Category: Nursing

  • NURS 5051/ 6051 The Role of the Nurse Informaticist in Systems Development and Implementation Portfolio Assignment

    NURS 5051/ 6051 The Role of the Nurse Informaticist in Systems Development and Implementation Portfolio Assignment

    Portfolio Assignment:

    The Role of the Nurse Informaticist in Systems Development and

     Implementation

    The purpose of this paper is to describe the role description for a graduate-level nurse to guide participants on the implementation team throughout the process. The role description is based on the SDLC stages and tasks. It will clearly define how this individual will participate in and impact each of the following steps: planning and requirements definition, analysis, design of the new system, implementation, and post-implementation support.

    The nursing professions’ impact on communication and information technology utilization possibilities are boundless. The systems development life cycle (SDLC) is a continual development process through planning and implementing advancement (McGonigle & Mastrian, 2018). The systems development life cycle (SDLC) is the model specifically useful in project management for the improvement of health information technology (HIT) systems (2018) NURS 5051/ 6051 The Role of the Nurse Informaticist in Systems Development and Implementation Portfolio Assignment.

    Role Description

    The nurse leader, usually the nurse manager in this role, needs to scrutinize the problems and what profits become connected with engaging the nurse leader in the health information system’s implementation process. The nurse leaders’ involvement safeguards that the system will be applicable and adequate for the nurses’ using the system. The nurse leaders’ inclusion on the SDLC team is conducive to informatics in health care. The role of informatics in health care integrates information providing evidence of how technology strengthens care quality (McKay & Vanaskie, 2018) NURS 5051/ 6051 The Role of the Nurse Informaticist in Systems Development and Implementation Portfolio Assignment.

    Planning and requirements definition

    The planning stage is of utmost importance for the SDLC project as it prepares for the steps to follow and fundamentally will determine the results of subsequent actions (Rehani, n.d.). The planning phase is where the nurse leader participates with the interdisciplinary team representatives to identify the breadth of the obstacles, examine potential solutions, gather needed resources, and plan a schedule for the project and itinerary to commence the project (n.d.). The nurse leaders’ clinical insight into the system and practice with the concurrence of critical thinking skills grants nurses’ superior ability to determine goals for the project. And establish expectations that can be realistically reached (n.d.). The evolution of the health care technology project will be successful with the nurse leader fully participating in the SDLC planning phase.

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    Analysis

               
    The analysis phase involves the nurse leader role to assist in setting up the project’s requirements, developing and examining feasible back-up plan recommendations (Weckman & Janzen, 2009). The lack of back-up plans may delay the project with errors, loss of data, and disintegration in communication between team members. Analysis of the process entails evaluating tools used for decision making, communication, and function processes (Rojas & Seckman, 2014). The analysis also includes examining the technical, hardware, software, staffing, and determining if additional space is needed (Rehani, n.d.). The nurse leaders’ input in this phase includes assessing the organization’s policies to determine if changes are necessary to have the new health care technology system (Darvish et al., 2014) NURS 5051/ 6051 The Role of the Nurse Informaticist in Systems Development and Implementation Portfolio Assignment.
                                                                        

     
                                                                          Design

    The design phase requires the nurse leaders’ full engagement to inform the SDLC team to establish that the software’s configuration clearly and correctly is described and to regulate the operation of the system (Rehani, n.d.) Included in the system’s operation requiring regulation are hardware, software, user interface, archiving and use, retrieval of data, networking, and processes (n.d.). The nurses’ role in design includes emphasizing the system’s vital goal is to improve patient safety (n.d.). The nurse leader will collaborate to design the system to support clinical decisions to integrate various specialties (n.d.) NURS 5051/ 6051 The Role of the Nurse Informaticist in Systems Development and Implementation Portfolio Assignment.

                                                                Implementation   

    During the implementation phase, the nurse works jointly with the team to facilitate specialization, evaluate by testing, and install the system (Rehani, n.d.). The nurse leader role continues to be vital now with the need to educate and train staff, maintain the system, and communicate results to the information technology (IT) department (n.d.). The nurse leaders’ role remains essential for establishing communication between themselves and the staff to promote evaluation for use in the system’s redesign to improve results (n.d.). The staff evaluation is necessary for modification of the system for tailoring to enhance healthcare technology capability ultimately. Furthermore, the nurse leader will need to make rounds to ensure safety and to assess for problems in the workflow, and identify

    system glitches for significant problem solving (n.d.)

                                                                Maintenance

               
    The nurse leader maintains involvement in the maintenance phase by providing ongoing support and sufficient training (Rehani, n.d.). The nurse leader needs to recognize how the system works and the importance of promoting cooperation and submission (n.d.).  The nurse leaders’ engagement in this process will also improve approval and encourage evidence-based practice (n.d.). The nurse informaticist involvement in the SDLC maintenance phase is crucial to minimize technical issues (n.d.). During the maintenance phase, the nurses’ role informs IT of glitches requiring problem-solving to improve the system (n.d.) NURS 5051/ 6051 The Role of the Nurse Informaticist in Systems Development and Implementation Portfolio Assignment.

                                                               
    Conclusion

    The nurse leader, including nurse informaticist importance in full engagement in the SDLC, cannot be understated. The nurse is the backbone of health care organizations. Without the nurses’ participation in the SDLC team phases, improvement in patient safety would be missing. The nurses and other staff using the health care systems would be frustrated and disgruntled due to the lack of logical and smooth functioning of the system meant to improve such and safety. The nurse leaders’ role is crucial to the system being useful to the health care organizations improved safety results NURS 5051/ 6051 The Role of the Nurse Informaticist in Systems Development and Implementation Portfolio Assignment.

    References

    Darvish, A., Bahramnezhad, F., Keyhanian, S., & Navidhamidi, M. (2014).
    The role of nursing

    informatics in promoting the quality of health care and the need for appropriate education. Global Journal of Health Science,
    6(6), 11-18. DOI:10.5539/gjhs.v6n6p11

    McGonigle, D., & Mastrian, K. G. (2018).
    Nursing informatics and the foundation of
    (4
    th
    ed.).

    Burlington, MA: Jones and Bartlett Learning.

    McKay, C. & Vanaskie, K. (2018).
    Partnering for success: The role of the nurse leader in

    Health information technology implementation for coordination of care. Nurse Leader,
    16(6), 385-388.
    https://doi-org.ezp.waldenulibrary.org/10.1016/j.mnl.2018.07.012

    Rehani, N. (n.d.
    ). Using SDLC methodology to implement HIT.
    https://pdfs.semantic

    scholar.org/7fbd/35017b7085209694cd56373e8eab62b84b2a.pdf

    Rojas, C., & Seckman, C. (2014).
    The informatics nurse specialist role in electronic health

    record usability evaluation. Computers, Informatics, Nursing
    , 32(5). 221-222. DOI: 10.1097/CIN.0000000000000042

    Weckman, H., Janzen, S. (2009).
    The critical nature of early nursing involvement for

    Introducing new technologies. The Online Journal of Issues in Nursing, 14(2), 1-13. DOI: 10.3912/ojIN.Vol14No02Man02

    new technologies. The Online Journal of Issues in Nursing
    , 14(2), 1-13. DOI:103912/OJN.Vol14No02Man02 NURS 5051/ 6051 The Role of the Nurse Informaticist in Systems Development and Implementation Portfolio Assignment

  • NRNP 6565 Discussion: Certification and Licensure

    NRNP 6565 Discussion: Certification and Licensure

    Discussion: Certification and Licensure

    Now that you are in your 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 a national AGPCNP 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 NRNP 6565 Discussion: Certification and Licensure.

    Photo Credit: Getty Images/iStockphoto

    Although there is a movement called the APRN Consensus Model to standardize NP regulations nationally, it is still the case that requirements vary state to state. In some states, NPs may establish 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. Prescriptive authority is granted under state law by the appropriate board. The board granting prescriptive authority may be the medical board, state board of pharmacy, or nursing board for the appropriate state licensure being pursued. The authority to write for a 
    controlled substance
     is granted at a federal level and is verified through the Drug Enforcement Administration (DEA) by the appropriate state board. Drug Enforcement Agency registration is granted at the federal level and has additional requirements/fees for the registration process.

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    Finally, the legal landscape for NPs is constantly changing as the status of NPs as providers improves on a national level. Legislative changes may occur annually, bi-annually, or during an emergency legislative meeting at the state or federal level. These legislative sessions and any subsequent changes will significantly impact your scope of practice as a nurse practitioner NRNP 6565 Discussion: Certification and Licensure.

    For this Discussion, you examine professional issues for your state, including certification and licensure, scope of practice, independent practice, prescriptive authority, and legislative activities.

    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 in your state?

    What is the application process for certification in your state?

    What is the primary nurse licensure office resource website in your state?

    How does your state define the scope of practice of a nurse practitioner?

    What is included in your state’s practice agreement?

    How do you get a Drug Enforcement Agency (DEA) license?

    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 what legislative and advocacy activities are your state nurse practitioner organization(s) involved?

    By Day 3

    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

    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 NRNP 6565 Discussion: Certification and Licensure.

  • NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists

    NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists

    Informatics Week 3 discussion

        
     
    When electronic records came to the Iowa Department of Corrections, Ill be honest, I was very skeptical, and everyone resisted the change from “how we do business.” According to Gaines (2020), nursing informaticist is a specialty area that combines nursing and technology to help with electronic records and other varies health technology areas.
     
    (Gaines, 2020)
     
    In reading another discussion post, I am quite jealous that they have a Nurse Informaticist. Our system was developed by an outside technology company and did have a “help desk.” Unfortunately, we have to go through other management to be able to call and get assistance. It cost money every time they are called. From my understanding, it would be cost-effective to have a Nurse Informaticist working for the IDOC NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists.
     

                  
     
    Another frustrating issue with not having a NI is that nurses that use the program every day do not get a say in what needs added or taken out of the medical record program or the medication administration record. Some of these decisions are made at nurse manager meetings, which many are not as familiar with using the program as nurses at the forefront of patient care. If we had a NI, those ideas could be developed into more efficient ways of documenting and possibly decrease medication errors. Medical errors cost nearly $40 billion every year in healthcare, and many can be prevented from having an NI in the healthcare system.
     
    (Rupp, 2016) 
     
    The NI could visit every institution and listen to the concerns of nurses, which would decrease stress and make the program better. It is incredibly frustrating to have a program that assessment and plan of care are sometimes inaccessible together without consulting a physician to write as orders.
     

