APRN Certification and Licensure Plan
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.
Note:
For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the
Reply
button to complete your initial post. Remember, once you click on
Post Reply
, you cannot delete or edit your own posts and you cannot post anonymously. Please check your post carefully before clicking on
Post Reply
!
Introduction
According to the State of Virginia Board of Nursing, “Psychiatrist mental health nurse practitioners (PMHNP’s) are registered professional nurses who are prepared, through advanced graduate education and clinical training, to provide a range of mental health services, including the diagnosis and management of common as well as complex mental health conditions to individuals of all ages.” (VDHP, 2023).
How to get certified and licensed as an Advanced Practice Registered Nurse (APRN) in Virginia.
Nursing practitioner licenses in Virginia are issued with a specialty designation; they are not generic licenses. The Boards of Nursing and Medicine jointly have jurisdiction over Virginia’s Licensed Nurse Practitioners (LNPs). The nurse practitioner specialties recognized eight others by the Board include nurse midwife and nurse anesthetist, which represent various populations and fields of practice. On the basis of graduate education and specialty certification, nurse practitioners are granted licenses. Nurse practitioner must hold licenses as registered nurse in Virginia (VDHP, 2023). The graduate degree and specialty certification of nurse practitioners serve as the basis for licensing. Registered nurses hold licenses as nurse practitioners. The nurse will have RN licensure in the other state if their home state is one of the other states that are signatories to the nurse license compact (VDHP, 2023).
The application process for certification in Virginia
In the state of Virginia, a prospective nurse practitioner will need to complete a graduate Nurse Practitioner program in a clinical specialty (VDHP, 2023). The program must be approved. A program can be considered approved if it is accredited by an acceptable organization. The Joint Committee has approved the following agencies such as Commission on Collegiate Nursing Education (CCNE), National League for Nursing Accrediting (NLNA). Then, the applicant must first apply for the initial certification and request the university transcripts and other supporting documents to determine eligibility to take the exam (VDHP, 2023). Pay the fees and schedule a date and time and place to take the exam. The application process for initial NP licensure is now online.
Virginia board of nursing website
Https://www.dhp.virginia.gov/Boards/Nursing/
How Virginia State define the scope of practice of a nurse practitioner?
Practice authority in Virginia is defined as a NP’s ability to practice with or without a physician’s oversight. Before being allowed full independent practice authority NPs must complete five years of full-time clinical experience as a licensed nurse practitioner under a practice agreement with a physician under the Va Code 54.1-295 (Smith et al., 2020) APRN Certification and Licensure Plan
What is included in Virginia State practice agreement?
A Practice Agreement is an agreement between an NP and the NP’s supervising physician that describes the relationship between the parties, including the procedures to be followed and acts to be performed by the NP in the course of providing care to patients. In Virginia, a Practice Agreement must include, without limitation, the following provisions: A description of the NP’s scope of practice and the setting or settings in which the NP is actively practicing; Provisions for the periodic review of patient records by the supervising physician; Provisions for particular situations that require input by the supervising physician; Provisions for what the NP should do in case of a patient emergency and when a referral should be made; Categories of drugs and devices the NP may prescribe; Guidelines for the availability and ongoing communication between the NP and the supervising physician; A provision for periodic joint evaluation of the services being provided and of patient outcomes; A provision for the periodic review and revision of the practice agreement; and Signature of both parties. A backup clause. Identify a secondary or back-up physician for the NP to contact in the event that the primary supervising physician cannot be reached (AANP, 2022).
GET ASSIGNMENT HELP HERE
How to get a DEA license in Virginia?
The NP must first pass the ANCC certification exam to become a PMHNP. Maintain a valid RN license to practice in the state of Virginia. A DEA number is an identifying series of numbers and letters that is assigned by the drug enforcement administration so health care providers can write prescriptions for controlled substances. To apply visit the DEA website online complete it and the cost is about 888.00 for a 3-year period (VDHP, 2023).
Does the state of Virginia have a prescription monitoring program (PMP)?
Virginia does have the Prescription Monitoring Program (PMP) a central database containing information used primarily by healthcare providers to be better informed about treatment and dispensing decisions. The database contains information on dispensed controlled substances as well as naloxone and registered cannabis products (VDHP, 2023). PMP data is used to track trends in drug utilization, measure the impact of policy (legislative) actions, and support activities related to the opioid crisis response in the Commonwealth (VDHP, 2023). The PMP also provides information to authorized law enforcement agents and regulatory personnel to assist with authorized law criminal or licensee investigations.
How does Virginia describe a nurse practitioners’ controlled-substance prescriptive authority, and what nurse practitioner drug schedules are nurse practitioners authorized to prescribe?
In Virginia, The Nurse Practitioner controlled substance prescribing medications must include the DEA registration number. For Schedule II and III and IV drugs, those in schedule V where a prescription is required. The Nurse Practitioner is authorized to prescribe a 30-day dosage supply (VDHP, 2023). With the ongoing opioid crisis, the focus on prescriptive authority and ethical ramifications have taken center stage.
Conclusion
The role of the Nurse practitioners (NPs) in working collaboratively with physicians has been demonstrated as essential. NPs represent an efficient solution in addressing the health care needs. Providing holistic approach to care is grounded in their nursing training, a unique role that not only supports patients and their families. They are therefore the established links between fragmented systems of care; coordinating and implementing care pathways.
References
Virginia Department of Health Professions (2023). Prescription monitoring Program, PrescriptiveAutority.https://www.dhp.virginia.gov/Boards/Nursing/ApplicantResources/ApplyforLicense/PrescriptiveAuthority/
Virginia Department of Health Professions (2023).Application Wizard – Nurse Practitioner. https://www.dhp.virginia.gov/Boards/Nursing/ApplicantResources/ApplyforLicense/NursePractitioner/
Virginia Department of Health Professions (2023).Prescription Monitoring Program. https://www.dhp.virginia.gov/PractitionerResources/PrescriptionMonitoringProgram/#:~:text=Virginia’s%20Prescription%20Monitoring%20Program%20(PMP)%20is%20a%2024%2F7,by%20a%20pharmaceutical%20processor%20in
Smith, S., Buchanan, H., & Cloutier, R. (2020). Virginia NP scope of practice: A legislative case study.
The Nurse practitioner
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45
(2), 33–37. https://doi.org/10.1097/01.NPR.0000651120.61281.12
American Association of Nurse Practitioners (2022). Education
https://www.aanp.org/advocacy/virginia
How do you get certified and licensed as an Advanced Practice Registered Nurse (APRN) in your state?
To get certified and licensed as an APRN in North Carolina the RN must graduate from a master’s or DNP program from an accredited school. The APRN is then certified by 1 of 5 credentialing boards. Those boards include the American Nurses Credentialing Center (ANCC), American Academy of Nurse Practitioners (AANP), American Academy of Critical Care Nurses Certification Corporation (AACN), National Certification Corporation of the Obstetric Gynecological and Neonatal Nursing Specialties (NCC), and Pediatric Nursing Certification Board (PNCB) (2022).
