Review the Advanced Practice Registered Nurses (APRN) scope of practice as defined by your practice state (California). Answer the following questions:

Table of Contents

QUESTION

Review the Advanced Practice Registered Nurses (APRN) scope of practice as defined by your practice state (California). Answer the following questions:

  • Share your findings of how your state defines an APRNs scope of practice.
  • Why are Standardized Procedures required for APRNs to practice?
  • List two (2) safeguards that Standardized Procedures provide the APRN.
  • Do Standardized Procedures need to include information about the furnishing of drugs and devices?
  • List three (3) patient scenario examples where you would feel compelled to collaborate with your supervising physician and why.

ANSWER

Understanding the APRN Scope of Practice in California: Standardized Procedures, Safeguards, and Collaboration with Supervising Physicians

In California, APRNs include four distinct roles: nurse anesthetists, nurse midwives, clinical nurse specialists, and nurse practitioners. The scope of practice for APRNs in California is defined by the California Nursing Practice Act and is regulated by the California BRN. The scope of practice encompasses a wide range of responsibilities, including but not limited to:

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Assessment and evaluation of the health status of patients.

Diagnosis and treatment of common acute and chronic illnesses.

Ordering and interpretation of diagnostic tests.

Prescription and administration of medications.

Collaboration and consultation with other healthcare professionals.

Patient education and counseling.

Participation in research and evidence-based practice.

Standardized Procedures are required for APRNs to practice in California. These procedures outline the collaborative and supervisory relationship between an APRN and their supervising physician. They are designed to ensure patient safety, provide clear guidelines for the APRN’s practice, and define the parameters of their practice in accordance with the Nursing Practice Act (Altman, 2016). Standardized Procedures are required because APRNs work autonomously, and collaboration with a supervising physician helps ensure that patient care is coordinated, comprehensive, and of the highest quality.

Here are two safeguards that Standardized Procedures provide to APRNs:

Clear Communication and Collaboration: Standardized Procedures establish clear lines of communication and collaboration between the APRN and their supervising physician. This promotes effective teamwork and coordination in patient care, allowing for consultation, referral, or collaboration when necessary. Regular communication between the APRN and the supervising physician ensures ongoing support, guidance, and oversight.

Structured Practice Guidelines: Standardized Procedures provide APRNs with a structured framework for their practice. They outline specific protocols, guidelines, and restrictions relevant to the APRN’s scope of practice (Boehning, 2022e). This helps to ensure consistency, uniformity, and adherence to legal and professional standards. Standardized Procedures also define the parameters within which APRNs can prescribe and administer medications, ensuring patient safety and appropriate use of drugs and devices.

Standardized Procedures do need to include information about the furnishing of drugs and devices. In California, APRNs are authorized to furnish drugs and devices to their patients. Furnishing refers to the act of providing medication or medical devices directly to patients under specified conditions and in compliance with the laws and regulations governing furnishing. The Standardized Procedures must include specific guidelines regarding the furnishing of drugs and devices, including the medications and devices that the APRN is authorized to furnish, the required education and training, and the documentation and record-keeping requirements.

Now, let’s discuss three patient scenario examples where an APRN in California would feel compelled to collaborate with their supervising physician:

Complex Diagnosis and Treatment: In a scenario where a patient presents with a complex or rare condition that falls outside the APRN’s expertise or experience, collaboration with the supervising physician would be necessary. The APRN may seek the physician’s guidance and expertise to ensure an accurate diagnosis and develop an appropriate treatment plan. Collaborating with the supervising physician ensures that the patient receives comprehensive and specialized care.

Medication Management: If a patient’s condition requires a medication or treatment plan that is beyond the scope of the APRN’s authority, collaboration with the supervising physician is essential. For example, prescribing certain controlled substances or adjusting medications for complex conditions may require the approval or oversight of the supervising physician (Zhang, 2022). Collaboration ensures that medication management is optimized and aligned with best practices and regulatory requirements.

Emergencies and Critical Situations: In urgent or critical situations where immediate decisions are required, collaboration with the supervising physician becomes vital. These scenarios may involve complex medical interventions, emergency procedures, or critical care management. Collaboration ensures that the APRN can seek real-time guidance and support from the supervising physician, enabling them to provide timely and appropriate care to the patient.

In summary, the scope of practice for APRNs in California is defined by the Nursing Practice Act and regulated by the California Board of Registered Nursing. Standardized Procedures are required to ensure patient safety, provide guidelines for practice, and define the collaborative relationship between APRNs and their supervising physicians. Standardized Procedures need to include information about the furnishing of drugs and devices. Collaboration with a supervising physician becomes necessary in scenarios involving complex diagnoses, medication management, and emergencies. By optimizing collaboration, APRNs can deliver high-quality, coordinated care to their patients.

References

Altman, S. H. (2016, February 22). Removing Barriers to Practice and Care. Assessing Progress on the Institute of Medicine Report the Future of Nursing – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK350160/ 

Boehning, A. P. (2022e, July 18). Nursing Practice Act. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK559012/ 

Zhang, P. (2022, September 19). Practitioners And Prescriptive Authority. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK574557/ 

 

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