APRNs and State Regulations

APRNs and State Regulations

APRNs and State Regulations 150 150 Peter

APRNs and State Regulations


Develop a personal philosophy and framework acknowledging professional and accrediting agency competencies relating to the role and scope of practice of the family nurse practitioner. Identify a nurse theorist that you align your current/ planned practice and how they provide the foundation for this philosophy development.
Describe the type of educational courses and professional requirements required for APRN professional certification and licensing within the state that you will practice.
Identify the precise application process for your certification exam, your state regulations for application for prescriptive authority/practice, and issues related to APRN practice within your state.
Evaluate and discuss APRN roles and prescriptive privileges and impact on client safety and care
Compare the differences between prescriptive authority, credentialing, and clinical privileges and how each of these impact client safety and care
Evaluate the development of the advanced practice nurse role from a global perspective.

Assignment Guidelines:

1200 – 1500 word paper (not including the cover page and references)
Required APA 7th edition for references and citations
Include a minimum of 6 scholarly references (does not include text or websites) and the majority of references must not be older than 5 years
Demonstrate analysis, evaluation and synthesis of information (see the rubric for specifics)

Sample Paper

APRNs and State Regulations

Personal Philosophy and Framework

            My philosophy concerning the role and scope of family nurse practitioners is that they need to provide patient-centered care. Patient-centered care involves healthcare services that take into account the patients’ preferences, being respectful, and where the clinical decisions are guided by the values, needs, and preferences of the patients. I believe that patient-centered care is essential since it enhances access to personalized healthcare services and the involvement of patients and their families in the process, which facilitates an easy transition from the healthcare facility to home care after being discharged. It also promotes respect for personal values and preferences, promotes patient education, and ensures emotional support due to the involvement of family members. Core competencies guide this philosophy for patient-centered care, which includes identifying the needs of the patients, expressing respect for patient values, preferences, and emotions, relieving pain and suffering.

Virginia Henderson influences this philosophy. Henderson developed the needs theory, which suggests that the role of a nurse in caring for a patient is to increase their independence and thus promote quick progress through the hospital. Henderson believed that a patient wholeness is determined by the balance between emotional and physiological needs. This theory thus supports my philosophy of patient-centered care because the main aim of patient-centered care is to increase independence by supporting them emotionally through family engagement, recognizing their values and preferences, and meeting their physiological needs by integrating their values and preferences. Patient-centered care also promotes patient independence by encouraging patient education, which increases knowledge and empowers patients to take actions that promote health and emotional wellbeing (Indra, 2018).

APRN Professional Certification and Licensing in Wisconsin

In Wisconsin, advanced practice nurses are registered nurses with national certification and have met the set educational requirements. Under the current law, any person seeking APRN/APNP certification must be licensed as a registered nurse by the board of nursing, must have completed a graduate or post-graduate program that prepares them to provide care as APRNs in one of the four recognized roles, including nurse practitioner, certified nurse-midwife, clinical nurse specialist and certified registered nurse anesthetist. One must also earn a master’s degree in a regionally recognized institution, which can be in nursing or another health-related field. The institution must be accredited by a regional agency that is approved by the board of education in the state. The master’s degree, however, does not apply to APN certifications earned by 1 July 1998. Other typical requirements by the state regulations include complete course work in pharmacology, advanced pathophysiology, advanced assessment, and approximately 500 clinical hours in one of the recognized roles, which should be supervised. Another requirement is that one should hold malpractice insurance unless they fall under the exemption category. After submitting the application letter, one must pass a test on state laws and rules for successful certification and licensing (Nursing Licensure. org, 2022).

Identify the Precise Application Process for your Certification Exam, your State Regulations for Application for Prescriptive Authority/practice

To obtain the APRN certification, one must meet the requirements such as a master’s degree or doctoral program from an accredited institution. The applicant can then apply to sit for the exam, which requires one to have an RN license from Wisconsin or a compact state, a minimum of 500 supervised clinical hours, a doctoral or master’s degree from an accredited institution. Once the application is accepted, the applicant is required to pass the certification exam with a passing score of 85% or above. After successful completion, a certificate is issued, and in case of fail, a retake is required. The prescriptive authority in Wisconsin is regulated under APNP. To be certified as an APNP, one must first be licensed as an APRN. The APRN license is obtained from bodies such as the American Association of Nurse Practitioners. The initial step is to prove that one holds APRN certification and has a qualifying master’s degree. The applicant must then submit official verification from all the states he/she has had prescriptive authority. This is submitted in form 741, directly to the licensing agency. An initial fee of $75 is paid for credentials, and another $75 is paid for the jurisprudence exam. A score of less than 85% in the exam requires the individual to take another exam. For the application of prescriptive authority, one is required to have had 45 contact hours in clinical pharmacotherapeutics in the last 3 years (Nursing Licensure. org, 2022).

