NURS 8100 Week 9 Discussion Policy and State Boards of Nursing

Walden University NURS 8100 Week 9 Discussion Policy and State Boards of Nursing– Step-By-Step Guide

This guide will demonstrate how to complete the Walden University NURS 8100 Week 9 Discussion Policy and State Boards of Nursing assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NURS 8100 Week 9 Discussion Policy and State Boards of Nursing

Whether one passes or fails an academic assignment such as the Walden University NURS 8100 Week 9 Discussion Policy and State Boards of Nursing depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NURS 8100 Week 9 Discussion Policy and State Boards of Nursing

The introduction for the Walden University NURS 8100 Week 9 Discussion Policy and State Boards of Nursing is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for NURS 8100 Week 9 Discussion Policy and State Boards of Nursing

After the introduction, move into the main part of the NURS 8100 Week 9 Discussion Policy and State Boards of Nursing assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NURS 8100 Week 9 Discussion Policy and State Boards of Nursing

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NURS 8100 Week 9 Discussion Policy and State Boards of Nursing

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NURS 8100 Week 9 Discussion Policy and State Boards of Nursing

The Illinois state board of nursing has made several amendments to advanced nursing practice regulations. The board created a pathway for APRNs working in hospitals, hospital-affiliated settings, and ambulatory surgery centers to offer most advanced practice nursing care with no career-long collaborative agreement (Illinois General Assembly, n.d.). A written collaborative agreement is needed for all APRNs engaged in clinical practice, except those privileged to practice in a hospital, hospital affiliate, or ambulatory surgical treatment center. However, if an APRN engages in clinical practice outside of a hospital, hospital affiliate, or ambulatory surgical treatment center must have a written collaborative agreement (Illinois General Assembly, n.d.). Besides, APRNs must have an ongoing relationship with a physician to prescribe benzodiazepines and some other scheduled agents. 

The state regulations are supported in my current place of employment since the organization’s leadership allows APRNs to practice within their full scope of education without a collaborative agreement with a physician. APRNs in our organization are authorized to: conduct patient assessment; diagnose; order, perform, and interpret diagnostic tests; order treatments; provide palliative and end-of-life care; provide advanced counseling, patient education, and patient advocacy. 

The scope of APRN practice differs across various states in the US. Various states grant APRNs Full practice authority, while others have Reduced and Restricted practice. States with Full practice allow APRNs to practice within their full scope of education (Peterson, 2018). APRNs with Reduced practice are required to have a collaborative agreement with a physician to engage in the elements of APRN practice. Besides, states with restricted practice need supervision and delegation to practice. The APRN scope of practice disparity negatively affects APRN professional practice since APRNs in some states are not allowed to practice as their counterparts in other states. Patients in states with Full practice have more access to healthcare since APRNs act as primary care providers (Ortiz et al., 2018).  

References 

Illinois General Assembly. (n.d.). Nurse Practice Act. https://ilga.gov/legislation/ilcs/ilcs4 

Ortiz, J., Hofler, R., Bushy, A., Lin, Y. L., Khanijahani, A., & Bitney, A. (2018). Impact of Nurse Practitioner Practice Regulations on Rural Population Health Outcomes. Healthcare (Basel, Switzerland), 6(2), 65. https://doi.org/10.3390/healthcare6020065 

Peterson, M. E. (2018). Barriers to Practice and the Impact on Health Care: A Nurse Practitioner Focus. Journal of the advanced practitioner in oncology, 8(1), 74–81. 

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Sample Answer 2 for NURS 8100 Week 9 Discussion Policy and State Boards of Nursing

The goal of the state boards of nursing is protect the safety of the community by ensuring nurses who practice are competent and have received the required training to provide care (Thomas, Benbow, & Ayars, 2010).  Since this scope of practice is defined at the state level, there can be a discrepancy in what nurses are allowed to do state-to-state and the license needed to practice in that state.  There has been tremendous effort to form legislature around the compact nursing license to allow nurses reciprocity in participating states.  However, this is not the standard with advanced practice registered nurses (APRN) (Watson & Hillman, 2010).  In the state of New Mexico, the board of nursing is actively involved in promoting and encouraging the expansion of the APRN Compact (New Mexico Board of Nursing, n.d.).  Currently, the only two states involved in the APRN are Utah, North Dakota, and Delaware (APRN Compact, n.d.).  States not involved in the APRN Compact can vary greatly in terms of scope of practice.  For example, recently in Florida it was passed that nurse practitioners have full practice authority while in many other states that has been the norm for years.  This type of discrepancy can disrupt the distribution of qualified providers across the country due to scope of practice limitations.  Additionally, it can cause confusion among practitioners on what they can/can not do by law.     

