NCSBN Model Nursing Practice Act and Model

Connecticut Nurse Practice Act (NPA) and the APRN Practice Environment

The state of Connecticut is one of those states in which there is full practice authority (FPA) for advanced practice registered nurses (APRNs) such as certified nurse practitioners (CNPs). What this means is that the APRN is allowed to practice autonomously to the fullest extent of their education, training, knowledge, and skills (AANP, 2020). However, immediately after initial licensure, the Connecticut State Nurse Practice Act (NPA) requires that the APRN enters into a collaborative agreement with a practicing physician licensed in the state for a period of three years (Connecticut State Department of Public Health, 2020). This must be a written agreement as stipulated in the Connecticut general statutes §20-87a(2). In my opinion, there should be no restriction on the scope of practice for APRNs whatsoever. The restriction and requirement for supervision by a physician (even if it is just for the first three years of practice as in the case of Connecticut) hinders the APRN from exercising their knowledge and skills freely (Ortiz et al., 2018; Peterson, 2017; Duncan & Sheppard, 2015). NCSBN Model Nursing Practice Act and Model  The only good thing with the Connecticut statutes is that the initial 3 years of practice under a collaborative agreement are only meant to assist the APRN gain experience. This is because after those years the APRN can now practice independently and autonomously in Connecticut.

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            The Connecticut NPA also requires the APRN to have a written collaborative agreement with a practicing physician to supervise them for the initial three years after graduating and getting licensure. With this agreement the (Conn. Gen. Stat. §20-87a(3)) physician will supervise the APRN prescribing and decide the level of Schedule II and III controlled substances the APRN can prescribe (Connecticut State Department of Public Health, 2020). Again, not allowing APRNs to prescribe all classes of scheduled medications is hindering their practice and the provision of primary health care (PHC). A collaborative approach to treating rashes across the lifespan involves the CNP treating the patient at first contact (PHC). However, if the condition does not resolve, the CNP must refer the patient.    NCSBN Model Nursing Practice Act and Model

References

American Association of Nurse Practitioners [AANP] (October 20, 2020). State practice environment. https://www.aanp.org/advocacy/state/state-practice-environment

Connecticut State Department of Public Health (2020). Connecticut general statutes chapter 378 – Nursing. https://portal.ct.gov/DPH/Public-Health-Hearing-Office/Board-of-Examiners-for-Nursing/Board-of-Examiners-for-Nursing

Duncan, C.G. & Sheppard, K.G. (2015). Barriers to nurse practitioner full practice authority (FPA): State of the science. International Journal of Nursing Student Scholarship, 2. https://journalhosting.ucalgary.ca/index.php/ijnss/article/view/56778

Ortiz, J., Hofler, R., Bushy, A., Lin, Y-L., Khanijahani, A., & Bitney, A. (2018). Impact of nurse practitioner practice regulations on rural population health outcomes. Healthcare (Basel), 6(2), 65-72. https://doi.org/10.3390/healthcare6020065

Peterson, M.E. (2017). Barriers to practice and the impact on health care: A nurse practitioner focus. Journal of the Advanced Practitioner in Oncology, 8(1), 74-81. https://doi.org/10.6004/jadpro.2017.8.1.6

Locate Connecticut state nurse practice act (NPA) and associated regulations governing prescribing by advanced practice nurses (CNPs, CRNAs, CNMs, CNSs). Answer and discuss the following in this forum:

Does your NPA require the APRN to have a collaborative agreement with a physician? Discuss whether you think the NPA should or should not require the APRN to have a collaborative agreement, and explain why/why not.

Does your NPA require the APRN to have a prescribing agreement with a physician? Discuss whether you think the NPA should or should not require the APRN to have a prescribing agreement, and explain why/why not.

Does your NPA permit APRNs to prescribe all classes (schedules) of medications? Discuss whether you think the NPA should or should not permit APRNs to prescribe all classes of medications, and explain why/why not.

Describe collaborative approaches to treating rashes across the lifespan. Should the CNP treat without a collaborator or consultant? Support your statements based upon evidence.NCSBN Model Nursing Practice Act and Model