American Sentinel N521-19B_21 Advanced Pharmacology Assignment 1

Permalink: https://nursingessaygurus.com/american-sentine…ogy-assignment-1/ ‎

Assignment 1

Using peer-reviewed journal articles or evidence-based practice websites locate policy or regulatory position statements or campaigns that support changes in APRN prescribing practices at the state or national level.

In a paper not to exceed six double-spaced pages, excluding title and reference pages, analyze these statements by assessing their alignment with the American Association of Nurse Practitioners (AANP)’s Nurse Practitioner Prescriptive Privilege statement (see AANP Position Statement & Papers). Use the Assignment 1 Rubric below to guide you in completing this assignment.

Assignment 1 Rubric – American Sentinel N521-19B_21 Advanced Pharmacology Assignment 1

Competency	30 points	27 points	25 points	0 points	Points Earned
Policies, regulator position statements, campaigns	Locates multiple policies or regulator position statements or campaigns that support changes in APRN prescribing practices at state and at national level	Locates several state or national level policy or regulator position statement, but not both	Locates only one policy or position statement	Does not locate policies or position statements	/30
peer reviewed journals and evidence-based practice	Applies multiple peer reviewed journals and evidence-based practice websites to the assignment	Applies several peer reviewed journals or evidence-based practice websites to the assignment, but not both	Applies one peer reviewed journals or evidence-based practice websites to the assignment	Does not use peer reviewed journals or evidence-based practice websites in the assignment	/30
Analyzes regulatory position statements by assessing their alignment with the American Association of Nurse Practitioners (AANP)’s Nurse Practitioner Prescriptive Privilege statement. Discusses teamwork and collaboration as it relates to regulatory requirements	Evidence of analysis of regulatory statements and alignment of AANP statements. Discusses teamwork and collaboration as it relates to regulatory requirements. American Sentinel N521-19B_21 Advanced Pharmacology Assignment 1	Evidence of analysis of regulatory statements and alignment of AANP statements. Discusses teamwork and collaboration as it relates to regulatory requirements	Minimal evidence of analysis of regulatory statements and alignment of AANP statements. Discusses teamwork and collaboration as it relates to regulatory requirements	No evidence of analysis of regulatory statements and alignment of AANP statements. No discussion of teamwork and collaboration as it relates to regulatory requirements	/30
Competency	5 points	4 points	3 points	0 points	Points Earned
Grammar, spelling, and punctuation	There are no errors in grammar, spelling, and punctuation	There are a few minor errors in grammar, spelling, and punctuation that do not detract from the meaning	There are major errors in grammar, spelling, and punctuation that do not reflect scholarly writing	NA	/5
APA Compliance	The paper meets APA format guidelines	There are minor APA format errors	There are significant errors in format	NA	/5
Total Points					/100

Discussion 1

Locate your state’s nurse practice act (NPA) and associated regulations governing prescribing by advanced practice nurses (CNPs, CRNAs, CNMs, CNSs). Answer and discuss the following in this forum:

Does your NPA require the APRN to have a collaborative agreement with a physician? Discuss whether you think the NPA should or should not require the APRN to have a collaborative agreement, and explain why/why not.
Does your NPA require the APRN to have a prescribing agreement with a physician? Discuss whether you think the NPA should or should not require the APRN to have a prescribing agreement, and explain why/why not.
Does your NPA permit APRNs to prescribe all classes (schedules) of medications? Discuss whether you think the NPA should or should not permit APRNs to prescribe all classes of medications, and explain why/why not.
Describe collaborative approaches to treating rashes across the lifespan. Should the CNP treat without a collaborator or consultant? Support your statements based upon evidence.

Remember to respond to at least two of your peers. Please see the Course Syllabus for Discussion Participation Requirements and Grading Criteria. American Sentinel N521-19B_21 Advanced Pharmacology Assignment 1

Example Discussion 1 Approach

State of Illinois Nurse Practice Act

Once I complete the MSN Adult Gerontology Primary Care Nurse Practitioner program, I will be practicing in Illinois. It was very helpful to review the Illinois Nurse Practice Act (NPA) specifically focusing on Article 65: Advanced Practice Registered Nurses (Illinois General Assembly, 2021). The regulatory structure for Illinois is considered a “reduced practice state” (AANP, 2021). This means that the law requires the APRN to maintain a collaborative agreement with a physician for at least one element of APRN practice (AANP, 2021). After two to three years of clinical practice with a collaborative agreement with a physician, the APRN can apply for Full Practice authority which requires proof of completion of at least 250 hours of continuing education and at least 4,000 hours of clinical experience after first attaining national certification (Illinois General Assembly, 2021). For the purposes of the discussion, I will focus on the required collaborative agreement with a physician and the collaborative prescribing agreement that is required in the first 2-3 years of practice as an APRN.

