NRNP 6675 WEEK 1 Response To My Colleague No 1 Rebeka L Discussion Post

NRNP 6675 WEEK 1 Response To My Colleague No 1 Rebeka L Discussion Post

Response to Rebekah

            Hello Rebekah. Your discussion is impressively detailed promoting more insight on the process of becoming an APRN in Nebraska. It is quite clear from your discussion that becoming a Nebraska-certified and licensed APRN requires successful completion of a master’s degree or higher in a nursing program and passing the nationally recognized certification examination to gain approval just like in my state Georgia. However, unlike in my state, I can see that APRNs in Nebraska have the privilege to full practice without supervision. In Georgia, a collaborative agreement with a physician is required for APRNs to attain prescriptive authority (Clement,2018). On the other hand, collaborative practice through the transition-to-practice agreement ishowever exercised in both states.

In the third paragraph, you have mentioned that the scope of practice of APRNs in Nebraska involves assessing, ordering diagnostic tests, treatments, prescribing medications, and synthesizing and analyzing data just like in Georgia. The only difference comes in prescription rights as mentioned earlier. DEA license is required in both states with a similar application procedure. However, it is crucial to point out that APRNs in both states are only allowed to prescribe and dispense controlled substances under schedules III to V (Moore,2019). The prescription monitoring program helps the prescriber retrieve treatment information for patients taking controlled substances, to promote the safe use of such medications.

Transition-to-practice regulations can indeed limit nurses from exhibiting full provision of patient care (Hudspeth & Klein, 2019). However, collaborative practice is necessary for promoting patient-centered care. Lastly, additional training in pharmacology is required for APRNs to be able to prescribe or dispense medication.

 

References

Clement, D. M. (2018). Factors Influencing Georgia Legislators’ Decision-Making on Nurse Practitioner Scope of Practice. Policy, Politics, & Nursing Practice, 19(3-4), 91-99. https://doi.org/10.1177/1527154418817036

Hudspeth, R. S., & Klein, T. A. (2019). Understanding nurse practitioner scope of practice: regulatory, practice, and employment perspectives now and for the future. Journal of the American Association of Nurse Practitioners, 31(8), 468-473. https://doi.org/10.1097/JXX.0000000000000268

Moore, D. J. (2019). Nurse practitioners’ pivotal role in ending the opioid epidemic. The Journal for Nurse Practitioners, 15(5), 323-327. https://doi.org/10.1016/j.nurpra.2019.01.005

PLEASE RESPOND TO MY COLLEAUGE REBEKA, L discussion post below
Respond to my colleague in one or more of the ways listed below. My own state is Georgia

• 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

ORDER A PLAGIARISM-FREE PAPER HERE

Summary of findings
In the state of Nebraska Nurse Practitioners (NP) in mental health fully practices independently without supervision or collaboration with a physician (American Association of Nurse Practitioners, 2020). To become certified and licensed as an Advance Practice Registered Nurse (APRN) successful completion of a program of study in a clinical specialty for NP along with completion of nationally recognized certification examination and board approved recertification program. A license as a registered nurse by the State of Nebraska with proof of successfully completing a graduate-level program in the clinical specialty for NP specialty that is accredited by a national accrediting body (Department of Health and Human Services Division of Public Health Licensure Unit, 2019). Proof of passing specific NP examination approved by the board with the department approval. Professional liability insurance is required too. Proof of completing two thousand hours of practice as a nurse practitioner in any combination of transition-to-practice agreement, collaborative agreement, or independent practice, in the state of Nebraska or another state (Department of Health and Human Services Division of Public Health Licensure Unit, 2019). The transition-to-practice agreement is a formal agreement between the nurse practitioner for 2,000 hours and supervising provider (doctor or nurse practitioner) with at least 10,000 hours of clinical experience.