            At my organization, the state regulations are supported within my place of employment through the Professional Nursing Practice Department who advocate for state and federal legislature involving nursing and support the state regulations around registered nurses and APRNs.  This department looks at our nurse residency program, nursing credentials, nursing accreditations etc. for the academic hospital.  This department works in collaboration with several other complimentary nursing departments and reports directly to our Chief Nursing Officer.          

References 

APRN Compact. (n.d.) https://aprncompact.com/about.htm  

New Mexico Board of Nursing. (n.d.) https://www.ncsbn.org/policy-and-government.htm  

Thomas, M. B., Benbow, D.A., & Ayars, V. D. (2010). Continued competency and board             regulations: One state expands options.  Journal of Continuing Education in Nursing, 41(11), 524-528.   

Watson, E., & Hillman, H. (2010). Advanced practice registered nursing: Licensure, education,  scope of practice, and liability issues. Journal of Legal Consulting, 21(3, 25-29.  

Sample Response 3 for NURS 8100 Week 9 Discussion Policy and State Boards of Nursing

Hello . Thanks for the insightful discussion. From your discussion, I have learned that in the state of New Mexico, the board of nursing is actively involved in promoting and encouraging the expansion of the APRN Compact. However, in order to become a registered nurse in our state (Florida), one must first graduate from an approved nursing program and pass the National Council Licensure Examination (NCLEX) (Toney-Butler & Martin, 2018). They must also complete a number of hours of continuing education each year in order to maintain their license. Our state board of nursing is responsible for promulgating all the regulations that govern the profession of nursing, including requirements for licensure and continuing education (Kumar & Williams, 2018). The state of Florida nursing regulations can be found on the website of the Florida Board of Nursing. There are a variety of regulations related to nurses, including requirements for licensure, practice standards, and continuing education (Delgado et al., 2021). Nurses are also required to renew their licenses every two years, and must complete 20 hours of continuing education in order to do so. 

References 

Delgado, A., Hale, E., Schulkin, J., Macri, C., & Fryer, K. (2021). Provider Perception and Office Practices of the Initial Prenatal Visit Pre–Coronavirus 2019 Pandemic. Florida Public Health Review, 18(1), 4. https://digitalcommons.unf.edu/fphr/vol18/iss1/4/ 

Kumar, C. D., & Williams, D. A. (2018). Florida One Step Closer. Journal of Emergency Nursing, 44(6), 645-646. https://www.intljourtranur.com/article/S0099-1767(18)30407-0/fulltext 

Toney-Butler, T. J., & Martin, R. L. (2018). Florida Nurse Practice Act Laws and Rules. https://europepmc.org/books/n/statpearls/article-41861/?extid=29083631&src=med 

Sample Answer 4 for NURS 8100 Week 9 Discussion Policy and State Boards of Nursing

Obtaining a license is just the beginning of any nurse’s career. Just as medical technology is evolving, so must we. Most state boards of nursing require the ongoing safe and competent practice of licensees. Texas Board of Nursing has identified specialty nursing certification as one method of demonstrating continuing competency in the nurse’s specialty or area of practice (Texas Board of Nursing – Laws & Rules – Nursing Practice Act, n.d.). Both professional and practicing nurses are affected by the rule changes. 

Continuing education is essential to maintain patient safety by keeping knowledge, skills, and abilities. Forty-two state boards require national nursing certification to practice as an advanced practice nurse (Watson & Hillman, 2010). Houston Methodist hospital regulates advanced practice registered nurses (APRNs) by providing written verification of recertification to continue practicing.

One of the most significant issues is that state boards of nursing are held to legislative mandates that vary from state to state—determining who should be held responsible in payment for certification and renewal. For example, should the public/organization be obliged to fund regulation to implement measures for individual nurses (Thomas, Benbow, & Ayars, 2010)? For some, this may cause an additional financial burden. 

