Response to Week 1 Discussion Post Paper

Response to Week 1 Discussion Post Paper

Your post provides an accurate and insightful discussion of Mississippi’s rules and regulations regarding licensure requirements for registered nurses and advanced practice registered nurses (APRNs). For instance, I concur with your contentions regarding various barriers to practice for nurse practitioners and APRNs in Mississippi. According to the American Association of Nurse Practitioners (AANP, 2022), Mississippi is among states with practice and licensure laws that restrict the nurses’ ability to engage in at least one element of nursing practice. Compared to states with laws that grant full practice, NPs and APRNs in Mississippi must embrace a career-long collaborative agreement with another healthcare provider to provide patient care (Petersen, 2017). Although states’ laws and regulations regarding operational scopes of APRNs vary, the stipulations on certification and licensure requirements remain relatively similar, alongside the procedure for certification application. Undoubtedly, your post adequately captures all the state’s provisions on nursing certification, application procedures, DEA license, state’s practice agreement, and the presence of a prescription monitoring program (PMP).

As much as I agree with your perspective on barriers to nurses’ independent practice in Mississippi, it is essential to add the state should revise practice and licensure laws to allow nurse practitioners to engage in all elements of nursing practice, including patient evaluation, interpretation of diagnostic tests, medication prescription and controlled substances, and treatment initiation and management. According to Ortiz et al. (2018), relaxing the scope of practice restrictions could enable APRNs to meet the critical demand for primary care, especially in constrained areas such as rural areas. Another challenge that compromises the mobilization of nursing workforce is a lack of a multistate licensure for advanced practice registered nurses (Batchel et al., 2020). Amidst the need to address these regulatory barriers, it is essential for nurses to advocate for the relaxation of practice and licensure laws. In essence, they can influence policies and laws through lobbying, joining professional organizations to push for their agenda, and applying their reputable knowledge and experience to advise legal committees in law-making chambers.

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References

American Association of Nurse Practitioners. (2022, April 15). State practice environment. https://www.aanp.org/advocacy/state/state-practice-environment

Bachtel, M. K., Hayes, R., & Nelson, M. A. (2020). The push to modernize nursing regulations during the pandemic. Nursing Outlook, 68(5), 545–547. https://doi.org/10.1016/j.outlook.2020.05.006

Ortiz, J., Hofler, R., Bushy, A., Lin, Y., Khanijahani, A., & Bitney, A. (2018). Impact of nurse practitioner practice regulations on rural population health outcomes. Healthcare, 6(2), 65. https://doi.org/10.3390/healthcare6020065

Peterson, M. E. (2017). Barriers to practice and the impact on health care: A nurse practitioner focus. Journal of the Advanced Practitioner in Oncology, 8(1), 74–81. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5995533/

 

Respond to this person\’s post using the instructions,thank you.Respond to at least two of your colleagues on 2 different days in one or more of the ways listed below.

Share an insight from having viewed your colleagues’ posts.
Suggest additional actions or perspectives.
Share insights after comparing state processes, roles, and limitations.
Suggest a way to advocate for the profession.
Share resources with those who are in your state.

2 days agoTiffany Edwards
Week 1 Discussion Post- Tiffany Edwards Attachment
COLLAPSE
Certification and Licensure Plan

The role of the Mississippi Board of Nursing is to provide rules and regulations for the licensure of registered nurses and advanced practice registered nurses. The function of the board also includes regulating the practice of nursing by establishing scope of practice. Nurse Practitioner’s (NP) shall practice according to the standards and guidelines of the national certification organization for which they are certified (Mississippi Board of Nursing [MSBON], n.d.).

Does Mississippi require physician collaboration or supervision for nurse practitioners, and if so, what are those requirements?