       
     
    By having an NI, new employees can be trained on the system by that nurse instead of a line staff nurse that is trying to care for patients as well as train a new nurse. That new nurse would learn the program much quicker and correctly by having NI do training.
     

        
     
    I’m excited to see how using nurses in this role in the future helps develop and improve patient care! There are so many places that NIs can be of benefit. Base salaries for informatics nurses are increasing to be a pretty substantial wage at sometimes 100,000. One excellent concept of this up and coming career option is that these nurses can be developing programs that still advocate for the bedside nurse. I can be supportive and educate older nurses that may not be “technically inclined” yet teach the newer nurses how to use to use the technology efficiently.
     
    (Rupp, 2016) NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists    
     

    References

    Gaines, K. (2020, July 22).
     
    nurse.org Career Guide Series: Nursing informatics
    . nurse.org.
     
    http://nurse.org

    Nelson, T. L. (2019, March 12).
     
    Nursing informatics: The EHR and beyond
    . American Nurse.com.
     

    Home – American Nurse Journal

    Rupp, S. (2016). How Nurses Are Using Health Informatics to Improve Patient Care.
     
    Electronic Health Reporter
    .
     
    https://doi.org/http://electronic health reporter.com

     
    Whenever there is a change in computer systems, even something as simple as an upgrade, there is bound to be push back and difficulties with the change. At my current place of employment there are nursing super users with each change. The managers, coordinators, and floor educators are automatically put in super user classes. The management can then ask 3-4 floor nurses to become super users as well. These super users are expected to attend a longer more in-depth class with the IT teams. These classes are set up by management as well as the higher-level informatics officers. One of the informatics officers is a nurse, she is also management of IT. This setup is similar to the framework of decision making in informatics proposed by
     
    Mosier et al (2019), in that there is a defined timeline and defined roles of all those involved NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists.
     

     
    This system is important because management is not on the floor at all times. Having super users from both shifts available is a very useful asset. We upgraded the computer system last month and there was a large change in the care plan section. There was required online training, but everyone still had a really hard time adjusting. The super users were able to help and their helpful tricks filtered through the floor like a ripple effect. This made the transition much more-smoothly for everyone. Nurses are knowledge workers, and this is evident at a time of new technology
     
    (McGonigle & Mastrian, 2017). Nurses tend to be great learners; they catch on fast and teach each other well NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists.
     

     
    One informatics change I would like to see implemented is a further use of the mobile devices. There are a handful of things we can complete on the iPhone we use for texting physicians, charting vitals, and printing lab slips. As discussed by Ng et al (2018), mobile devices have a huge benefit for population in health. There is so much we can do with mobile devices now related to healthcare. There should also be a nursing portion of the health reminders. These could be flags for medications, or reminders for vitals rechecks, or some sort of integration with the new computer system we have started. There could be a way to progressively chart the care plan section as the day goes by, on a mobile device. There is no reason mobile device advancements should only be for patients and the population. Decreasing the amount of time nurses need to sit at a desk to chart, would increase the time patients are able to see them. This is a benefit to hospitals. I am hopeful for advancement in our mobile charting soon, with the further advancement of other healthcare apps NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists.
     

    References

    McGonigle, D., & Mastrian, K. (2017). 
    Nursing Informatics and the Foundation of Knowledge
    . Jones & Bartlett Learning.

    Mosier, S., Roberts, W. D., & Englebright, J. (2019). A Systems-Level Method for Developing Nursing Informatics Solutions. 
    JONA: The Journal of Nursing Administration
    , 
    49
    (11), 543–548. https://doi.org/10.1097/nna.0000000000000815

    Ng, Y. C., Alexander, S., & Frith, K. H. (2018). Integration of Mobile Health Applications in Health Information Technology Initiatives. 
    CIN: Computers, Informatics, Nursing
    , 
    36
    (5), 209–213. https://doi.org/10.1097/cin.0000000000000445NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists

    Discussion: Interaction Between Nurse Informaticists and Other Specialists

    Nature offers many examples of specialization and collaboration. Ant colonies and bee hives are but two examples of nature’s sophisticated organizations. Each thrives because their members specialize by tasks, divide labor, and collaborate to ensure food, safety, and general well-being of the colony or hive.

    Of course, humans don’t fare too badly in this regard either. And healthcare is a great example. As specialists in the collection, access, and application of data, nurse informaticists collaborate with specialists on a regular basis to ensure that appropriate data is available to make decisions and take actions to ensure the general well-being of patients.

    In this Discussion, you will reflect on your own observations of and/or experiences with informaticist collaboration. You will also propose strategies for how these collaborative experiences might be improved.

    To Prepare:

    Review the Resources and reflect on the evolution of nursing informatics from a science to a nursing specialty.

    Consider your experiences with nurse Informaticists or technology specialists within your healthcare organization NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists.

    By Day 3 of Week 3

    Post
     a description of experiences or observations about how nurse informaticists and/or data or technology specialists interact with other professionals within your healthcare organization. Suggest at least one strategy on how these interactions might be improved. Be specific and provide examples. Then, explain the impact you believe the continued evolution of nursing informatics as a specialty and/or the continued emergence of new technologies might have on professional interactions.

    By Day 6 of Week 3

    Respond
     to at least 
    two
     of your colleagues
    * on two different days
    , offering one or more additional interaction strategies in support of the examples/observations shared or by offering further insight to the thoughts shared about the future of these interactions.

     

    Collaboration with Nurse Informaticists

    I can honestly say I have never seen the nurse informaticist that works within my healthcare organization. I have heard that there is one that works down in information technology (IT) and occasionally makes changes in the electronic health record (EHR) but I have never interacted with her. I feel that there needs to be more nurse informaticists and more professional collaboration between them and the rest of the hospital. Nobody really talks about nursing informatics at my hospital and that is starting to become a problem. I currently work in the heart and vascular ICU where we have been overburdened with high-acuity patients and a significant shortage of staff. One strategy I offer for improvement is to simply have the nurse informaticist come up to the unit and start interacting with the staff. Another strategy is to increase training and education for nurses in the field of informatics. Sipes (2016) states that nurse informaticists must be competent in over 200 skills now. This will require an increase in training and education programs to better prepare them to improve clinical practice (Sipes, 2016). Now is a better time than ever to implement these changes. Ideally, they will benefit interprofessional collaboration and, ultimately, improve patient outcomes NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists.

    Informatics, technology, and Professional Interaction

    Technology has made dramatic progress in the past four decades and has forever changed the way that healthcare is delivered (Elsayed et al., 2016). The field of nursing informatics has also come a long way considering that it has only been a specialty since 1992 (Cummins et al., 2016). Technological advancements in nursing informatics have benefited the way we interact with other professionals as well as the patients we aim to serve. Advancements include the electronic health record (EHR), handheld digital devices, upgrades in computer systems, and much more (Elsayed et al., 2016). It is estimated that nurses spend about 50% of their time at work documenting and charting (Elsayed, 2016). That being said, informatics has come to their rescue with the above advancements in technology such as the EHR. As technology continues to improve, collaboration with other professionals will benefit as well. Advancements in hands-free devices, telecommunications, and telehealth could forever change the way nursing is done (Fathi et al., 2017). As nursing informatics and technology continue to make strides, the end goals will be to enhance the delivery of healthcare, increase interprofessional collaboration, and improve the clinical outcomes of the patients NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists.

    References

    Cummins, M. R., Gundlapalli, A. V., Murray, P., Park, H. A., Lehmann, C. U., & Gundlapalli, A. V. (2016). Nursing Informatics Certification Worldwide: History, Pathway, Roles, and Motivation. 
    Yearbook of Medical Informatics
    , 
    25
    (01), 264–271. 
    https://doi.org/10.15265/iy-2016-039

    Elsayed, I. A., El-Nagger, N. S., & AzimMohamed, H. A. (2016). Evolution of Nursing Informatics: A key to Improving Nursing Practice. 
    Research Journal of Medicine and Medical Sciences
    , 
    11
    . 
    https://www.academia.edu/29974363/Evolution_of_Nursing_Informatics_A_key_to_Improving_Nursing_Practice
    .

    Fathi, J. T., Modin, H. E., & Scott, J. D. (2017). Nurses Advancing Telehealth Services in the Era of Healthcare Reform. 
    The Online Journal of Issues in Nursing
    , 
    22
    (2). 
    https://10.3912/OJIN.Vol22No02Man02   

    Sipes, C. (2016). Project Management: Essential Skill of Nurse Informaticists. 
    Nursing Informatics 2016
    , 
    225
    . 
    https://doi.org/10.3233/978-1-61499-658-3-252

    Recently this writer has spent a great deal of time reflecting on my experiences and interactions with Information’s Technology and those who make it all happen. Early on in this writer’s career, I was exposed to the emergence of new software, programs, and even the implementation of electronic medical records for the first time in a facility or agency NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists.

    When beginning a career as an RN at Beaufort Memorial Hospital (BMH), a rural hospital in Beaufort, SC, I was asked to participate as a “Superuser” when BMH went electronic, less than a year into my working there. According to Bullard (2016), a superuser is vital to the implementation, upkeep, and affordability of any electronic health record (EHR) system. As this writer progressed in my career, I have found myself in the center of every committee or orientation process related to health information technology. Reflecting on the implementation of the EHR at BMH, specifically the excellence of care that now, after experiencing other hospital systems was greatly influenced by the presence of bedside computers in every patient room. The electronic version of the flow chart and head to toe assessment including the timely documentation, the ability to quickly access information for the patient including evidenced-based practice (EBP) standards, education materials, and the ability to print these documents for the patients later use were all elements that shaped the nurse I am today NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists.

    As a Certified Nurse Assistant (CNA) and then a Licensed Practical Nurse (LPN) for a grand total of only eighteen months prior to graduating to the novice Registered Nurse (RN), this writer can attest to the difference in a new graduate-level of skills including presence, versus those of the seasoned nurse as discussed by (McGonigle, 2017). However, many years of bedside charting and then a transition to home care and eventually hospice care gave this writer a different perspectives regarding the presence and documenting in an (EHR) in the home. This the writer now understands the perspective of the executive leader as discussed by Mosier et al., (2019). A while later this writer landed in the middle of a complete software revamp when the company to which employed agreed to be the pilot agency for software designed for homecare but also being implemented in hospice. At the executive level, this writer spent many hours, at least 50% of my day either building workarounds or  literally working on the necessary changes to the software needed to not only qualify for reimbursement form insurers but also to pass a state survey NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists.

