Posted: November 30th, 2022

APRN Consensus Model

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 AGPCNP 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 Prescriptive authority is another key factor to examine and plan for. The proper board is granted prescriptive authority under state law. For the proper state licensure, the board awarding prescriptive authority may be the medical board, state board of pharmacy, or nursing board. The authority to write for a controlled substance is provided at the federal level and is validated by the appropriate state board through the Drug Enforcement Administration (DEA). Registration with the Drug Enforcement Agency is issued at the federal level, and there are additional requirements/fees for the registration process.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.

To prepare: My state is Texas
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?

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