ASSIGNMENT: WEEK 1 CERTIFICATION AND LICENSURE

ASSIGNMENT: WEEK 1 CERTIFICATION AND LICENSURE

ASSIGNMENT: WEEK 1 CERTIFICATION AND LICENSURE

PRAC 6568 Week 1 Certification and Licensure Justina
Certification and licensure requirements for advanced practice nurses vary across states in the country based on the scope of practice. In Texas, nursing regulations stipulate that APRNs should practice under the supervision of a physician. In Texas, physicians review patient charts and sign a form that allows NPs to prescribe medications to patients. As a restricted practice environment, nurse practitioners in Texas must work under a physician’s supervision for all of their scope of practice (AANP, 2024).

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Upon the completion of graduate-level education, nurses can apply for certification by taking an exam in their specialties with one of the certifying entities like the American Nurses Credentialing Center and American Academy of Nurse Practitioners (AANP) (Leik, 2021). After certification, the APRN applies using online or paper form by providing official transcript of the graduate degree, evidence of the present certification, consent to release information and payment of $100 to the Board of Nursing, Texas.
The primary nurse licensure office resource website is the Texas Board of Nursing online portal where nurses make their application based on the outlined procedure above (Texas Board of Nursing, 2023). Further, the Texas Board of Nursing asserts that the scope of practice shows the types of patients for whom the APRN can care, the procedures and activities they can perform, and affects their ability to seek reimbursement for services offered. The practice agreement has information relating to APRNs full name, address and all professional license numbers. The practice agreement also requires parties to provide the nature of the practice, location, setting and type of drugs and devices that the APRN can order or prescribe. The agreement should also have a plan for consultation, referral, and dealing with the patients’ emergencies.
Nurse practitioners also apply online for a Drug Enforcement Agency (DEA) license through the Department of Justice website. Texas has a prescription monitoring program which collects and monitors prescription data for controlled substance in outpatient facilities. Therefore, Texas requires nurses to have prescriptive authority based on their DEA license (Texas Board of Nursing, 2024). They can only prescribe medications based on the permitted drug scheduled by the DEA. State nurse practitioner organizations like the Texas chapter of the American Association of Nurse Practitioners (AANP) are involved in legislative and advocacy activities focused on having nurses get full practice authority. Currently, nurse practice authority is restricted and nurse practitioners practice under physician’s supervision (Kleinpell et al., 2023). The restricted practice authority is a critical barriers that affects nurse practitioner independent practice in Texas.
The surprising aspect about the research is the significant efforts by nursing associations to advocate full practice authority for NPs across Texas and other states with restricted practice authority that hinders the ability of nurses to deliver quality care to the extent of their training and education.

References
American Association of Nurse Practitioners (AANP) (2024). State Practice Environment.
https://www.aanp.org/advocacy/state/state-practice-environment
Kleinpell, R., Myers, C. R., & Schorn, M. N. (2023). Addressing Barriers to APRN Practice:
Policy and Regulatory Implications during COVID-19. Journal of Nursing Regulation, 14(1), 13-20. DOI: 10.1016/S2155-8256(23)00064-9
Leik, M. T. C. (2021). Family nurse practitioner certification intensive review (4th ed.). Springer
Publishing Company.
Texas Board of Nursing (2023). Practice – APRN Scope of Practice.
https://www.bon.texas.gov/practice_scope_of_practice_aprn.asp.html
Texas Board of Nursing (2024). Licensure – Endorsement Information.
https://www.bon.texas.gov/licensure_endorsement.asp.html

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CERTIFICATION AND LICENSURE

Now that you are in your final course in your program, it is time to turn in earnest to preparing for certification and licensure. You will need to take and pass a national FNP certification exam.  Once certified, you will then be eligible to apply for licensure as an advanced practice registered nurse (APRN) in the state desired. It will be up to you to ensure you are knowledgeable about the practice agreements, scope of practice, and prescriptive authority in your state.

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Although there is a movement called the APRN Consensus Model to standardize NP regulations nationally, it is still the case that requirements vary state to state. In some states, NPs may establish independent practice without the supervision of an MD. Additionally, states are currently categorized as either allowing full practice, reduced practice, or restricted practice. Full practice states allow NPs to evaluate, order diagnostics, diagnose, and treat patients. They are licensed under the exclusive authority of the state board of nursing for the appropriate state. Many states may require prescriptive authority protocols in addition to collaborative agreement.

Another important area to consider and plan for is prescriptive authority. Prescriptive authority is granted under state law by the appropriate board. The board granting prescriptive authority may be the medical board, state board of pharmacy, or nursing board for the appropriate state licensure being pursued. The authority to write for a controlled substance is granted at a federal level and is verified through the Drug Enforcement Administration (DEA) by the appropriate state board. Drug Enforcement Agency registration is granted at the federal level and has additional requirements/fees for the registration process.

Finally, the legal landscape for NPs is constantly changing as the status of NPs as providers improves on a national level. Legislative changes may occur annually, bi-annually, or during an emergency legislative meeting at the state or federal level. These legislative sessions and any subsequent changes will significantly impact your scope of practice as a nurse practitioner.

