2replies | NURS 6050 – Policy and Advocacy for Improving Population Health | Walden University

First

Comparison of Virginia, Maryland and District of Columbia APRN Regulations

     The region of Virginia in which I live is locally known as “the DMV” (the abbreviation for District/Maryland/Virginia). It is common for many practitioners to live in one jurisdiction and practice in another. For this reason, I chose to compare the three jurisdictions.

     According to the American Association of Nurse Practitioners, an APRN’s practice is restricted in Virginia. However, in the District and Maryland, APRNs may practice to their full scope of education and experience. Two differences I noted were in regulating agencies and in prescriptive authority. In Virginia, APRNs are regulated jointly by the Board of Nursing and the Board of Medicine. In contrast, in the District and Maryland, the respective Boards of Nursing are the only regulatory agencies.

     Regarding prescriptive authority, in Virginia, in order for a nurse practitioner (other than a nurse anesthetist or midwife) to have autonomy in practice, one must have practiced in a restricted capacity for at least five years (9000 hours). Also, nurse practitioners may only prescribe Schedule II – V medications in partnership with a physician. In the District, APRNs have full prescriptive authority (DC Health), and in Maryland, full prescriptive authority includes prescribing medical marijuana (Maryland Board of Nursing).

     Loversidge (2019), in addressing the regulation of Advanced Practice Registered Nurses (APRNs), proffered that it “has been inconsistent because…states [have] the right to establish laws governing professions and occupations” (p. 65). As a note of interest regarding practicing

RNs, the District does not participate in the Nursing Licensure Compact either, and an RN that wants to practice in DC must obtain a separate DC-specific license. In a region as geographically close as the DMV, especially during health-related crises, collaboration among the three regions Boards of Nursing could allow for scope expansion of a Virginia-licensed APRN. In the meantime, it is essential for APRNs crossing borders into other jurisdictions to familiarize themselves with the regulations of each in order to adhere to both prescriptive authority and other regulations.

References

American Association of Nurse Practitioners. Retrieved September 28, 2020, from https://www.aanp.org/advocacy/state/state-practice-environment

DC Health, Nursing Regulations, Nurse Practitioners. Retrieved September 28, 2020, from

https://dchealth.dc.gov/sites/default/files/dc/sites/doh/publication/attachments/Chapter%2059%20Nurse-Practitioners.pdf

Loversidge, J.M. (2019). Government response: regulation. In J. A.Milstead, & N. M. Short (Eds.), Health policy and politics: A nurse’s guide (6th ed., pp 57-86). Burlington, MA: Jones & Bartlett Learning

Maryland Board of Nursing Scope and Standards of Practice. Retrieved September 28, 2020, from http://www.dsd.state.md.us/comar/comarhtml/10/10.27.07.03.htm

Virginia Department of Health Professions Board of Nursing. Retrieved September 28, 2020, from https://www.dhp.virginia.gov/media/dhpweb/docs/nursing/leg/NursePractitioners.pdf

Second 

 APRN Board of Nursing Regulations in Texas and Florida.

Most states in the U.S of America have similar and different regulations to govern APRN in their practice acts because of the complexity of the health care system. According to Milstead & Short (2019), “Regulation means to control over something by rule or restriction, and health professions regulation is needed as a mechanism to protect the interest of the public safety (p. 60). Each states Board of Nursing in the U.S put in place regulations to protect the public of interest because of the potential risk for harm so that APRN can be held accountable and responsible of any rules that are outline in the practice acts. In Texas, to renew APRN license, applicant must completed an APRN educational program, attest to having a minimum of 400 hours of current practice within the preceding biennium, and attest to being in compliance of continuing competency and APRN with prescriptive authority (Office of the Secretary of States, n.d). In Texas, APRN with full valid prescription authorization number can obtain authority to order or prescribe control substance in Schedule II, III through V. Prescription for controlled substance in Scheduled III through V including refill of the prescription shall not exceed 90 days’ supply, beyond the initial 90 days the refill prescription cannot be authorized, and prescription of the controlled substance in Schedule III through V for child less than two years of age can not be authorize prior to consultation with delegating physician and notation of consultation in the patient’s chart (Office of the Secretary of States, n.d). This regulation enables the APRN to follow the guidelines when prescribing certain categories of control substance.

