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· Grid View · List View Excellent Good Fair Poor Main Posting 45 (45%) - 50 (50%) Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. Supported by at least three current, credible sources. Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. 40 (40%) - 44 (44%) Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. At least 75% of post has exceptional depth and breadth.

Supported by at least three credible sources. Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. 35 (35%) - 39 (39%) Responds to some of the discussion question(s). One or two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module. Post is cited with two credible sources. Written somewhat concisely; may contain more than two spelling or grammatical errors. Contains some APA formatting errors. 0 (0%) - 34 (34%) Does not respond to the discussion question(s) adequately.

Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible sources. Not written clearly or concisely.

Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style. Main Post: Timeliness 10 (10%) - 10 (10%) Posts main post by day %) - 0 (0%) 0 (0%) - 0 (0%) 0 (0%) - 0 (0%) Does not post by day 3 First Response 17 (17%) - 18 (18%) Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. . Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English. 15 (15%) - 16 (16%) Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. . Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English. 13 (13%) - 14 (14%) Response is on topic and may have some depth. Responses posted in the discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

0 (0%) - 12 (12%) Response may not be on topic and lacks depth. Responses posted in the discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited. Second Response 16 (16%) - 17 (17%) Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. . Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English. 14 (14%) - 15 (15%) Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English. 12 (12%) - 13 (13%) Response is on topic and may have some depth. Responses posted in the discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. . Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

0 (0%) - 11 (11%) Response may not be on topic and lacks depth. Responses posted in the discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited. Participation 5 (5%) - 5 (5%) Meets requirements for participation by posting on three different days.

0 (0%) - 0 (0%) 0 (0%) - 0 (0%) 0 (0%) - 0 (0%) Does not meet requirements for participation by posting on 3 different days Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier. · Chapter 1, “Prescriptive Authority†(pp.

1–3) · Chapter 2, “Rational Drug Selection and Prescription Writing†(pp. 4–7) · Chapter 3, “Promoting Positive Outcomes of Drug Therapy†(pp. 8–12) · Chapter 4, “Pharmacokinetics, Pharmacodynamics, and Drug Interactions†(pp. 13–33) · Chapter 5, “Adverse Drug Reactions and Medication Errors†(pp. 34–42) · Chapter 6, “Individual Variation in Drug Response†(pp.

43–45) American Geriatrics Society 2019 Beers Criteria Update Expert Panel. (2019). American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 67 (4), 674–694. doi:10.1111/jgs.15767 This article is an update to the Beers Criteria, which includes lists of potentially inappropriate medications to be avoided in older adults as well as newly added criteria that lists select drugs that should be avoided or have their dose adjusted based on the individual's kidney function and select drug-drug interactions documented to be associated with harms in older adults. Drug Enforcement Administration. (n.d.-a).

Code of federal regulations. Retrieved February 1, 2019, from This website outlines the code of federal regulations for prescription drugs. Drug Enforcement Administration. (n.d.-b). Mid-level practitioners authorization by state. Retrieved May 13, 2019 from This website outlines the schedules for controlled substances, including prescriptive authority for each schedule.

Drug Enforcement Administration. (2006). Practitioner’s manual. Retrieved from This manual is a resource for practitioners who prescribe, dispense, and administer controlled substances. It provides information on general requirements, security issues, recordkeeping, prescription requirements, and addiction treatment programs. Drug Enforcement Administration. (n.d.-c).

Registration. Retrieved February 1, 2019, from This website details key aspects of drug registration. Fowler, M. D. M., & American Nurses Association. (2015).

Guide to the Code of Ethics for Nurses with Interpretive Statements: Development, Interpretation, and Application (2nd ed.). Silver Spring, Maryland: American Nurses Association. This resource introduces the code of ethics for nurses and highlights critical aspects for ethical guideline development, interpretation, and application in practice. Institute for Safe Medication Practices. (2017). List of error-prone abbreviations, symbols, and dose designations.

Retrieved from This website provides a list of prescription-writing abbreviations that might lead to misinterpretation, as well as suggestions for preventing resulting errors. Ladd, E., & Hoyt, A. (2016). Shedding light on nurse practitioner prescribing. The Journal for Nurse Practitioners, 12 (3), 166–173. doi:10.1016/j.nurpra.2015.09.17 This article provides NPs with information regarding state-based laws for NP prescribing. Sabatino, J.

A., Pruchnicki, M. C., Sevin, A. M., Barker, E., Green, C. G., & Porter, K. (2017). Improving prescribing practices: A pharmacistâ€led educational intervention for nurse practitioner students. Journal of the American Association ofNursePractitioners, 29 (5), 248–254. doi:10.1002/.12446 The authors of this article assess the impact of a pharmacistâ€led educational intervention on family nurse practitioner (FNP) students’ prescribing skills, perception of preparedness to prescribe, and perception of pharmacist as collaborator.

Paper for above instructions

Understanding Prescriptive Authority and the Implications of Medication Management

In the ever-evolving field of healthcare, prescriptive authority plays a crucial role in enhancing patient care and managing therapeutic outcomes. Effective medication management is not only about understanding the prescription laws but also entails pharmacology principles, adherence to ethical guidelines, and the ability to evaluate patient responses to therapy. This reflection synthesizes knowledge gained from the course readings and current credible literature on prescriptive authority, particularly among advanced practice nurses (APNs).

