Advanced Practice Nursing Case Study
Advanced Practice Nurses (APNs) are often primary care providers and are at the forefront of providing preventative care to the public. APN practice is typically defined by the Nurse Practice Act and governed by the states Board of Nursing, but other laws and regulations may impact practice, and other boards may play a role. The purpose of this paper is to develop a greater understanding of the scope of practice for nurse practitioners within the state of Oklahoma. Oklahoma’s mission for nurse practitioners is to promote, advance, and support high standards of health care delivery. The Association of Oklahoma Nurse Practitioners (AONP) and the Oklahoma Board of Nursing will help recognize professional guidelines for which Advanced Practice
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Nurses (APNs) must follow within the state.
Governance The Oklahoma state practice act can be found on the Oklahoma state board of nursing website. Laws, policies, and procedure guidelines for the state can be found within the act. A collaborative agreement with a physician is not required for a nurse practitioner to practice within the state however prescriptive supervision is required. With prescription collaboration being required most nurse practitioners within the state choose to work collaboratively with a physician. Primarily the Oklahoma board of nursing regulates rules for supervision of APNs with prescriptive authority. The Oklahoma medical Board does not have prior notification or approval of the supervising agreement between physicians and APNs. The Oklahoma State Board of Nursing regulates advanced Practice Nurses and issues the supervisory agreements. The medical board however does periodically review the list of doctors supervising these APNs. Therefore responsibility falls on the MD agreeing to be the APN's supervisor to be sure that he/she meets all regulations (Zumwait, 1999)
Scope of Practice
The APN in accordance with Oklahoma Nursing Practice Act may prescribe medications that are within the APN’s scope of practice, under the medical direction of a supervising physician and that is in compliance with the exclusionary formulary.
The APN with prescriptive authority shall prescribe no more than a 30-day supply of Schedule III-V drugs. All Schedule I and II controlled substances cannot be prescribed by the APN with prescriptive authority (Exclusionary Formulary, 2015). To obtain prescriptive authority within the state of Oklahoma, a APN must be able to provide evidence forty-five contact hours or three academic credit hours of education in pharmacotherapeutics, clinical application, and use of pharmacological agents in the prevention of illness, restoration, and maintenance of health in a program beyond basic registered nurse preparation, that has been approved by the Board. Such contact hours or academic credits shall be obtained within a time period of three years immediately preceding the date of application for prescriptive authority (Oklahoma Nurse Practice Act, 2015). Physician supervision is required in order for nurse practitioners to prescribe in Oklahoma. The supervision arrangement must be outlined in a written agreement. The physician is to be available for consultation, assistance, or patient referral through direct contact, by phone, or other means of communication but is not required to be physically present with the NP. In order to prescribe controlled substances, nurse practitioners are required have a DEA number. Nurse practitioners practicing in Oklahoma are allowed to sign handicap-parking permits but are not permitted to sign death
certificates.
Conclusion
Given the variation between APNs and related state statutes, rules and regulations, it is essential that APNs have a clear understanding of how their scope of practice is defined within their specific state of practice.
Nurses (APNs) must follow within the state.
Governance The Oklahoma state practice act can be found on the Oklahoma state board of nursing website. Laws, policies, and procedure guidelines for the state can be found within the act. A collaborative agreement with a physician is not required for a nurse practitioner to practice within the state however prescriptive supervision is required. With prescription collaboration being required most nurse practitioners within the state choose to work collaboratively with a physician. Primarily the Oklahoma board of nursing regulates rules for supervision of APNs with prescriptive authority. The Oklahoma medical Board does not have prior notification or approval of the supervising agreement between physicians and APNs. The Oklahoma State Board of Nursing regulates advanced Practice Nurses and issues the supervisory agreements. The medical board however does periodically review the list of doctors supervising these APNs. Therefore responsibility falls on the MD agreeing to be the APN's supervisor to be sure that he/she meets all regulations (Zumwait, 1999)
Scope of Practice
The APN in accordance with Oklahoma Nursing Practice Act may prescribe medications that are within the APN’s scope of practice, under the medical direction of a supervising physician and that is in compliance with the exclusionary formulary.
The APN with prescriptive authority shall prescribe no more than a 30-day supply of Schedule III-V drugs. All Schedule I and II controlled substances cannot be prescribed by the APN with prescriptive authority (Exclusionary Formulary, 2015). To obtain prescriptive authority within the state of Oklahoma, a APN must be able to provide evidence forty-five contact hours or three academic credit hours of education in pharmacotherapeutics, clinical application, and use of pharmacological agents in the prevention of illness, restoration, and maintenance of health in a program beyond basic registered nurse preparation, that has been approved by the Board. Such contact hours or academic credits shall be obtained within a time period of three years immediately preceding the date of application for prescriptive authority (Oklahoma Nurse Practice Act, 2015). Physician supervision is required in order for nurse practitioners to prescribe in Oklahoma. The supervision arrangement must be outlined in a written agreement. The physician is to be available for consultation, assistance, or patient referral through direct contact, by phone, or other means of communication but is not required to be physically present with the NP. In order to prescribe controlled substances, nurse practitioners are required have a DEA number. Nurse practitioners practicing in Oklahoma are allowed to sign handicap-parking permits but are not permitted to sign death
certificates.
Conclusion
Given the variation between APNs and related state statutes, rules and regulations, it is essential that APNs have a clear understanding of how their scope of practice is defined within their specific state of practice.