What is the application process for certification in your state?
APRNs must have a North Carolina nursing license or a multistate compact license that permits them to practice nursing in North Carolina.
Register with the North Carolina board of nursing as a Nurse Practitioner.
Complete the initial approval to practice application as a nurse practitioner.
What is your state’s board of nursing website?
https://www.ncbon.com
Links to an external site.
How does your state define the scope of practice of a nurse practitioner?
North Carolina defines the nurse practitioner’s scope of practice as being educationally prepared, nationally certified, competent in health and maintenance and health promotion, illness prevention, diagnosing and treating illnesses, counseling, prescribing and administering tests and drugs, and recognizing when situations are out of your scope of practice and then referring to appropriate providers (2022).
What is included in your state practice agreement?
The state practice agreement includes working with a physician to create a collaborative practice agreement that entails the treatments, procedures, drugs, etc that the APRN is responsible for. The agreement is reviewed yearly and can be requested by the certifying board (2021).
How do you get a DEA license?
Register for a DEA number through the U.S. department of justice diversion control division after your NP license is approved by the NCBON.
Does your state have a prescription monitoring program (PMP)?
In North Carolina prescriptions are monitored through the controlled substances reporting system.
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 North Carolina, a Nurse Practitioner can prescribe legend drugs and controlled substance schedules II-V.
References:
North Carolina Board of Nursing. (2022, December 28). Nurse Practitioner Laws & Rules.
https://www.ncbon.com/practice-nurse-practitioner-nurse-practitioner-laws-rules
Links to an external site.
North Carolina Board of Nursing. (2021, June 1). Quality Assurance Standards for a Collaborative Practice Agreement.
http://reports.oah.state.nc.us/ncac/title%2021%20-%20occupational%20licensing%20boards%20and%20commissions/chapter%2036%20-%20nursing/21%20ncac%2036%20.0810.html
Links to an external site.
North Carolina Board of Nursing. (2022, December 28). Scope of practice.
http://reports.oah.state.nc.us/ncac/title%2021%20-%20occupational%20licensing%20boards%20and%20commissions/chapter%2036%20-%20nursing/21%20ncac%2036%20.0802.html
Links to an external site.
In 2021, full independent practice was passed for NPs who have worked for more than 6,240 hours (Arkansas State Board of Nursing, n.d). Once the hour requirement has been met, the NP can apply for full practice authority (Arkansas State Board of Nursing, n.d). Besides completing the application for full practice authority, the NP will also need two recommendation letters, a notarized Practice Hours Affidavit signed by their collaborating physician, a certificate of five hours of continuing education hours in advanced pharmacology completed with the past two years, and their updated resume (Arkansas State Board of Nursing, n.d.).
All nursing licensure applications are processed through the Arkansas Nurse Portal (Arkansas State Board of Nursing, n.d.). To apply for a NP license the state of Arkansas requires the following documentation: notarized statement stating that the applicant has a minimum of 2,000 hours working as a registered nurse (RN), official transcript, RN licensure verification, and a copy of national certification or a certification verification form (Arkansas State Board of Nursing, n.d.). A state and federal background check must be completed before the application can be submitted (Arkansas State Board of Nursing, n.d.). Once the NP licensure application has been accepted, it is time to apply for prescriptive authority. It is required that a collaborating physician sign a Collaborative Practice Agreement and a Quality Assurance Plan (Arkansas State Board of Nursing, n.d.). Additionally, it is required that prescribing protocols are uploaded to the applicants nursing portal (Arkansas State Board of Nursing, n.d.). After the applicant has received a full NP license with a Prescriptive Authority Certificate number they must apply for a DEA license, if they plan to prescribe controlled medications (Arkansas State Board of Nursing, n.d).
It is required that all Arkansas NPs who have a DEA license monitor the Prescription Drug Monitoring Program (PDMP) (Arkansas State Board of Nursing, n.d). It is specifically required that the PDMP be monitored before prescribing an opiate medication and before initiating treatment with a benzodiazepine then every six months after the initial prescription (Arkansas State Board of Nursing, n.d). Scope of practice for Arkansas NPs is to be defined by the specific national certifying body for the NP’s specialty (Arkansas state board of nursing, 2022). In addition to NPs providing health care in the specialty they are educationally prepared to be competent in (Arkansas state board of Nursing, n.d.)
I am currently practicing in Georgia. With time and research, I have discovered that Georgia is among the most restrictive for nurse practitioners (NP) among other states. Mid-level providers cannot operate independently, must have a supervising physician, and are limited in ordering medications and tests. While being an NP greatly benefits the community, such restrictions limit one’s ability to service patients wholly.
Identify whether your state requires physician collaboration or supervision for nurse practitioners, and if so, what those requirements are.
If an advanced practice registered nurse (APRN) has been delegated prescriptive authority, a nurse protocol agreement must be submitted to the Georgia Medical Board. In Georgia, general supervision is required by a physician or dentist. The protocol agreement between the NP and the physician: who practices in comparable specialty areas must contain a provision for immediate consultation, identify the parameters under which delegated the NP may perform acts, require documentation by the NP of those acts performed by the NP which are specific to the medical acts authorized by the delegating physician; include a schedule for periodic review by the physician of patient records; provide for patient evaluation or follow up examination by the physician; be reviewed, revised, or updated annually; be available upon written request by the Board of Nursing; and provide that a patient who receives a prescription for a controlled substance under a nurse protocol agreement shall be evaluated or examined by the physician at least quarterly. Further, if the authority to prescribe controlled substances is among those delegated to the NP under the written protocol, the protocol must include written provisions regarding the procedure for ordering controlled substances (AMA, n.d.).
How do you get certified and licensed as an Advanced Practice Registered Nurse (APRN) in your state?
The initial authority for certification requires current licensure as a registered professional nurse in GA, a completed board application with required fees, and an official transcript verifying graduation with a master’s degree or higher in nursing for the given specialty. Required courses within the curriculum must include advanced pharmacology, advanced physical assessment, and pathophysiology. Lastly, applicants are required to pass via an exam of a current national certification from the respective board-recognized certifying organization, the American Association of Nurse Practitioners (AANP) or the American Nurses Credentialing Center (AANC) (Chapter 410-11 regulation of advanced practice registered nurses. GA., n.d.).
What is the application process for certification in your state?
Once the applicant has passed the certification exam, the national certification agency will send the verification of your certification electronically to Ga. Board of Nursing. A completed application, an official graduate program transcript, and fees are also required. Georgia Board of Nursing’s website is https://sos.ga.gov/georgia-board-nursing.
How does your state define the scope of practice of a nurse practitioner?