Mississippi State law requires that Nurse Practitioners practice in collaboration with a physician. Each physician can supervise no more than four drug-prescribing Nurse Practitioner\’s. Practitioners must collaborate with one or more doctors within 75 miles of the NP\’s clinic (MSBON, n.d.). However, the collaborating physician does not need to be present with the NP when the services are furnished or to make an independent evaluation of each patient who is seen by the NP. Collaborating physician\’s and nurse practitioners must have jointly-developed, written protocols covering all major elements of practice. The supervising physician is then required to randomly review up to 20 of the nurse practitioner’s patient charts and meet with the nurse practitioner once every quarter (MSBON, n.d.).

How do you get certified and licensed as an Advanced Practice Registered Nurse (APRN) in Mississippi?

A prospective advanced practice nurse must earn a degree at the master\’s level or higher. The program is to include clinical experience. It is to be nationally accredited through an agency approved by the Board. Once an NP completes a Master’s leveled agree from an approved and accredited educational institution, certification must be obtained. Certification is obtained by sitting for a National Board Certified examination that consist of questions for perspective course of study (MSBON, n.d.). Any nurse desiring to be certified as an advanced practice registered nurse shall apply to the board and submit proof that he or she holds a current license to practice professional nursing and that he or she meets one or more of the following requirements: satisfactory completion of a formal post-basic educational program of at least one academic year, certification by a board-approved certifying body, or graduation from a program leading to a master\’s or post-master\’s degree in a nursing clinical specialty area with preparation in specialized practitioner skills. Applicants for Mississippi Board of Nursing (Board) APRN certification must be currently licensed as a Registered Nurse in Mississippi or hold an active unrestricted Registered Nurse multi-state Compact license. Applicants for licensure must submit an online application on Nurse gateway. The initial fee for licensure is $100 in addition to a $75 background check fee, and $100 Controlled Substance Prescriptive Authority fee (MSBON, n.d.). The MS licensure process is done online and requires the following documentation: proof of RN license, proof of national nurse practitioner certification, official transcript from an accredited nurse practitioner program, verification of the protocol/practice for each physician with whom you have entered into a collaborative practice agreement, completion of a fingerprint-based criminal background check (MSBON, n.d.). The candidates NP license is renewed every two years and Certification is renewed every five years. Initially, to get licensed, a candidate must have a certain number of practice hours prior to a license being obtained. However, the MS Board of Nursing Board of Directors met in 2021 during the peak of COVID-19, and voted to repeal Part 2840, Chapter 1, Rule 1.3 Monitored Practice Hours by an emergency temporary rule. Therefore, monitored hours for APRNs are no longer required to practice in Mississippi. All other licensure requirements pursuant to Miss. Code Ann. Section 73-15-20 (7) and 30 Miss. Admin. Code Part 2840 continue to be mandatory for APRNs to practice in the state of Mississippi.

What is the application process for certification in Mississippi?

NP’s are required by state law to take and pass a national certification exam. The candidate must have completed a master’s degree to sit for the certification examination. The applicant must access the MS BON website or go to https://gateway.licensure.msbn.ms.gov/ . Once site is accessed, candidate must register with demographic information. In addition, candidate must verify graduation from an accredited school, submit an official transcript, and verify that a collaborative agreement has been made or in the process of being made with a Physician (MSBON, n.d.).

What is the Mississippi board of nursing website?

The Mississippi Board of Nursing website is https://www.msbn.ms.gov/.

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How does Mississippi define the scope of practice of a nurse practitioner?

According to the Mississippi Nursing Practice Law §73-15-20(3), NP’s working in the state of MS are under reduced practice. State law modifies patient access to nurse practitioner (NP) care. NPs are required by law to maintain a regulated collaborative agreement with a physician for at least one element of NP practice (AANP, 2020). NP’s may diagnose, treat, and manage medical conditions. This can also include prescriptive authority as identified by the MSBON (Buppert, 2021).

What is included in Mississippi’s state practice agreement?

