Professional Issues

Question 1

What is certification?

Answer 1

attests to the education, skills, and training of an APN via standardized exams

Question 2

Who certifies APNs?

Answer 2

American Nurses Credentialing Center (ANCC) or American Association of Nurse Practitioners (AANP)

Question 3

What are the requirements to be certified?

Answer 3

completion of an accredited advanced degree program and application for testing

Question 4

What is licensure?

Answer 4

provision of a license to practice as an APN, as defined by State statutes or regulations

Question 5

Who provides licensure for APNs?

Answer 5

State Board of Nursing

Question 6

What are the requirements for licensure?

Answer 6

current RN license in the state and passage of certification exam (ANCC or AANP)

Question 7

What is credentialing?

Answer 7

obtaining the authorization by a hospital’s governing board to provide specific patient care and treatment services within defined limits

Question 8

Who credentials APNs?

Answer 8

hospital’s highest governing body (e.g., Board of Directors) - but may be delegated (e.g., health insurance providers)

Question 9

What are the key elements of credentialing?

Answer 9

individual’s license, education, training, experience, competence, health status, and judgment; must be reassessed every 2 years (static information reviewed only one, dynamic information verified at review or reappointment); based on peer review

Question 10

What are privileges?

Answer 10

authorization of a credentialed individual to perform or order specific diagnostic or therapeutic services within a hospital

Question 11

Who grants privileges?

Answer 11

hospital’s highest governing body (e.g., Board of Directors) - but may be delegated

Question 12

What are the key elements of privileges?

Answer 12

license and credentials to practice; reassessed every 2 years; based on peer review; 4 methods for focused review: (1) direct observation, (2) chart review, (3) monitoring of diagnostics and treatment patterns, and (4) discussion with other members of treatment team

Question 13

What is scope of practice?

Answer 13

defines the functions that an APN can perform

Question 14

Who authorizes scope of practice?

Answer 14

State statutes or regulations

Question 15

What are the key elements of scope of practice?

Answer 15

professional association versus State statutes/regulations; diagnosis, treatment, prescription, hospital admission, laceration repair, teaching, ordering diagnostic tests, physician involvement

Question 16

What are standards of practice?

Answer 16

requirement to ensure the highest quality of care is provided by APNs

Question 17

Who authorizes standards of practice?

Answer 17

professional societies (e.g., American Association of Nurse Practitioners)

Question 18

What are the key elements of standards of practice?

Answer 18

conformance with regulatory requirements; participation in management activities; performance of functions within full scope of practice; maintenance of health and medical records for patients; participation in quality assurance; maintenance of high standards of professionalism; competitive salaries; use of the scientific process and national standards in managing patient care; serving as patient advocate; maintenance of competence

Question 19

What is prescriptive authority?

Answer 19

ability of APNs to independently prescribe medications and controlled drugs, devices, adjunct health/medical services, durable medical goods, and other equipment and supplies - does not require collaboration with a physician

Question 20

Who establishes prescriptive authority?

Answer 20

State statutes or regulations - State Board of Nursing grants authorization

Question 21

What factors are considered in establishing prescriptive authority (i.e., sources of variation across states)?

Answer 21

in some states, prescriptive authority is granted at the time of APN licensure - in others, the APN must apply separately for these privileges; how much and what type of advanced pharmacology and pharmacotherapeutics education is required; whether and how much supervision of prescribing practice must take place before independent prescriptive authority is granted; whether all, or only some, APN roles can be granted prescriptive authority; restrictions on prescribing controlled substances or the schedules of controlled drugs included; requirements for collaboration with a physician

Question 22

What are the requirements for prescriptive authority in New Jersey?

Answer 22

completion of a graduate-level pharmacology course/CE; complete 6 contact hours in controlled substances pharmacology, prescribing, and addiction; authority to prescribe controlled substances requires CDS registration; prescription of controlled drugs requires use of universal New Jersey prescription blanks; all prescribers must access the PDMP when prescribing controlled substances to a patient for the first time and quarterly thereafter; joint protocol/standing orders