Week 9

         All the registered nurses in my state Nurses celebrate a milestone in the nursing practice during the month of March . More exactly, the H.B. 607, which establishes the basis for autonomous practice for APRNs, was adopted by the senate after many years of study. The law had clear revisions, which resulted in the following alterations, which I was unaware of until the bill was enacted today. (1) To be eligible for an Autonomous Practice designation, an APRN must have an unencumbered practice license, have had no disciplinary act in any state in the five years prior to the request, and an experience consisting of a minimum of 3000 hours of activity in any of the American states, , including clinical instructional hours, within the five years prior to the request. Also, within 5 years of the demand for autonomous practice, the candidate must have accomplished a minimum 3 graduate-level semester hours.

         H.B. 607 also allows autonomous practice APRNs to admit individual to a facility, such as a healthcare facility, supervise the patient's treatment while they are there, and release the patient. The new legislation will enable APRNs to sign some papers that previously required the signature of a medical doctor. As noted under Statute 381.986, this will prevent APRNs from prescribing medicinal marijuana or issuing certificates for patients to get medical marijuana. APRNs will also be prohibited from undertaking surgical operations other than subcutaneous treatments under the new regulation. The new rule mandates that autonomous practice APRNs provide written notice to new patients about their credentials and scope of practice (Lachenr et al.,2020).

         The ability of autonomous practice APRNs to commence forced evaluation for mental illness is one of the new law's most significant provisions. The law is known as the Baker Act. Previously, obtaining this endorsement needed the signature of a doctor or psychiatrist, as well as an ex parte order from a circuit or county court or a qualified law enforcement official. Because many APRNs offer direct patient care under a supervision agreement, this has been a source of tremendous worry in the past. The physician is not permitted to be on site during a visit when the APRN has doubts about the individual’s mental health under the supervision agreement. In certain cases, the doctor may not have felt comfortable beginning an involuntary examination, keeping the patient from receiving necessary care. This new legislation will now enable autonomous practice APRNs to file a Baker Act complaint (Maniaci et al.,2019).

         APRNs may seek for a DEA license to recommend prohibited medications in the schedules II through V. According to my research, APRNs may only prescribe prohibited medicines for a maximum of seven days under current legislation, with the exception of psychiatric APRNs, who can prescribe 30-day prescriptions.  Statute 458.3256 went into effect on July 1, 2019. The period of restricted drug prescription for schedule Il medicines is now limited under this new regulation. In most cases, the length of therapy for acute pain cannot exceed three days. In rare cases, schedule Il medicines may be provided for up to approximately 7 days. Every prescription for schedule Il drugs for acute pain must include the phrase "Acute Pain Exception." Chronic pain drugs may still be administered for up to 30 days, however APRNs are not authorized to prescribe for more than 7 days in any case, according to my interpretation of the legislation. Additionally, before prescribing any category II, III, IV, or controlled drug, all prescribers must search through the controlled substances board (Lachnet et al.,2020)

All of this information were new for me and I am sure it will help me ensure that I provide adequate care to my patients. In addition, staying up to date to all these changes can help me contribute to enhancing the quality of the care practice.

References

Maniaci, M. J., Burton, M. C., Lachner, C., Vadeboncoeur, T. F., Dawson, N. L., Roy, A., Dumitrascu, A. G., Lewis, P. C., & Rummans, T. A. (2019). Patients Threatening Harm to Others Evaluated in the Emergency Department under the Florida Involuntary Hold Act (Baker Act). Southern medical journal, 112(9), 463–468. https://doi.org/10.14423/SMJ.0000000000001019

Lachner, C., Maniaci, M. J., Vadeboncoeur, T. F., Dawson, N. L., Rummans, T. A., Roy, A., Hall, L. L., & Burton, M. C. (2020). Are pre-existing psychiatric disorders the only reason for involuntary holds in the emergency department?. International journal of emergency medicine, 13(1), 4. https://doi.org/10.1186/s12245-020-0265-4