NRNP 6675 Discussion: Certification and Licensure Plan

Arkansas Board of Nursing Licensing and Practice information

• How do you get certified and licensed as an Advanced Practice Registered Nurse (APRN) in your state?

Complete a graduate degree nurse practitioner program, pass the national certification exam associated with the degree focus, apply for state licensure online and submit all required documentation (Healthy.arkansas.gov, 2022a).

• What is the application process for certification in your state?

Create a user profile, if you do not already have one, on the Arkansas Nurse Portal using a personal email address. Complete an application for APRN licensure and upload all required documentation. Obtain a full license history report from nursys.com. Obtain a notarized statement attesting to practicing as a nurse for a minimum of 2,000 hours. Submit national certification documentation once exam is passed. Complete a background check utilizing the number obtained on payment page of application. Submit official transcripts and proof of Arkansas RN licensure. (Healthy.arkansas.gov, 2022c)

• What is your state’s board of nursing website?

https://arsbn.boardsofnursing.org/arsbn

• How does your state define the scope of practice of a nurse practitioner?

Arkansas is a reduced practice state, requiring APRN’s to practice with a collaborative practice agreement with a physician, also limited Schedule II prescribing with strict guidelines in place (Healthy.arkansas.gov, 2022d). Recently they have allowed for independent practice authority to be granted to APRN’s that have demonstrated 6,250 hours of practice, however Schedule II privileges are still restricted with the practice authority .

• What is included in your state practice agreement?

Scope of practice relating to collaborative practice agreements, licensing and education, independent practice requirements and restrictions (Healthy.arkansas.gov, 2022d).

• How do you get a DEA license?

You must apply for prescriptive authority through the Arkansas State Board of Nursing at the end of the APRN application or at another time. The prescriptive authority may only be obtained with a collaborative practice agreement and quality assurance plan (Healthy.arkansas.gov, 2022c). The prescriptive authority must have prescriptive protocols (Healthy.arkansas.gov, 2022b). Once prescriptive authority is obtained and a certificate number is issued then you apply for a DEA certificate through the Arkansas Nurse Portal. Submit DEA certificate number to ASBN once received.

• Does your state have a prescription monitoring program (PMP)?

Arkansas does have a prescription drug monitoring program. This program requires APRN’s who hold a DEA registration to register with the PMP and review that PMP with every Schedule II and III opioid prescription and with the initial prescription for benzodiazepines and every 6 months therafter (Healthy.arkansas.gov. 2022a).

• 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?

Advanced practice registered nurses may prescribe Schedule III-V and hydrocodone products reclassified as Schedule II from Schedule III as of 2014 and only if authorized by the CPA and in accordance with the specific area of practice (Healthy.arkansas.gov, 2022. Schedule II may be prescribed if one of the following apply: for a period of 5 days or less; or if it is a stimulant meeting specific criteria.

References

Healthy.arkansas.gov. (2022a). ASBN – Adv. Practice. Retrieved from https://www.healthy.arkansas.gov/programs-services/topics/arsbn-adv.-practice

Healthy.arkansas.gov. (2022b). ASBN – Collaborative Practice. Retrieved from https://www.healthy.arkansas.gov/programs-services/topics/arsbn-collaborative-practice

Healthy.arkansas.gov. (2022c). ASBN – Laws & Rules Arkansas Department of Health. Retrieved from https://www.healthy.arkansas.gov/programs-services/topics/arsbn-laws-rules

Healthy.arkansas.gov. (2022d). Nurse Practice Act of the State of Arkansas. Retrieved from https://www.healthy.arkansas.gov/images/uploads/pdf/NURSEPRACTICEACT.pdf.

Sample Answer for NRNP 6675 Discussion: Certification and Licensure Plan

Very Informative post!  As you mentioned Arkansas is currently a reduced practice authority state but with the Act 412, nurse practitioners in Arkansas will soon be able to practice independently when eligible (Kilhore-Hill, 2021). A minimum of three years of practice under the collaboration of physician is needed to acquire practice authority. I believe the NPs to be giving a chance to practice to the full extent of their training and education. Across the United Stated, ARNPs received the same training, education, and certification. Therefore, I find it concepts of full, reduced or restricted authority very frustrating. I think that relaxing the ARNPs scope of practice across the States will help achieve better results for both health care professionals and patients. In a research study, the Institute of Medicine “ The IOM recommends that the nursing community, other health professions groups, and policy makers, establish a common ground to remove scope of practice restrictions and increase interprofessional collaboration.” (Ortiz et al., 2018)  I believe that this is necessary to avoid ARNPs to start moving massively from restricted states to reduced and full practice authority states.

