Module 3 week 5 Discussion.

Posted: November 16th, 2022

Module 3 week 5 Discussion.

Respond to the 2 discussions below separately,
and explain how the regulatory environment and the regulations selected by your colleague differ from your state/region. Be specific and provide examples.
Discussion 1

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Post a comparison of at least two Advanced Practice Registered Nurses (APRN) board of nursing regulations in your state/region with those of at least one other state/region.

The two states chosen for comparison is the state of Maryland and the state of Colorado. For the state of Maryland, the length of time of transition to practice period is 18 months which became effective 15 October 2015 (Center for Disease Control, 2016). This transition to practice time is required before an Advanced Practice Nurse (APRN) is granted full practice authority. After that time period has passed, the APRN can practice on his/her own (Policy Surveillance Program Staff and National Nurse-Led Care Consortium, 2015). An additional regulation for Colorado is that all APRNs must obtain liability insurance and for Maryland it is not a requirement (Nursing Licensure.org, 2019).Module 3 week 5 Discussion.

Describe how they may differ. Be specific and provide examples.

In the state of Colorado, they recently made a change in the length of transition to practice time. Sometime between 1 May 2015 and 1 April 2016, the state of Colorado changed from requiring 1,800 hours to now 1,000 hours of mentor ship with a physician or an Advanced Practice Nurse requiring full prescriptive authority and experience in prescribing medications (Code of Colorado Regulations Board of Nursing, n.d.) In Colorado, transition to practice period is also required before an APRN is granted full practice authority. The exception with Colorado law is that it includes a transition period to attain full prescriptive authority as well unlike Maryland law does not include a clause as such (Policy Surveillance Program Staff and National Nurse-Led Care Consortium, 2015). During the transition period, an APRN is considered in orientation training under a physician or another Nurse Practitioner and are somewhat covered under an umbrella. Module 3 week 5 Discussion.When an APRN is practicing on their own, obtaining liability insurance will serve as their umbrella protecting them and others from liability associated with wrongful practices resulting in bodily injury, medical expenses and property damage, as well as the cost of defending lawsuits related to such claims (National Association of Insurance Commissioners, 2019). For example, an APRN prescribes the wrong medication to a patient and they suffer an adverse reaction. The liability insurance will provide protection against lawsuits involving malpractice.Module 3 week 5 Discussion.

Explain how the regulations you selected may apply to Advanced Practice Registered Nurses (APRNs) who have legal authority to practice within the full scope of their education and experience.

This time will allow the APRN to experience the best hands-on in regards to their specialty including proper medications, appropriate dosing, and staying abreast with the latest medications on the market. Once the APRN has completed their mentorship training and completed the requirements for full prescriptive authority, they can begin prescribing and treating patients for their medical conditions without any supervision.Module 3 week 5 Discussion. The APRNs are required to maintain continuing education courses, stay up to date with peer reviewed preceding that involves opioid prescribing, volunteer service, and attendance at a relevant conference to name a few (Code of Colorado Regulations Board of Nursing, n.d.). The Institute of Medicine recognized that evidenced based practice as a key solution to ensure care delivered has the highest clinical effectiveness known to science. Having these competencies provide the road map for expected levels of evidence based practice in the clinical setting (Halm, 2018).Module 3 week 5 Discussion.

In reference to coverage, liability insurance can provide that sense of reassurance knowing that if they make a mistake during their practice or someone attempts to sue them for wrong doing, they have protection coverage in place for legal matters. Considering all the hours of training and education APRNs go through, someone can still make a mistake.

Provide at least one example of how APRNs may adhere to the two regulations you selected.

Advanced Practice Registered Nurses can collaborate with physicians and physician assistants to ensure patients are receiving the best evidenced-based treatment. APRNs greater scope of practice privileges and autonomy leads to lower rates of malpractice suits and significantly lower health care costs at the individual, state, and national levels (Online FNP Programs, 2019).Module 3 week 5 Discussion.

