Licensure and Certification for Advance Practice Registred Nurse.

  • 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.

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

 

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Please respond to the following post regarding Licensure and certification.I am practicing int the state of Texas and this post below is regarding State of Delaware practice.

 

JILLIAN’S post.

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In the state of Delaware, APRN’s who are approved for independent practice are allowed to practice outside of the employment of an established health-care organization, health-care delivery system, physician, podiatrist, or practice group owned by a physician or podiatrist (Independent Practice, n.d.). In order to be granted full independent practice, the APRN can be authorized after two full years of practice under a collaborative agreement with a physician (Delaware, 2021). The collaborative agreement is to outline how the APRN and the supervising physician will “cooperate, coordinate, and consult pursuant to the Board of Nursing’s rules and regulations” (Delaware, 2021).

In order to apply for an APRN license in the state of Delaware, the candidate must hold an active RN license in Delaware or a coinciding compact state (Advanced Practice Registered Nurse [APRN] License, n.d.). Other options to apply include a master’s degree of post-basic program certificate in a clinical nursing specialty with nursing certification from a national certification body recognized by the Board, be a graduate of a specialty program within the past two years, or practiced in the specialty of either 600 hours over the previous two years or 1,500 hours over the past five years (APRN License, n.d.).

All applications are processed through the online platform DELPROS, or Delaware Professional Regulation Online Services (APRN License, n.d.). In addition to the online application, a Delaware and Federal Bureau of Investigation criminal background check, copy of the applicant’s driver’s license, official transcript sent from an APRN certified program, copy of the original certification notice, verification of national certification, and a self-query from the National Practitioner Data Bank website must all be submitted (APRN License, n.d.).

The primary nurse licensure office resource website in the state of Delaware is through the Delaware.gov website on the Board of Nursing division of professional regulation (APRN License, n.d.).

In order to obtain a Drug Enforcement Agency, or DEA license, the APRN must hold an APRN license with prescriptive authority before the application for controlled substance registration, or CSR, can be processed (Controlled Substances, n.d.).  Once the Delaware CSR is approved, the APRN can file for a federal DEA registration. In addition to DEA registration, a one-hour mandatory course on the prescribing and distribution of controlled substances must be completed (Controlled Substances, n.d.).

The state of Delaware allows the nurse practitioner to prescribe legend drugs and Schedules II-V controlled substances (Delaware, 2021). The APRN who has not had independent prescriptive authority within the past two years must have a collaborative agreement with a physician and complete 30 hours of advanced pharmacology (Delaware, 2021).

What surprised me the most from this research was Delaware’s collaborative agreements for independent practice. The state boasts independent practice for advanced practice nurse practitioners, however, I was unaware of the barriers involved. For example, an agreement must be in place for each individual business/practice that the APRN will be practicing (APRN License, n.d.). Also, an agreement must be in place if the provider has practiced for less than two years or fewer than 4,000 hours (APRN License, n.d.). Personally, I would feel more comfortable as a new graduate APRN in an office/business setting that has a variety of different resources available before considering independent practice, but it is still interesting to learn what would be required if that was something I wished to pursue in the future.

 

Resources:

 

Buppert, C. (2018). Nurse practitioner’s business practice and legal guide (6th ed.). Jones & Bartlett.

  • Ch. 1, What Is a Nurse Practitioner
  • Ch. 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

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

Note: You should have studied Primary Care: Interprofessional Collaborative Practice in prior coursework. Review the chapters assigned in this course, as needed.

Leik, M. T. C. (2018). Family nurse practitioner certification intensive review: Fast facts and practice questions (3rd ed.). Springer Publishing Company.

  • Ch. 1, Certification Exam Information
  • Ch. 2, Question Dissection and Analysis

American Association of Nurse Practitioners (n.d.-a). Nurse practitioners in primary care. https://www.aanp.org/images/documents/publications/primarycare.pdf

American Association of Nurse Practitioners. (2019). State practice environment. https://www.aanp.org/advocacy/state/state-practice-environment

On the map on the webpage, click on your state and review.

American Nurses Association. (2020). https://www.nursingworld.org/

American Association of Nurse Practitioners. (2020). https://www.aanp.org/

American Nurses Credentialing Center. (2020). https://www.nursingworld.org/ancc/

Centers for Disease Control and Prevention. (2020). https://www.cdc.gov/

Office of Disease Prevention and Health Promotion. (2020b). Healthy people 2020. https://www.healthypeople.gov/

Office of Disease Prevention and Health Promotion. (2020a). Development of the national health promotion and disease prevention objectives for 2030. 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 practice. Nursing Economics, 36(1), 43–45.

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