Explain the types of regulations that exist and the barriers that may impact nurse practitioner independent practice
Explain the types of regulations that exist and the barriers that may impact nurse practitioner independent practice
CERTIFICATION AND LICENSURE PLAN
Now that you are in the final course in your program, it is time to turn in earnest to preparing for certification and licensure. You will need to take and pass the national PMHNP certification exam. Once certified, you will then be eligible to apply for licensure as an advanced practice registered nurse (APRN) in the state desired. It will be up to you to ensure you are knowledgeable about the practice agreements, scope of practice, and prescriptive authority in your state.
Although a movement called the APRN Consensus Model is attempting to standardize NP regulations nationally, it is still the case that requirements vary state to state. In some states, NPs may establish an independent practice without the supervision of an MD. Additionally, states are currently categorized as either allowing full practice, reduced practice, or restricted practice. Full practice states allow NPs to evaluate, order diagnostics, diagnose, and treat patients. They are licensed under the exclusive authority of the state board of nursing for the appropriate state. Many states may require prescriptive authority protocols in addition to collaborative agreement.
Another important area to consider and plan for is prescriptive authority. The appropriate board, which may be the medical board, state board of pharmacy, or nursing board, grants prescriptive authority under state law for the appropriate state licensure. The federal government grants the authority to write for a controlled substance, and the Drug Enforcement Administration (DEA) verifies this action through by the appropriate state board. Drug Enforcement Agency registration is granted at the federal level and has additional requirements/fees for the registration process.
In this Discussion, you will locate and review the practice agreements in the state in which you plan to practice, identify potential collaboration requirements in your state, and understand the certification and licensing process that you will need to follow.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
TO PREPARE:
- Review practice agreements in your state.
- Identify whether your state requires physician collaboration or supervision for nurse practitioners, and if so, what those requirements are.
- Research the following:
- How do you get certified and licensed as an Advanced Practice Registered Nurse (APRN) in your state?
- What is the application process for certification in your state?
- What is your state’s board of nursing website?
- How does your state define the scope of practice of a nurse practitioner?
- What is included in your state practice agreement?
- How do you get a DEA license?
- Does your state have a prescription monitoring program (PMP)?
- 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?
BY DAY 3 OF WEEK 1
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.
Read a selection of your colleagues’ responses.
BY DAY 6 OF WEEK 1
Respond to at least two of your colleagues on 2 different days in one or more of the ways listed below.
- Share an insight from having viewed your colleagues’ posts.
- Suggest additional actions or perspectives.
- Share insights after comparing state processes, roles, and limitations.
- Suggest a way to advocate for the profession.
- Share resources with those who are in your state.
LEARNING RESOURCES
- American Association of Nurse Practitioners. (2020). State practice environmentLinks to an external site.. https://www.aanp.org/advocacy/state/state-practice-environment
- On the map on the webpage, click on your state and review. After you complete the PMHNP Program, pass the certification exam, and get a job, you will need to revisit this website to apply for the privilege to practice as an APRN with your state Board of Nursing.
- American Psychiatric Association. (2020). TelepsychiatryLinks to an external site.. https://www.psychiatry.org/psychiatrists/practice/telepsychiatry
- Buppert, C. (2021). Nurse practitioner’s business practice and legal guide (7th ed.). Jones & Bartlett Learning.
- Chapter 1, “What Is a Nurse Practitioner?”
- Chapter 2, “Nurse Practitioner Scope of Practice”
- Chapter 3, “State Regulation of the Nurse Practitioner Practice”
- Chapter 4, “Federal Regulation of the Nurse Practitioner Profession”
- Chapter 5, “Prescribing”
- Centers for Disease Control and Prevention. (2020). Using telehealth to expand access to essential health services during the COVID-19 pandemicLinks to an external site.. https://www.cdc.gov/coronavirus/2019-ncov/hcp/telehealth.html
- Centers for Medicare & Medicaid Services. (2019). National provider identifier standard (NPI)Links to an external site.. https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/NationalProvIdentStand
- The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions.
- Drug Enforcement Administration Diversion Control Division. (2020). RegistrationLinks to an external site.. https://www.deadiversion.usdoj.gov/drugreg/index.html
- This site contains information about applying for your DEA registration number. This number is required for writing prescriptions.
- After completing PMHNP Program and passing the PMHNP certification exam, complete the DEA application to request prescriptive privileges. Your DEA number will be renewable every five years.
- National Panel for Psychiatric Mental Health NP Competencies. (2003). Psychiatric-mental health nurse practitioner competenciesLinks to an external site.. National Organization of Nurse Practitioner Faculties (NONPF). https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/imported/PMHNPcomps03.pdf
- Stewart, J. G., & DeNisco, S. M. (2019). Role development for the nurse practitioner (2nd ed.). Jones & Bartlett Learning.
- Chapter 1, “Historical Perspectives: The Art and Science of Nurse Practitionering”
- Nurse Practitioner Core Competencies
- Nurse Practitioners’ Unique Role
- Chapter 13, “Quality, Safety, and Prescriptive Authority”
- Chapter 1, “Historical Perspectives: The Art and Science of Nurse Practitionering”
- Substance Abuse and Mental Health Services Administration. (2020). Become a buprenorphine waivered practitionerLinks to an external site.. https://www.samhsa.gov/medication-assisted-treatment/buprenorphine-waiver-management/apply-for-practitioner-waiver
- This site contains information about applying for a practitioner waiver to prescribe or dispense buprenorphine under the Drug Addiction Treatment Act of 2000 (DATA 2000).
- After youobtain a Drug Enforcement Agency (DEA) number and completed 24-hour medication-assisted treatment (MAT) waiver training, you may apply to Substance Abuse and Mental Health Services Administration(SAMSHA) for MAT waiver to be able to prescribe Schedule III, IV, or V opioid drugs for the maintenance and detoxification treatment of opioid use disorders relapse prevention.
- Zakhari, R. (2021). The psychiatric-mental health nurse practitioner certification review manual. Springer Publishing Company.
- Chapter 2, “The Role of the Psychiatric-Mental Health Nurse Practitioner: Regulations and Scope of Practice”
- Chapter 3, “Theoretical Foundations of Care and Nonpharmacological Therapies”
Consult these professional organization websites as needed.
- American Psychiatric Nurse AssociationLinks to an external site. (APNA) https://www.apna.org
- International Society of Psychiatric-Mental Health NursesLinks to an external site. (ISPN) www.ispn-psych.org
- National Alliance on Mental IllnessLinks to an external site. (NAMI) https://www.nami.org
- National Council for Behavioral HealthLinks to an external site. (NCBH) www.thenationalcouncil.org
- National Institute of Mental HealthLinks to an external site. (NIMH) https://www.nimh.nih.gov/index.shtml
- Substance Abuse and Mental Health Services AdministrationLinks to an external site. (SAMHSA) www.samhsa.gov
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