According to the Ga Board of Nursing, the nurse practitioner provides advanced practice nursing care and medical services specific to the nurse practitioner’s respective specialty to individuals, families, and groups, emphasizing health promotion, disease prevention, and the diagnosis and management of acute and chronic diseases. The nurse practitioner collaborates with various individuals to diagnose and manage clients’ healthcare problems. An NP’s practice must be consistent with certifying board’s practice standards for the respective nurse practitioner specialty (Chapter 410-11 regulation of advanced practice registered nurses. GA., n.d.).
What is included in your state practice agreement?
“Nurse Protocol Agreement” means a written document, mutually agreed upon and signed by an APRN and a physician, by which the physician delegates to that APRN the authority to perform certain medical acts, which may include but is not limited to, the ordering medications, providing medical devices, providing medical treatments, ordering diagnostic studies, x-rays, ultrasounds or medical imaging (Chapter 410-11 regulation of advanced practice registered nurses. GA., n.d.).
How do you get a DEA license?
First-time applicants must complete an application providing full name, address, social security number, and phone number. Information about business activity and drug schedule is also required. The applicant must also provide state medical and/or controlled substance licenses/registrations. For mid-level providers, this includes supervisory agreements with specific authority for controlled substances, a background check about controlled substances obtained, payment of fees (currently $880), and confirmation of the application is completed before submission.
Does your state have a prescription monitoring program (PMP)?
Georgia does have a database used for monitoring the prescribed and dispensing of controlled substances called the Georgia Prescription Drug Monitoring Program (PDMP). To register with the GA PDMP prescribers, have to create an account that includes your name, employment information, last 4 of your social security number, have a Ga professional license number, a DEA number (personal or employer), and an NPI number (personal or employer) (Prescription Drug Monitoring Program, n.d).
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?
Georgia’s Advanced Practice Registered Nurse (APRN) practice laws are some of the most restrictive in the nation. Georgia law requires that APRNs have a protocol agreement with a supervising physician and mandates additional supervision requirements. APRNs in Georgia cannot write prescriptions for Schedule II medications, and their ability to order diagnostic tests is also limited.
References
American Medical Association. (n.d.). AMA code of Medical Ethics. Retrieved March 2, 2023, from
https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/principles-of-medical-ethics.pdf
Links to an external site.
Chapter 410-11 regulation of advanced practice registered nurses. GA. (n.d.). Retrieved March 1, 2023, from
https://rules.sos.ga.gov/gac/410-11
Links to an external site.
Prescription Drug Monitoring Program. (n.d.). Georgia Department of Public Health. Retrieved March 1, 2023, from
https://dph.georgia.gov/pdmp#:~:text=The%20Georgia%20Prescription%20Drug%20Monitoring%20Program%20(PDMP)%20is%20an%20electronic,patient’s%20controlled%20substance%20prescription%20history
Links to an external site.
Nursing Practice Certification and Licensure
This paper will review and discuss practice agreements in Maryland (my state). Maryland is a full-practice authority state hence does not require physician collaboration or supervision for NPs. Therefore, NPs in Maryland have the privilege of using their license to provide full extensive care. Maryland’s State Board of Nursing regulates the practice of advanced practice registered nurses (APRNs).
Maryland Advanced Practice Registered Nurse (APRN) certification and licensure
Maryland recognizes four distinct types of APRNs: certified nurse practitioners, certified nurse midwives, psychiatric mental health clinical nurse specialists, and certified registered nurse anesthetists. APRN status is granted based on education and certification. Maryland offers its potential Nurse Practitioners (NPs) one of the world’s friendliest certification and licensing processes. To receive an APRN certificate in Maryland, one must first hold an unencumbered RN license, either in Maryland or in one of the combat states. If you have an RN license in another state, you must apply for licensure by endorsement using Nurse Endorsement Temporary License Application System. If you are an RN who received training from a foreign country or have never been licensed, request an application for a US-trained RN license by examination.
The steps to becoming a certified APRN in Maryland include completing a Board-approved APRN program culminating in a master’s degree or post-master’s certificate before applying for APRN certification, earning a national certification, applying for the certificate, and renewing the certificate annually no later than the 20
th
day of your birth month. Licensing takes between three to four weeks, depending on the seasonal demand. Maryland requires all interested applicants to complete an automated background check and fingerprints. There is a CHRC form that should be filled out and its last page printed and taken to any of the approved sites. The CJIS number is a must for people residing outside of Maryland (Maryland Board of Nursing, 2022)
The application process for certification in Maryland
Provide a Maryland RN number that can be verified that the applicant holds a valid RN license in the state of Maryland and a current valid compact current state RN license.
Complete the certification application thoroughly and correctly.
Complete the declaration of residence form.
Provide sealed official transcripts of the courses taken during the NP program.
Provide a copy of your current national certification or letter of eligibility to take the certification exam.
CNS interested in applying for alternate certification must provide additional documentation to showcase work history, resume, course descriptions, letter of recommendation, and proof of any successful examination.
All applicants need to pay a non-refundable fee of $50.
Those who want to earn second, advanced practice credentials pay $25 (Maryland Board of Nursing, 2022)
The Maryland board of the nursing website
https://mbon.maryland.gov/Pages/default.aspx
Links to an external site.
Maryland’s definition of the scope of practice of a nurse practitioner
The nurse practitioner’s scope of practice in Maryland is full practice. In other words, the NP can evaluate, diagnose and treat the patient individualistically. The NP is permitted to practice autonomously, deliver care in the primary care setting, order physical training, sign death certificates, and sign disabled person placard forms. They are also able to sign POLST forms or similar forms. The NP can prescribe schedule II drugs independently, but for their first 18 months of practice, a collaborative agreement with a physician is needed. The NP must also complete and maintain the educational requirements to prescribe schedule II drugs. There is no law in Maryland regarding the NP and medical staff membership.
Inclusions in Maryland practice agreement
The nurse practitioners are required to have a one-page agreement that substantiates that there is a physician readily available for consultation whenever the NP needs any assistance. Also, an NP must consult and collaborate with a physician or NP for the first 18 months of practice. Additionally, the NP must have a Maryland Drug Control Number to prescribe a controlled substance. Their licensure requires coursework in advanced pathophysiology, pharmacology, and physical assessment.
Steps to get a DEA license in Maryland
Register with the Prescription Drug Monitoring Program (PDMP). Registration with PMDP is done on the CRISP website.
Apply for a Maryland state Controlled Dangerous Substance (CDS) registration with the office of controlled substances administration.
After CDS registration is approved, NP applicants can then apply for the federal DEA license using their state license number.
Pay the application fee.
Renew the DEA license as required (Maryland Department of Health-Public Health Services-Office of Controlled Substances Administration, 2021)
Maryland prescription monitoring program (PMP)
As of July 1, 2018, the program took effect. It collects and securely stores information on drugs containing controlled substances dispensed to Maryland patients. It requires prescribers to request and assess data before beginning a new course of treatment with an opioid or benzodiazepine and when a course of treatment with an opioid or benzodiazepine extends beyond 90 days. Prescribers must view the last four months of data.