    A strategy proven to improve patient outcomes as well as employee morale and financial stability within an organization is to include the nurse in the design and decision making of your EHR (Bullard, 2016). Many frustrations this writer experienced at a Long-Term Acute Care (LTAC) assignment recently could have been avoided. The lack of acknowledgment of nurse feedback regarding much-needed changes to the EHR, especially regarding lack of presence and an incredible amount of time spent documenting redundantly rather than caring for the patient were discovered to be cultural. This writer intended to share ideas and proven improvement learned throughout my career and the evolution of technology, but it was not reciprocated. As Nursing Informatics evolves into a specialty all its own, this writer believes the culture mentioned earlier will have to change.

    After the recent interactions or lack thereof at that last assignment and taking a heap of assessments on various job boards, this writer was actually a bit surprised to find that the only areas in which I am more than “very proficient” is in areas that include IT and Management, all scoring in the “excellent” category. Long story short, as of last Friday, I have changed my concentration of major to HIT. This is my strategy NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists.

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    References

    Bullard, K. L. (2016). Cost-Effective Staffing for an EHR Implementation. Nursing Economic$, 34(2), 72–76.

    McGonigle, D.  (20170317). Nursing Informatics and the Foundation of Knowledge, 4th Edition. [[VitalSource Bookshelf version]].  Retrieved from vbk://9781284142990

    Mosier, S., Roberts, W. D., & Englebright, J. (2019). A Systems-Level Method for Developing Nursing Informatics Solutions: The Role of Executive Leadership. JONA: The Journal of Nursing Administration, 49(11), 543-548.

     

    NURS_5051_Module02_Week03_Discussion_Rubric

    Excellent

    Good

    Fair

    Poor

    Main Posting

    45 
    (45%)
     – 50 
    (50%)

    Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.

    Supported by at least three current, credible sources.

    Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

    40 
    (40%)
     – 44 
    (44%)

    Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.

    At least 75% of post has exceptional depth and breadth.

    Supported by at least three credible sources.

    Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

    35 
    (35%)
     – 39 
    (39%)

    Responds to some of the discussion question(s).

    One or two criteria are not addressed or are superficially addressed.

    Is somewhat lacking reflection and critical analysis and synthesis.

    Somewhat represents knowledge gained from the course readings for the module.

    Post is cited with two credible sources.

    Written somewhat concisely; may contain more than two spelling or grammatical errors.

    Contains some APA formatting errors.

    0 
    (0%)
     – 34 
    (34%)

    Does not respond to the discussion question(s) adequately.

    Lacks depth or superficially addresses criteria.

    Lacks reflection and critical analysis and synthesis.

    Does not represent knowledge gained from the course readings for the module.

    Contains only one or no credible sources.

    Not written clearly or concisely.

    Contains more than two spelling or grammatical errors.

    Does not adhere to current APA manual writing rules and style.

    Main Post: Timeliness

    10 
    (10%)
     – 10 
    (10%)

    Posts main post by day 3.

    0 
    (0%)
     – 0 
    (0%)

    0 
    (0%)
     – 0 
    (0%)

    0 
    (0%)
     – 0 
    (0%)

    Does not post by day 3.

    First Response

    17 
    (17%)
     – 18 
    (18%)

    Response exhibits synthesis, critical thinking, and application to practice settings.

    Responds fully to questions posed by faculty.

    Provides clear, concise opinions and ideas that are supported by at least two scholarly sources NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists.

    Demonstrates synthesis and understanding of learning objectives.

    Communication is professional and respectful to colleagues.

    Responses to faculty questions are fully answered, if posed.

    Response is effectively written in standard, edited English.

    15 
    (15%)
     – 16 
    (16%)

    Response exhibits critical thinking and application to practice settings.

    Communication is professional and respectful to colleagues.

    Responses to faculty questions are answered, if posed.

    Provides clear, concise opinions and ideas that are supported by two or more credible sources.

    Response is effectively written in standard, edited English.

    13 
    (13%)
     – 14 
    (14%)

    Response is on topic and may have some depth.

    Responses posted in the discussion may lack effective professional communication.

    Responses to faculty questions are somewhat answered, if posed.

    Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

    0 
    (0%)
     – 12 
    (12%)

    Response may not be on topic and lacks depth.

    Responses posted in the discussion lack effective professional communication.

    Responses to faculty questions are missing.

    No credible sources are cited.

    Second Response

    16 
    (16%)
     – 17 
    (17%)

    Response exhibits synthesis, critical thinking, and application to practice settings.

    Responds fully to questions posed by faculty.

    Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

    Demonstrates synthesis and understanding of learning objectives.

    Communication is professional and respectful to colleagues.

    Responses to faculty questions are fully answered, if posed.

    Response is effectively written in standard, edited English.

    14 
    (14%)
     – 15 
    (15%)

    Response exhibits critical thinking and application to practice settings.

    Communication is professional and respectful to colleagues.

    Responses to faculty questions are answered, if posed.

    Provides clear, concise opinions and ideas that are supported by two or more credible sources.

    Response is effectively written in standard, edited English.

    12 
    (12%)
     – 13 
    (13%)

    Response is on topic and may have some depth.

    Responses posted in the discussion may lack effective professional communication.

    Responses to faculty questions are somewhat answered, if posed.

    Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

    0 
    (0%)
     – 11 
    (11%)

    Response may not be on topic and lacks depth.

    Responses posted in the discussion lack effective professional communication.

    Responses to faculty questions are missing.

    No credible sources are cited.

    Participation

    5 
    (5%)
     – 5 
    (5%)

    Meets requirements for participation by posting on three different days.

    0 
    (0%)
     – 0 
    (0%)

    0 
    (0%)
     – 0 
    (0%)

    0 
    (0%)
     – 0 
    (0%)

    Does not meet requirements for participation by posting on 3 different days.

    Total Points: 100

    Name: NURS_5051_Module02_Week03_Discussion_Rubric

    The purpose of this discussion is to gain insight into aspects of interdisciplinary informatics in healthcare. Informatics in healthcare is the exchange of digital information utilizing technology across a multitude of medical disciplines in order to facilitate a continuum of care NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists. The digital age of informatics has advanced since the creation of the Office of the National Coordinator for Health Information Technology (ONC) within the US Department of Health and Human Services (Desalvo et al., 2015). Further advancing informatics was the passage of the e-Health Information Technology for Economic and Clinical Health (HITECH) Act, which prioritized financial allocations for the advancement of healthcare technology development (Desalvo et al., 2015). This funding allowed for the creation of the Meaningful Use (MU) Act, designed to completely digitize the healthcare record (Desalvo et al., 2015). This digitization allows for the scrutinization of the healthcare delivery landscape, enabling for identification of poorly performing processes, thus enabling the proficient delivery of patient-center, evidenced-based, quality healthcare delivery.  The following is a discussion pertaining to the role of informatics in interdisciplinary collaboration.

    The Emergency Department is a unique setting in that it allows for data to be simultaneously accessed and utilized across a number of independent patient care areas.  Information regarding patients presenting must be accessed by lab technicians, imaging technologists, radiologists, ED physicians, intensivists, and other ancillary staff.  The information available across these disciplines represents the patient and their acute and chronic health status.  Interventional decisions can then be directed to allow for evidenced-based care.  These decisions are made by utilizing the Foundation of Knowledge, which is the base for (Marstrian & McGonigle, 2019). The Foundation of Knowledge is the base healthcare providers use to make appropriate interventions based on empirical evidence and evidenced-base practice NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists.  Below are strategies designed to allow informatics to function in an interdisciplinary healthcare environment (Marstrian & McGonigle, 2019).

    In order for biomedical informatics to be effectively utilized across the vast array of interdisciplinary demands present in the clinical setting, the focus must be on both the members of the interdisciplinary team and the health systems’ ability to maintains the technological infrastructure utilized to access clinical data. Team members must possess leadership quality, maintain a clear vision and goal, focus on efficient time management, and excel in prioritizing initiatives to continually improve the delivery of patient-centered care (Holden et al., 2018).  It is also essential to have defined roles for informaticians across the interdisciplinary team and ensure informatics education supports the established defined interdisciplinary decision process (Holden et al., 2018).

    Predictive medicine is believed to the future of healthcare and is affords it’s attainability to the advancement of biomedical informatics (Jen, 2019).  Intercollarborative practice success will be destined to parallel the advancement of biometric informatics.  Visual analytic tools and informatic collection systems will continue to evolve, with the dissemination and subsequent analyzation of patient data allowed to be more concisely presented (Wu et al., 2019) NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists.  New evaluation tools will provide us with more data that will allow insight into the acute and future health of our patients (Wu et al., 2019).  Another future component of healthcare delivery that will is deep learning of health informatics (Ravì et al., 2019).  Deep learning aims to accelerate algorithm calculations in order to hasten diagnostic intervention and prescriptive medicine by analyzing data and learning from patterns represented in the clinical informatics (Ravì et al., 2019). The promise for more effective healthcare delivery is bright for both providers and patients utilizing informatics and interdisciplinary collaboration NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists.

    References

    DeSalvo, K. B., Dinkler, A. N., & Stevens, L. (2015). The US Office of the National Coordinator for Health Information Technology: progress and promise for the future at the 10-year mark. Annals of emergency medicine, 66(5), 507-510. 
    http://doi.org/10.1016/j.annemergmed.2015.03.032

    Holden, R. J., Binkheder, S., Patel, J., & Viernes, S. H. P. (2018). Best practices for health informatician involvement in interprofessional health care teams. Applied clinical informatics, 9(1), 141. 
    https://doi.org/10.1055/s-0038-1626724

    Jen, M. Y., & Teoli, D. (2019). Informatics. In StatPearls [Internet]. StatPearls Publishing. 
    https://www.ncbi.nlm.nih.gov/books/NBK470564/

    Mastrian, K., & McGonigle, D. (2019). Informatics for health professionals. Jones & Bartlett Learning.