Reference

Texas Board of Nursing – Laws & Rules – Nursing Practice Act. (n.d.). Retrieved April 26, 2022, from https://www.bon.texas.gov/laws_and_rules_nursing_practice_act.asp

Thomas MB, Benbow DA, & Ayars VD. (2010). Continued Competency and Board Regulation: One State Expands Options. Journal of Continuing Education in Nursing, 41(11), 524–528. https://doi.org/10.3928/00220124-20100701-04

Watson E, & Hillman H. (2010). Advanced practice registered nursing: licensure, education, scope of practice, and liability issues. Journal of Legal Nurse Consulting, 21(3), 25–29.

Sample Response 5 for NURS 8100 Week 9 Discussion Policy and State Boards of Nursing

In the state of Maryland some of the advanced practice registered nurses (APRNs) include certified midwives, nurse anesthetist, certified nurse practioner (NP) and a clinical nurse specialist. This should be similar to other states too. At a minimum and from personal experience Maryland board of nursing has to give permission to practice as an NP and there are basic requirements that have to be met to qualify to be certified. Not all the regulations that are set forth by the state of Maryland for APRN to practice are recent but they are however all currently used.

Code of Maryland regulations (COMAR) are the compilation of the state of Maryland regulations that help govern the state, (Maryland.org, n.d). Health care is not an exception and APRNP have to abide by the COMAR regulations. According to COMAR, (2020), APRNs can perform multiple functions independently. These include comprehensive assessments, complete a death certificate, do not resuscitate orders, interpret diagnostic and laboratory tests, prescribe medications, provide care and give referrals to other providers. An NP can also practice as a registered nurse and for those who have certifications for mental health, they can admit a client on an involuntary basis for treatment.

How State Regulations Are Supported within Place of Employment

The place of employment has set standards at the same level of practice as expected by the state but for some treatment approaches the expectation is to defer to the primary physician or the medical director.  Establishing this baseline helps achieve the expected standards and also remain in compliance with the COMAR and federal regulations. The place is very supportive that when the NP completes an admission assessment, the doctor does not have to double check unless there is a concern.

As a nurse practioner, at the place of work there are multiple activities that can be performed independently. These tasks include but not limited to giving orders for medications and treatment, reviewing diagnostic tests, and responding to families as required. One task that is permitted by the state of Maryland but not encouraged at the place of work is signing of certificates of incapacity. (A. Speer, personal communication, July 26, 2021). The primary physician and the psychiatrist sign the Maryland order for life sustaining treatment (MOLST) also and only encourage the NP to sign it if they are not available. This is a task that is authorized by COMAR regulations.

How States Differ in Terms of Scope of Practice

Different states have different prescriptive authorities and conditions that they give to their APRNs. There are those states that are referred to as independent states which allow APRN independent prescribing and there are those which do not, (Schirle & McCabe, 2016).  Barriers to practice are not uncommon even when the states are flexible, health care settings can still impose different strict policies and procedures. This leads to restriction of some aspects of patient care and limited access to providers despite the states having full practice authority, (Schorn, Myers, Barroso, Hande, Hudson, Kim & Kleinpell 2022).

Impact on Professional Nurses across the United States.

Some nurses have opted to relocate or work where there is more prescriptive authority. Some nurses also have opted not to relocate but get licensures in neighboring states that can give them more autonomy. There are also nurses who have opted to work in other areas where they are needed. These areas include working as lobbyists, researchers, nurse educators and consultants. In this aspect their full potential is more effectively utilized.

References

COMAR 10.27.07.00 (2020) Practice of the Nurse Practitioner​ , http://www.dsd.state.md.us/comar/comarhtml/10/10.27.07.03.htm

Maryland.org (n.d), Division of state documents. http://www.dsd.state.md.us/COMAR/ComarHome.html

Schirle, L., & McCabe, B. E. (2016). State variation in opioid and benzodiazepine prescriptions between independent and nonindependent advanced practice registered nurse prescribing states. Nursing Outlook, 64(1), 86–93. https://doi.org/10.1016/j.outlook.2015.10.003