In Florida, to renew APRN license, the applicant must prescribe up to 30 hours of continuing education biennially as a condition for renewal of a license or certificate, must complete at least 3 hours of continuing education on the safe and effective prescription of controlled substances, and complete a 2-hour continuing education course on human trafficking. In Florida, APRN has been granted legal authority to prescribed drugs listed as controlled substance subject to approval by their supervising Practioner, will need mid-level Practioner DEA registration, APRN cannot prescribe more than 7-day supply of Schedule II control substance except the APRN is a psychiatric nurse who only can prescribe 7-day supply of Schedule II controlled substance that is mental health drugs, and ARNPs who are not psychiatric nurses cannot prescribe psychiatric mental health controlled substances for children younger than 18 years of age (Akerman LLP – Health Law Rx, 2016).

Regulations for Advance Practice Registered Nurse (APRNs): Legal Authority to      Practice

American Health care delivery system is face with so many complex issues which requires adequate access to health care for positive health outcome. There is a barrier to health delivery because of shortage of health care providers in the U.S and these are affecting millions of Americans to seek health care at their convenient time. Every year, foreign immigrants, people living in rural areas, lower-middle class citizen find it difficult to access health care due to race, color, ethnicity, nationality, sexual orientation or socioeconomic status. Granting APRN full legal authority to practice without limitation can help resolve the issue of the barriers facing health care delivery system in the U.S. Some states allow APRNs to practice independent without physician supervision to lessen the high demands of their health care delivery system while other states are still deliberately on the issue. In 2017, 15 states report that NPs are regulated solely by a BON and have independent scope of practice and prescriptive authority without physician supervision, delegation, consultation, or collaboration… (Milstead & Short, 2019 p.63). If an APRN with full legal right to practice moved to another states with limitation, the APRN must abide to the regulations of the new states when it comes to renewal of license and prescription of some categories of control substance. For example, Texas regulation requires APRN to obtain authority to prescribe control substance in Schedule II, III through V, the APRN with legal right to practice independently must abide to the rules of Texas with no exception to the law because the APRN is within the jurisdiction of the new states.

                                                References

Akerman LLP – Health Law Rx. (2016). Deciphering Florida’s New Laws on ARNP and PA Controlled Substance Prescribing. Retrieve from: https://www.jdsupra.com/legalnews/deciphering-florida-s-new-laws-on-arnp-25553.

Milstead, J & Short, N. (2019). Health Policy and Politics: A Nurse’s Guide. Government Response: Regulation. p. 60, 63, 6th edition. Burlington. MA. Jones & Bartlett Learning.

Office of Secretary of States. (n.d). Texas Administrative Code. Retrieve from: https://texreg.sos.state.tx.us/public/readta1c$ext.ViewTAC?tac_view=3&ti=22&pt=11

Order a unique copy of this paper
(550 words)

Approximate price: $22

Basic features
  • Free title page and bibliography
  • Unlimited revisions
  • Plagiarism-free guarantee
  • Money-back guarantee
  • 24/7 support
On-demand options
  • Writer’s samples
  • Part-by-part delivery
  • Overnight delivery
  • Copies of used sources
  • Expert Proofreading
Paper format
  • 275 words per page
  • 12 pt Arial/Times New Roman
  • Double line spacing
  • Any citation style (APA, MLA, Chicago/Turabian, Harvard)

Our guarantees

We value our customers and so we ensure that what we do is 100% original..
With us you are guaranteed of quality work done by our qualified experts.Your information and everything that you do with us is kept completely confidential.

Money-back guarantee

You have to be 100% sure of the quality of your product to give a money-back guarantee. This describes us perfectly. Make sure that this guarantee is totally transparent.

Read more

Zero-plagiarism guarantee

The Product ordered is guaranteed to be original. Orders are checked by the most advanced anti-plagiarism software in the market to assure that the Product is 100% original. The Company has a zero tolerance policy for plagiarism.

Read more

Free-revision policy

The Free Revision policy is a courtesy service that the Company provides to help ensure Customer’s total satisfaction with the completed Order. To receive free revision the Company requires that the Customer provide the request within fourteen (14) days from the first completion date and within a period of thirty (30) days for dissertations.

Read more

Privacy policy

The Company is committed to protect the privacy of the Customer and it will never resell or share any of Customer’s personal information, including credit card data, with any third party. All the online transactions are processed through the secure and reliable online payment systems.

Read more

Fair-cooperation guarantee

By placing an order with us, you agree to the service we provide. We will endear to do all that it takes to deliver a comprehensive paper as per your requirements. We also count on your cooperation to ensure that we deliver on this mandate.

Read more

Calculate the price of your order

550 words
We'll send you the first draft for approval by September 11, 2018 at 10:52 AM
Total price:
$26
The price is based on these factors:
Academic level
Number of pages
Urgency