For this Discussion, you examine professional issues for your state, including certification and licensure, scope of practice, independent practice, prescriptive authority, and legislative activities.

RESOURCES

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

WEEKLY RESOURCES

LEARNING RESOURCES

Required Readings

  • Leik, M. T. C. (2021). Family nurse practitioner certification intensive review (4th ed.). Springer Publishing Company.
    • Ch. 1, Certification Exam Information
    • Ch. 2, Question Dissection and Analysis
  • Buppert, C. (2021). Nurse practitioner’s business practice and legal guide (7th ed.). Jones & Bartlett.
    • Chapter 1, “What Is a Nurse Practitioner”
    • Chapter 7, “Negligence and Malpractice”
      • See especially the section on “Working with Practice Guidelines.”
    • Appendix 1-A: State-by-State Definitions of Nurse Practitioner
    • Appendix 1-B: State-by-State Titles for Nurse Practitioners

Note: The textbook listed below is from NRNP 6531. Review the chapters assigned in this textbook as needed to refresh your knowledge.

  • Buttaro, T. M., Polgar-Bailey, P., Sandberg-Cook, J., & Trybulski, J. (2021). Primary care: Interprofessional collaborative practice (6th ed.). Elsevier.
    • Ch. 5, An Introduction to Health Care Disparities and Culturally Responsive Primary Care
    • Ch. 6, Patient/Family Education and Health Literacy
    • Ch. 7, Genetic Considerations in Primary Care
    • Ch. 8, Risk Management

RESOURCE WEB LINKS: Please access throughout the quarter as needed.

Required Media

  • Walden University. (2020e). Walden graduation and next steps [Video]. Walden University Canvas. https://waldenu.instructure.comWalden Graduation and Next Steps

    In this video, Dr. Judi Kuric discusses important topics related to the transition from coursework to advanced nursing practice. (35 min)

  • Professional Issues in Advanced Practice NursingDr. Phyllis Morgan discusses important professional issues related to advanced practice nursing. (24m)
  • Walden University. (2022). Test taking strategies: Preparation for your certification exam [Video].Links to an external site. https://lifelonglearning.waldenu.edu/test-taking-strategies-preparation-for-certification/WANC1026.htmlNote: You will need to create an account to access this free resource.

To prepare:

  • Review practice agreements in your state.
  • Identify whether your state requires physician collaboration or supervision for nurse practitioners and, if so, what those requirements are.
  • Research the following:
    • How do you get certified and licensed in your state?
    • What is the application process for certification in your state?
    • What is the primary nurse licensure office resource website in your state?
    • How does your state define the scope of practice of a nurse practitioner?
    • What is included in your state’s practice agreement?
    • How do you get a Drug Enforcement Agency (DEA) license?
    • How does your state describe a nurse practitioner’s controlled-substance prescriptive authority and what nurse practitioner drug schedules are nurse practitioners authorized to prescribe?
    • In what legislative and advocacy activities are your state nurse practitioner organization(s) involved?

BY DAY 3

Post a summary of your findings on your state based on the questions listed above. Explain the types of regulations that exist and the barriers that may impact nurse practitioner independent practice in your state. Be specific. Also, describe what surprised you from your research.

Read a selection of your colleagues’ responses.

BY DAY 6

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.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Reply button to complete your initial post. Remember, once you click on Post Reply, you cannot delete or edit your own posts and you cannot post anonymously. Please check your post carefully before clicking on Post Reply!

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NRNP_6568_Week1_Discussion_Rubric

NRNP_6568_Week1_Discussion_Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeMain Posting:Response to the discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.
44 to >39.0 ptsExcellent Point range: 90–100

Thoroughly responds to the discussion question(s). … Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. … No less than 75% of post has exceptional depth and breadth. … Supported by at least 3 current credible sources.

39 to >34.0 ptsGood Point range: 80–89

Responds to most of the discussion question(s). … Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module. … 50% of the post has exceptional depth and breadth. … Supported by at least 3 credible references.

34 to >30.0 ptsFair Point range: 70–79

Responds to some of the discussion question(s). … One to two criteria are not addressed or are superficially addressed. … Is somewhat lacking reflection and critical analysis and synthesis. … Somewhat represents knowledge gained from the course readings for the module. … Post is cited with fewer than 2 credible references.

30 to >0 ptsPoor Point range: 0–69

Does not respond to the discussion question(s). … Lacks depth or superficially addresses criteria. … Lacks reflection and critical analysis and synthesis. … Does not represent knowledge gained from the course readings for the module. … Contains only 1 or no credible references.

44 pts
This criterion is linked to a Learning OutcomeMain Posting: Writing
6 to >5.0 ptsExcellent Point range: 90–100

Written clearly and concisely. … Contains no grammatical or spelling errors. … Further adheres to current APA manual writing rules and style.

5 to >4.0 ptsGood Point range: 80–89

Written concisely. … May contain one to two grammatical or spelling errors. … Adheres to current APA manual writing rules and style.