    Ravì, D., Wong, C., Deligianni, F., Berthelot, M., Andreu-Perez, J., Lo, B., & Yang, G. Z. (2016). Deep learning for health informatics. IEEE journal of biomedical and health informatics, 21(1), 4-21. 
    https://doi.org/10.1109/JBHI.2016.2636665

    Wu, D. T., Chen, A. T., Manning, J. D., Levy-Fix, G., Backonja, U., Borland, D., … & Kandaswamy, S. (2019). Evaluating visual analytics for health informatics applications: a systematic review from the American Medical Informatics Association Visual Analytics Working Group Task Force on Evaluation. Journal of the American Medical Informatics Association, 26(4), 314-323. 
    https://doi.org10.1093/jamia/ocy190 NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists

              Nursing informatics is a field of nursing that incorporates nursing, computer, and information sciences to maintain and develop medical data and systems to support the practice of nursing, and to improve patient care outcomes (Whithers, 2020). As a Nurse, I see data and technology on a daily basis. We utilize nursing informatics in almost everything we do. Staying up-to-date with this growing concept is vital in ensuring patient safety.

    Nurses aren’t the only profession to utilize and benefit from data and technology. From my observation, nurse informatics have a great impact in the interaction with other professions. The mental health hospital where I currently work has new technology of electronic health records. The EHR allows those healthcare providers designated by the patient to obtain healthcare information related to past episodes of healthcare. It is hoped that such a record will eventually be a birth-to-death electronic healthcare record (Vasilescu, 2015).The IT department works with all professions within the workplace, which includes Nurses, Doctors, Clinicians, Therapists, Secretaries, and so forth.

    A strategy on how the interaction between IT and these professions can improve is by continuous education of the electronic healthcare records. Learning the HER can be complicated, but with the right training, the system can and should run smoothly. IT must be aware of the healthcare staff’s level of computer competency in order to effectively educate. Super users can assist with this training. Super Users answer questions, help end users navigate through the system, and report issues to the project team to support prompt resolution (
    Epic@UNC
    2015) NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists.

    Whithers, F. (2020, May 08). What is Nursing Informatics & How to Become a Nurse Informaticist. Retrieved September 15, 2020, from 
    https://www.registerednursing.org/nursing-informatics/

    Vasilescu, A. (2015). Informatics: The Electronic Health Record: Will Nursing Be on Board When the Ship Leaves? Retrieved September 16, 2020, from 
    http://ojin.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/Health-IT/ElectronicHealthRecord.html

    Epic@UNC. (2015, December 22). Retrieved September 16, 2020, from http://news.unchealthcare.org/epic/training/super-user-responsibilities NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists

  • Nursing Certification and Licensure in South Carolina Essay

    Nursing Certification and Licensure in South Carolina Essay

    Week 1 Main Discussion Post—

    NRNP – 6565 –
    Synthesis in Advanced Nursing Practice of Patients in Primary Care Settings

    Summary of findings

          Laws that govern nurse practitioner (NP) definition, scope of practice, and prescriptive authority, along with any requirements for physician collaboration, are governed by state legislature (Buppert, 2021).  In South Carolina, the state Board of Nursing (BON) has the authority to govern NP practice. Requirements for becoming certified and licensed in SC include holding an active RN license, obtaining a graduate-level degree in an NP role, and passing a national certification exam (American Association of Nurse Practitioners [AANP], 2020). The application process is managed by the state board of nursing online through the state’s labor, licensing, and regulation (LLR) website found at llr.sc.gov Nursing Certification and Licensure in South Carolina Essay.

    The South Carolina Legislature (South Carolina Legislature, n.d., 40 section) defines the scope of practice for a nurse practitioner in the Nurse Practice Act as “ (5) “Advanced Practice Registered Nurse” or”APRN” means a registered nurse who is prepared for an advanced practice registered nursing role by virtue of additional knowledge and skills gained through an advanced formal education program of nursing in a specialty area that is approved by the board. The categories of APRN are nurse practitioner, certified nurse-midwife, clinical nurse specialist, and certified registered nurse anesthetist. An advanced practice registered nurse shall hold a doctorate, a post-nursing master’s certificate, or a minimum of a master’s degree that includes advanced education composed of didactic and supervised clinical practice in a specific area of advanced practice registered nursing. APRNs must achieve national certification within two years post-graduation. An APRN may perform those activities considered to be the practice of registered nursing or advanced practice consisting of nonmedical acts, such as population health management; quality improvement or research projects within a health care system; and analysis of data and corresponding system recommendations, revisions, developments, or informatics Nursing Certification and Licensure in South Carolina Essay. An APRN also may perform specified medical acts pursuant to a practice agreement as defined in item (45). (40) “Nurse Practitioner” or “NP” means a registered nurse who has completed an advanced formal education program at the master’s level or doctoral level acceptable to the board, and who demonstrates advanced knowledge and skill in assessment and management of physical and psychosocial health, illness status of persons, families, and groups. Nurse practitioners who perform medical acts must do so pursuant to a practice agreement as defined in item (45).”

         The state of South Carolina has an in-depth Nurse Practice Act which covers many aspects of practice including definitions, criminal records, license requirements and renewal, initial certification exam, demonstration of continued competency, and code of ethics (South Carolina Legislature, n.d.). The state’s practice agreement is a written agreement developed by an NP and collaborating physician to establish the medical aspects of care that are to be provided by the NP and must contain a way for evaluation to ensure patient safety and quality of care in accordance with state and federal laws (Buppert, 2021) Nursing Certification and Licensure in South Carolina Essay.

         A DEA license is required for healthcare providers who prescribe controlled substances. The DEA will assign an NP a DEA number as a mid-level practitioner if the NP has a practice site, if state law permits, and the NP has no felony on record (Buppert, 2021). South Carolina requires physician collaboration and poses restrictions for prescribing controlled substances. Schedule II nonnarcotic substances can be prescribed for up to 30 days and schedule II narcotic substances must not exceed a 5-day supply with exceptions being hospice or palliative care instances not exceeding a 30-day supply (South Carolina Legislature, n.d.).

         Recent legislative and advocacy activities include a senate bill which passed in May 2021 passed which authorizes APRNs and Pas the ability to issue orders for home health care (AANP, 2020). The Myrtle Beach, SC, area has a nurse practitioner advocacy and continuing education group that meets monthly called
    Grand Strand Advance Practice Nurse Association
    which offers membership to APRNs in the area along with NP students who are close to graduation Nursing Certification and Licensure in South Carolina Essay.

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    Regulations/Barriers

         South Carolina is a restricted practice state and requires physician delegation, supervision, and collaboration for NP practice. The state board of medical examiners must review cases when a supervising physician has more than three NPs practicing under their license (AANP, 2020). A specific barrier in South Carolina is the lack of access to medical care and health professionals in rural areas along with a short supply of statewide primary care physicians. Adopting full scope of practice in SC can be associated with improved access to care, especially in rural areas (Kandrack et al., 2019). If the growing supply of NP practitioners in the workforce is optimally utilized, access to health care especially for racial and ethnic minorities can be improved dramatically (Poghosyan & Carthon, 2017). Additional research is needed surrounding the heated debate on policy reform that grants full state-level NP scope of practice in all states and additional work is needed to align practice and policy efforts with healthcare accessibility (Patel et al., 2018).

    Surprising Research Findings

         The lack of consistency state to state regarding APRN scope of practice is alarming and surprising, as well as the lack of a clear scope of practice in some states. Clarity is essential for an NP to practice safely and confidently. With the aging population in the United States along with the challenges of rising healthcare costs and growing disease burden, NPs bring high-quality care and have a strong potential to vastly increase access to care and help address the healthcare challenges of the future Nursing Certification and Licensure in South Carolina Essay.

    References

    American Association of Nurse Practitioners. (2020, October 15).
    AANP state fact sheet: South Carolina
    . statepolicy@aanp.org. Retrieved August 31, 2021, from
    https://www.aanp.org/advocacy/south-carolina

    Buppert, C. (2021).
    Nurse practitioner’s business practice and legal guide
    (7th ed.). Jones & Bartlett.

    Kandrack, R., Barnes, H., & Martsolf, G. R. (2019). Nurse practitioner scope of practice regulations and nurse practitioner supply.
    Medical Care Research and Review
    ,
    78
    (3), 208–217.
    https://doi.org/10.1177/1077558719888424

    Patel, E. Y., Petermann, V., & Mark, B. A. (2018). Does state-level nurse practitioner scope-of-practice policy affect access to care?
    Western Journal of Nursing Research
    ,
    41
    (4), 488–518.
    https://doi.org/10.1177/0193945918795168

    Poghosyan, L., & Carthon, J. (2017). The untapped potential of the nurse practitioner workforce in reducing health disparities.
    Policy, Politics, & Nursing Practice
    ,
    18
    (2), 84–94.
    https://doi.org/10.1177/1527154417721189

    South Carolina Legislature. (n.d.).
    South Carolina code of laws: Nurse practice act
    . scstatehouse.gov. Retrieved August 31, 2021, from https://www.scstatehouse.gov/code/t40c033.php Nursing Certification and Licensure in South Carolina Essay

  • Wisconsin nursing practice Certification and Licensure

    Wisconsin nursing practice Certification and Licensure

    Summarize nurse practitioner certification and licensure processes

    Certification of a nurse practitioner (NP) includes applying for an exam with the American Academy of Nurse Practitioners Certification Board (AANPCB) or the American Nurses Credentialing Center (ANCC) by graduating from an accredited master’s, postgraduate, or doctorate degree program and possessing an active registered nurse (RN) license (Leik, 2021). NP licensure is governed by the state of residence or practice and information can be quite difficult to find. In Wisconsin, you must submit an application and fee, provide evidence of current registered nurse licensure, current NP certification by a certifying body, master’s or doctoral degree, and completion of 45 contact hours in clinical pharmacology (Wisconsin Department of Safety and Professional Services, 2021) Wisconsin nursing practice Certification and Licensure.

    Explain state-specific scope of practice for family practice nurse practitioners and restrictions or limitations for practice

    Wisconsin NPs do not have a separate scope of practice from RNs and LPNs. Wisconsin NPs must have a collaboration with a medical doctor or doctor of osteopathic medicine to practice and prescribe no more than schedule II drugs. A Wisconsin NP can never practice independently and never be named a primary care provider (NCLS, n.d.).

    Explain nurse practitioner prescriptive authority and DEA registration processes

    As stated above the prescriptive authority of a Wisconsin NP is limited to schedule II drugs. Any NP that prescribes controlled substances needs a Drug Enforcement Administration (DEA) number. To apply for a number an NP must either apply online, call DEA Headquarters, or mail DEA Form 222a (American Associated of Nurse Practitioners, n.d.).

