prescribing in nursing
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he Role of the Nurse Practitioner as Prescriber p. 3-10
Roles of Registered Nurses and Advanced Practice Nurses Who are Not Nurse Practitioners p.3
Registered Nurses
Advanced Practice Nurses
Roles
...
and Responsibilities of Nurse Practitioners p. 4
Advanced Knowledge p.4
Benefits of Nurse Practitioners as Prescriber p. 5
Roles and Responsibilities of Physician Assistants p. 5
Clinical Judgement in Prescribing p. 6
Collaboration with other Providers p. 7
Physicians
Pharmacists
Other Nurse Practitioners and Advanced Practice Nurses who are Prescribers
Other APNs who are not prescribers
Physician Assistants
Nurses not in APN roles
Canadian Nurse Practitioner Practice p.8
Current Issues and Trends In Health Care and Their Effect on Prescriptive Authority p.8
Autonomy and Prescriptive Authority
Interdisciplinary Teams
Level of Education of Team Members
Reimbursement
Chapter 1 Outline
The Role of the Nurse Practitioner as Prescriber p. 3-10
Roles of Registered Nurses and Advanced Practice Nurses Who are Not Nurse
Practitioners p.3
o Registered Nurses
Advocate for patients, give input on medications, input is highly valued
o Advanced Practice Nurses
States vary in their laws related to prescriptive authority for non APNs, a
lot of APNs who are not NPs do not have prescriptive authority
Roles and Responsibilities of Nurse Practitioners p. 4
o The degree of autonomy in this role and the breadth of drugs that can be
prescribed varies from state to state , based on the nurse practice act of that state
o Every January the issue of the journal for Practitioners and an issue of the
American journal for nurse practitioners present a summary of each states practice
acts relate to titling, roles, prescriptive authority,
o January 2009, NP regulation of practice and prescribing authority true statements
p.4 para 2 (bullets)
Advanced Knowledge p.4
o Need to know what labs to order when ordering drugs, need to understand
dosages with large and small volumes of distribution and when selecting drugs for
renal, pregnant, cardiac patients, need to know prescriptive authority
o How to correctly write prescriptions
Benefits of Nurse Practitioners as Prescriber p. 5
o Role of nurse is similar to Np such as teaching lifestyle management issues for
cardiac patient, relaxation techniques for a patient experiencing stress, appropriate
exercise for a patient with low back pain or arthritis,
o NP must have reliable info on Herbal therapies and having knowledge of nutrition
o Knowledge of how drugs affect drug therapy
o Choices of NP also depend on patient culture, pt. preferences, attitudes, and
willingness
o NPs should look at whole patient.. treating holistically
o Less than 50% of patients adhere to medication regimen, research shows that
adherence is higher for NPs because of looking at the whole patient
o Improved adherence : patient education, NPs take more times to teach their
patients about their disease process and relationship to treatment regimen
Roles and Responsibilities of Physician Assistants p. 5
o Have title protection in all states
o As of may of 2008, all states have some form of legal definition of prescriptive
authority. The laws vary but the following are generally true
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