How does Maryland describe a nurse practitioner’s controlled-substance prescriptive authority, and what nurse practitioner drug schedules are nurse practitioners authorized to prescribe?
NPs are recognized in state policy as primary care providers. The state allows NPs’ prescriptive authority for drugs that fall into schedules II, III, IV, or V. However, physician involvement is required for the first 18 months of practice. Additionally, the NP must have a Maryland Drug Control Number to prescribe a controlled substance. Their licensure requires coursework in advanced pathophysiology, pharmacology, and physical assessment (American Medical Association, 2021)
References
American Medical Association (2021). State law chart: Nurse Practitioner Prescriptive Authority. Retrieved from
https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/specialty%20group/arc/ama-chart-np-prescriptive-authority.pdf
Links to an external site.
American Association of Nurse Practitioners (2020). Practice Environment Details. Retrieved from https://www.aanp.org/advocacy/state/state-practice-environment
Maryland Board of Nursing (2022). Criteria for Nurse Practitioner Certification & Instructions for the applicant. Retrieved from
https://mbon.maryland.gov/Documents/np_application.pdf
Links to an external site.
Maryland Board of Nursing (2022). Nurse Practitioner — Scope and Standards of Practice. Retrieved from
https://mbon.maryland.gov/Pages/adv-prac-nurse-practitioner-index.aspx
Links to an external site.
Maryland Department of Health-Public Health Services-Office of Controlled Substances Administration (2021). Practitioner Instructions. Retrieved from
https://health.maryland.gov/ocsa/Documents/Applications%20Instructions%20(Pra.Revised%209-25-2018).pdf
Links to an external site.
Schirle, L., Norful, A., Rudner, N., & Poghosyan, L. (2018).
Organizational facilitators and barriers to optimal APRN practice: An integrative review
Links to an external site.
.
Health Care Management Review
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(4), 311-320.
My research outcomes in Florida.
Chapter 464 Part 1 of the Nurse Practice Act contains all the regulations and practice agreements for advanced nurse practitioners in Florida. The APRN and PMHNP are not classified under primary care in Florida
.
Regulations and barriers are affecting an MHNP’s unconventional practice in Florida, and the most shocking discovery was the judgment of October 2022.
On October 6
,
2022, the board of nursing (BON) determined that the practice of an APRN, certified as a PMHNP, is not considered solely within the definition of primary care and must maintain a collaborative agreement and practice with the physicians. It is stunning to discover that HB 607 (Autonomous Practice law), passed on March 11, 2020, omitted APRNs and PMHNPs, thereby limiting their practices within the collaborative coverage of the medical directors. Florida requires that the basic educational, clinical, financial, and current standards be met before applying for certification to practice as PMHNP in Florida. To meet the above criteria, the NP will complete an application form through the website under the MQA online portal to ‘’manage my license’’. To maintain eligibility for certification, the MHNP would have completed three graduate-level semester hours or comparable 45 CE hours, submitted proof of 45 CE credits in pharmacology, and confirmed 45 CE merit in differential diagnosis, which must have been achieved in the last five years. This requirement is accepted as a statutory equivalence of two three-credit courses. The state of Florida board of nursing websites:
www.MyFlorida.com
Links to an external site.
,
www.flhealthsource.gov> ( Department
of Health),
www.flhealthsource.gov
Links to an external site.
>,
https://mqa-vo.doh.state.fl.us/datamart/voservicesportal
Links to an external site.
>
The 2020 Florida Statues, which is updated yearly after the conclusion of the legislative session on practice and regulations, highlights and defines the nurse practitioner’s scope of practice. It highlights the role and extent of the course and training of a nurse practitioner as permitted by the regulatory body. It encompasses the actions of a licensed professional as allowed by the regulatory body under which the practitioner should be liable. The issuing state regulates the extent of the practice. Drug Enforcement Administration (DEA) is a license or permit to prescribe controlled substances. Florida State obtains it by application, approval, and issuance of a number. When the practitioner is officially registered, they can call Drug Enforcement Administration (DEA) office or its help desk. According to Fla. Admin. Code 64B9-4.010 and Florida. Stat. 464.012 is a written collaborative agreement for prescriptive authority by Nurse practitioners, and only MHNP can prescribe medications to children under eighteen. The maximum allowed prescription for Schedule 11 controlled substances is for seven days, with the exemption of psychiatric controlled substances without limitation. In Florida, there are no additional academic acquisitions by a nurse practitioner to have prescriptive authority; however, controlled substances registration to prescribe substances is required. According to Fla. Stat. & 465.0267, (2)(a) registration with the board of nursing is a requirement for practitioners whose practice involves dispensing medication. The joint committee of NPs, physicians, and pharmacists in Florida determines the formulary for controlled substances. NPS must complete 3 AMA PRA Category 1 credit hours in prescribing controlled substances. What surprised me in the research was the exclusion of MHNPs from autonomous practice and the multiple barriers impacting their practice. The obstacles, which could be in the form of restricted reduced FPA or collaborative approach, include but are not limited to federal statutes from the Center for Medicare and Medicaid services and nongovernmental organizations. Policies affect institutions, organizations, and insurance, impacting provider credentialing policies, practices- reimbursement, and the high cost of state-mandated collaborative or supervisory assistance. In Florida, a medical director’s (MD) signature is required in long-term admission orders and co-signs all new hire physicians and workers’ compensation injuries. There is collaborating/supervising physician practice and population restriction, so an NP can pronounce death but cannot issue or sign a death certificate.
References:
American Psychiatric Nurse Association Links to an external site.
Links to an external site.
(APNA)
Links to an external site.
International Society of Psychiatric-Mental Health Nurses Links to an external site.
(ISBN)
www.ispn-psych.org
Links to an external site.
National Alliance on Mental Illness Links to an external site.
Links to an external site.
(NAME)
Links to an external site.
National Council for Behavioral Health Links to an external site.
Links to an external site.
(NCBH)
www.thenationalcouncil.org
Links to an external site.
National Institute of Mental Health Links to an external site.
Links to an external site.
(NIMH) https://www.nimh.nih.gov/index.shtml
Substance Abuse and Mental Health Services Administration Links to an external site.
(SAMHSA) www.samhsa.gov
DEA
.
Registration
.Help@
dea
.gov
https://www.deadiversion.usdoj.gov › drugs
www.MyFlorida.com
Links to an external site.
,
www.flhealthsource.gov ( Department
of Health),
www.flhealthsource.gov
Links to an external site.
,
https://mqa-vo.doh.state.fl.us/datamart/voservicesportal
Links to an external site.
