Yanet G. Coutin
There are statutes that mandate the APRNs to prescribe controlled substances in relation to the supervisory standards. The professionals are required to take part in a three-hour training session on secure prescription and effective implementation of the associated strategies. The APRNs are required to assess and outline the health issues relating to the health issues of the patients and provide the right prescription. They are required to equip the patients with the required information in relation to the warning and how the prescribed drugs are required to be taken (Torrens et al., 2020). Furthermore, the practitioners monitor the patients often to ensure that they acquire the required benefits of the prescriptions that are at hand. In relation to the requirement of the state the APRN practitioners have to meet the same prescriptions standards as
There exist a lot of barriers that limit the APRN practitioners from undertaking them prescription responsibilities efficiently. To begin the state license limits the APRNs from taking part in full practice in relation to their educational qualification. The practitioners can only take part in one of the NP responsibilities on the basis of collaborative agreements. Secondly, the training programs of APRN might not be able to equip learners with advanced skills for the delivery of the best health care services. Negative discernments of the existing working environments and insufficient knowledge hinder the practitioners from the performance of them prescription responsibilities (Jun et al., 2016). Finally, certain financier policies do not allow the APRN from taking part in the delivery of healthcare activities to the full extent of their training and licensure. For example, some scope of practice policies limit practitioners to certain responsibilities. The issue of Job satisfaction limit practitioners from performing their roles of prescriptions in a manner that impacts significantly on the results of the patient. Some of the practitioners undergo working conditions that are not favorable which limit their productivity.
Jun, J., Kovner, C. T., & Stimpfel, A. W. (2016). Barriers and facilitators of nurses’ use of clinical practice
guidelines: an integrative review. International journal of nursing studies,60, 54-68.
Torrens, C., Campbell, P., Hoskins, G., Strachan, H., Wells, M., Cunningham, M., Bottone, H., Polson, R., & Maxwell, M. (2020). Barriers and facilitators to the implementation of the advanced nurse
practitioner role in primary care settings: A scoping review. International Journal of Nursing Studies,
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Some of the barriers affect safe prescribing by advanced practice nursing. First, there is a barrier to access to prescription drug monitoring programs (PDMP). Studies show that despite the awareness of many APRNs on the effectiveness of PDMP in nursing practice, less than 50% of them utilize the prescription of opioids (Young et al., 2019). PDMP is a useful tool and needs to be consulted before an opioid is prescribed. The state of Florida does not put the use of PMDP as mandatory, and the providers only utilize it when they suspect that an individual may misuse medication (Young et al., 2019). The use of PDMP only during clinical suspects leads to bias and ineffectiveness of this tool. The barriers to the use of PMDP include nurseâ€™s knowledge, education, personal biases, and experiences.
Besides, nurse practitioners in Florida face barriers related to the issues of physicians. One of the barriers identified is that the physicians and other healthcare professionals lack knowledge of the scope of practice of the APRNs (Hain and Fleck, 2019). A collaboration between physicians and APRNs is essential in achieving best practices. Nursing practitioners often experience this barrier to a successful collaboration with physicians despite sharing the same goal of improving patient outcomes.
Another barrier to safe prescribing in Florida lies in the state practice. â€œState licensure regulates NP practice and is a barrier to NPs practicing to the fullest extent of their education and trainingâ€ (Hain and Fleck, 2019). APRNs have been struggling to exit from licensure and restrictive practices to have full authority on their practice, but they have not been successful due to the opposition from the medical organizations . The regulations determine the scope of nursing practice and limits APRNs to work only to the extent of the licensure. Allowing the independence of APRNs may lead to higher-value services (Peterson, 2019).
Hain, D., Fleck, L., (2019). Barriers to Nurse Practitioner Practice that Impact Healthcare Redesignâ€Â OJIN: The Online Journal of Issues in NursingÂ Vol. 19, No. 2, Manuscript DOI:Â 10.3912/OJIN.Vol19No02Man02
Peterson, M. E. (2019). Barriers to Practice and the Impact on Health Care: A Nurse Practitioner Focus.Â Journal of the Advanced Practitioner in Oncology,Â 8(1), 74â€“81. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5995533/
Young, H. W., Tyndall, J. A., & Cottler, L. B. (2019). The current utilization and perceptions of prescription drug monitoring programs among emergency medicine providers in Florida.Â International Journal of Emergency Medicine,Â 10(1).
