PROFESSIONAL NURSING AND STATE-LEVEL REGULATIONS NURS 6050

PROFESSIONAL NURSING AND STATE-LEVEL REGULATIONS NURS 6050

APRNs in Missouri must adhere to strict supervision laws. A regulation Missouri APRNs are to follow is that an APRN and their collaborating physician are still required to work within a specific geographic proximity, even after the first initial thirty days (Sommer et al., n.d.). An APRN must be within a 30-mile radius in a non-Health professional shortage area (non-HPSA) or a 50-mile radius in a HPSA of their collaborating physician to practice legally (ThriveAPb, 2013). An APRN can only practice outside of those 30 miles if they are utilizing telehealthcare but must obtain consent from patients before telehealth services are initiated. Although APRNs must have a practice agreement in place with a physician, they are not required to meet. Another regulation APRNs in Missouri are to follow are that they are not allowed to sign death certificates or declare someone deceased.  Like Missouri, Illinois APRNs have practice agreement sent in place with a collaborating physician, but how they differ is that Illinois APRNs must meet monthly with their collaborating physician (ThriveAPa, 2013). Illinois APRNs also cannot sign death certificates or pronounce someone deceased.  

To adhere to these regulations, APRNs must find a collaborating physician and have a collaborative practice agreement set in place.

PROFESSIONAL NURSING AND STATE-LEVEL REGULATIONS NURS 6050

Collaborative practice agreements is a written agreement that must establish guidelines for consultation and referral to collaborating physician or health facility, agreement of protocols and standing orders, must be signed and dated by both APRN and collaborating physician before the APRN can start practicing, there must be a subsequent notice of termination and must identify the process for review and management of abnormal test results, the scope of practice, physician’s number of collaborative practice arrangement limitations, distance from a physician (30 non-HPSA or 50 HPSA miles),  other physician designated to collaborative practice arrangement, physician two-week provisions, process and documentation of review, prescription pad requirements, controlled substance limitations, dispensing logs and 72-hour dispensing boundaries, diagnosis and initiation of treatment, self-limited or well-defined problem parameters, population-based public health services, review and revision of collaborative practice arrangements as needed, and physician accountability for delegated medical acts  (Missouri Division of Professional Registration, n.d.). Having a professional and respected relationship with your collaborated physicians will help APRNs adhere to their regulations. 

APRNs who have full practice authority allow APRNs the full ability to utilize knowledge, skills, and judgment to practice to the full extent of their education and training (American Nurses Association, n.d.). APRNs allowed to full practice authority have advantages such as reduction in health care costs, expansion of care to rural or underserved areas, and efficient and effective care as they do not have to wait for directions from their collaborating physician (Bradley University, n.d.). APRNs who are allowed full authority practice would function as a primary care physician. They would be allowed to make decisions as a physician and practice to their full extent. They would be unaffected by the regulations I selected; they would be allowed to make these decisions without breaking the law.  

References 

American Nurses Association. (n.d.). Advanced Practice Registration Nurses (APRN). https://www.nursingworld.org/practice-policy/aprn/ 

Bradley University. (n.d.). What is Full Practice Authority for Nurse Practitioners? https://onlinedegrees.bradley.edu/nursing/msn-fnp/resources/understanding-regulations-what-is-full-practice-authority/#:~:text=According%20to%20the%20American%20Association%20of%20Nurse%20Practitioners,nursing%20board%20%28a%20definition%20last%20updated%20in%202015%29.