 

References:

Center for Disease Control. (2016, April). State law fact sheet: A summary of nurse practitioner.Retrieved December 23, 2019, from https://www.cdc.gov/dhdsp/pubs/docs/SLFS_NSOP_508.pdf

Code of Colorado Regulations Board of Nursing (Ed.). (n.d.). Code of colorado regulations board of nursing. Retrieved December 23, 2019, from https://www.sos.state.co.us/CCR/ GenerateRulePdf.do?ruleVersionId=8403&fileName=3 CCR 716-1

 

 

Halm, M. A. (2018). Evaluating the impact of EBP education: Development of a modified Fresno test for acute care nursing. Worldviews on Evidence-Based Nursing, 15(4), 272–280. doi:10.1111/wvn.12291

 

 

National Association of Insurance Comissioners. (2019, September 30). Medical malpractice insurance. Retrieved December 24, 2019, from https://content.naic.org/cipr_topics/

topic_medical_malpractice_insurance.htm

Response :…………
3 Reference for this discussion reponse:….
Nursing Licensure.org (Ed.). (2019). Advance practice registered nurse license requirements in

maryland. Retrieved December 24, 2019, from https://www.nursinglicensure.org/np-state/

maryland-nurse-practitioner.html

 

 

Online FNP Programs (Ed.). (2019). APRN scope of practice: A guide for graduate nursing students and practicing APRNs. Retrieved December 24, 2019, from https://www.onlinefnpprograms.com/features/guide-to-aprn-practice-authority/

 

 

Policy Surveillance Program Staff and National Nurse-Led Care Consortium. (2015.). Nurse practitioner scope of practice. Retrieved December 23, 2019, from http://lawatlas.org/datasets/nurse-practitioner-scope-of-practice-1460402165

 

Disscussion 2

Comparison of at least two APRN board of nursing regulations in your state/region.

Regulations are the governing laws for the the APRN to follow in their state of licensure. When comparing the state of Maryland to Alaska, APRNs are similar in that they both can practice independently. This autonomy allows the nurse practitioners to safely evaluate, diagnose, analyze test and manage treatment plans for the patient. The APRNs for the the state of Maryland and Alaska are also similar because they both are required to sign a Collaboration Practice Agreement with a experienced nurse practitioner or physician. Signing the Collaboration Practive Agreement assures a complementary working relationship with the providers and promotes safe nursing practice. Majority of states require collaborative prescribing agreements between advance practice nurse and physician (Kaas, et. al., 2000).Module 3 week 5 Discussion.

Describe how they may differ. Be specific and provide examples.

Even though nurse practitioners in the state of Maryland can work independently, they are still required to have a physician involvement/requirement for the first 18 months of practicing (Ann. Code Maryland Section 8-302 (b) (5). In the state of Alaska, the physician involvement is not required to practice (12 Alaska Admin. Code 44. 400). Some examples for the licensed maryland nurse practitioner are the nurse practitioner can sign a death certificate, issue emergency DNR orders, verify that an underage female may get married if pregnant or has just deliver a child. The nurse practitoner in Alaska has to apply to deliver health care services. The NP has to submit a written consultation and referral plan that describes the method and documentation process for routine documentation and referrals ( American Medical Association, 2019).

Explain how the regulations selected apply to the Advanced Practice Registered Nurses (APRN) who have legal authority to practice with the full scope of their education and experience.Module 3 week 5 Discussion.

The regulations allow the nurse practitioner to safely practice, evaluate, diagnose and treat patients within those guideline that have been put in place by the board of nursing. The nurse practitioner can gain more knowledge by attending trainings and seminars to assure they are competent. The nursing regulation bodies (NRBs) that comprise NCSBN to protect the publice health and welfare by assuring that safe and competent nursing care is provided by the licensed nurses (National Council of State Board of Nursing, Inc., 2019).Module 3 week 5 Discussion.

Provide at least one example of how APRNs may adhere to the two regulations selected.

APRNs may adhere to the two regulations selected is by stating current with educational information regarding their scope of practice, practicing within their scope of practice and collaborating with experienced nurse practitioner and physicians in their field. NP licensure is based on NP education and certification that competency based with population foci, and credentialing by employers should align with these parameters. Continuing to work toward a more common NP SOP between states and achievement of full practice authority means periodic reassessment of NP education and practice models (Hudspeth & Klein, 2019).Module 3 week 5 Discussion.