    Explain legislative and advocacy activities related to nurse practitioner practice

    For several years NPs have been fighting for updating legislation in Wisconsin including independent practice, being labeled advanced practice registered nurses (APRN), and providing a definition and scope of practice (Wisconsin Nurses Association, 2021). Hearings are currently being held in Wisconsin legislation.

    Identify key concepts of professional issues related to nurse practitioner practice

    A few issues related to nurse practitioner practice includes the presumed lack of education, experience, and knowledge to care for patients. However, studies show that NPs provide holistic, safe, and cost-effective care and when complex patients arise an NP utilizes resources to assist with the needed care (Buttaro et al., 2021; Moldestad et al., 2020) Wisconsin nursing practice Certification and Licensure.

    References

    American Association of Nurse Practitioners. (n.d.). How to get information about obtaining a DEA number. Retrieved August 31, 2021, from https://www.aanp.org/practice/practice-management/business-resources-for-nurse-practitioners/how-to-order-a-dea-number

    Buttaro, T. M., Polgar-Bailey, P., Sandberg-Cook, J., & Trybulski, J. (2021).
    Primary care: Interprofessional collaborative practice
    (6th ed.). Elsevier.

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    Leik, M. T. C. (2021). Adult-gerontology nurse practitioner certification: Intensive review (4th ed.). Springer Publishing Company

    Moldestad, M., Greene, P. A., Sayre, G. G., Neely, E. L., Sulc, C. A., Sales, A. E., Reddy, A., Wong, E. S., & Liu, C. (2020). Comparable, but distinct: Perceptions of primary care provided by physicians and nurse practitioners in full and restricted practice authority states. 
    Journal of Advanced Nursing
    , 
    76
    (11), 3092–3103. https://doi-org.ezp.waldenulibrary.org/10.1111/jan.14501

    NCSL. (n.d.) State overview: Wisconsin. Retrieved August 31, 2021, from https://scopeofpracticepolicy.org/states/wi/

    Wisconsin Department of Safety and Professional Services. (July 2021). Board of nursing. Retrieved August 31, 2021 from https://dsps.wi.gov/Credentialing/Health/fm2124.pdf

    Wisconsin Nurses Association. (August 2021). APRN modernization act 2021. Retrieved August 31, 2021, from https://www.wisconsinnurses.org/aprn-modernization-act-2021/ Wisconsin nursing practice Certification and Licensure

  • South Carolina nursing practice Certification and Licensure

    South Carolina nursing practice Certification and Licensure

    Identify whether your state requires physician collaboration or supervision for nurse practitioners and, if so, what those requirements are.

    South Carolina requires physician involvement for diagnosis and treatment under the S.C.CodeAnn.$$40-33-20 (41), 40-33-34 (C)(I). The physician must be nearby and can be contacted either in person or by telecommunication or other electronic means to provide consultation and advice to the nurse practitioner. When an application is made for more than three NP’s to practice with one provider, or when an NP is performing delegated medical acts in a practice site greater than 45 miles from the physician, the Board of Nursing and Board of Medical Examiners shall review the application to determine if adequate supervision exists (Nurse practitioners overview. Scope of Practice Policy (n.d.) South Carolina nursing practice Certification and Licensure.

    Certified and licensed in your state

    The application process for certification in South Carolina

    South Carolina is a member of the Nurse Licensure Compact. A current APRN South Carolina or temporary license is required to practice advanced nursing in this state. All nurses must possess a current South Carolina licensure and/or temporary licensure before beginning orientation. An applicant for licensure as an Advanced Practice Registered Nurse will provide satisfaction to the board met all qualifications for licensure as a registered nurse, new graduates provide evidence of certification within one year of program completion, earned a master’s degree from an accredited college, has paid the board all applicable fees. The application for Advanced Practice Registered Nurse License will be completed and a money order made payable to LLR-Board of Nursing with a recent 2×2 full-faced passport type photo, copy of a birth certificate, copy of social security card, copy of the current license, copy of APN certification, authorize a name change, complete affidavit of eligibility, and copy of clinical background check (South Carolina board of nursing. SCLLR. (n.d.)) South Carolina nursing practice Certification and Licensure.

    Primary nurse licensure office resource website in your state

    The mission of the State Board of Nursing for South Carolina is to protect public health and provide safety and welfare by assuring safe and competent practice of nursing. The mission is accomplished with safe initial training, continuing competency in nursing practice, and promoting nursing excellence in areas of education and training. The board licenses qualified individuals as practical nurses registered nurses, or advanced practice registered nurses (South Carolina board of nursing. SCLLR. (n.d.). The official website for the South Carolina board of nursing is as follows: https://llr.sc.gov.

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    South Carolina state define the scope of practice of a nurse practitioner

    Nurse practitioners’ practice in nearly every healthcare setting, including clinics, hospitals, Veterans Affairs, Indian Health Care facilities, emergency rooms, urgent care sites, private physician practices, nursing homes, schools, colleges, retail clinics, etc. NP practice includes, but is not limited to, assessment; ordering, performing, supervising, and interpreting diagnostic and laboratory tests; making diagnoses; initiating and managing treatment including prescribing medication and nonpharmacologic treatments; coordinating care; counseling; and educating patients and their families and communities. NP role is consistent with the APRN consensus model practicing in the population foci of family. Each NP is accountable to patients, the nursing profession, and the state board of nursing. NPs are expected to practice consistent with an ethical code of conduct, national certification, evidence-based principles, and current practice standards. The patient-centered nature of the NP requires a commitment to meet the evolving needs of society and advances in health care science. As leaders in our community, NPs combine as providers, mentors, educators, researchers, advocates, and administrators (Scope of practice for nurse practitioners. American Association of Nurse Practitioners (n.d.).

     

    South Carolina practice agreement

    The South Carolina practice agreement is a written agreement developed between an NP and physician or medical staff who work with and support the NP. This agreement must establish the medical aspects of care provided by the NP and includes prescribing medication. The practice agreement must contain mechanisms that allow the physicians to ensure that quality of clinical care and patient safety are maintained per state and federal laws and applicable Board of Nursing and Board of Medical Examiners rules and regulations (Code of Laws-title 40-chapter 33-nurses. (n.d.) South Carolina nursing practice Certification and Licensure.

    Drug Enforcement Agency (DEA) license

    Physicians who administer, prescribe, or dispenses any controlled substance must be registered with the federal Drug Enforcement Administration (DEA). The application is located on www.deadiversion.usdoj.gov. When applying, you will need to note the control number, have your social security number and date of birth on hand. To obtain a DEA number, the individual must have an active license in the state they intend to practice.

    South Carolina description of a nurse practitioner’s controlled-substance prescriptive authority and authorization to prescribe

    In the state of South Carolina, nurse practitioners are required to submit a prescriptive authority application after completing 45 contact hours of education in pharmacotherapeutics acceptable to the board within two years before application. Of the 45 contact hours, at least 15 of the 20 hours should be in controlled substances. New graduates (who graduated within two years before the application) who have completed a graduate-level pharmacology course meet these educational requirements for prescriptive authority and controlled substances (South Carolina board of nursing SCLLR. (n.d.). Drugs and devices prescribed must be within the NP’s specialty and listed in the written protocol developed by the NP and the supervising physician. An NP may also prescribe Schedules II-V. In South Carolina NP are allowed to prescribe a 5-day supply of schedule II, a 30-day supply of schedule 2N, and can prescribe schedule III, 3N, IV, V (Drug Enforcement Administration (DEA), 2021) South Carolina nursing practice Certification and Licensure.

    References:

    Code of laws-title40-chapter 33-nurses. (n.d.).

    https://www.scstatehouse.gov/code/t40c033/php.

     

    Drug Enforcement Administration (DEA). (2021). Mid-Level practitioner’s authorization by

    state. U.S. Department of Justice.

    https://www.deadiversion.usdoj.gov/drugreg/practioners/mlp_by_state.

    Nurse practitioners overview.
    Scope of Practice Policy. (n.d.).

    https:scopeofpracticepolicy.org/practitioners/nurse-practitioners.

     

    Scope of practice for nurse practitioners.
    American Association of Nurse Practitioners. (n.d).

    https://www.aanp.org/advocacy/advocacy-resource/positions-statements/scope-of-

    practice-for-nurse-practitioners

     

    South Carolina board of nursing
    . SCLLR. (n.d.).

    https://llr.sc.gov/nurse/Online/APRNUPDATELEAD.aspx South Carolina nursing practice Certification and Licensure.

  • Ohio State nursing practice Certification and Licensure

    How do you get certified and licensed in your state?

    In Ohio, an individual qualifies to apply for Advance Practice Registered Nurse (APRN) licensure as defined by the state board of nursing nurse practice act (NPA; OBN, 2021a).  The NPA in Ohio requires that the individual applying for licensure have an active Ohio Registered Nurse (RN) license (OBN, 2021a).  Applicants must also hold a master’s or doctoral degree in a major that that qualifies the individual to sit for at minimum one of the certification exam administered by one of the national certified organizations approved by the Ohio Board of Nursing (OBN; OBN, 2021a).  The master’s or doctoral degree obtained for Certified Nurse Practitioners (CNP) in Ohio must include proof of an Advanced Pharmacology course that is 45 contact hours or greater and was completed in the five-year time before applying for APRN licensure (OBN, 2021a).

    What is the application process for certification in your state?

    Applicants for APRN licensure in Ohio apply through the eLicense Ohio Professional Licensure System that is located
    https://elicense.ohio.gov/OH_HomePage
    (OBN, 2021b).  The applicant’s school must email an official transcript showing the completion of a master’s or doctoral degree with a major in a nursing specialty that qualifies the individual to take an APRN national certification examination to
    licensureaprn@nursing.ohio.gov
    (OBN, 2021b).  This transcript must reflect the required 45 contact hours in Advanced Pharmacology completed in the last 5 years (OBN, 2021b).  Next, the applicant must submit proof of national certification emailed directly from a National Certification Organization approved by the OBN to
    licensureaprn@nursing.ohio.gov
    (OBN, 2021b).  For the Adult-Gerontology Primary Care Nurse Practitioner Ohio currently recognizes the American Association of Nurse Practitioners Certification Board (AANPCB) and American Nurses Credentialing Center (ANCC) as approved national testing agencies (OBN, 2021b).  Applicants that complete a program not located in Ohio must also provide continuing education in Ohio law and rules that govern schedule II prescribing (OBN, 2021b).  The application may be submitted conditionally before completing the APRN education program or before a national examination is taken (OBN, 2021b).  The OBN will hold onto the application for one year from receiving.  There is also a nonrefundable fee of $150.00 that is due at the time the application is submitted (OBN, 2021b).

