Family Nurse Practitioner and Kansas Statutes



Family Nurse Practitioner and Kansas StatutesDana M. HoganWashburn UniversityProfessional Role DevelopmentNU 510Joleyn OwensJuly 1, 2011Family Nurse Practitioner and Kansas StatutesFamily Nurse Practitioner (FNP) is a specialized Registered Nurse (RN) that has had extensive knowledge and training in the diagnosis and treatment of acute and chronic illnesses in newborn to elderly patients (Nurse Practitioner, 2011). FNP's use primary, secondary, and tertiary prevention to optimize the health of patients and promote healing. FNP's in the state of Kansas are authorized to practice by the Kansas State Board of Nursing (KSBN) and must follow the regulatory statutes that are passed through the legislation. By following the KSBN Nursing Practice Act, quality and safety of the care given can be ensured. This paper will discuss the role of the FNP along with the KSBN statutes that FNP's licensed in the state of Kansas must adhere to. After the completion of an approved graduate level education specializing in FNP an application must be made and approved by the KSBN prior to practicing as an Advanced Registered Nurse Practitioner (ARNP) in the state of Kansas (KSBN, 2010). National certification as a FNP is not required in Kansas however 42 states require both initial and maintenance of national certification to practice (Watson & Hillman, 2010). According to the American Academy of Nurse Practitioners (AANP) regardless of state requirements, national certification examinations offer the entry level ARNP a way to validate their knowledge, education, and expertise in the area of FNP (American Academy of Nurse Practitioners [AANP], 2009-2010). Licensed ARNP's in Kansas retain licensing through a two year renewal cycle in which approved continuing education is required (KSBN, 2010). The scope of practice of the FNP varies from state to state (Watson & Hillman, 2010). In Kansas, FNP's are not required to have the immediate or physical presence of a physician as they are allowed to make independent decisions about patients based on the authorization for collaborative practice with one or more physicians (KSBN, 2010. The authorization for collaborative practice is a jointly developed agreement entered into by a physician or group with an ARNP that must be reviewed annually (KSBN, 2010). This agreement authorizes the ARNP to develop and manage the plan of care for patients based upon the agreed upon operating procedures (KSBN, 2010). With the independent practice of FNP's they are held directly accountable, responsible, and liable for the care of their patients' (KSBN, 2010). Watson and Hillman identified six liability issues: unlicensed practice of medicine, failure to adequately diagnose, negligence in the delivery of health care, conduct exceeding physician-delegated authority resulting in harm, conduct exceeding scope of practice resulting in harm, and failure to refer appropriately (Watson & Hillman, 2010). The KSBN also gives the ARNP the authority to prescribe medication through a set of written prescriptive protocols developed and reviewed annually by the physician or group and the ARNP (KSBN, 2010). These written protocols must be keep in the ARNP's place of practice and contain each disease or injury with the corresponding class of drugs that the ARNP may prescribe (KSBN, 2010). The KSBN also requires that each prescription written by an ARNP contain the name, address, and telephone number of the practice location of the ARNP and the responsible physician, be signed by the ARNP with the title of A.R.N.P., and contain the DEA number if prescribing a controlled substance (KSBN, 2010).The traditional setting for the FNP is clinical outpatient primary care however more and more FNP's are expanding the role and the scope of practice to different areas. One study done to examine Nurse Practitioners (NP) practice setting and additional education received from the employer showed that 5% of FNP's practice in nontraditional practice settings with 65% of those working in a high-acuity emergency care departments (Keough, Stephenson, Martinovich, Young, & Tanabe, 2011). KSBN allows ARNP's to work varies settings in an "expanded role at a specialized level through the application of advance knowledge and skills" (KSBN, 2010). The advanced knowledge and skills are attained through initial education and additional training that ensure competency of the ARNP (KSBN, 2010). The study by Keough et al, found that additional education through field training, seminars, and mentoring would benefit and expand the FNP's practice (Keough et al., 2011). ARNP's are given the authority to diagnosis and treat patients with in their scope of practice. The KSBN defines diagnosis in the context of nursing practice as "identification of and discrimination between physical and psychosocial signs and symptoms essential to effective execution and management of the nursing regimen and shall be construed as distinct from a medical diagnosis" (KSBN, 2010). The Kansas FNP has the ability under the authorization for collaborative practice to make an independent diagnosis, determine appropriate treatments, and establish an appropriate plan of care for patients. The quality of care given by ANP's is seen by patients as equal to or better than that of physician providers (Horrocks, Anderson, & Salisbury, 2002). A systemic review of 11 randomized clinical trials and 23 observational studies where examined for the primary care setting looking at patient satisfaction, health status, cost, and process of care (Horrocks et al., 2002). The study found that the patients where more satisfied with NP's as they offered more information, spent a longer amount of time with the patients, had more complete documentation, and communicated better than physicians (Horrocks et al., 2002).FNP's are well know ledged, have an extended skill set, and are varied in clinical settings. Patients perceive receiving the same or better care from FNP's as they do from physicians in the same setting of care (Horrocks et al., 2002). The KSBN uses the scope of practice to ensure that the quality of care, safety of care, and the skills of the FNP are held to a high standard (KSBN, 2010). With the vast settings that FNP's can practice in, patients are more likely than not to have an experience with a FNP than in past years. As the Nursing Practice Act increases the role of the FNP patients can obtain the same high quality of care without ever seeing the physician.ReferencesAmerican Academy of Nurse Practitioners. (2009-2010). American academy of nurse practitioners national certification program. Retrieved June 19, 2011, from State Board of Nursing (KSBN), (2010). Nurse practice act: statutes & administrative regulations. Topeka, KS: Retrieved June 28, 2011, from , S., Anderson, E., & Salisbury, C. (2002). Systemic review of whether nurse practitioners working in primary care can provide equivalent care to doctors [Entire issue]. British Medical Journal , 324(7341). Retrieved from EBSCOhostKeough, V. A., Stephenson, A., Martinovich, Z., Young, R., & Tanabe, P. (2011). Nurse practitioner certification and practice settings: Implications for education and practice [Entire issue]. Journal of Nursing Scholarship, 43(2). doi: 10.1111/j.1547-5069.2011.01395.x.Nurse practitioner. (2011). In Nurse Practitioner. Retrieved June 19, 2011, from , E., & Hillman, H. (2010). Advanced practice registered nursing: Licensure, education, scope of practice, and liability issues [Professional practice, trends, and issues]. Journal of Legal Nurse Consulting, 21(3), 25-29. Retrieved from EBSCOhost ................
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