Evaluate and Discuss APRN Roles and Prescriptive Privileges and Impact on Client Safety and Care

Advanced practice registered nurses comprise four specialties, including nurse practitioners, certified nurse-midwife, clinical nurse specialist, and certified registered nurse anesthetist, and they all play an essential role in the provision of healthcare services. APRNs are primary care providers and are involved in preventive care services. The main roles of APRNs include diagnosis and treatment of illness, for example, the nurse practitioners. Certified nurse-midwife, provides primary reproductive and gynecological healthcare services. Nurse practitioners provide a wide range of care services across the lifespan, such as management of chronic diseases, diagnosis, and treatment, while nurse anesthetists provide a full range of services in pain management. Prescriptive privileges for APRNs allow them to provide a prescription for their patients. This is important in reducing the waiting periods to meet a physician for a prescription (Philips, 2020).

The impact of APRNs roles and prescription privileges on patient safety and care is that it has increased access to care services and has reduced waiting periods, allowing for timely diagnosis and treatment of diseases, leading to improved care outcomes. For example, previously, only the physicians were allowed to make diagnoses and provide prescriptions; this led to longer waiting periods for patients, contributing to the deterioration of health. However, with the increased availability of APRNs, the patients can be diagnosed and receive the appropriate prescriptions within a shorter period, leading to improved health outcomes (Philips, 2020).

Compare the differences between prescriptive authority, credentialing, and clinical privileges and how each of these impact client safety and care

Prescriptive authority refers to the ability of care providers to give drug prescriptions, including those of controlled substances. The level of authority is dependent on the drug in question and the qualifications of the care providers. Doctors of medicine and doctors of osteopathic medicine have the highest level of authority in drug prescription. APRNs prescriptive authority is usually determined by the state where one is practicing. For example, in Wisconsin, APRNS have to apply for an APNP license for prescriptive authority (Zhang & Patel, 2021). In most cases, however, APRNs’ prescriptive authority is limited. For example, most APRNs are not allowed to prescribe controlled substances or be supervised by a physician. Limited prescriptive authority for APRNs negatively impacts patient care and safety since, in the absence of a physician, the patient has to wait for a longer period to receive the appropriate care, which contributes to the deterioration of health (Zhang & Patel, 2021).

Credentialing refers to a formal process that involves establishing the qualification for medical professionals and assessing the educational background legitimacy of the care providers. Credentialing contributes to improved patient safety and care. Credentialing scrutinizes a care provider’s medical and educational background to ensure that they possess an adequate level of education and skill. Through this process, only those care providers that are qualified and possess adequate skills are allowed to treat patients, hence ensuring the quality and safety of the patients (Patel & Sharma, 2021).

Clinical privileges are authorization given by a healthcare facility to care providers to provide specific care services and are usually limited based on the care provider’s qualifications. They usually include a set of clinical responsibilities that a care provider can conduct in the facility. Clinical privileges contribute to improved patient care and safety since the care providers are limited to practice only what they are trained on and are competent enough to accomplish (Lu et al., 2020).

Evaluate the Development of the Advanced Practice Nurse Role from a Global Perspective

Over the last few decades across the globe, the role of advanced practice nurses has expanded to include more responsibility. Although there are differences in APRN requirements in different countries, in most countries, APNs can now provide a wider range of services than they used to in the past. In the US, APNs are now allowed to make diagnoses and provide prescriptions even for controlled substances; however, physicians and other regulatory bodies require some level of supervision. Also, in other countries, APNs are allowed to make diagnoses and prescribe drugs, among other functions such as engaging in leadership, which is a recent trend. In the future, the role of APNs is expected to continue expanding to meet the expected increase in healthcare demand and respond to physician shortages in the different regions of the world (Schober & Stewart, 2019). 


Indra, V. (2018). Nursing theories: a review. International Journal of Advances in Nursing Management, 6(3), 271-274. https://www.indianjournals.com/ijor.aspx?target=ijor:ijanm&volume=6&issue=3&article=023

Lu, W., Arouchanova, D., Dang, R., & Mirzaian, E. (2020). Impact of credentialing and provider privileges on clinical interventions made by advanced practice pharmacists in California. Journal of the American Pharmacists Association, 60(5), 663-668. https://www.sciencedirect.com/science/article/abs/pii/S1544319120300959

Nursing Licensure. org, (2022) Advanced Practice Nurse Prescriber (APNP) Requirements in Wisconsin Retrieved from: https://www.nursinglicensure.org/np-state/wisconsin-nurse-practitioner/

Patel, R., & Sharma, S. (2020). Credentialing. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK519504/

Phillips, S. J. (2020). 32nd Annual APRN Legislative Update: Improving access to high-quality, safe, and effective healthcare. The Nurse Practitioner, 45(1), 28-55. https://journals.lww.com/tnpj/FullText/2020/01000/32nd_Annual_APRN_Legislative_Update__Improving.6.aspx

Schober, M., & Stewart, D. (2019). Developing a consistent approach to advanced practice nursing worldwide. International nursing review, 66(2), 151-153. https://onlinelibrary.wiley.com/doi/full/10.1111/inr.12524

Zhang, P., & Patel, P. (2021). Practitioners And Prescriptive Authority. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK574557