    How does your state define the scope of practice of a nurse practitioner/ State Practice Agreement?

    The OBN defines the scope of practice of CNPs in Ohio as practicing in collaboration with one or more physicians or podiatrists.  Current Ohio law requires a Standard Care Agreement (SCA) to be entered with the collaborating physician (OBN, 2021a).  Ohio Revised Code (ORC) 4723.43 further defines the scope of practice for CNPs as providing preventative and primary care services, providing services for acute illness, evaluating and promoting patient wellness within one’s specialty, and consistent with the CNPs education and certification and rule of the OBN (ORC, 2020).   In addition to direct patient care, Ohio does allow CNP’s to perform research, education, and health policy advocacy (OBN, 2021a).  Despite requiring a SCA, CNPs in Ohio are qualified to make independent decisions and are accountable for their care decisions.  CNPs in Ohio also receive prescriptive authority to prescribe medications (OBN, 2021a).  The scope of practice differs slightly when the collaborating physician is a podiatrist and is limited to the podiatrist’s scope (OBN, 2021a).

    Explain state-specific restrictions or limitations for practice

               
    Certified Nurse Practitioners in Ohio are required to practice in collaboration with a physician or podiatrist via a SCA (OBN, 2021a).   As stated above, specific practice limitations include not being able to prescribe schedule II mediations a physician has not previously prescribed that except in certain circumstances (OBN, 2021a).  APRNs are prohibited from prescribing any drug or device to perform or induce an abortion or to perform the abortion (OBN, 2021a).

    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?

    Current legislation in Ohio allows CNPs the authority to prescribe.  The prescribing practice of the CNP must be in line with their scope of practice, national certification, SCA, standards of practice, and the prescriptive authority of their collaborating physician (ORC, 2011).  CNPs in Ohio must prescribe by the Exclusionary Formulary defined in the ORC and must comply with current state and federal laws (ORC, 2011).  All APRNs in Ohio with prescriptive authority are required to register with the Ohio Automated Rx Reporting System (OARRS) Furthermore, to review OARRS reports for controlled substances (OBN, 2021a).  A collaborating physician is limited to not collaborate in prescribing with more than five CNP’s (ORC, 2011).  Schedule II controlled substances are also in the prescribing authority of CNP’s in Ohio with some specific regulations, including that a physician had previously prescribed the medication, and the supply will not exceed 72 hours and in any thirty days the amount that exceeds 2500 dosage units (OBN, 2021a).  Opioid analgesics may be prescribed by CNP’s in Ohio to treat acute pain, subacute pain, and chronic pain (OBN, 2021a).  The prescriptive authority of a clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner shall not exceed the prescriptive authority of the collaborating physician (ORC, 2011).  APRNs are permitted to prescribe a schedule II-controlled substance in circumstances where a patient has a terminal illness (OBN, 2021a).

    Explain nurse practitioner prescriptive authority and DEA registration processes

    Federal law requires that nurse practitioners obtain a DEA number to write prescriptions for medications classified as controlled substances (DEA, 2021). Nurse practitioners may not write for even common controlled substances such as medication for attention deficit and hyperactivity and restless leg syndrome without a DEA number.  Before applying for DEA licensure, potential applicants must be licensed to practice by the state (DEA, 2021).  Applicants apply for a DEA number directly on the Department of Justice website located at
    https://apps.deadiversion.usdoj.gov/webforms2/spring/main?execution=e1s1
    (DEA, 2021). The application consists of 6 sections, with one requiring the CNP to select which classes of medications they can prescribe following state laws (DEA, 2021).  In Ohio, CNP’s with a DEA waiver can prescribe and administer medications in classes 2, 2N, 3, 3N, 4, 5 (DEA, 2021).  The cost of DEA registration is quite hefty, with current rates being $888 per 3-year renewal (DEA, 2021).  It takes approximately 4 to 6 weeks from when the application is submitted until the DEA number is issued (DEA, 2021).

    In what legislative and advocacy activities are your state nurse practitioner organization(s) involved?

    The Ohio Association of Advanced Practice Nurses (OAAPN) is the primary organization responsible for legislation at the state level in the advocacy of standards of care for nurse practitioners (OAAPN, 2021).  The OAAPN was founded in 1996 and is the only full-service statewide organization for APRNs in Ohio of all specialties.  The OAAPN’s 12,800 members participate in advocacy at the state, local, state, and federal levels intending to provide high-quality, cost-effective, accessible healthcare for Ohio residents (OAAPN, 2021).

    In 2019 the OAAPN introduced House Bill 177, the Better Access, Better Care Act aimed at allowing APRNs in Ohio to treat patients without the current required SCA (OAAPN, 2021).  While HB 117 did receive backing from the Federal Trade Commission (FTC), and it never made it out of the House of Representatives (OAAPN, 2021).  In March of 2021, the OAAPN worked with Representative Thomas Brinkman to reintroduce the new Better Access, Better Care Act as HB 221 which would allow an APRN to practice without a SCA after completing 2000 hours of practice time (OAAPN, 2021).  Passage of HB 221 would be monumental for APRNs in Ohio who have been shown to provide safe and equitable care in setting such as primary care (OAAPN, 2021).  The OAAPN also was instrumental in the revision of HB 203- 133
    rd
    General Assembly to expand the type of providers with whom a pharmacist may enter into a consulting agreement to include clinical nurse specialists, certified nurse-midwives, or certified nurse practitioners if they have an active SCA with a physician (OAAPN, 2021).  This law went into effect in December 2020.

    Other notable legislation by the OAAPN includes the introduction and passing of HB 111 in 2018 (OAAPN, 2021).  The bill allows psychiatric certified clinical nurse specialists (CNS) and psychiatric mental health nurse practitioners (PMHNP) the authority to pink slip individual who demonstrates behavior that would pose harm to another or oneself (OAAPN, 2021).   Before HB 111, only physicians, psychologists, police, and public health officers could issue pink slips to patients (OAAPN, 2021).

    Barriers

               
    Barriers to independent practice in Ohio seem to be centered around current physician views of APRNs and their role.  The Ohio State Medical Association (OSMA) released a statement in response to the proposed Better Access Better Care Act in opposition of the act (OSMA, 2020).  The current view of the OSMA is that there is not a shortage of physicians in Ohio and that a healthy pipeline of students in medical schools and physicians in residency is available in Ohio (OSMA, 2020).  As part of their statement, OSMA argues that argue nurse practitioners do not have the training to care for patients without physician safely supervision (OSMA, 2020).  While current Ohio legislation is slowly evolving to support the future independence of APRNs, outdated rules such as the requirement for an SCA and the inability to start a patient on a controlled substance that was not originally ordered by a Physicians also continue to be barriers.

    Biggest Insight

    I enjoyed performing this exercise in preparation for my AGPCNP licensure.  Knowledge of the current regulations and the application process will certainly be helpful as I begin the application process soon.  Among the most important insights, I took away from this exercise is that the process of licensure ideally should begin far before graduating from Walden.  I have committed time each week over the next month to begin the application process.  Other insights include the hefty cost of obtaining a DEA license.  This knowledge is important as I enter future negotiations in obtaining my NP contract.

    References

    Drug Enforcement Administration (DEA). (2021).
    Mid-Level practitioners authorization by state
    .

    U.S. Department of Justice
    .
    https://www.deadiversion.usdoj.gov/drugreg/practioners/mlp_by_state.pdf

    Ohio Association of Advanced Practice Nurses (OAAPN). (2021).
    Our accomplishments and legislative efforts
    .  https://oaapn.org/2021/03/our-accomplishments-and-legislative-efforts/

    Ohio Board of Nursing. (2021a).
    APRN licensure and practice in Ohio.
    https://nursing.ohio.gov/wp-content/uploads/2021/02/APRN-Licensure-and-Practice.pdf

    Ohio Board of Nursing. (2021b).
    Advanced practice registered nurse application certified nurse practitioner
    .  
    https://nursing.ohio.gov/wp-content/uploads/2021/04/CNP-Sample-APP.pdf

    Ohio State Medical Association (OSMA). (2020).
    Ohio legislative update.

    https://osma.org/aws/OSMA/pt/sd/news_article/302869/_PARENT/layout_details-news/false

    Ohio Rev. Code. § 4723.43 (2020).
    https://codes.ohio.gov/ohio-revised-code/section-4723.43

    Ohio Rev. Code. § 4723.481 (2011).
    https://codes.ohio.gov/ohio-revised-code/section-4723.481

     

     

     

    Discussion: Certification and Licensure

    Now that you are in your 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 a national AGPCNP 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.

    Photo Credit: Getty Images/iStockphoto

    Although there is a movement called the APRN Consensus Model to standardize NP regulations nationally, it is still the case that requirements vary state to state. In some states, NPs may establish 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. Prescriptive authority is granted under state law by the appropriate board. The board granting prescriptive authority may be the medical board, state board of pharmacy, or nursing board for the appropriate state licensure being pursued. The authority to write for a 
    controlled substance
     is granted at a federal level and is verified through the Drug Enforcement Administration (DEA) by the appropriate state board. Drug Enforcement Agency registration is granted at the federal level and has additional requirements/fees for the registration process.

    Finally, the legal landscape for NPs is constantly changing as the status of NPs as providers improves on a national level. Legislative changes may occur annually, bi-annually, or during an emergency legislative meeting at the state or federal level. These legislative sessions and any subsequent changes will significantly impact your scope of practice as a nurse practitioner.

    For this Discussion, you examine professional issues for your state, including certification and licensure, scope of practice, independent practice, prescriptive authority, and legislative activities.

    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 in your state?

    What is the application process for certification in your state?

    What is the primary nurse licensure office resource website in your state?

    How does your state define the scope of practice of a nurse practitioner?

    What is included in your state’s practice agreement?

    How do you get a Drug Enforcement Agency (DEA) license?

    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 what legislative and advocacy activities are your state nurse practitioner organization(s) involved?

    By Day 3

    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

    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.

  • Maryland Registered Nurse Certification and Licensure

    Maryland Registered Nurse Certification and Licensure

    Certification and Licensure

    Regulation is defined as having authority over something that originated from the broad spectrum of legislation (Milstead & Short, 2019). Different states have specific rules, certification, and licensure requirements for advanced practice registered nurses, yet all aim to safeguard the interest of public safety by controlling health professional’s activity. The board of nursing makes these regulations based on the Nurses Practice Act to protect the community by ensuring that healthcare professionals comply with the qualification to enter the profession (Bosse et al., 2017). Also, they are responsible for maintaining appropriate standards of practice continuously Maryland Registered Nurse Certification and Licensure.

