why or why not?
What is the proper order in the consensus model? Please define the purpose of the Certifying organizations? Accrediting organizations? Licensing boards? What are the four categories of APRNs?
Module 1.4
When you prescribe to patients can you prescribe to persons that live outside your state? For instance, if a person is visiting from Alaska and gets sick and visits your clinic can you prescribe to them?
Can you prescribe to persons that reside in the U.S. Virgin Islands and they are visiting your town and get sick?
Can you prescribe to persons that live in Mexico and they are visiting their daughter that lives in your town?
Can you prescribe Adderall to 11-year-old patients by yourself?
Can you prescribe Morphine to a 50-year patient with chronic pain?
Do you need to keep any records of your prescriptions?
Should you carry insurance when you prescribe? What type of insurance should you carry?
Should you get a DEA number? If so what is the process of getting a DEA number?
What is the Texas Prescription Monitoring aware program (PMP)? When should an APRN utilize this program?
If an APRN is working in Telemedicine and they prescribe medications to a patient that calls in with sinusitis and lives in the same state. Does prescribing to a patient via telemedicine work differently? and if so how?
Advanced Practice Nursing Role
Module 2.1
Beside the Texas Board of Nursing what other agencies or government bodies regulate or create rules for APRN’s?
How can APRN’s influence their state representatives?
What other groups can APRN’s collaborate with to influence potential legislation?
Please include the government address of your state representative and state senator?
Write a letter to your state representative about an APRN issue that matters to you (Example: full practice authority or any other issue that affects APRN’s). Make sure you address your state representative as Honorable State Representative (their last name). Mail the letter to their Austin address.
How do APRN’s find out about rule changes or changes in the law? How do laws become enacted in Texas?
When does the Texas legislature meet? When does the Texas Board of Nursing meet?
SAMPLE ANSWER
Advanced Practice Nursing Role
Module 1.2
The Texas Board of Nursing considers that nursing practice is dynamic. The advanced nursing practice evolves through technology development, evidence-based practice, acquisition of knowledge, experience, and the changes in health care delivery (NursingLicensure.org, 2019). The scope of practice shows the type of patients APNs need to perform and forms APNs ability to seek reimbursement for provided services. Therefore, APNs can perform new procedures, practice in new settings, and practice new skills during their practice.
APRNs can practice with any population as they can diagnose and treat the public on various health complications and manage chronic diseases. This means that APRNs can provide specialty care across all people through assessment, diagnosis, and treatment including reproductive and gynecological care (Texas Board of Nursing,2019). Thus, APRNs drive evidence-based care and best practices changes to ensure and improve patient outcomes.
Advanced Practice Nursing Role
The Texas BON regulate where APRN’s can practice. Graduates who complete nursing education in the US or who receive the licensure may be allowed to operate temporarily in Texas (Texas Board of Nursing, 2019). However, individuals graduating from outside the US looking for license in Texas cannot get temporary authorization. Besides, even if they file for NCLEX-PN® they cannot get temporary authorization to practice (NursingLicensure.org, 2019). Medicaid or Medicare does not influence where APRN’s can practice or what type of training. Their role is only to reimburse for services provided. The Texas Board of Medicine also does not regulate what kind of practice APRN’s can participate. The board is only concerned in investigating complaints against medical physicists, surgical assistants, nurse and physicians (Texas Board of Nursing, 2019). There are many APRN credentialing organizations, and APRNs can choose from NCC, PNCB, AACN, and AANPCB, for certification.
APRNs in Texas must have at least a master’s degree to be certified. The certification must be consistent with education (Texas Board of Nursing, 2019). However, there are instances where an individual does not meet Texas standards despite training. The main types of certifications include the American Midwifery Certification Board, the American Academy of Nurse Practitioners, American Nurses Credentialing, and American Association of Critical-Care Nurses (Texas Board of Nursing, 2019). Therefore, the certifications help nurses grow in nursing field, expand their knowledge, and evolve as professionals, which in turn lead to improvement of healthcare delivery.
Module 1.3
The APRN Consensus Model is a model that helps to outline the recommendations regarding APRN licensure, education, certification, accreditation in all states in the United States. The model was developed between 2005 and 2008 by the American Nurses’ Association (National Council of State Boards of Nursing, 2019). The implementation of the model got an endorsement of over 40 nursing organizations in 2008 (National Council of State Boards of Nursing, 2019). The model impacts APRN certification organizations because their certification requirements must reflect the model requirements. APRNs need to stay updated on the requirements of in their profession and population focus to ensure their licensure requirements meet practice in Texas. Thus, the APRN Consensus Model has helped ensure APRNs are trained to ensure public safety, and developing standards, which reaffirm the certification and qualifications of APRNs in medical environments (National Council of State Boards of Nursing, 2019).
Advanced Practice Nursing Role
The consensus model has been endorsed and adopted by the state board of nursing in Texas to help in their revision of the policies on the APRN scope of practice and licensure requirements. The model has a particular order for APRN regulation such as Licensure, Accreditation, Certification, and Education (Milstead & Short, 2019). The uniform model is therefore designed to align the interrelationship aspects within the model as mentioned above.
The certifying organizations, accrediting organizations, and licensing boards are responsible for certifying APRNs based on their patient population focus. They provide tests to examinees looking to become certified nurses in the state of Texas. The Consensus Model outlines the four types of APRNs, including nurse practitioner (NP), clinical nurse specialist (CNS), certified registered nurse anesthetist (CRNA), and certified nurse-midwife (CNM) (Milstead & Short, 2019).
