Respond to at least two of your colleagues* on two different days and explain how the regulatory environment and the regulations selected by your colleague differ from your state/region. Be specific and provide examples.
Colleague 1
Discussion – Week 5
COLLAPSE
Prescriptive authority for nurse practitioners varies from state to state. Certain locations require extensive training, additional coursework, or a certain number of supervised hours under a physician. Where I reside in Washington State, physician involvement is not required for prescriptive authority (American Medical Association, 2017). Additionally, in Washington State, nurse practitioners can prescribe schedule II-V controlled substances, must be registered with the Drug Enforcement Agency, and prescribers must complete 30 hours of pharmacotherapeutics education (American Medical Association, 2017). However, in Florida, nurse practitioners must preserve a written collaborative agreement with a physician for prescriptive authority (American Medical Association, 2017). Currently, only psychiatric mental health nurse practitioners are able to prescribe schedule III-V controlled substances to patients under the age of 18 (American Medical Association, 2017). Currently, nurse practitioners have a 7-day limit for prescribing schedule II controlled substances, with the exception of psychiatric nurse practitioners (American Medical Association, 2017).
Furthermore, in Florida, nurse practitioners are prohibited from discharging a patient from an involuntary psychiatric hold (Baker Act), if the initial examination was completed by a psychiatrist unless the discharge has been authorized by a psychiatrist (Florida Board of Nursing, 2015). In Washington State, nurse practitioners are approved to practice without any physician involvement because Washington State law views nurse practitioners as fully qualified to assume accountability for the care of patients, as they are primarily responsible for all aspects of care (Washington State Hospital Association, 2020). The Involuntary Treatment Act permits psychiatric mental health nurse practitioners to assess, treat, and make recommendations about mental health and stability, without the oversight of a physician (Washington State Hospital Association, 2020).
Psychiatric mental health nurse practitioners in Washington State are permitted to work to the full extent of their scope of practice. They would be able to assess a patient to determine if they meet the criteria for involuntary hospitalization for a mental health reason as outlined by the Involuntary Treatment Act. Additionally, the nurse practitioner would be able to prescribe controlled substances from schedule II-V when required. This is an example of how the nurse practitioner would be able to practice and adhere to the regulations in Washington State.
References
Florida Board of Nursing. (2015). Chapter 2015-111, laws of Florida: psychiatric nurses. Retrieved from Florida Board of Nursing » New Law to Take Effect July 1, 2015 – Licensing, Renewals & Information (floridasnursing.gov)
American Medical Association. (2017). State law chart: nurse practitioner prescriptive authority. Retrieved from State Law Chart: Nurse Practitioner Prescriptive Authority (ama-assn.org)
Washington State Hospital Association. (2020). Bulletin: changes to the involuntary treatment act (ITA)- part 1- key changes. Retrieved from Bulletin: Changes to the Involuntary Treatment Act (ITA) – Part 1 – Key Changes – Washington State Hospital Association (wsha.org)
Required Readings
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.
Chapter 4, “Government Response: Regulation” (pp. 57–84)
American Nurses Association. (n.d.). ANA enterprise. Retrieved September 20, 2018, from http://www.nursingworld.org
Bosse, J., Simmonds, K., Hanson, C., Pulcini, 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.
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 Council of State Boards of Nursing (NCSBN). (n.d.). Retrieved September 20, 2018, from https://www.ncsbn.org/index.htm
Neff, D. F., Yoon, S. H., Steiner, R. L., Bumbach, M. D., Everhart, D., & Harman J. S. (2018). The impact of nurse practitioner regulations on population access to care. Nursing Outlook, 66(4), 379–385. doi:10.1016/j.outlook.2018.03.001
Peterson, C., Adams, S. A., & DeMuro, P. R. (2015). mHealth: Don’t forget all the stakeholders in the business case. Medicine 2.0, 4(2), e4.
Last Completed Projects
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