Prescribing Role and Responsibilities of a Nurse Practitioner



Prescribing Role and Responsibilities of a Nurse Practitioner

QUESTION
1. what are the roles and responsibilities of the advanced nurse practitioners in prescribing medications
2. specific prescribing responsibility for a nurse practitioner in Florida
Prescribing Role and Responsibilities of a Nurse Practitioner

ANSWER
Prescribing Role and Responsibilities of a Nurse Practitioner

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Prescribing Role and Responsibilities of a Nurse Practitioner
Nurse practitioners are mandated with, among other responsibilities, to apply research skills and knowledge in prescribing medications. They follow guidelines for ethical prescribing, from evaluation of the problem to the final use of the appropriate tools to prescribe the correct dose and reduce prescription errors. Nurse practitioners can only prescribe in their respective competent areas and according to the guidelines. Prescriptive authority differs according to jurisdictions and is governed by different legislation within counties and hospital or agency guidelines. There is full practice, reduced practice, and restricted practice.
Full prescriptive authority means the advanced practice registered nurses can evaluate patients, order diagnostic tests, and diagnose patients’ diseases. They can also prescribe medication with unlimited capacity provided they are within the recommended scheduled drugs; prescription and controlled substances including contraceptives and drugs for sexually transmitted infections in an outpatient setting, medical devices and offer additional medical services or equipment, prescribe medical goods, and other equipment and supplies. These measures mean that APRNs can freely offer clinical and prescriptive services without consulting anyone as long as they meet all the desired requirements. Despite recent advances in Currently, only the District of Columbia and twenty-two states have full prescriptive authority.
Reduced prescriptive authority means that an APRN is mandated to collaborate with a physician or other advanced healthcare workers when prescribing medication. This method can limit the scope of practice to a minimum of one area, like prescribing only a schedule III to V drugs. In the end, the scope of practice gets greatly reduced. Currently, only sixteen U.S. states have reduced prescriptive authority. Additionally, the U.S. territory of Puerto Rico, American Samoa, and the Virgin Islands also reduce the prescriptive authority of nurse practitioners. Restricted practice requires nurse practitioners to collaborate with other advanced healthcare workers to diagnose patients, treat illnesses, and prescribe medications of any class to patients. These restrictive rules greatly snuffle the freedoms of advanced practice nurses and place the burden of prescription on physicians. Currently, twelve U.S. states place restrictive rules on APRNs. Individual states have their Nurse Practice Act, and it dictates additional restrictions placed on nurse practitioners.
The nurse practitioners are first mandated to evaluate and define the problem presented by the patient. Then they ought to determine the therapeutic objective of any drug therapy they are to prescribe. They should then select the appropriate medication based on the therapeutic objective and the presented problem. The APRNs should then provide the patient with information on warnings and instructions for dosage. They should then monitor the patient for any unwanted or unusual reactions. The APRNs should also consider the cost of medication when prescribing to patients, especially those without insurance. They should also use appropriate tools for dispensing, like electronic drug references to obtain the relevant information and prescribing software to get the accurate dosage and quantity recommendations. These tools reduce the chances of prescription errors.
APRNs are also advised against prescribing to family members unless they are patients at the facility where they work. Some states forbid it, while others advise against it (“APRN’s role in ethical prescribing | Duquesne University,” 2020). When managing opioid pain medication, the practitioners ought to make a comprehensive history of the pain and past methods of trying to control it, examine a wide range of treatment options before settling on opioid medication, and educate the patient regarding the risks associated with taking the drugs and follow up to mitigate possible substance abuse.
Florida requires that physicians supervise nurse practitioners, and the decision be outlined in writing. An advanced practice nurse may prescribe only within an outlined framework of protocol, as they have limited authority to prescribe scheduled II substances that are controlled (AMA, 2021). Those with a minimum of three thousand clinical hours, have certain graduate-level coursework, and currently work in primary care are exempt from the requirement and can freely prescribe. The overseeing physician does not necessarily have to be in person but must be found on the phone for a consultation. Nurse practitioners are also allowed to prescribe schedule III-V controlled substances. They only do that if an APRN has a master’s or a doctorate in a clinical nursing specialty area and specific practitioner skills.
A psychiatric nurse may prescribe psychotropic substances to treat mental disorders that meet the framework for psychotropic medications and regulations (AMA, 2021). The prescriptions should follow formulary recommendations from a joint committee composed of nurse practitioners, physicians, and pharmacists under the nursing board. Nurse practitioners must also complete three American Medical Association nursing practice categories and one credit hour in prescription controlled medication. If nurse practitioners want to practice without collaboration, they must meet the clinical practice hours and requisite graduate coursework. The nurse practitioners with protocols that permit them to dispense medication must first register with the Florida Board of Nursing.

References
AMA. (2021, March 2). State law chart: Nurse practitioner prescriptive authority | AMA. American Medical Association. https://www.ama-assn.org/system/files/2020-02/ama-chart-np-prescriptive-authority.pdf
APRN’s role in ethical prescribing | Duquesne University. (2020, May 20). Duquesne University School of Nursing. https://onlinenursing.duq.edu/blog/aprns-role-responsibility-ethical-prescribing/
ICN. (2021). Guidelines on prescriptive authority for nurses. International Council of Nurses (ICN) | ICN – International Council of Nurses. https://www.icn.ch/system/files/2021-09/ICN_Nurse_prescribing_guidelines_EN_WEB.pdf

Prescribing Role and Responsibilities of a Nurse Practitioner


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