In the state of Maryland, nurse practitioners (NPs) are required to work in collaboration with a licensed physician, either through a written agreement or a protocol. The scope of practice for NPs in Maryland includes evaluation, diagnosis, treatment, and prescription of medications, subject to physician collaboration. To become a certified and licensed Advanced Practice Registered Nurse (APRN) in Maryland, one must first obtain national certification from an accredited certification body such as the American Nurses Credentialing Center (ANCC) or the American Academy of Nurse Practitioners (AANP) (Maryland Nurses Association, 2019). Then, one must apply for licensure through the Maryland Board of Nursing and meet specific educational, clinical, and examination requirements. Maryland has a prescription monitoring program (PMP), which requires healthcare providers to report prescriptions for controlled substances to a state database (National Council of State Boards of Nursing, 2019). Maryland nurse practitioners are authorized to prescribe drugs under schedules II through V, subject to physician collaboration and approval by the appropriate board. To obtain a DEA license, one must first be licensed by the applicable state board and then register with the Drug Enforcement Administration.
One barrier to nurse practitioner independent practice in Maryland is the requirement for physician collaboration. However, Maryland is categorized as a full-practice state, allowing NPs to evaluate, diagnose, and treat patients. Maryland also allows NPs to practice independently in specific settings, such as rural health clinics and public health departments (Maryland Board of Nursing, 2021). Maryland’s practice agreements and regulations align with the APRN Consensus Model, although the requirement for physician collaboration remains a barrier to independent practice. What is surprising from the research is the variation in requirements and regulations for nurse practitioners across different states, despite the efforts to standardize rules nationally through the APRN Consensus Model. It highlights the importance of knowing the specific rules and requirements in the state where one plans to practice as an NP.
References
Maryland Nurses Association. (2019). Maryland nurse practitioner practice environment. Retrieved from https://www.marylandrn.org/page/np-environment
Maryland Board of Nursing. (2021). Nurse practitioners. Retrieved from https://www.mbon.org/Pages/nurse-practitioners.aspx
National Council of State Boards of Nursing. (2019). APRN maps: Maryland. Retrieved from https://www.ncsbn.org/aprn.htm
How do you get certified and licensed as an Advanced Practice Registered Nurse (APRN) in your state?
In In the state of Georgia, “the advanced practice registered nurse (APRN) is a registered professional nurse who is qualified to practice under the title categories of nurse practitioner, certified registered nurse anesthetist, certified nurse-midwife, clinical nurse specialist, and clinical nurse specialist in psychiatric/mental health” (Lawriter LLC., 2023). In order to get certified and licensed (apply for licensure by initial authority), an active Georgia registered nurse license or a multistate license from an eNLC compact state must be held by the individual, along with a master’s or higher APRN or specialty degree from an accredited institution. However, if a person does not primarily live in Georgia and does not plan on relocating to the state, in that case, a Georgia Approved Based on Another State application should be utilized.
What is the application process for certification in your state?
There are several steps to the Georgia Board of Nursing – Initial Authorization as an Advanced Practice Registered Nurse application process. The application can be downloaded from
https://sos.ga.gov/how-to-guide/how-guide-aprn-cns#GAA%20Licensure%20Checklist
Links to an external site.
. Once the application is completed, it must be signed, notarized, and submitted online or by mail. A non-refundable fee of $85.00 is paid to the Georgia Board of Nursing by check or money order.
“Official transcript with proof that one has a Master’s degree or higher; has successfully completed Advanced Pharmacology, Pathophysiology, and an Advanced Physical Assessment; and must show an APRN/specialization degree. The APRN/specialization degree from an accredited institution must be obtained within four years of the application date. Credentials are verified nationally, ensuring that they are in good standing. Additionally, a background consent form, an affidavit regarding citizenship, and a secure and verifiable document have to be sent to the GA BON” (Georgia Secretary of State, 2023).
What is your state’s board of nursing website?
https://sos.ga.gov/georgia-board-nursing
Links to an external site.
How does your state define the scope of practice of a nurse practitioner?
The state of Georgia defines the scope and standards of practice for the nurse practitioner as “the nurse practitioner provides advanced practice nursing care and medical services specific to the nurse practitioner’s respective specialty to individuals, families, and groups, emphasizing health promotion and disease prevention as well as the diagnosis and management of acute and chronic diseases” (Lawriter LLC., 2023). The nurse practitioner also adheres to the nationally recognized nursing practice standards for the specific nurse practitioner specialty as well as the national certification organization that is recognized by the board.
What is included in your state practice agreement?
The state of Georgia requires the advanced practice registered nurse (APRN) to enter into a mutual protocol agreement with a supervising physician. The physician grants the advanced practice registered nurse authority to carry out specific medical tasks, including but not limited to ordering medications, medical devices, treatments, diagnostic tests, or radiographic imaging tests.
How do you get a DEA license?
Seeking prescriptive authority in Georgia requires a nurse protocol agreement to be authorized by the Georgia Composite Medical Board after being authorized as an advanced practice registered nurse. After submitting the application and being approved, the DEA website
https://www.deadiversion.usdoj.gov/drugreg/
Links to an external site.
can be visited, and several steps must be followed before submitting the application for a DEA number.
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?
“According to GA ADC. 480-22-.12 and Ga. Code Ann. § 43-34-25, APRNs are not permitted to have Schedule I-II prescriptive authority” (American Association of Nurse Practitioners, 2023). However, Schedules III-V controlled substances may be prescribed if authorized and have a protocol agreement with the supervising physician.
Does your state have a prescription monitoring program (PMP)?
Georgia utilizes Appriss – PMP Aware for its PDPM. The electronic database is used to monitor the prescribing and dispensing of controlled substances.
References:
American Association of Nurse Practitioners. (2023). Georgia State Policy Fact Sheet. https://www.aanp.org/advocacy/state/state-practice-environment/state-policy-fact-sheets/georgia-state-policy-fact-sheet
Georgia Secretary of State. (2023).
How to guide: APRN / CNS: Georgia secretary of State
. https://sos.ga.gov/how-to-guide/how-guide-aprn-cns#GAA%20Licensure%20Checklist
Lawriter LLC. (2023).
Chapter 410-11 regulation of advanced practice registered nurses
. Rules and Regulations of the State of Georgia. https://rules.sos.ga.gov/gac/410-11
Nurse Practitioner License and Certification Process in ILLINOIS.
ILLINOIS is one of the states with detailed process and rigorous application requirement for most careers like healthcare: nursing, pharmacy and other fields like Lawyers and real estate certifications. When it comes to nursing, the Illinois credentialing board acknowledges four main areas of Advanced Practice RN’s which are Certified Nurse Practitioner, Certified Clinical Nurse Specialist, Certified Nurse Midwifery and Certified Registered Nurse Anesthetist.