References

American Medical Association. (2019). Advocacy Resource Center. Retrieved from https://journal of ethics.ama-assn.org

Hudspeth, R. S. P. M. M. A.-C. F. F., & Klein, T. A. P. A.-C. F. F. F. (Assistant P. P. C. (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. Retrieved from

https://search-ebscohost-com.ezp.waldenulibrary.org/login.aspx?

Kaas, M., Dehn, D., Dahl, D., Frank, K., Markely, J., & Hebert, P. (2000). A view of prescriptive practice collaboration: Perspectives of psychiatric mental health clinical

nurse specialists and psychiatrists. Archives of Psychiatric Nursing, 14(5), 222-234. https://doi-

org.ezp.waldenulibrary.org/10.1053/apnu2000.9813

National Council of State Board of Nursing. (2019). Nursing Regulation. Retrieved from https://www.ncsbn.orgs

Reponse to discussion2:………..
3 Refrences to discusion 2:………

Discussion 1
The author offers an analysis of the comparisons between nurse regulatory environments in the states of Maryland and Colorado. It is particularly informative on the regulatory requirements for APRN practice in the two states, noting how a transition period is required before an APRN can be allowed to practice independently and with full authority. Another notable regulation concerns liability insurance with the State of Colorado requiring a liability insurance while the State of Maryland does not require one.Module 3 week 5 Discussion.Module 3 week 5 Discussion.

The two regulations are described as instrumental in familiarizing APRN with the practice environment and protecting them from any intentional or accidental harm caused in the process of completing their professional duties and responsibilities. Also, the discussion presents an understanding of how APRN can adhere to the two regulations. Although the discussion is informative, there was a need for the author to include more details. Firstly, there is a need to mention that the two states offer APRN full practice authority status whereby the state licensure and practice laws act through the state Board of Nursing. They allow nurses to evaluate and diagnose patients, order and interpret diagnostic tests, and initiate and management treatments. Secondly, the State of Colorado requires that APRN follow the board of nursing laws as the practice act, while the State of Maryland requires that APRN observe the nurse practice act.Module 3 week 5 Discussion. Generally, the two states follow a full practice model that allows them to practice under the exclusive license of the state board of nursing as recommended by the National Council of State Boards of Nursing, and the Institute of Medicine (Nursing Licensure, 2019; Online FNP Programs, 2019; Policy Surveillance Program Staff and National Nurse-Led Care Consortium, 2015). Overall, the analysis has been well conducted with information relevant to APRN seeking to practice in the two states of Colorado and Maryland.Module 3 week 5 Discussion.Module 3 week 5 Discussion.
Discussion 2
The author offers a comparison of the APRN practice environments in the states of Maryland and Alaska. In fact, it compares and contrasts regulations for APRN practice as presented by the state board of nursing. It notes that an APRN would only be allowed to practice in the state of licensure, a regulation that holds true for both the states of Maryland and Alaska. Next it notes that collaboration practice agreements are a requirement in both states, with newly qualified APRN expected to sign them with an experienced nurse practitioner or physician to indicate a complementary and collaborative relationship. In addition, the essay explores the differences between the APRN practice regulations for the two states, mentioning the specific codes and how they affect nurses with regards to independent practice. Besides that, the essay discusses how the regulations mentioned have improved APRN practice safety and quality.Module 3 week 5 Discussion. The discussion is informative, but there is a need for a more comprehensive discussion. Firstly, there is a need to mention that although APRN have full prescriptive authority with licensure in the two states, there are some restrictions concerning controlled substances and opioids. Module 3 week 5 Discussion.This restriction is intended to combat prescriptive drugs abuse, particularly opioids. Secondly, all practice authority is determined by the state board of nursing that issues licenses. Thirdly, the practice requirements are presented in the Nurse Practice Act for the State of Maryland, and the Nursing Statutes for the State of Alaska. Besides that, there is a notable difference between the APRN practices in the two states with the State of Maryland requiring that all nurses register with the Prescription Drug Monitoring Program (PDMP) while the State of Alaska requires that all APRN file a separate application for prescribing schedule 2-5 controlled substances (American Association of Nurse Practitioners, 2019; Nurse Practitioner Schools, 2019). Overall, the author has offered a comprehensive analysis of the APRN practice environments in the states of Maryland and Alaska.Module 3 week 5 Discussion.Module 3 week 5 Discussion.

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