Module 1.4
APRNs in Texas does not have a prescribing authority of prescribing drugs and offering health care services to persons visiting from a different state in the US such as Alaska. Texas regulates the scope of prescription and primarily prohibited independent prescription (NursingLicensure.org, 2019). The APRNs are required to have the federal DEA registration and must have the prescriptive authority before ordering and prescribing drugs to people visiting from other states. APRNs still has to get the prescription authority to treat individuals who get sick while visiting the town and are from Mexico or Virgin Island. However, this regulation is always challenging because APRNs should not be deterred from prescribing appropriately for individuals who need emergency treatment while visiting the state since failing to provide care does meet the standard of nursing practice (NursingLicensure.org, 2019). Therefore, APRNs must provide appropriate assessment, treatment, and prescriptions for patients from outside the United States.
APRNs in Texas have limitations when prescribing Adderall to 11-year-old patients by themselves. The APRNs are limited to prescribing a 90-day supply of Adderall to individuals of the age of 2 years and older. Physician consultation is always needed, and the consultation must be outlined n the patient’s chart (NursingLicensure.org, 2019). Besides, pharmacists are not allowed to fill a schedule of subscription filled by an APRN. Prescription within the hospital can only be done by physician delegation for Schedule II prescriptions.
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APRNs in Texas can prescribe Morphine to a 50-year patient with chronic pain under controlled practice conditions because they must have physician consultation before prescribing the morphine. The Texas Medical Board considers that the patient must first be evaluated before prescribing the morphine including assessment of patient medical history, morphine prescription data (NursingLicensure.org, 2019). Besides, informed consent must be considered before providing a morphine treatment, and this is tracked through the prescription monitoring program (PMP). The complete medical records for prescriptions must be maintained to help review the patient’s medical data in their future morphine treatment. Besides, the board of nursing requires APNs to help patients with insurance procedures during prescription. Therefore, complying with the Texas Insurance Code §1467.0511 is critical (Texas Board of Nursing, 2019).
The DEA number is essential because all APRNs working in Texas must be registered with the federal Drug Enforcement Administration (DEA). APRNs are covered under the registration, and they get individual DEA registration number. The process of applying the DEA number include application in the DEA website in which you are given a registration ID number based on the state of practice (Texas Board of Nursing, 2019). The ID number is also essential during the renewal of registration.
The Prescription Monitoring Program (PMP) in Texas aims to collect and monitor prescription data for all controlled substances by pharmacies in the state or located in other countries. The PMP helps APRNs to check and eliminate duplicate controlled substances, get substance history information, and obtain overprescribing of controlled substances (Nursing World, 2019). APRNs with the authority of a physician may treat patients through the use of telemedicine using his or her license. Prescription in telemedicine works differently because there must be an established patient-practitioner relationship and the practitioner must meet the standard of care for the individual.
Module 2.1
Apart from the Texas Board of Nursing, other government bodies and agencies that create rules for nurses include NCSBN, AANA, ACNM, and the Citizen Advocacy Center. These bodies help legislators to make decisions regarding APRNs scope of practice, including the regulatory and regulatory requirements (National Council of State Boards of Nursing, 2019). APRNs can influence legislation through policy work involving practice processes and standards and collaborate with patients to ensure quality health care delivery. Influencing policy change also affects resource allocation and provision of care.
Advanced Practice Nursing Role
APRN’s always found out about rule changes or changes in the law through the weekly publication called Texas registry after the Texas Board of Nurses submit all proposed changes (Texas Board of Nursing, 2019). The registry includes notices of rule review, repealed rules, notice of withdrawn, adopted standards, emergency rules, and proposed rules.
Laws are enacted in Texas through the legislations enacted by the Legislature that convenes after every 140 days after every two years (Nursing World, 2019). However, sometimes special sessions can be conducted by the governor in case of emergency issues that may impact the nursing profession more positively. Most legislation can also be amended during the sessions.
References
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.).
Burlington, MA: Jones & Bartlett Learning.
American Nurses Association (ANA). (November 14, 2017). ANA Enterprise.
https://www.nursingworld.org/practice-policy/aprn/
National Council of State Boards of Nursing (NCSBN). (20191). APRN consensus
implementation status. NCSBN. https://www.ncsbn.org/5397.htm
National Council of State Boards of Nursing (20192). “Consensus Model for APRN
Regulation: Licensure, Accreditation, Certification & Education,” ncsbn.org, National Council of State Boards of Nursing, https://www.ncsbn.org/Consensus_Model_for_APRN_Regulation_July_2008.pdf
NursingLicensure.org, (20191). Advanced Practice Registered Nurse license requirements in
Texas. Nursing licensure. https://www.nursinglicensure.org/np-state/texas-nurse-practitioner.html
NursingLicensure.org, (20192). Advanced Practice Registered Nurse license requirements in
California. Nursing licensure. https://www.nursinglicensure.org/np-state/california-nurse-practitioner.html
Nursing World. (2019). “FAQ: Consensus Model for APRN Regulation,”
nursecredentialing.org, American Nurses Credentialing Center, https://www.nursingworld.org/certification/aprn-consensus-model/faq-consensus-model-for-aprn-regulation/
Texas Board of Nursing. (2019). National Certification Expectations for Entry-Level
NPS,” aanp.org, American Association of Nurse Practitioners, https://www.aanp.org/education/student-resource-center/starting-your-career/9-education/1060-certification-for-entry-level-nps
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