    In Maryland, my home state, the main requirement to be a certified nurse practitioner is to complete a board-approved nurse practitioner program and pass a board-approved examination (Maryland Board of Nursing, 2019). The Maryland Board of Nursing provided the list of approved NP programs around the country, including Walden University. Suppose the program is not on the list. In that case, the NP can apply for approval as long as it is recognized by the US Department of Education or the Council for Higher Education Accreditation. MBON mentioned four approved organizations for board certification, including the American Nurses Credentialing Center, the American Academy of Nurse Practitioners, the Pediatric Nursing Certification Board, and the National Certification Corporation. To apply for a Maryland NP license, the MBON requires a copy of the current RN license, certification application, declaration of resident form, sealed official transcript, copy of the current national certification, or letter to take the eligibility to take the certification exam. An additional requirement made effective October 2015, and applicants must have a Mentor for 18 months from the date of application. The mentor must be a Maryland licensed Nurse Practitioner or Physician with a license in good standing (Maryland Board of Nursing, 2019) Maryland Registered Nurse Certification and Licensure.

    Regarding the scope of practice, NPs are recognized as primary care providers after 18 months of mentorship with a physician or experienced NP upon passing the licensure exam. Maryland NPs can have the full scope of practice without physicians’ supervision, perform functions authorized by law, including but not limited to patient assessments, diagnoses, and ordering and interpretation of laboratory tests (Maryland Board of Nursing, 2019).

    To get a drug enforcement administration (DEA) license in the state of Maryland, the NP can apply for a Maryland State Controlled Dangerous Substances (CDS) with the Office of Controlled Substances Administration (OCSA). The NP needs to complete the CDS application form mail to the Maryland Department of Health- Public Health Services Office of Controlled Substances Administration. In Maryland, nurse practitioners have a full prescriptive authority that has no physician involvement and can prescribe drugs from Schedule II, III, IV, and V (Maryland Board of Nursing, 2019).

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    The Nurse Practitioner Association of Maryland (NPAM) is one of the NP organizations in Maryland with a strong legislative committee that monitors nurse practitioner (NP) practice issues dictated by state law and regulations. The legislative committee has several members all over Maryland, which conducts legislative and advocacy activities such as assessing legislative and regulatory issues that impact NP practice, develop a plan, educate legislators, and enact changes as needed Maryland Registered Nurse Certification and Licensure. The organization also develops a legislative agenda, works with NPAM lobbyists to develop legislation, promotes legislation to members, legislators, and the public reviews health-related bills introduced in the legislature by other groups and makes recommendations to NPAM about support or opposition, builds relationships with other health care stakeholders representing nursing, medicine, education, government, business, and the community (Nurse Practitioner Association of Maryland, n.d.).

    The majority of the regulations in Maryland are in favor of the NP independent prescriptive and practice authority. However, the only barrier that may impact independent practice is the regulation made effective October 2015 onwards, which states that newly certified NPs should have a physician mentor for 18 months before they can independently practice Maryland Registered Nurse Certification and Licensure.

    It is interesting how different states differ from each other regarding NP’s independent practice authority. What surprises me is that Maryland NPs have several independent functions aside from prescribing drugs, ordering diagnostic, therapeutic measures. I have discovered that Maryland NPs can complete a death certificate if the deceased was under their care. NPs can also certify to the Department of Transportation that an individual needs special consideration for specific health reasons and can witness an advance directive (Maryland Board of Nursing, 2019). Knowing some other independent functions motivated me to serve my community in the future, knowing how broad the scope of practice of NPs in Maryland is Maryland Registered Nurse Certification and Licensure.

    Overall, APRNs’ full practice authority plays a significant role in providing citizens high-quality, reliable, and cost-effective healthcare services (Bosse et al., 2017). Michael et al. (2019) stated that the number of Americans 65 and older is projected to be more than double in the next four decades. Thus, the number of medical workforces, specifically primary care providers, will be in demand to cater to the medical needs of our population. Also, the high number of individuals who acquired insurance due to the Affordable Care Act has reported having less access to healthcare due to physician shortage (Bosse et al., 2017). These are just a few reasons that the government should allow APRNs to have a full scope of practice in all states in response to the increasing demand of health care providers to provide access to quality care for all Americans. APRNs are highly qualified health care professionals that undergone extensive education and training. Thus, removing the restrictions will allow nurse practitioners to practice to the full extent in response to the country’s increasing need Maryland Registered Nurse Certification and Licensure.

    References

    Bosse, J., Simmonds, K., Hanson, C., Pucini, J., Dunphy, L., Vanhook, P., & Poghosyan, L. (2017).

              Position statement: Full practice authority for advanced practice registered nurses is

              necessary to transform primary care.
    Nursing Outlook
    ,
    65
    (6), 761–765.

              https://doi.org/10.1016/j.outlook.2017.10.002

    Buppert, C. (2021).
    Nurse practitioner’s business practice and legal guide
    (7th ed.).

              Jones & Bartlett.

    Maryland Board of Nursing. (2019).
    Nurse practitioner: Scope and standards of practice. 

              https://mbon.maryland.gov/Documents/proposed-regs-for-20171113-md-

              register.pdf

    Milstead, J. A., & Short, N. M. (2019). Overview: Economics and finance of healthcare. In 
    Health

                policy 
    and politics: A nurse’s guide
    (6th ed., pp. 171–211). Jones & Bartlett Learning.

    Nurse Practitioner Association of Maryland. (n.d.).
    Maryland legislative districts and NPAM

               legislative committee
    . https://www.npamonline.org/page/35 Maryland Registered Nurse Certification and Licensure.

  • Texas State Nursing Certification and Licensure Essay

    Texas State Nursing Certification and Licensure Essay

    Certification and Licensure

    The state of Texas defined advanced practice nurse as a registered nurse approved by the board to practice at an advanced level after the completion of advance education program acceptable to the Board (22 Tex. Admin. Code § 11.221.1[3]; Buppert, 2021). The advance practice nurse should be prepared to practice in an expanded role such as nurse practitioner, nurse-midwife, nurse anesthetist, and a clinical nurse specialist providing healthcare to individual, families, and or group in various setting. Practice settings include homes, hospitals, institutions, offices, industry, schools, community agencies, public and private practice. To obtain licensure, the advanced practice registered nurse (APRN) must graduate and advanced education program with curriculum consistent with competencies of the specific areas of practice Texas State Nursing Certification and Licensure Essay. Each instructional track/major shall have a minimum of 500 supervised clinical hours as defined by the Board. The supervised experience shall have been directly related to the role and population focus area of licensure and include pharmacotherapeutic management of patients consistent with competencies of the specific areas of practice. The APN can act independently or with collaboration with other health care professionals (22 Texas Admin. Code §11.221.1[3]; Buppert, 2021). Advanced practice registered nurse includes advanced nurse practitioner and advanced practice nurse as defined by administrative code 301.152 (Buppert, 2021). The graduate APRN shall pass either the American Nurse Credentialing Center (ANCC) or the American Academy of Nurse Practitioners Certification Board (AANPCB) examination (Leik, 2021). For prescriptive authority the APRN shall have full licensure from the Board of Nursing and have successfully completed graduate level courses in pharmacotherapeutics advanced pathophysiology, advanced health assessment, and diagnosis and management of diseases and conditions within the role and population focus area (Buppert, 2021) Texas State Nursing Certification and Licensure Essay.

    The scope of practice of APRN is in addition to the registered nurse (RN) scope of practice. Texas law requires that APRN shall be under the supervision of a physician with practice protocols and other authorization agreements such as prescribing authority written and signed by the APRN and the physician. This agreement shall be reviewed annually and remain in the practice setting available for verification to authority. The advanced practice nurse remains in authority and professional accountability for advance practice (Bupert, 2021). The APRN is authorized to prescribe drugs and devices allowed by the supervising physician if facility-based authorized either by prescriptive authority or by protocols. The APRN should follow the format of prescription specified by the State of Texas with the US DEA number if prescribing controlled substance. APRN shall prescribe only FDA approved drugs and for off-label purpose if such practice is evidenced-based and within the current standard of care to treat certain diseases and condition. The APRN shall authorize or prevent generic substitution on a prescription in compliance with the current rules of Texas State Board of Pharmacy relating generic substitution. The APRN acts in observation, assessment, diagnosis, intervention, evaluation, rehabilitation, care and counsel, and health teachings of persons who are injured, sick, or ill who are experiencing changes in normal health, promotes and maintain health, and works in the prevention of diseases (Buppert, 2021). The APRN is required to retain the copy of the prescriptive authority agreement until the second anniversary of the date the agreement is terminated. According to the Texas Administrative Code (22 Tex. Admin. Code §221.12; Buppert, 2021), the scope of practice for specialty areas shall be defined by the national professional specialty organizations or advanced practice nursing organizations recognized by the Board. The Board does not prohibit the APRN from practicing the scope of a registered nurse Texas State Nursing Certification and Licensure Essay.

    To obtain a DEA number, an APRN with full Licensure and prescriptive authority must comply with the following requirements prior to ordering or prescribing controlled substances: (a) The advanced practice registered nurse must have a prescriptive authority number that has been issued by the Texas Board of Nursing before submitting the controlled substance registration form and (b) DEA applications may be obtained via the DEA’s web site or by calling the local DEA office (Texas Board of Nursing, 2013).

    APRN shall have periodic meeting with the supervising physician at least once a month to share information relating to patient treatment and care, changes in plan of care, referral and other issues relating to patient management. This meeting shall be documented and available for review from authority Texas State Nursing Certification and Licensure Essay.

    Currently the APRN limitation to full practice authority (FPA) has been a long battle by the various nursing organization such as the American Nurse Association (ANA). Some scope of practice to specific functions of the APRN requires clarity in the State of Texas such as diagnosing, treatment, admission to hospital and psychiatric institution, referral, teachings, ordering of tests, performing procedures, assisting in surgery, ordering of medical equipment and restraints, certifying use of medical marijuana, and performing palliative care (Buppert, 2021).

