NURS 6050 Professional Nursing and State-Level Regulations

NURS 6050 Professional Nursing and State-Level Regulations

Boards of Nursing (BONs) exist in all 50 states, the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, and the Virgin Islands. Similar entities may also exist for different regions. The mission of BONs is the protection of the public through the regulation of nursing practice. BONs put into practice state/region regulations for nurses that, among other things, lay out the requirements for licensure and define the scope of nursing practice in that state/region.
It can be a valuable exercise to compare regulations among various state/regional boards of nursing. Doing so can help share insights that could be useful should there be future changes in a state/region. In addition, nurses may find the need to be licensed in multiple states or regions.
To Prepare:
• Review the Resources and reflect on the mission of state/regional boards of nursing as the protection of the public through the regulation of nursing practice.
• Consider how key regulations may impact nursing practice.
• Review key regulations for nursing practice of your state’s/region’s board of nursing and those of at least one other state/region and select at least two APRN regulations to focus on for this Discussion.
NURS 6050 Professional Nursing and State-Level RegulationsBy Day 3 of Week 5
Post a comparison of at least two APRN board of nursing regulations in your state/region with those of at least one other state/region. Describe how they may differ. Be specific and provide examples. Then, 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. Provide at least one example of how APRNs may adhere to the two regulations you selected.
By Day 6 of Week 5
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.
Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.
*Note: Throughout this program, your fellow students are referred to as colleagues.
3 months ago
Adesola Adedapo
RE: Discussion – Week 5
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A Comparison of APRN Illinois Board of Nursing and Iowa Board of Nursing.

NURS 6050 Professional Nursing and State-Level RegulationsI will be comparing the two states where I have practiced.
Firstly, Nurse practitioner is a registered nurse educated in the disciplines of nursing who has advanced knowledge of nursing, physical and psychological assessment, appropriate interventions, and management of health care, and who possesses evidence of current certification by a national professional nursing certifying body approved by the board (AANP, 2021).
The difference between APRN in Illinois and Iowa is that a nurse practitioner in Illinois requires physician involvement for diagnosis and treatment. In contrast, a nurse practitioner in Iowa does not need a physician involvement in this decision making. In Illinois, a collaborative practice agreement is required for all clinical practice, except for practice within a hospital or ambulatory surgical treatment center.
In Illinois, APRN must consult with their collaborating physician at least once a month, but this doesn’t happen in Iowa.
For example, a mental health nurse practitioner in the state of Iowa has an autonomy to diagnose a psychiatric condition and prescribe medications for these set of patients, including controlled substances.

References
AANP. (2021). What’s a nurse practitioner (NP)? American Association of Nurse Practitioners. https://www.aanp.org/about/all-about-nps/whats-a-nurse-practitioner
Advanced registered nurse practitioner – Role & scope. (2020, October 10). Iowa Board of Nursing | Kathleen R. Weinberg, MSN, RN, Executive Director. https://nursing.iowa.gov/practice/advanced-registered-nurse-practitioner-role-scope
Advocacy Resource Center. (2017). Nurse Practitioner Practice Authority. American Medical Association. https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/specialty%20group/arc/ama-chart-np-practice-authority.pdf
Illinois Nursing Workforce Center. (2019). Illinois General Assembly. https://www.ilga.gov/commission/jcar/admincode/068/068013000D04400R.html

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3 months ago
Faisal Aboul-enein Walden Instructor Manager
RE: Discussion – Week 5
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Great comparison between two states, so which state benefits in lowering costs and improving outcomes when NP’s are independent to practice?
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3 months ago
Adesola Adedapo
RE: Discussion – Week 5
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Thank you, Dr. A.E. Due to the fact that Iowa board of nursing nurse practitioners have the autonomy to practice independently, I would say Iowa benefit in lowering costs and improving outcomes because NPs are independent to practice. Overall, NPs provide equivalent or improved medical care at a lower total cost than physicians. NPs in a physician practice potentially decrease the cost of patient visit by as much as one-third, particularly when seeing patient in an independent, rather than complementary manner (AANP, 2016). References Nurse practitioner cost effectiveness. (2016). American Association of Nurse Practitioners. https://www.aanp.org/advocacy/advocacy-resource/position-statements/nurse-practitioner-cost-effectiveness
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3 months ago
Miki Campbell
RE: Discussion – Week 5
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Hi, Adesola
Thank you for your post! It just makes me realize that the Nurse Practice Act varies in states. I compared rules and regulations of the state in Tennessee and Hawaii, and they share similar rules yet are still different. First of all, Tennessee is a restricted practice state for nurse practitioners, so they require a professional healthcare licensee like a physician to supervise NPs. In fact, the Board of Nursing in TN mentions having a supervisee for NPs. However, the state of Hawaii is a full practice state where NPs have complete autonomy. Iowa is the same as Hawaii. And Illinois must be a reduced practice authority state for NPs (American Association of Nurse Practitioners, 2021)
The more I learn about the Nurse Practice Act, the more I realize how laws are made and how hard it must have been to create the policies. The policy is how we practice in our workplace, and the Nurse Practice Act is literally our guidebook. I researched a little about the original intent of the nurse practice act. The original intention of creating nurse practice acts was regulating nursing practice through registration, which we now call licensure. Martin & Zolnierek states that “North Carolina was the first state to enact nurse registration law in 1903. The first licensure exam was created in 1904. And Texas was the first state to require registration of nurses through a Board of nursing, creating the first nurse practice act in Texas”.