To be certified and obtain NP license in ILLINOIS, the applicant must first hold an ILLINOIS RN license, must have completed a graduate school or master’s degree program from an accredited school and the applicant has obtained a graduate degree appropriate for national certification in a clinical advance nurse practitioner specialty or a post-master’s certification from a graduate level program in advance practice RN specialty (Illinois General Assembly, n.d). Other requirements after obtaining master’s degree for the specialty and holding an active Illinois RN license include completing at least 4000 hours of direct bedside or patient care, application fees for the license and pursue an exam-based certification for the desired specialty, fingerprints and background checks are all included in the certification process (Nursing Licensure, n.d). The application process is listed on Illinois Department of Finance and Professional Regulation or IDPR, (
http://www.idfpr.com/profs/nursing.asp
Links to an external site.
).
The application process for certification of APRN in Illinois:
Indication of the APN category for which the applicant is applying for, e.g., Certified Nurse Midwifery, or Certified Nurse Practitioner or Certified Clinical Nurse Specialist
Application fees is $125 for most of the APN but is based on the specialty.
The applicant’s Illinois RN License Number
A copy of the applicant’s current national certification. The applicant can apply through various certification board depending on the specialty. For example, American Midwifery Certification Board, National Board of Certification and Recertification of Nurse Anesthetists, Certification Board of Urologic Nurses and Associates, American Nurses Credentialing Center and American Academy of Nurse Practitioners and many other credentialing associates.
Official, sealed college transcript showing receipts of a graduate degree in the category applying for or the obtained degree.
Affidavit certifying 250 hours of additional Continuing Education (CE) or training
Supporting Document VE-APRN-FPA must be completed indicating 4000 hours of clinical experience.
Illinois State Board of Nursing is Illinois Department of Financial and Professional Regulation, IDFPR or
https://idfpr.illinois.gov/profs/boards/nursing.asp
Links to an external site.
Illinois APRN Scope of Practice:
Illinois requires that an APRN obtains a written collaboration agreement with a physician that they will be working with as a supervising physician. The agreement must describe and states the categories of care, treatment, and procedures that the NP will provide under the supervision of the physician. However, the NP can file with the Department of notarization attestation of completing at 250 hours of continuing education or training, and at least 4,000 hours of clinical experience after first attaining the national certification and the NP would not need a written collaboration but can practice as an independent practitioner at this level (NCSL, n.d). The NP also have full prescriptive authority including Schedule II to V control substance under the Act 225ILCS 65/65-35 (NCSL, n.d). The NP are seen as primary care providers and this is included in the scope of their practice, and they are part of Maternal/Child Health providers (NCSL, n.d). The practice agreement between the NP and supervising physician include treatments and procedures that the NP can offer but with the attestation from a notarized department outlining the completion of the required hours of clinical experience exempts the NP from any agreement with a physician.
Control Substance Prescribing for NP
In Illinois, for DEA license, the supervising or collaborating physician will have to submit a notice of prescriptive authority indicating that the NP has been delegated prescriptive and the NP will apply for mid-level practitioner controlled substances license in accordance with the Illinois Control Substances Act (IDPH, n.d). Also, if the NP is working with multiple physicians, was collaborating physician will have to submit a notice to the prescriptive authority on behalf of the NP and then the NP will apply for the mid-level prescribing license as delegated by the physician (IDPH, n.d). When applying the for the prescriptive license, the NP must submit a school transcript with school seal affixed to the document and completion of 45 graduate hours in pharmacology (IDPH, n.d). The NP can only prescribe 30-day supply of the controlled substance. The NP has the authority to prescribe Controlled Substance schedule II to V per the 225ILCS 65/65-35 ACT (IDPHR, n.d). Illinois have Prescription Monitoring Program which was last audited September of 2021, and it is operated by Department of Human Services or DHS (Illinois Office of the Auditor General, n.d).
Reference
Illinois General Assembly (n.d). Professions, Occupations, and Business Operations (225 ILCS 65/) Nurse Practice Act. Retrieve from:
https://www.ilga.gov/legislation/ilcs/ilcs4.asp?DocName=022500650HArt%2E+65&ActID=1312&ChapterID=24&SeqStart=16500000&SeqEnd=17850000
Links to an external site.
Illinois Office of the Auditor General (n.d). (309) Advance Practice Nurse Control Substance License. Retrieved from:
https://idfpr.illinois.gov/Forms/Online/(309)%20APN%20Controlled%20Substance%20User%20Guide.pdf
Links to an external site.
IDPH (n.d). Advance Practice Registered Nurse Full Practice Authority. Retrieved from:
https://idfpr.illinois.gov/Renewals/Apply/Forms/APRN-FPA.pdf
Links to an external site.
Nursing Licensure (n.d). Advanced Practice Nursing. Retrieved from:
https://www.nursinglicensure.org/np-state/illinois-nurse-practitioner/#education
Links to an external site.
NCSL (n.d). Scope of Practice Policy-ILLINOIS. Retrieved from:
https://scopeofpracticepolicy.org/states/il/
Links to an external site.
License and Certification of APRN in Alabama State
Physician Collaboration or Supervision for Nurse Practitioners and Requirements
The Alabama State Board of Medical Examiners (ABME) requires that cooperating physicians submit acknowledgment forms to the state for nurse practitioners to practice here. Nurses who have submitted the necessary applications and paperwork for new collaborations continue to receive interim permissions from the Alabama Board of Nursing. However, once their cooperating physicians have completed the ABME, they can activate the collaborative practice (Alabama Board of Nursing, 2022). The physician must submit an electronic application for the start of collaborative practice with a $2000 fee to the Board of Medical Examiners to initiate the collaboration under the APRN’s Temporary Approval given by the ABN (Alabama Board of Medical Examiners, 2023).
Certification as an Advanced Practice Registered Nurse in the State of Alabama
In Alabama, nursing practitioners can get certified and licensed by completing an advanced nursing degree, completing the required clinical hours, passing a national certification exam, and applying for licensure in Alabama state (Alabama Board of Nursing, 2022).
Application Process
One must hold an unencumbered, active Alabama Registered Nursing (RN) license to be authorized as an APRN. They must obtain a graduate degree, in this case, a master’s degree in advanced practice nursing that corresponds to the APRN category in which they wish to work. Obtaining national certification in advanced practice nursing is the next stage. This involves applying for APRN certification, the initial fee is $175. The next step is to renew certification every two years for $75 (Alabama Board of Nursing, 2022).
Alabama State’s Board of Nursing Website
The board of nursing website in Alabama is
www.abn.alabama.gov
Links to an external site.
Definition of the Scope of Practice of a Nurse Practitioner in Alabama
Under Alabama Nurse Practitioners supervision laws, nurse practitioners must have a written collaborative practice agreement with a physician. One physician may collaborate with up to three full-time nurse practitioners or 120 NP collaboration hours per week (Alabama Board of Nursing, 2022). Nurse practitioners in Alabama have limited authority to prescribe, allowing them to do so only with physician collaboration. Additionally, strict laws regulating nurse practitioners extend beyond supervision and prescribing, meaning NPs in Alabama can perform but not sign sports physicals, death certificates, or even handicap parking permits. NPs in Alabama is also not formally recognized as primary care providers.