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Manuel A Garcia Periu
Florida National. University
Dr.Â Latoya Dotson
Nursing is a highly regulated profession to ensure safe and high-quality health services are provided to patients. Nursing is legislated at the state level through laws and policies. The state of Florida outlines policies to guide advanced practice registered nurses (APRN) to prescribe medication in line with the set standards (Florida Board of Nursing, 2016). In order to ensure safety, APRNs engage in a training session on safe prescribing to enable the evaluation and definition of patient health problems for an appropriate prescription. Besides, advanced practice nurses should also educate patients with relevant information about the side effects and warnings of certain drugs. They should also guide them on how to take the prescribed medication. Practitioners also follow up on patients to assess the outcome of prescribed drugs and ensure they benefit from the prescription given.
Â Certain barriers prevent APRNs from administering their prescriptions appropriately. First, poor working conditions hinder practitioners from performing their prescription duties effectively (Peterson, 2017). Poor working conditions affect practitioners’ job satisfaction, which in turn hinders them from delivering prescription activities effectively. The unfavorable working conditions also reduce nurses’ productivity and motivation significantly. Second, certain policies and standards limit them from exercising the prescription role to the full extent. The scope of nursing practice laws restricts APRNs to particular roles. Thirdly, state licensure limits APRNs to one of the nurse practitioner roles based on collaborative agreements and in line with their educational qualifications. Also, nursing training programs might fail to equip APRNs with the required knowledge and skills for delivering high-quality care services and drug prescriptions. Inadequate skills, coupled with a low number of nursing practitioners, affect the delivery of quality and safe healthcare services. These hindrances are likely to result in negative patient outcomes due to wrong prescriptions and other risks of medical errors.Â
Florida Board of Nursing (2016, April 15).Â Important Legislative Update regarding HB 423.Â
Peterson M. E. (2017). Barriers to practice and the impact on health care: A nurse practitioner focus.Â Journal of the Advanced Practitioner in Oncology,Â 8(1), 74â€“81.
Prescription falls under the practice and scope of nurse practitioners. Prescriptions being a major practice for APRNs necessitates that they undertake the role as required. In this respect, they should fully provide information, instructions, as well as warnings concerning the prescribed drugs (Woo & Robinson, 2019). In addition, APRNsÂ are required to adhere to practice and licensure requirements and should ensure that the cost of the drugs is ethical and in line with the existing regulations. Moreover, there is a need for these nurses to apply or utilize appropriate prescription tools or technology to enhance the wellbeing of the patients while at the same time minimizing prescription errors. In a nutshell, APRNs have a duty to ensure that the prescriptions are accurate and based on the existing policy.
Several barriers have prevented APRNs from prescribing appropriately. Nurse prescribers face these problems, making it difficult for them to contribute effectively to the desired health outcomes. According to Peterson (2017), the first barrier faced is that of state practice and licensure. This is a key problem because most states have not adopted full practice authority licensure, which means that there are some instances whereby nurses do not have the full authority to prescribe some drugs. Physician related issues are the other barrier that prescribers have to battle. According to Peterson (2017), some medical organizations are blamed for believing and insisting that the training and education for APRNs is not enough for them to perform prescriptions as physicians. For instance, nurses in Florida continue to struggle to overcome restrictive practices and licensure that prevent them from performing some duties like prescribing psychotropic medications for children under 18 years of age, unless prescribed by an ARNP who is a Psychiatric Nurse. Finally, payer policies are major barriers to prescribers. These policies make it difficult for nurses to provide services like prescriptions, forcing them to depend on physicians or remain as employees. Since nurses have to be associated with physicians to be allowed to practice, payer policies are some of the issues or barriers facing prescribing APRNs.
Peterson M. E. (2017). Barriers to practice and the impact on health care: A nurse practitioner focus.Â Journal of the Advanced Practitioner in Oncology,Â 8(1), 74â€“81
Woo, T. M, & Robinson, M. V. (2019).Â Pharmacotherapeutics for Advanced Practice Nurse PrescribersÂ (4thÂ ed.). Davis