Reference

Kilgore-Hill, M (2021). Arkansas Nurse Practitioners: Moving Toward Independence. https://www.arkansasmedicalnews.com/arkansas-nurse-practitioners—moving-toward-independence–cms-811

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

Sample Answer for NRNP 6675 Discussion: Certification and Licensure Plan

Certification and licensing are essential in nursing practice since they set minimum competencies/qualifications and assure the public and other stakeholders that predetermined standards of practice have been met. Licensing and certification are some of the requirements for all nurses operating at different levels. The certification is often done according to an individual’s qualifications, skills, and abilities to undertake different processes. In Maryland, all nurses, including registered nurses and advanced practice registered nurses, should be licensed to allow them to practice in different areas. Before licensing processes, exams or tests are given out; however, one must first be a qualified nurse.

How APRNs Get Certified and Licensed In Maryland

For APRNs to become certified and licensed in Maryland, one must complete approved graduate-level programs by the state’s board of nursing. These programs must culminate in a Master’s degree or post-Master’s degree certification. Also, APRN nurse practitioners must have a certificate that is recognized nationally and at the board level. Finally, nurse practitioners must have a specific or a particular area of specialization. Nurse practitioners should always focus on multiple populations.

The Application Process for Certification

There are five major steps that must be followed for APRNs to get registered and licensed in Maryland. The first step involves completing the accredited, state-approved nursing program. The second step involves undertaking actual application processes where the required feels are remitted to the state’s licensing board; this is only possible after completing the approved programs recognized by the licensing boards. The third step involves registering for the required exam and undertaking the tests (Kirschling, 2018). The final step involves completing additional state requirements, including background checks, proof of English language proficiency, and submission of referees, including supervisors and professors.

Maryland’s state board of nursing website and the definition of Scope of Practice

Maryland’s state board of nursing website is https://mbon.maryland.gov.  The website has steps or procedures that can be followed for a successful licensing process. According to the Maryland Board of Nursing, the scope of nursing practitioners includes diagnosis, treatment, research, and delivery of general quality services to patients (Evans, 2020). The board is currently committed to delivering quality services through preparing nurses and other healthcare practitioners to undertake their required roles.

What is Included in the State’s Practice Agreement and

Ways of obtaining DEA Licenses

   Maryland’s practice agreement include physician and APRN collaboration approaches or engagement, scope of practice, rules and regulations of practice, legal protection and set of rights and responsibilities. DEA licenses can be obtained from Maryland Board of Nursing website. The application process must be approved after verification processes. The entire process involves completing OCSA researcher questionnaire and a 3-year practitioner application form. Maryland has prescription monitoring program that tracks and control substance prescription.

Regulations and Barriers

There are different regulations undertaken by the Maryland Board of Nursing. Positive conducts and adherence to the set standards of practices are some of the regulations that would ensure successful outcomes in nursing professions. Besides, in Maryland, regulations are meant to enhance adherence to the rules established by the federal government. One of the barriers that may impact nurse practitioners’ independent practice in Maryland is the existence of laws that require collaboration between healthcare professionals (Mattingly & Boyle, 2020). Besides, stiff rules and regulations from the state government may interfere with the nurse practitioner’s independent practices. From the research process, one of the main surprises is the lack of physician support. For most states, physician support is necessary for enhancing the delivery of quality care to all patients.

Conclusion

The certification and licensing processes are always done by the state in collaboration with the federal government. In Maryland, there are specific procedures that must be followed to ensure effective certification and licensing. In Maryland, there is no requirement for physician collaboration or supervision for the registered, licensed, and certified nurse practitioners. Maryland allows advanced practice registered nurses to practice independently of a physician. In other words, the state does not require physician collaboration or supervision for nurse practitioners.

References

Evans, K. E. (2020). Executive Director’s Letter of the Maryland Board of Nursing to the Maryland Higher Education Commission Regarding COVID-19 dated April 13, 2020. https://archive.hshsl.umaryland.edu/handle/10713/16955

Kirschling, J. M. (2018). Maryland Board of Nursing Annual Report 2017-2018 for RN direct entry Masters. https://archive.hshsl.umaryland.edu/bitstream/handle/10713/8475/UMSON.MBON.2017_2018.Report.pdf?sequence=1

Mattingly, A. N., & Boyle, C. J. (2020). Salary and entry-level requirements for pharmacy technicians compared with other health technologist and technician occupations in Maryland. Journal of the American Pharmacists Association, 60(1), 17-21. https://doi.org/10.1016/j.japh.2019.09.009