Practice Agreement
The state of Alabama is a reduced practice authority state, this means that an advanced practice registered nurse must have a collaborative agreement with a physician, therefore the nurse practitioner cannot practice independently. (Alabama Board of Nursing, 2022).
DEA License
An APRN must have an Alabama license to apply for an initial Alabama Controlled Substances Certificate (ACSC) and obtain it before applying for an Alabama-specific DEA registration. The APRN must be working for a full year before they can qualify to apply for a DEA number. The practitioners must keep their Alabama-specific DEA registrations up to date to maintain their DEA licenses, and they must also be registered to access the Prescription Drug Monitoring Database (Andrilla et al., 2020) APRN Certification and Licensure Plan
Prescription Monitoring Program
Alabama State has a Prescription Drug Monitoring Program (PDMP), developed and designed to promote public health and welfare by detecting abuse, diversion, and misuse of prescription medications categorized as a controlled substances under the Alabama Uniform Controlled Substance act (Brown & Whitted, 2020).
Nurse Practitioner’s Controlled-Substance Prescriptive Authority and Drug Schedules Authorization
Prescriptive authority permits nurse practitioners to work under collectively established protocols when prescribing drugs (Hart et al., 2019). The Alabama Legislature also approved Act 2013-223, which grants certified registered nurse practitioners permission to prescribe drugs from Schedules III, IV, and V.
What are Barriers that Impact Practitioner’s Independent Practice?
The barriers that impact the Nurse Practitioner’s Independent practice include regulatory, state, and institutional barriers that hinder their ability to practice to the full extent of their education, licensure, and certification. Because in Alabama APRNs must have a collaborative agreement with a physician, this can impact the ability to practice independently.
Many physicians already meet the maximum allotted of NPs that they collaborate with, this makes it challenging to find suitable and available physicians to work with. Another barrier is that the public and other health professionals need to recognize their preparation. Many times, the public sees APRN’s not as prepared and capable as physicians therefore any request to be seen by a physician. Lack of formal marketing or business education and reduced reimbursement rates are the other barriers facing nursing practitioners’ independent practice in Alabama.
What Surprised Me from The Research
I was surprised to find out that in the state of Alabama I must work for a full year before I can be a candidate for my DEA license. I was also surprised to find that many physicians charge the NP a significant amount of money per year to agree to collaborate with them. These are fees that the NP must pay to be able to work here in Alabama.
References
Alabama Board of Nursing. (2022).
Alabama.gov
.
https://www.abn.alabama.gov/apply/
Links to an external site.
Alabama Board of Medical Examiners (2023).
Collaboration.
https://www.albme.gov/licensing/crnp-cnm/collaboration
Links to an external site.
Andrilla, C. H. A., Patterson, D. G., Moore, T. E., Coulthard, C., & Larson, E. H. (2020). Projected Contributions of Nurse Practitioners and Physicians Assistants to Buprenorphine Treatment Services for Opioid Use Disorder in Rural Areas.
Medical Care Research and Review
,
77
(2), 208–216. https://doi.org/10.1177/1077558718793070
Hart, L., Ferguson, R., & Amiri, A. (2019). Full Scope of Practice for Alabama Nurse Practitioners: Act Now.
The Journal for Nurse Practitioners
,
16
(2). https://doi.org/10.1016/j.nurpra.2019.10.016
Brown, W. C., & Whitted, K. (2020). Provider Prescription Drug Monitoring Program Utilization and Self-Auditing—A Pilot Study.
Journal of Doctoral Nursing Practice
, JDNP-D-19-00064. https://doi.org/10.1891/jdnp-d-19-00064
Reply from Ebenezer Bodude
Physician Collaboration or Supervision for Nurse Practitioners
The state of Arizona allows certified and licensed nurse practitioners to work independently without physician oversight, within their identified specialty and population focus.
Certification and licensure as an Advanced Practice Registered Nurse (APRN) in the state of Arizona
In the state of Arizona to become an Advanced Practice Registered Nurse (APRN), the person must have a current Arizona RN license in good standing or a current RN license with multistate privileges in another compact state. Secondly, the person must complete a master’s or doctoral degree in nursing from an accredited institution, with a specific APRN role and population focus. The official transcript directly from the institution must be sent directly from the program to the Arizona State Board of Nursing (AZBN), stating the role and population focus of the program. The applicant must complete a fingerprint-based criminal background check. The applicant must pass a national certification examination and apply for licensure in the state of Arizona (Arizona Board of Nursing, 2018a; Nursing License Map, 2019).
The application process for certification in Arizona state
The Arizona State Board of Nursing recognizes multiple nationally accredited organizations that offer certification for APRNs including the American Nurses Credentialing Center (ANCC), American Association of Nurse Practitioners Certification Board (AANPCB), Pediatric Nursing Certification Board (PNCB), American Midwifery Certification Board (AMCB), and National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA). The accreditation organization through which an individual chooses to earn certification will depend on the area of specialization. To become licensed as an APRN, nurses are required by the state of Arizona to pass a national certification exam upon completing their degree (Arizona Board of Nursing, 2018a).
The state board of the nursing website
The Arizona State Board of Nursing website is
https://www.azbn.gov/
Links to an external site.
The state of Arizona’s definition of the scope of practice of a nurse practitioner (NP)
The scope of practice for nurse practitioners in the state of Arizona is defined by the Arizona State Board of Nursing under the Nurse Practice Act. Nurse practitioners in Arizona are recognized as independent healthcare providers and are authorized to practice within their identified specialty and population focus. The scope of practice for nurse practitioners in Arizona includes the ability to independently diagnose, treat, and manage patient care. Nurse practitioners can order and interpret diagnostic tests, prescribe medications, and make referrals to other healthcare providers as needed. They are also authorized to provide patient education, counseling, and support services. (Arizona State Board of Nursing, 2018c).
According to R4-19-508, the scope of practice of nurse practitioners in the state of Arizona includes specifically the following:
An NP shall refer a patient to a physician or another health care provider if the referral will protect the health and welfare of the patient and consult with a physician and other health care providers if a situation or condition occurs in a patient that is beyond the NP’s knowledge and experience.
In addition to the scope of practice permitted to a registered nurse, a nurse practitioner, under A.R.S. §§ 32-1601 (22) and 32- 1606(B)(12), may perform the following acts within the limits of the population focus of certification (as found in the rules R-4-19-508):
Examine a patient and establish a medical diagnosis by client history, physical examination, and other criteria.
For a patient who requires the services of a healthcare facility:
Admit the patient to the facility,
Manage the care the patient receives in the facility
Discharge the patient from the facility.
