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Support all posts with at least 2 cited peer review references within 5 years of publication (references cannot be older than 5 years).

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Peer 1

The Role of Advanced Practice Nursing in Safe Prescribing

The s. 893.03 Florida Statutes mandate the APRNs to prescribe controlled substances in line with the supervisory standards. The professionals have to engage in three-hour training sessions on safe prescribing and the effective implementation of the related strategies (Florida Board of Nursing, 2016). The APRNs have to evaluate and define the patients’ health issues to offer the right prescriptions. They should also equip patients with relevant information about warnings as well as how one should take the prescribed drugs (Pigman et al., 2016). Additionally, the practitioners monitor the patients regularly to make sure they receive the intended benefits of the prescriptions at hand. According to the state requirements, the APRN practitioners have to meet the same prescription standards as physicians.

Prescribing Barriers for APRNs

Various barriers limit the APRN practitioners from undertaking their prescription roles effectively. First, state licensure restricts the APRNs from engaging in full practice in line with their educational qualifications. The practitioners can only engage in one of the NP roles based on collaborative agreements. Secondly, APRN training programs may fail to equip learners with advanced skills for delivering high-quality health care services. Negative perceptions of the existing working conditions and inadequate knowledge also limit the practitioners from performing their prescription roles effectively (Jun, Kovner, & Stimpfel, 2016). Additionally, certain payer policies deter the APRN from engaging in health care delivery activities to the full extent of their training as well as licensure. For instance, some scope-of-practice policies restrict practitioners to specific roles. Job satisfaction issues also hinder practitioners from undertaking their prescription roles in a way that impacts significantly on patient outcomes. Some practitioners experience unfavorable working conditions, which reduce their productivity.

Peer 2

ARNPs have in their hands a high level of responsibility when prescribing medications. The degree of responsibility depends on whether they can or not prescribe medicines that rely on the state’s laws related to the prescriptive authority given to APRNs. There are twenty-one states that are fully independent prescribing by nurse practitioners (Teri, & Marylou, 2015). The responsibility for the final decision on which drug to use and how to use it depends on the APRN prescriber. To be a safer prescriber, it is important that APRN assume the higher level of legal responsibility that is required. Also, the knowledge of medicine, pharmacology, determine the diagnose for which the drug will be ordered, prescribe the appropriate drug, monitor the outcome, and educate the patient about the medication and possible adverse effects.

Despite many positive expansions to the APRN role that include caring for ethnically diverse, underserved populations within an aging society and across many healthcare settings, there are a lot of barriers requiring attention. Prescribing medications is one of the main components of the APRN role and essential to his/her practice. One of the barriers is the restrictions on prescriptive authority that limit the ability of NPs to provide comprehensive health care services. AANP recommends that NP prescribing authority be solely regulated by state boards of nursing and in accordance with the NP role, education and certification. This process of license and regulation exclusively by the nursing board promotes public safety and competent practice (Hain, D., & Fleck, L., 2014).

The Florida Board of Nursing states that ARNP may only prescribe or dispense a controlled substance as defined in s. 893.03 Florida Statutes if the ARNP graduated from a program with a master’s or doctoral degree in a clinical nursing specialty area with training in specialized practitioner skills. However, all ARNPs and PAs are required to complete at least three hours of continuing education on the safe and effective prescribing of controlled substances. Also, Under the new law, an ARNP’s prescribing privileges for controlled substances listed in Schedule II are limited to a seven-day supply and do not include the prescribing of psychotropic medications for children under 18 years of age, unless prescribed by an ARNP who is a Psychiatric Nurse. The bill also clarifies that only allopathic physicians licensed under chapter 458, Florida Statutes, or osteopathic physicians licensed under chapter 459 Florida Statutes may dispense medications or prescribe controlled substances in a registered pain management clinic (Florida Board of Nursing, 2016).In addition, every person who prescribe controlled substances must register and obtain a registration number with the US Drug Enforcement Administration. Also, they have to maintain and keep on file for a minimum of 2 years accurate records of controlled drugs they purchase, distribute, administer, and dispense.  (Teri, & Marylou, 2015).