Mississippi limits the ability of nurse practitioners to practice up to their full training. In Mississippi, the APRN is responsible for gaining approval for practice site & collaborative physician through Board of Nursing prior to beginning to practice. The designated physical location in Mississippi which is usually the practice location must be reported to the Board to conduct a site visit to evaluate the delivery of care by a licensee and compliance with laws and regulations regarding delivery of care by a licensee (MSBON, n.d.).

How do you get a DEA license?

Every certified APRN authorized to practice in Mississippi who prescribes any controlled substances (Schedules II, Ill, IV, or V) within Mississippi or who proposes to engage in the prescribing of any controlled substance within Mississippi must be registered with the U.S. Drug Enforcement Administration (DEA) in compliance with Title 21 CFR Part 1301 Food and Drugs, and must also apply for this privilege with the Mississippi Board of Nursing. DEA registration can only be done after being issued prescriptive authority by the MBON. Registration occurs online at https://www.deadiversion.usdoj.gov (DEA, 2020). The applicant must pay the applicable fees and enter APRN license number on the application as the applicant will not have a state controlled substance number (MSBON, n.d.).

Does Mississippi have a prescription monitoring program (PMP)?

Yes, Mississippi does have a prescription monitoring. The NP can register online after passing boards, receiving licensure, and a DEA number.

How does Mississippi describe a nurse practitioner’s controlled-substance prescriptive authority, and what nurse practitioner drug schedules are nurse practitioners authorized to prescribe?

In the state of Mississippi, NP prescribing protocols must be approved by the Board of Nursing and physician involvement is required for NP prescriptive authority. Additional educational requirements for NP prescriptive authority include completion of a Board approved educational program prior to making application for controlled substance authority (American Medical Association, 2017). NP’s must also submit to the BON documentation of at least 40 contact hours related to the advanced clinical practice of the NP within the last 2 years. Two of these hours must be directly related to the prescription of controlled substances. NP’s have authority to prescribe schedule II-V controlled substances (American Medical Association, 2017).

Explain the types of regulations that exist and the barriers that may impact nurse practitioner independent practice in Mississippi. Describe what surprised you from your research.

MS State licensure regulates NP practice and is a barrier to NPs practicing to the fullest extent of their education and training. NP’s must practice under restricted authority, which in the author’s opinion significantly reduces their efficiency and ability to provide patients with the needed care. Allowing NP’s to practice under full authority can have benefits including mitigating and closing the gap on limited access to care (Peterson, 2017).

Conclusion

In conclusion, safe and competent practice is ensured through regulation. When medical professionals thoroughly understand and comply with all regulations and standards, they practice with confidence, which is reflected in the care they provide to their patients (Ortiz et al., 2018). NP’s are set to play key roles in improving health outcomes of diverse populations.

References

American Association of Nurse Practitioners [AANP]. (2020). State practice environment.

https://www.aanp.org/advocacy/state/state-practice-environment

American Medical Association. (2017). State Law Chart: Nurse Practitioner Prescriptive

Authority. Retrieved June 1, 2022, from https://www.ama-assn.org/sites/ama-

assn.org/files/corp/media-browser/specialty%20group/arc/ama-chart-np-prescriptive-

authority.pdf

Buppert, C. (2021). Nurse practitioner\’s business practice and legal guide (7th ed.). Jones &

Bartlett Learning.

Drug Enforcement Administration Diversion Control Division [DEA]. (2020). Registration.

https://www.deadiversion.usdoj.gov/drugreg/index.html

Mississippi Board of Nursing [MSBON]. (n.d.). Practice and licensure.

https://www.msbn.ms.gov/

Ortiz, J., Hofler, R., Bushy, A., Lin, Y. L., Khanijahani, A., & Bitney, A. (2018). Impact of

Nurse Practitioner Practice Regulations on Rural Population Health

Outcomes. Healthcare (Basel, Switzerland), 6(2), 65.

https://doi.org/10.3390/healthcare6020065

Peterson, M. E. (2017). Barriers to Practice and the Impact on Health Care: A Nurse Practitioner

Focus. Journal of the advanced practitioner in oncology, 8(1), 74–81.

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