References
American Association of nurse practitioners. (2021, 9 27). Retrieved from Advocacy: https://www.aanp.org/advocacy/state/state-practice-environment

Martin, E., & Zolnierek, C. (2020). Beyond the Nurse Practice Act: Making a Difference through Advocacy. Online Journal of Issues in Nursing, 25(1), N.PAG. https://doi-org.ezp.waldenulibrary.org/10.3912/OJIN.Vol25No01Man02

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3 months ago
Elizabeth Smith
RE: Discussion – Week 5
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Good evening Adesola,
Thank you for pointing out the differences between nursing board regulations in Iowa and Illinois. I wanted to understand why some states allow ARNPs the liberty to practice independently but in other states, they are not allowed. I wondered if the more rural states tended to give more liberty to the nursing profession in this regard. According to the online Family Nurse Practitioner (FNP) program from the Simmons School of Nursing (n.d.), lawmakers are working on expanding the nurse practitioner’s (NP) role to underserved areas because primary care physicians are in such short supply in these areas. More importantly, studies show that when the scope of practice for NPs is expanded, the quality of patient outcomes is not reduced (Ortiz et al., 2018).
References:
Ortiz, J., Hofler, R., Bushy, A., Lin, Y., Khanijahani, A., & Bitney, A. (2018, June 15). Impact of nurse practitioner practice regulations on rural population health outcomes. Healthcare (Basel, Switzerland), 6(2), 65. https://doi.org/10.3390/healthcare6020065
Simmons School of Nursing. (n.d.). Where can nurse practitioners work without physician supervision? Retrieved from https://online.simmons.edu/blog/nurse-practitioners-scope-of-practice-map/

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3 months ago
JOY PRYOR
Initial Discussion – Week 5 J. Pryor
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NURS 6050 Professional Nursing and State-Level RegulationsAn Advanced Registered Nurse Practitioner (ARNP) is a certified registered nurse who has completed national certification for a specialized area (Arizona Board of Nursing, 2020) such as Psychiatric Mental Health Nurse Practitioner (PMHNP). This nurse will compare the regulations from two of the places she has lived in, Alaska and Arizona

According to Ariz. Rev. Ann § 32-1601(20) (ARNP) has full independent authority and practice under licensure authority of the State Board of Nursing instead of a licensed physician (NCSL Scope of Practice Policy, 2021). The same is true in Alaska, (ARNP) have full independence to practice without the supervision of a physician according to Alaska Admin. Code §12-44.400. This means that both states allow (ARNP) to
1. Examine a patient and establish a medical diagnosis by client history, physical examination, and other criteria.
2. For a patient who requires the services of a health care facility: Order and interpret laboratory, radiographic, and other diagnostic tests, and perform those tests that the RNP is qualified to perform.
1. Admit the patient to the facility,
2. Manage the care the patient receives in the facility, and
3. Discharge the patient from the facility.
3.
4. Prescribe, order, administer and dispense therapeutic measures including pharmacologic agents and devices if authorized under R4-19-511, and non-pharmacological interventions including, but not limited to, durable medical equipment, nutrition, home health care, hospice, physical therapy, and occupational therapy.
5. Identify, develop, implement, and evaluate a plan of care for a patient to promote, maintain, and restore health.
6. Perform therapeutic procedures that the RNP is qualified to perform.
7. Delegate therapeutic measures to qualified assistive personnel including medical assistants under R4-19-509.
8. Perform additional acts that the RNP is qualified to perform and that are generally recognized as being within the role and population focus of certification. (ARIZONA STATE BOARD OF NURSING, 2017)
One key difference is in the prescribing and dispensing authority within each state. Arizona requires that evidence of a minimum of 45 contact hours of education within the three years immediately preceding the application be submitted, covering one or both of the following topics consistent with the population focus of education and certification: Pharmacology, or Clinical management of drug therapy (ARIZONA STATE BOARD OF NURSING, 2017). While Alaska requires the applicant to provide evidence of completion of 15 contact hours of education in advanced pharmacology and clinical management of drug therapy within the two-year period immediately before the date of application (DIVISION OF CORPORATIONS, BUSINESS AND PROFESSIONAL LICENSING, 2021)
NURS 6050 Professional Nursing and State-Level RegulationsReferences:
Arizona Board of Nursing. (2020, July 24). Arizona Board of Nursing Scope of Practice APRN Questions & Answers SCOPE OF PRACTICE Nurse Practitioners. Retrieved from Arizona Board of Nursing: https://www.azbn.gov/sites/default/files/2020-11/FAQs%20Final%20Questions-%20NP%207.24.20%20%281%29.pdf
ARIZONA STATE BOARD OF NURSING. (2017, July 1). RULES OF THE STATE BOARD OF NURSING. Retrieved from ARIZONA STATE BOARD OF NURSING: https://www.azbn.gov/sites/default/files/2018-12/rulesjuly12017final.pdf
DIVISION OF CORPORATIONS, BUSINESS AND PROFESSIONAL LICENSING. (2021). Statutes and Regulations Nursing Nursing. DEPARTMENT OF COMMERCE, COMMUNITY, AND ECONOMIC DEVELOPMENT (p. 23). State of Alaska.
NCSL Scope of Practice Policy. (2021). State Overview: Arizona. Retrieved from NCSL Scope of Practice Policy: https://scopeofpracticepolicy.org/states/az/