Prescriptive Authority and Its Regulation

Prescriptive authority refers to the legal authorization that allows healthcare providers, such as nurse practitioners (NPs), to prescribe medications and treatments. The outlined regulations differ by state, with each jurisdiction governing the practices regarding what medications can be prescribed and under what circumstances. According to the Drug Enforcement Administration (DEA), the regulations stipulate that mid-level practitioners must adhere to specific guidelines depending on the controlled substances they are authorized to prescribe (Drug Enforcement Administration, n.d.-b).
Recognition of prescriptive authority for NPs has evolved over the years, reflecting the growing acknowledgment of their education and competencies. For instance, an analysis by Ladd and Hoyt (2016) highlights that appropriate prescription practices by NPs can mitigate medication errors, thus improving patient safety and health outcomes. In accordance with the updated AGS Beers Criteria, it is crucial for prescribers to be aware of inappropriate medications for older adults, as these can lead to adverse effects (American Geriatrics Society, 2019). The capability of NPs to prescribe safely should always involve a thorough understanding of these criteria alongside state-specific prescribing regulations.

Rational Drug Selection

Rational drug selection is at the heart of effective medication management. This process involves evaluating a patient’s medical history, current medications, and overall health status to devise an optimal pharmacotherapy plan. According to Rosenthal and Burchum (2021), factors such as pharmacokinetics, pharmacodynamics, and individual patient variations must be meticulously considered when determining the appropriateness of a medication. APNs play a pivotal role in ensuring prescriptions align with each patient's unique profile to avoid adverse drug reactions (ADRs) and suboptimal outcomes.
A reflective practice involving continual education on drug interactions, side effects, and available alternatives is essential for all prescribers (Sabatino et al., 2017). Through educational interventions, developing enhanced competencies in medication management can significantly improve NPs’ confidence in their authority and efficacy (Sabatino et al., 2017).

Ethical Considerations in Prescribing

The ethical landscape surrounding prescriptive authority cannot be overlooked. According to the American Nurses Association (ANA), the Code of Ethics for Nurses establishes that nurses must embrace their role in advocating for patients (Fowler & American Nurses Association, 2015). Ethical prescribing goes beyond mere adherence to state laws; it encompasses moral accountability toward safeguarding patient welfare. This ethical framework encourages prescribers, especially APNs, to remain vigilant regarding the implications of their prescriptions and the potential harm that may arise from inappropriate medication use.
Furthermore, fostering professional communication is critical in upholding ethical standards, particularly when collaborating with other healthcare team members. Engaging effectively with pharmacists, for example, can promote discussion around drug therapy options and alternatives, further supporting positive patient outcomes and addressing any pharmacological concerns (American Geriatrics Society, 2019).

Promoting Positive Outcomes through Patient-Centered Care

Patient-centered care is a foundational principle in contemporary healthcare. Understanding the sociocultural backgrounds and individual preferences of patients can enrich their therapeutic experience and enhance the chances of compliance with prescribed regimens. As outlined by Rosenthal and Burchum (2021), the prescriber-patient relationship plays a vital role in influencing medication adherence and outcomes.
Engaging patients through shared decision-making creates a sense of ownership in their therapeutic management. For NPs, ensuring that patients understand the reasons for their prescribed medications fosters trust and diminishes the likelihood of non-adherence to treatment plans (Institute for Safe Medication Practices, 2017). APNs should apply effective communication strategies to educate patients about their medications, including the purpose, potential side effects, and the importance of following the prescribed regimen.

Conclusion

Effective management of prescriptive authority among healthcare providers, especially APNs, is vital for promoting safe, ethical, and patient-centered care. Understanding the legalities, engaging in rational drug selection, adhering to ethical practices, and fostering positive patient communication are fundamental in improving therapeutic outcomes. By embedding these practices into routine care, nurse practitioners can enhance their contributions to health and wellness outcomes across the patient population.

References

1. American Geriatrics Society. (2019). American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 67(4), 674-694. doi:10.1111/jgs.15767
2. Drug Enforcement Administration. (n.d.-a). Code of federal regulations. Retrieved from [DEA website].
3. Drug Enforcement Administration. (n.d.-b). Mid-level practitioners authorization by state. Retrieved from [DEA website].
4. Fowler, M. D. M., & American Nurses Association. (2015). Guide to the Code of Ethics for Nurses with Interpretive Statements: Development, Interpretation, and Application (2nd ed.). Silver Spring, Maryland: American Nurses Association.
5. Institute for Safe Medication Practices. (2017). List of error-prone abbreviations, symbols, and dose designations. Retrieved from [ISMP website].
6. Ladd, E., & Hoyt, A. (2016). Shedding light on nurse practitioner prescribing. The Journal for Nurse Practitioners, 12(3), 166-173. doi:10.1016/j.nurpra.2015.09.17
7. Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.). St. Louis, MO: Elsevier.
8. Sabatino, J. A., Pruchnicki, M. C., Sevin, A. M., Barker, E., Green, C. G., & Porter, K. (2017). Improving prescribing practices: A pharmacist-led educational intervention for nurse practitioner students. Journal of the American Association of Nurse Practitioners, 29(5), 248-254. doi:10.1002/12446
9. Drug Enforcement Administration. (2006). Practitioner’s manual. Retrieved from [DEA website].
10. Drug Enforcement Administration. (n.d.-c). Registration. Retrieved from [DEA website].
This synthesis integrates reflections from course materials regarding prescriptive authority, advocating for a comprehensive understanding of its implications for practice among advanced practice nurses.