The Nebraska application certification process requires eligibility be met by submission of proof of current registered nurse license and having a masters or higher from a psychiatric-mental health nurse practitioner (PMHNP) accredited program with at least 500 faculty-supervised clinical hours (American Nurses Credentialing Center, n.d.). An application must be submitted with payment of $395. Verification of education must be completed by mail or email and includes official and unofficial transcripts, validation of education form. Once the authorization to test is received then an appointment can be made to take the certification test but must be completed within 90 days (American Nurses Credentialing Center, n.d.).
The Nebraska state board website is https://dhhs.ne.gov/licensure/pages/nurse-licensing.aspx. The State of Nebraska defines the scope of practice for nurse practitioners as a registered nurse licensed under the APRN Act that provides health care services within the specialty scope for health promotion, health supervision, illness prevention, diagnosis and treatment for chronic and acute conditions. Also, establishing collaborative, consultative, and referrals for care of patients needed beyond the NP scope or experience (Nurse practitioner; functions; scope, 38-2315, 2015). The scope of practice includes assessing, ordering diagnostic tests, therapeutic treatments, prescribing medications, synthesizing and analyzing data, managing patients committed under the Nebraska Mental Health Commitment Act and incorporating advanced nursing principles (Nurse practitioner; functions; scope, 38-2315, 2015).
For a DEA license as an APRN an initial application must be completed. Schedule drug and business activity must be provided along with full license registration as an APRN. Liability questions regarding history with controlled substances must also be disclosed and payment submitted.
Nebraska has a prescription monitoring program with primary focus on patient safety which collects information regarding dispensed prescription medication and stores it on the Health Information Exchange (HIE) platform (Department of Health and Human Services Division of Public Health Licensure Unit, 2019). APRN have authority to prescribe legend drugs and controlled substances (American Medical Association, 2017). 2N, 3, 4, and 5 schedule drugs Nurse practitioners have the authority to prescribe (American Medical Association, 2017).

Regulations and barriers

Transition-to-practice regulations can be a barrier for patient access to care in certain areas which could eventually impact patient outcome depending on availability (Brom et al., 2018). Another barrier being regulations affecting reimbursement services as only certain NPs are considered direct primary providers in Nebraska (Brom et al., 2018). Nebraska has no state legislation mandating third-party reimbursement for NPs which can affect recognition as a provider (Brom et al., 2018).
Surprised from research
The regulation requirement for specialty training for nurse practitioners prescribing buprenorphine for opioid use disorder is the same as other approved providers. Initially I assumed there would be restrictions to be able prescribe this drug in particular. The lack of Medicaid expansion in Nebraska I was also surprised about considering the population of the area, the various types of populations and beneficial aspect for care. Ultimately the associated cost for the various

American Association of Nurse Practitioners. (2020). State practice environment. https://www.aanp.org/advocacy/state/state-practice-environment

American Medical Association. (2017). State law chart: Nurse Practitioner Prescriptive Authority. https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/specialty%20group/arc/ama-chart-np-prescriptive-authority.pdf

American Nurses Credentialing Center. (n.d.). Psychiatric-Mental Health nurse practitioner (across the lifespan) certification (PMHNP-BC): ANCC. ANA. Retrieved February 28, 2022, from https://www.nursingworld.org/our-certifications/psychiatric-mental-health-nurse-practitioner/
Brom, H. M., Salsberry, P. J., & Graham, M. C. (2018). Leveraging health care reform to accelerate nurse practitioner full practice authority. Journal of the American Association of Nurse Practitioners, 30(3), 120–130. https://doi.org/10.1097/JXX.0000000000000023
Department of Health and Human Services Division of Public Health Licensure Unit. (2019). State of Nebraska – Nebraska Department of Health & Human … STATUTES RELATING TO NURSE PRACTITIONER PRACTICE ACT. https://dhhs.ne.gov/licensure/Documents/Nursing-NursePracticeAct.pdf

Nurse practitioner; functions; scope, 38-2315. Nebraska Legislature. (2015). https://nebraskalegislature.gov/laws/statutes.php?statute=38-2315