Schorn, M. N., Myers, C., Barroso, J., Hande, K., Hudson, T., Kim, J., & Kleinpell, R. (2022). Results of a National Survey: Ongoing Barriers to APRN Practice in the United States. Policy, Politics & Nursing Practice, 23(2), 118–129. https://doi.org/10.1177/15271544221076524

Sample Answer 6 for NURS 8100 Week 9 Discussion Policy and State Boards of Nursing

The State Statutes mandate the State boards of nursing to ensure continued safe and competent practice, which results in the regulatory agencies facing many challenges, due to the diversity issues that characterize the nursing practice (Thomas et al., 2010).  One of the most recent regulations promulgated through the Texas State Boarding of nursing was, permitting advanced practice registered nurses (APRNs) to complete the medical certification for an adult or fetal death certificate, in accordance with Chapter 193 of the Texas Health and Safety Code (THSC), which was signed into law on June 15, 2021(Stevens & Landes, 2021). The APRNS full practice authority has not been fully embraced in Texas, which results in twenty percent of Texans, lacking access to a primary care provider, with the state being listed as 49th in the country, on access to and affordability of health care (Zhang & Wu, 2021). Recently Rep Stephanie Klick introduced the latest bill HB 2029 which removes antiquated laws, to allow APRNs full practice authority, and hopefully, Texas could soon join the full practice states (Stevens & Landes, 2021).

In my organization, the state regulations are fully supported through the provision of quality care, which is mandated by the federal, state-level regulations, and must be accredited by the Joint Commission to receive Medicare payments and the accreditation requirements. The organizations must also implement and comply with the Centers for Medicare & Medicaid Services (CMS) regulations, to promote care consistency (Hughes& Smith, 2014).

Different states differ in their scope of practice regulations, and currently, there are twenty-three states, which have granted APRNs full practice authority and can perform, the same tasks as physicians. The other states have either limitations or ultimate denial, like my home state Texas, which continues with the imposed restrictions of a physician’s supervision or collaboration. (Altman et al., 2016). This variation of the scope of practice across states has a significant impact on patient care delivery because the APRNs are subjected to different scope-of-practice (SOP) restrictions, based on the state in which they work which dictates the extent to which they can practice or prescribe They cannot, therefore, provide the same consistent level of care or independent chronic disease management, independent of a supervisory contract with a physician collaborator, the degree of physician supervision also affects the practice opportunities, and the payer policies for NPs scope of practice regulations, hinder access to primary care treatment, which results in the continued suffering of the vulnerable populations and the minorities (Hain & Fleck, 2014).

References

Altman, S. H., Butler, A. S., & Shern, L, (2016). Assessing Progress on the Institute of Medicine Report The Future of Nursing. Washington (DC): National Academies Press (US); 22. 2, Removing Barriers to Practice and Care. Available from: https://www.ncbi.nlm.nih.gov/books/NBK350160/

Buck J. (2011). Policy and the Re-Formation of Hospice: Lessons from the Past for the Future of Palliative Care. Journal of hospice and palliative nursing: JHPN: the official journal of the Hospice and Palliative Nurses Association, 13(6),

Hain, D., Fleck, L. (2014). Barriers to Nurse Practitioner Practice that Impact Healthcare Redesign OJIN: The Online Journal of Issues in Nursing Vol. 19, No. 2, Manuscript

Hughes, M. T. & Smith, T. J. (2014). The Growth of Palliative Care in the United States

Annual Review of Public Health Vol. 35:459-475 (Volume publication date March 2014)
https://doi.org/10.1146/annurev-publhealth-032013-182406

Stevens, J. D., & Landes, S. D. (2021). Assessing state-level variation in signature authority and cause of death accuracy, 2005-2017. Preventive medicine reports, 21, 101309. https://doi.org/10.1016/j.pmedr.2020.101309

Thomas, M. B., Benbow, D.A., & Ayars, V. D. (2010). Continued competency and board regulation: one state expands options. J Contin Educ Nurs.11):524-8. doi: 10.3928/00220124-20100701-04. Epub 2010 Jul 8. PMID: 20672758.

Zhang, J., & Wu, X. (2021). Predict Health Care Accessibility for Texas Medicaid Gap. Healthcare (Basel, Switzerland), 9(9), 1214. https://doi.org/10.3390/h