    Health policy related to APRN practice has been evolving rapidly, both locally and nationally. Legislative and regulatory advances are being made by various APRN organization. Within Texas, the main APRN legislative advocacy group is the APRN Alliance, which is made up of 4 APRN groups: Texas Nurse Practitioners, Texas Association of Nurse Anesthetists, Consortium of Texas Certified Nurse-Midwives, and Texas Clinical Nurse Specialists; with the support of the Texas Nurses Association (National Association of Pediatric Nurse Practitioners [NAPNAP], 2021). Texas is among the 12 states that still has restricted practice. Recently, Rep. Stephanie Klick filed full practice authority bill, H.B. 1792, which would remove costly, antiquated regulatory barriers to nurse practitioners and help expand access to care for Texans (NAPNAP, 2021; Texas Nurse Association [TNA], 2019). Since the bill was introduced, members of the Texas Medical Association and other physician groups have been inundating legislative offices with calls, personalized emails, and in-person visits (NAPNAP, 2021). For Texan APRNS, it is going to be a long way battle for unrestricted practice authority Texas State Nursing Certification and Licensure Essay.

    References:

    Buppert,C. (2021). Nurse practitioner scope of practice. Nurse Practitioners Business Practice and Legal Guide, 7
    th
    ed. Jones & Bartlett Learning.

    Leik, M. T. C. (2021). Certification exam information. Adult-Gerontology Nurse Practitioner Certification: Intensive Review 4
    th
    ed. Springer Publishing.

      ORDER A PLAGIARISM FREE PAPER NOW

    NAPNAP. (2021). APRN Legislative review-greater Texas NAPNAP. https://community.napnap.org/txgreater/advocate#

    22 Tex. Admim. Code § 11.221.3 (2019): https://www.bon.texas.gov/rr_current/221-3.asp

    Texas Board of Nursing. (2013). Obtaining a DEA number.

    https://www.bon.texas.gov/applications_obtaining_dea_number.asp#:~:text=The%20advanced%20practice%20registered%20nurse

    TNA. (2019). In the trenches at the Texas legislature. https://www.texasnurses.org/news/news.asp?id=445224 Texas State Nursing Certification and Licensure Essay

  • Connecticut Nursing Certification and Licensure Essay

    Connecticut Nursing Certification and Licensure Essay

    In Connecticut, in order to practice as a nurse practitioner without a Collaborative Agreement, a  Connecticut licensed APRN who has maintained his or her Connecticut license for at least three (3) years and who has performed advanced practice level nursing activities in collaboration with a Connecticut licensed physician for at least three (3) years and for at least two thousand (2,000) hours may practice alone or in partnership with a physician or another licensed health care professional in this state. Any APRN who chooses to practice without a collaborative agreement is required to keep documentation of advanced practice level nursing activities performed in conjunction with a Connecticut licensed physician. Such APRN must keep such documentation for at least three (3) years after fulfilling such requirements and must provide it to the Department of Public Health for examination no later than forty-five (45) days after the department makes a request for such documentation Connecticut Nursing Certification and Licensure Essay. After fulfilling the criteria outlined above and before to practicing without a collaborative agreement, APRNs must provide written notification to the Department of their intention to practice without one.

    In order to practice as a nurse practitioner requiring a Collaborative Agreement an APRN must work in cooperation with a Connecticut-licensed physician for the first three (3) years after receiving their license. “Collaboration” refers to a mutually agreed-upon working relationship between an APRN and a physician who is educated, trained, or has relevant expertise in the advanced practice registered nurse’s field of practice. A fair and adequate degree of consultation and referral, covering for the patient in the absence of an APRN, a means to assess patient outcomes, and a method of disclosing the connection to the patient are all part of the cooperation. The collaboration between such advanced practice registered nurse and a physician, in relation to the exercise of prescriptive authority, shall be in writing and shall address the level of schedule II and III controlled substances that such APRN may prescribe, as well as a method to review patient outcomes, including, but not limited to, the review of medical therapeutics, corrective measures, and diagnostic studies Connecticut Nursing Certification and Licensure Essay. The Department of Public Health will not collect copies of collaborative practice agreements on a regular basis. APRNs must, however, furnish the Department with a copy of the collaboration agreement upon request (
    Aprn practice
    . CT.gov, 2021).

    To be eligible for advanced practice registered nurse licensure in Connecticut, a person must have a current Connecticut registered nurse license and hold and maintain current certification as a nurse practitioner, clinical nurse specialist, or nurse anesthetist from one of the recognized national organizations, such as American Nurses Credentialing Center, National Certification Corporation for the Obstetric, Gynecologic and Neonatal Nursing Specialties, Pediatric Nursing Certification Board, American Association of Nurse Anesthetists, American Academy of Nurse Practitioners, Oncology Nursing Certification Corporation, or American Association of Critical-Care Nurses (
    Aprn practice
    . CT.gov, 2021) Connecticut Nursing Certification and Licensure Essay.

    The documents for the APRN application may be found at http://www.ct.gov/dph/cwp/view.asp?a=3121&q=389400&dphNav GID=1821 on the Department of Public Health’s website. A number of original source papers will be required by DPH. Official transcripts from the issuing institution must be used to demonstrate post-basic nursing education. The dean or director of the program must verify pharmacology courses; the Board has provided a form for this purpose. Applicants who respond “yes” to any question concerning a negative professional background (for example, suspensions, investigations, or criminal convictions) must provide supporting proof. A personal statement as well as formal documentation such as court records will be requested by the licensing agency. Notarization is required on the application form. A current photograph will be taped to the applicant’s resume. The Commissioner of Public Health must be notified by an advanced practice nurse who has fulfilled the cooperation criteria and desires to practice independently. The Department of Public Health oversees the Connecticut Board of Examiners in Nursing. The Connecticut Department of Health has information on advanced practice nursing at http://www.ct.gov/dph/cwp/view.asp?a=3121&q=389400&dphNav GID=1821. The licensing agency can be reached at (860) 509-7603 or through email at dph.nursingteam @ ct.gov (
    Connecticut APRN LICENSE Requirements: Become a nurse practitioner in CT
    . NursingLicensure.org – A more efficient way to find nursing license requirements in your state, 2021) Connecticut Nursing Certification and Licensure Essay.

    Instead of a licensed physician, NPs practice under the jurisdiction of the State Board of Nursing. The NP must work with a physician for the first three years following first licensure. A fair and acceptable degree of consultation and referral, covering for the patient in the absence of such an advanced practice registered nurse, a means to assess patient outcomes, and a method of disclosing the connection to the patient must all be addressed in the written agreement. The NP can practice independently after three years. Prescriptive authority is given three years following first license, a written cooperation addressing the degree of Schedule II and III restricted drugs that an NP can prescribe is needed. A strategy for reviewing patient outcomes must be included in the partnership. After three years, the NP is free to prescribe on her own. State policy recognizes NPs as primary care professionals. A patient’s main care provider might be a participating, in-network physician or a participating, in-network advanced practice registered nurse (
    Connecticut scope of Practice policy – State Profile
    . Scope of Practice Policy, 2021) Connecticut Nursing Certification and Licensure Essay.

    Controlled Substance Practitioner Registration allows practitioners to distribute, dispense, conduct research, administer, or purchase restricted drugs in the course of their professional practice if the Department of Public Health or another regulating entity has granted them permission. A valid active registration with the Department of Public Health is required of anybody seeking for this registration. If you have been convicted of a felony or if your license has been surrendered, revoked, suspended, limited, or refused, or if any such action is underway, no further proof is necessary. In Connecticut, licensed medical staff who prescribe restricted drugs must meet this criterion. In order to proceed with the Controlled Substances Registration application, all applicants will be required to have an application on file with the Department of Public Health. The application fee is $40 at first. ALL PRACTITIONERS WHO POSSESS A CONNECTICUT CONTROLLED SUBSTANCE REGISTRATION MUST REGISTER IN THE CONNECTICUT PRESCRIPTION MONITORING AND REPORTING SYSTEM*** at 
    https://connecticut.pmpaware.net
    (
    Controlled substance practitioner registration
    . CT.gov, 2021) Connecticut Nursing Certification and Licensure Essay.

    The DEA application is divided into six components. Personal/business information, activity, state license(s), history, payment, and confirmation. The DEA Form-224 is now available online (recommended), or you can fill out and submit a paper version. Other forms for new registration (Forms DEA-225, DEA-363, and DEA-510) are also now accessible online or can be mailed. For assistance with registration, contact the DEA Registration Service Center at 1-800-882-9539 (8:30 a.m. to 5:50 p.m. ET) or send an email to DEA.Registration.Help@usdoj.gov. In your email, be sure to mention your DEA registration number. Alternatively, you may speak with a Local Registration Specialist (Registration, 2021). In CT controlled-substance prescriptive authority and drug schedules nurse practitioners are authorized to prescribe, Dispense, Administer, and procure Schedule II/IIN substances (2/2N), Schedule II/IIN substances (2/2N), Schedule IV substances (4), and Schedule V substances (5) (CSA registration tools, 2021).

    Our Regional 1 Director has been honored with the AANP State Advocacy Award for Excellence, which honors committed advocates in each state who have made substantial contributions to raising NP knowledge and recognition. Improving Access for Patients Who Need Cardiac and Pulmonary Rehabilitation Services, Improving Medicare Patient Access to Needed Therapeutic Shoes, and Introducing/Reintroducing ourselves to our Members of Congress to educate them on the high-quality health care that NPs provide are just a few of the activities that our states are involved with (
    AANP regional directors and state representatives
    . American Association of Nurse Practitioners, 2020) Connecticut Nursing Certification and Licensure Essay.

    Reference:

    AANP regional directors and state representatives
    . American Association of Nurse Practitioners. (2020).
    https://www.aanp.org/about/about-the-american-association-of-nurse-practitioners-aanp/your-aanp-region/regional-directors-and-state-representatives
    .

    Aprn practice
    . CT.gov. (2021).
    https://portal.ct.gov/DPH/Practitioner-Licensing–Investigations/APRN/APRN-Practice
    .

    Connecticut APRN LICENSE Requirements: Become a nurse practitioner in CT
    . NursingLicensure.org – A more efficient way to find nursing license requirements in your state (2021).  
    https://www.nursinglicensure.org/np-state/connecticut-nurse-practitioner/
    .
     

    Connecticut scope of Practice policy – State Profile
    . Scope of Practice Policy. (2021).
    https://scopeofpracticepolicy.org/states/ct/
    .

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    .

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    Registration. (2021). https://www.deadiversion.usdoj.gov/drugreg/index.html#2 Connecticut Nursing Certification and Licensure Essay.