Professional Nursing And State-Level Regulations
Professional Nursing And State-Level Regulations
Response to Caitlin Waters
Scope of practice and prescriptive authority are two APRN board f nursing regulations in Kansas. Kansas is a full practice state while Oklahoma is a reduced authority state. According to Kleinpell et al. (2022), the American Association of Nurse Practitioners categorizes state regulations and laws impacting the practice of APRNs and recognizes the practice environment within the state as reduced, restricted or full. In full practice states, APRNs are permitted by licensure laws to evaluate patients and diagnose their problems, order and interpret diagnostic and laboratory tests, and commence and manage treatments including prescribing controlled substances and medications under the licensure authority of a state BON. In a restricted practice state, APRNs are required to have supervisory agreements while in a reduced practice state, APRNs are required to have collaborative agreements Professional Nursing And State-Level Regulations.
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APRNs in Kansas are authorized to independently practice and prescribe medications. In April 2022, Kansas passed a bipartisan bill to grant APRNs full practice authority. With full practice authority, nurse practitioners are permitted to order diagnostic tests, initiate and manage treatments, and prescribe drugs without being supervised by a physician. Unlike Kansas where APRNs have full practice authority, APRNs in Oklahoma are not required to be supervised by a physician to practice, but they require physician supervision to prescribe Professional Nursing And State-Level Regulations.
APRNs in Oklahoma practice within the scope of practice as defined by the Nurse Practice Act (NPA) . The NPA grants APRNs authority to practice independently; however, APRNs require physician supervision to prescribe medications. According to Phillips (2021), APRNs with prescriptive authority are required to submit a written statement from a physician licensed in Oklahoma to the BON. The statement outlines the mechanisms for consultation, referral, and collaboration, and the availability of the physician to communicate with the APRN. The prescriptions must be within the scope of practice of the APRN, and might only include schedule III-V controlled substances (theory-day supply). To prescribe controlled substances, APRNs are required to obtain DEA registration along with the Oklahoma Bureau of Narcotics and Dangerous Drugs registration. Restrictive prescriptive authority laws limit the ability of APRNs in Oklahoma to independently prescribe medications proportionate to their educational training.
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
Phillips, S. J. (2021). 33rd Annual APRN Legislative Update: Unprecedented changes to APRN practice authority in unprecedented times. The Nurse Practitioner, 46(1), 27-55. doi: 10.1097/01.NPR.0000724504.39836.69 Professional Nursing And State-Level Regulations
#2
Caitlin Waters
RE: Discussion – Week 5
COLLAPSE
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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. Professional Nursing And State-Level Regulations
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.
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References: Professional Nursing And State-Level Regulations
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