PRAC 6568 WEEK 1 ASSIGNMENT: CERTIFICATION AND LICENSURE
PRAC 6568 WEEK 1 ASSIGNMENT: 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.
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.
- American Association of Nurse Practitioners (n.d.-a). Nurse practitioners in primary care.Links to an external site. https://www.aanp.org/images/documents/publications/primarycare.pdf
- American Association of Nurse Practitioners. (2019). State practice environmentLinks to an external site.. https://www.aanp.org/advocacy/state/state-practice-environment On the map on the webpage, click on your state and review.Links to an external site.
- American Nurses AssociationLinks to an external site.. (2020). https://www.nursingworld.org/
- American Association of Nurse PractitionersLinks to an external site.. (2020). https://www.aanp.org/
- American Nurses Credentialing Center.Links to an external site. (2020). https://www.nursingworld.org/ancc/
- Centers for Disease Control and Prevention.Links to an external site. (2020). https://www.cdc.gov/
- Office of Disease Prevention and Health Promotion. (2020a). Development of the national health promotion and disease prevention objectives for 2030.Links to an external site. https://www.healthypeople.gov/2020/About-Healthy-People/Development-Healthy-People-2030
- Poghosyan, L. (2018). Federal, state, and organizational barriers affective nurse practitioner workforce and practiceLinks to an external site.. Nursing Economics, 36(1), 43–45.
- World Health Organization.Links to an external site. (2020). https://www.who.int/
Required Media
- Walden University. (2020e). Walden graduation and next steps [Video]. Walden University Canvas. https://waldenu.instructure.com
Walden 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 Nursing
Dr. 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.html
Note: 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
| 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 pts | ||||
| This criterion is linked to a Learning OutcomeMain Posting: Writing |
|
6 pts | ||||
| This criterion is linked to a Learning OutcomeMain Posting: Timely and full participation |
|
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 pts | ||||
| This criterion is linked to a Learning OutcomeFirst Response: Writing |
|
6 pts | ||||
| This criterion is linked to a Learning OutcomeFirst Response: Timely and full participation |
|
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 pts | ||||
| This criterion is linked to a Learning OutcomeSecond Response: Writing |
|
6 pts | ||||
| This criterion is linked to a Learning OutcomeSecond Response: Timely and full participation |
|
5 pts | ||||
| Total Points: 100 | ||||||
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