4 to >3.0 ptsFair Point range: 70–79

Written somewhat concisely. … May contain more than two spelling or grammatical errors. … Contains some APA formatting errors.

3 to >0 ptsPoor Point range: 0–69

Not written clearly or concisely. … Contains more than two spelling or grammatical errors. … Does not adhere to current APA manual writing rules and style.

6 pts
This criterion is linked to a Learning OutcomeMain Posting: Timely and full participation
10 to >8.0 ptsExcellent Point range: 90–100

Meets requirements for timely, full, and active participation. … Posts main discussion by due date.

8 to >7.0 ptsGood Point range: 80–89

Posts main discussion by due date. … Meets requirements for full participation.

7 to >6.0 ptsFair Point range: 70–79

Posts main discussion by due date.

6 to >0 ptsPoor Point range: 0–69

Does not meet requirements for full participation. … Does not post main discussion by due date.

10 pts
This criterion is linked to a Learning OutcomeFirst Response: Post to colleague’s main post that is reflective and justified with credible sources.
9 to >8.0 ptsExcellent Point range: 90–100

Response exhibits critical thinking and application to practice settings. … Responds to questions posed by faculty. … The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

8 to >7.0 ptsGood Point range: 80–89

Response has some depth and may exhibit critical thinking or application to practice setting.

7 to >6.0 ptsFair Point range: 70–79

Response is on topic, may have some depth.

6 to >0 ptsPoor Point range: 0–69

Response may not be on topic, lacks depth.

9 pts
This criterion is linked to a Learning OutcomeFirst Response: Writing
6 to >5.0 ptsExcellent Point range: 90–100

Communication is professional and respectful to colleagues. … Response to faculty questions are fully answered, if posed. … Provides clear, concise opinions and ideas that are supported by two or more credible sources. … Response is effectively written in Standard, Edited English.

5 to >4.0 ptsGood Point range: 80–89

Communication is mostly professional and respectful to colleagues. … Response to faculty questions are mostly answered, if posed. … Provides opinions and ideas that are supported by few credible sources. … Response is written in Standard, Edited English.

4 to >3.0 ptsFair Point range: 70–79

Response posed in the discussion may lack effective professional communication. … Response to faculty questions are somewhat answered, if posed. … Few or no credible sources are cited.

3 to >0 ptsPoor Point range: 0–69

Responses posted in the discussion lack effective communication. … Response to faculty questions are missing. … No credible sources are cited.

6 pts
This criterion is linked to a Learning OutcomeFirst Response: Timely and full participation
5 to >4.0 ptsExcellent Point range: 90–100

Meets requirements for timely, full, and active participation. … Posts by due date.

4 to >3.0 ptsGood Point range: 80–89

Meets requirements for full participation. … Posts by due date.

3 to >2.0 ptsFair Point range: 70–79

Posts by due date.

2 to >0 ptsPoor Point range: 0–69

Does not meet requirements for full participation. … Does not post by due date.

5 pts
This criterion is linked to a Learning OutcomeSecond Response: Post to colleague’s main post that is reflective and justified with credible sources.
9 to >8.0 ptsExcellent Point range: 90–100

Response exhibits critical thinking and application to practice settings. … Responds to questions posed by faculty. … The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

8 to >7.0 ptsGood Point range: 80–89

Response has some depth and may exhibit critical thinking or application to practice setting.

7 to >6.0 ptsFair Point range: 70–79

Response is on topic, may have some depth.

6 to >0 ptsPoor Point range: 0–69

Response may not be on topic, lacks depth.

9 pts
This criterion is linked to a Learning OutcomeSecond Response: Writing
6 to >5.0 ptsExcellent Point range: 90–100

Communication is professional and respectful to colleagues. … Response to faculty questions are fully answered, if posed. … Provides clear, concise opinions and ideas that are supported by two or more credible sources. … Response is effectively written in Standard, Edited English.

5 to >4.0 ptsGood Point range: 80–89

Communication is mostly professional and respectful to colleagues. … Response to faculty questions are mostly answered, if posed. … Provides opinions and ideas that are supported by few credible sources. … Response is written in Standard, Edited English.

4 to >3.0 ptsFair Point range: 70–79

Response posed in the discussion may lack effective professional communication. … Response to faculty questions are somewhat answered, if posed. … Few or no credible sources are cited.

3 to >0 ptsPoor Point range: 0–69

Responses posted in the discussion lack effective communication. … Response to faculty questions are missing. … No credible sources are cited.

6 pts
This criterion is linked to a Learning OutcomeSecond Response: Timely and full participation
5 to >4.0 ptsExcellent Point range: 90–100

Meets requirements for timely, full, and active participation. … Posts by due date.

4 to >3.0 ptsGood Point range: 80–89

Meets requirements for full participation. … Posts by due date.

3 to >2.0 ptsFair Point range: 70–79

Posts by due date.

2 to >0 ptsPoor Point range: 0–69

Does not meet requirements for full participation. … Does not post by due date.

5 pts
Total Points: 100

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