Order and interpret laboratory, radiographic, and other diagnostic tests, and perform those tests that the NP is qualified to perform.
Prescribe, order, administer and dispense therapeutic measures including pharmacologic agents and devices if authorized under R4-19-511, and nonpharmacological interventions including, but not limited to, durable medical equipment, nutrition, home health care, hospice, physical therapy, and occupational therapy.
Identity, develop, implement, and evaluate a plan of care for a patient to promote, maintain, and restore health.
Perform therapeutic procedures that the NP is qualified to perform.
Delegate therapeutic measures to qualified assistive personnel including medical assistants under
R4-19-509.
Perform additional acts that the NP is qualified to perform and that are generally recognized as being within the role and population focus of certification.
An NP shall only provide health care services including prescribing and dispensing within the NP’s population focus and role and for which the RNP is educationally prepared and for which competency has been established and maintained. Educational preparation means academic coursework or continuing education activities that include both theory and supervised clinical practice (Arizona State Board of Nursing, 2018b; Arizona State Board of Nursing, 2022).
State practice agreement for Advanced Practice Registered Nurse
In the state of Arizona, Advanced Practice Registered Nurses (APRNs) have full practice authority, which means they could practice independently without a physician’s involvement. Thus, since APRNs have full practice authority, APRNs are not required to have a practice agreement with a physician (Stokowski, 2018)
Steps to get a DEA license.
To obtain a DEA (Drug Enforcement Administration) license as a nurse practitioner in Arizona, the applicant must first have a valid and unencumbered Arizona RN license and an Arizona nurse practitioner license.
Once applicants have obtained the Arizona nurse practitioner license, they can apply for a DEA license by following these steps:
Complete the DEA application: Download the DEA application from the DEA’s website or call the DEA Headquarters Registration Unit toll-free at 800-882-9539 or call your nearest DEA Registration Field Office to request a physical copy of the order form. The applicant will need to provide background information about education, licensure, and work experience.
Submit required documentation: The applicant needs to provide documentation to support the application, including a copy of current, unencumbered RN and nurse practitioner licenses as well as State medical and/or controlled substance licenses/registrations.
Complete the background check: The applicant needs to complete a fingerprint-based criminal background check.
Pay the application fee: The applicant will need to pay a non-refundable fee when submitting the application. The information on the current fee amount is available on the DEA’s website.
Wait for approval: The DEA will review the application and notify the applicant of their decision.
(Drug Enforcement Administration-Diversion Control Division, n.d.).
The state prescription monitoring program
The state of Arizona has a prescription monitoring program called the Controlled Substances Prescription Monitoring Program (CSPMP). The CSPMP is an electronic database that collects information on controlled substance prescriptions that are dispensed in Arizona. The CSPMP is administered by the Arizona Board of Pharmacy and is designed to promote public health and safety by preventing prescription drug abuse, through the collection of data on all controlled substance prescriptions in Arizona (schedules II to V). This information assists healthcare providers in making better-informed care decisions when treating patients. The CSPMP also helps prevent the diversion and misuse of controlled substances at the provider, pharmacy, and patient levels.
Healthcare providers, including nurse practitioners, are required to register with the CSPMP and use it to obtain a patient’s-controlled substance prescription history before prescribing or dispensing a controlled substance. The CSPMP is also used to identify potential instances of prescription drug abuse or diversion. Healthcare providers can use the CSPMP to monitor a patient’s-controlled substance prescription history and identify patterns of misuse or abuse. Law enforcement agencies can also use the CSPMP to identify potential instances of illegal drug trafficking or other criminal activity (American Association of Nurse Practitioners, 2019; Arizona Prescription Monitoring Program, 2018) APRN Certification and Licensure Plan
The state Description of Nurse Practitioner’s
Controlled-Substance Prescriptive Authority
In Arizona, a nurse practitioner (NP) with prescriptive authority is authorized to prescribe controlled substances as part of their scope of practice. Prescriptive and dispensing authority is linked to the NP’s area of population focus and certification and prescribing without documenting an assessment is a violation of the rule. NPs who wish to prescribe controlled substances must hold both a DEA number and a Controlled Substances Prescription Monitoring Program registration number issued by the Arizona State Board of Pharmacy.
(Drug Enforcement Administration-Diversion Control Division, n.d.; Stokowski, 2018).
Drug schedules for nurse practitioners authorized to prescribe in the state of Arizona
Nurse Practitioners (NPs) with a valid DEA license and prescriptive authority are authorized to prescribe controlled substances within their scope of practice, subject to certain limitations and regulations. The Drug Enforcement Administration (DEA) classifies controlled substances into five schedules based on their potential for abuse and accepted medical use. Nurse Practitioners in Arizona are authorized to prescribe controlled substances in Schedules II through V, subject to certain restrictions, including mandatory registration with the Controlled Substances Prescription Monitoring Program (CSPMP), maintaining appropriate records, patient evaluation and documentation, adherence to prescribing limits, as well as complying with all state and federal laws related to controlled substance prescribing. Consequently, In the state of Arizona, an NP with an active DEA license can prescribe, order, administer, and procure Schedule 2, 2N, 3, 3N, 4, and 5 substances. However, a nurse practitioner (NP) in the state of Arizona cannot prescribe marijuana, since marijuana is a Schedule I drug according to the Controlled Substances Act.
(Arizona Board of Nursing, 2018c; Arizona Prescription Monitoring Program, 2018).
References
American Association of Nurse Practitioners (2019). State Practice Environment.
https://www.aanp.org/advocacy/state/state-practice-environment
Links to an external site.
Arizona State Board of Nursing. (2018a). Advance Practice Resources: Certification Requirements-Nurse Practitioners and clinical Nurse specialists. https://www.azbn.gov/licenses-and-certifications/advanced-practice-resources
Arizona State Board of Nursing. (2018b). Laws and Rules: Status.
https://www.azbn.gov/laws-and-rules/statutes
Links to an external site.
Arizona State Board of Nursing. (2018c). Nurse Practice Act.
https://www.azbn.gov/education/nurse-practice-act
Links to an external site.
Arizona State Board of Nursing (2022). Arizona Administrative Code: Standard Related to Registered Nurse Practitioner Scope of Practice.
https://apps.azsos.gov/public_services/Title_04/4-19.pdf
Links to an external site.
Arizona State Prescription Monitoring Program (2018). Controlled Substances Prescription Monitoring Program.
https://pharmacypmp.az.gov/
Links to an external site.
Drug Enforcement Administration-Diversion control Division (n.d.). Registration. https://www.deadiversion.usdoj.gov/drugreg/index.html
Nursing License Map (2019). Nursing Licensure by states. https://nursinglicensemap.com/states/arizona-nursing-license/
Stokowski, L. (2018).
APRN Prescribing Law: A State-by-State Summary
. https://www.medscape.com/viewarticle/440315
APRN Certification and Licensure Plan
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