Collaborative Agreement

Illinois NPA requires the APRN to have a written collaborative agreement with a physician except for APRNs who are privileged to practice in a hospital, hospital affiliate or ambulatory surgical treatment center. However, the written agreement does not require the physical presence of the physician at the local the services are rendered (Illinois General Assembly, 2021). The physician must be available for consultation by telecommunication of electronic communication if not in person (Illinois General Assembly, 2021). At the same time, “a written collaborative agreement may not (1) restrict the categories of patients of an advanced practice registered nurse within the scope of the advanced practice registered nurses training and experience, (2) limit third party payors or government health programs, such as the medical assistance program or Medicare with which the advanced practice registered nurse contracts, or (3) limit the geographic area or practice location of the advanced practice registered nurse in this State” (Illinois General Assembly, 2021). I agree with this requirement from the Illinois NPA. During the initial 2-3 years of practice as a new APRN, I will feel more comfortable knowing that I have a physician who has agreed to be my collaborating physician who is available to me for questions or issues. After meeting the requirements for Full Practice Authority (2-3 years) I can apply and practice independently. This makes sense to me as I do not feel that it inhibits my practice or limits access and care for patients.

Collaborative Prescribing Agreement

In Illinois, a collaborating physician can delegate prescriptive authority to an APRN as part of a written collaborative agreement as long as the collaborating physician has a current valid Illinois controlled substance license and federal registration to delegate authority to prescribe controlled substances (Illinois General Assembly, 2021). Again, during the initial 2-3 years of practice as a new APRN, I will feel more comfortable knowing that I have a physician who has agreed to be my collaborating physician who is available to me for questions or issues including related to prescribing. After meeting the requirements for Full Practice Authority (2-3 years) I can apply and practice independently. This makes sense to me as I do not feel that it inhibits my practice or limits access and care for patients. American Sentinel N521-19B_21 Advanced Pharmacology Assignment 1

Prescribing All Classes of Medications

This written collaboration and delegation of prescriptive authority includes Schedule III through V controlled substances. APRNs may prescribe Schedule II controlled substances that are oral, topical or transdermal (not injectable) as long as the medication is one that the collaborating physician prescribes regularly and specifically lists as an approved medication that may be prescribes by the APRN (Illinois General Assembly, 2021). I do not think it makes sense for the Illinois NPA to require the physician to specifically list which controlled substances are approved to be prescribed. I believe this is a bit restrictive to practice. An example where this may be an issue is a situation where a patient is appropriate to receive a Schedule II medication, but has an intolerance or allergy to the medication(s) on the approved list. If my collaborating physician is not required to be onsite, and I do not have the authority to write that specific medication the patient can take, I could cause a delay in care for the patient.

Collaborative Approach to Treating Rashes

Rashes and skin conditions are extremely common and vary significantly including allergic contact dermatitis, fungal infections, viral infections, acne, psoriasis, and bacterial infections from impetigo up to necrotizing fasciitis (Arcangelo & Peterson, 2017, pp. 155-217). Because visually identifying the cause of the rash or skin infection is so important, it makes sense to have a dermatologist available for consultation and collaboration. As per the Illinois NPA, the dermatologist would not be required to be onsite if telehealth, telecommunications were available. Because incorrect diagnosis and treatment can cause significant complications such as serious systemic infection if a bacterial skin infection is not treated appropriately or a secondary infection such as osteomyelitis or endocarditis, collaboration with a dermatologist is warranted (Arcangelo & Peterson, 2017, p. 193).

References

American Association of Nurse Practitioners (AANP). (2021, March 15). Illinois state policy fact sheet. https://www.aanp.org/advocacy/state/state-practice-environment/state-policy-fact-sheets/illinois-state-policy-fact-sheet

Arcangelo, V. P., & Peterson, A. M. (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins.

Illinois General Assembly. (2021, March 15). Illinois nurse practice act. https://www.ilga.gov/legislation/ilcs/ilcs5.asp?ActID=1312&ChapterID=24