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It is incumbent upon every nurse to possess a profound understanding of their state’s regulations, ensuring that their practice aligns with the boundaries set forth by their licensing authority. Each state boasts its unique set of rules and guidelines, necessitating nurses, including midwives, specialty nurses, and nurse anesthetists, to be well-versed in their specific jurisdiction’s regulations. These healthcare professionals play a pivotal role in the healthcare landscape, focusing on patient care, illness prevention, and health management, often catering to underserved populations in rural areas (Kapu, 2021). As a practicing registered nurse pursuing my master’s degree in Pennsylvania, it is imperative to remain cognizant of the evolving obligations to avert potential misconduct within my practice.
Evidence-Based Practice (EBP), Quality Improvement (QI), and Research Discussion
The State Board of Nursing assumes the vital responsibility of licensure, certification, and regulation of various nursing categories in the Commonwealth of Pennsylvania. These categories encompass registered nurses, practical nurses, certified registered nurse practitioners, clinical nurse specialists, dietitian-nutritionists, and graduate nurses practicing professional and practical nursing and dietetics-nutrition. The Board’s multifaceted role includes granting licenses and certifications to eligible candidates, authorizing nursing education programs, establishing practice standards, and disciplining licensees and unlicensed individuals found in violation of the governing Acts and rules (Pennsylvania Department of State, n.d).
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Pennsylvania APRN Board of Nursing Regulations
In Pennsylvania, my current place of residence, nurse practitioners (NPs) possess the authority to diagnose medical conditions, develop and execute treatment plans, order and conduct diagnostic tests, and provide a spectrum of healthcare services. However, this authority is contingent upon the existence of a formal collaboration agreement with a licensed physician. This agreement mandates the physician’s direct accessibility to the NP, either through direct contact or telecommunication, outlines a protocol for emergency services, and necessitates the physician’s routine review of patient charts and records under the NP’s care. Furthermore, a formal collaborative agreement empowers NPs in Pennsylvania to prescribe medications, medical devices, and Schedule II-V controlled substances. In instances where the supervising physician is certified, trained, or licensed to manage patients with opioid use disorder, Pennsylvania NPs, with the requisite training or experience, are eligible to obtain a federal waiver to prescribe buprenorphine-containing medications (Pennsylvania Coalition of Nurse Practitioners, n.d).
Comparison Between Pennsylvania and Texas APRN Board of Nursing Regulations
To illustrate the contrast between Pennsylvania’s and California’s APRN board of nursing regulations, I have selected California as a point of comparison. Pennsylvania operates under a reduced practice model, which stipulates that NPs must deliver patient care exclusively through a regulated collaborative relationship with another healthcare provider or entails certain limitations on NP practice. In contrast, California adheres to a restricted practice model, which mandates that NPs, throughout their careers, operate under the supervision, delegation, or management of another healthcare provider (AANP, n.d).
In California, nurse practitioners collaborate with physicians, with NPs required to function under a physician’s supervision and adhere to standardized protocols (California Board of Nursing, n.d). Conversely, in Pennsylvania, NPs operate under a “collaborative agreement” with physicians to deliver patient care. Notably, California NPs are prohibited from signing death certificates, whereas their counterparts in Pennsylvania possess the authority to certify the cause of death and endorse death certificates (The Hospital & Health System Association of Pennsylvania, n.d).
In conclusion, adherence to these regulations demands that Advanced Practice Registered Nurses (APRNs) remain abreast of evolving education and practices pertinent to their healthcare specialties. Joining professional organizations, such as the American Association of Nurse Practitioners (AANP), provides access to journals and continuous education opportunities, reinforcing their commitment to their profession. Additionally, APRNs can pursue certification and accumulate valuable experience within their respective fields of expertise.
References:
Advanced Practice and Certification. (n.d.). https://www.rn.ca.gov/applicants/ad-pract.shtml#np
American Association of Nurse Practitioners. (2021, January 1). State practice environment. https://www.aanp.org/advocacy/state/state-practice-environment
In the Hospital Setting Pennsylvania Hospital Quality: Achieving More Together. (2021). https://pspa.net/wp-content/uploads/2014/04/HAP2013HospitalSettingMatrixFinal.pdf
Pennsylvania Department of State. https://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/Nursing/Pages/default.aspx
Scope of Practice – Pennsylvania Coalition of Nurse Practitioners. (2020). https://www.pacnp.org/page/ScopeofPractice
Walden University Library. Kapu, A. (2021). Patients are Choosing Nurse Practitioners as Their Primary Care Provider in Many Communities Across the US. The Journal of Nursing Administration, 51(9), 422–423. https://doi-org.ezp.waldenulibrary.org/10.1097/NNA.0000000000001040
Betsy Koplin Discussion: Professional Nursing and State-Level Regulations
Boards of Nursing (BONs) are a presence in every U.S. state, including the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, and the Virgin Islands. In some cases, similar entities may exist for specific regions within states. These BONs share a common mission, which revolves around safeguarding the well-being of the public by overseeing and regulating the practice of nursing. BONs play a pivotal role in translating state and regional regulations into practical guidelines for nurses, including the criteria for obtaining licensure and the delineation of the scope of nursing practice within a given state or region.
Engaging in a comparative analysis of regulations among different state and regional boards of nursing can yield valuable insights. Such comparisons can serve as a proactive measure, providing nurses with a foundation of knowledge that may prove beneficial in anticipation of potential changes within their own state or region. Furthermore, in an increasingly mobile healthcare workforce, nurses may encounter circumstances where they need to hold licenses in multiple states or regions to facilitate their practice.
To Prepare:
- Review the Resources and reflect on the overarching mission of state and regional boards of nursing, which centers on safeguarding the public by regulating nursing practice.
- Consider the potential impact of key regulations on nursing practice.
- Familiarize yourself with the pertinent regulations governing nursing practice in your state or region, as well as those of at least one other state or region. For this Discussion, focus on selecting at least two regulations specifically relevant to Advanced Practice Registered Nurses (APRNs).
By Day 3 of Week 5
Share a comprehensive comparison of at least two APRN board of nursing regulations from your state or region with those of at least one other state or region. Articulate the distinctions between them, offering specific examples to illustrate these differences. Subsequently, elucidate how the regulations you have chosen are applicable to APRNs who possess legal authority to practice within the full scope of their education and experience. Provide a practical example to illustrate how APRNs may adhere to these two selected regulations.
By Day 6 of Week 5
Reply to a minimum of two peers on two separate days, elucidating the distinctions between your colleague’s regulatory context and the regulations they have chosen, in comparison to those governing your own state or region. Provide detailed and specific examples to underscore these variations in the regulatory landscape. This discussion should center on the comparative analysis of regulations, fostering a deeper understanding of the differences that exist among state or regional nursing practice guidelines.
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