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APRN COMPACT: Past, Present, and Future

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2000: The RN/LPN compact becomes effective among Utah, Maryland, Arkansas, Texas ... Each state enacts a compact via legislation ... General Purposes of the Compact ... – PowerPoint PPT presentation

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Title: APRN COMPACT: Past, Present, and Future


1
APRN COMPACT Past, Present, and Future
Laura Poe, MS, RN Chair, NLCA
2
1903
  • World Series had begun
  • Wright Brothers took flight
  • Ford Motor Company was founded
  • Telephone had been in existence for 27 years
  • Computer would not be invented for another 43
    years (1946)
  • NC passed the first Nurse Practice Act in U.S.

3
Much has changed . . . except regulation
4
Objectives
  • Review the history of mutual recognition.
  • List the components of the model APRN compact.
  • Discuss issues of concern.

5
Telenursing Differs from Other Telepractice
  • Physician consultation generally involves a
    licensed practitioner in each state
  • Telenursing generally involves the nurse being in
    direct contact with the patient frequently in
    the patients home

6
RegulatoryIssues
?
  • States right or Interstate Commerce 200
    years of case law ruled that states have
    the right to protect consumers.
  • Where does practice occur location of provider
    or patient?
  • Does practice by electronic means constitute the
    practice of nursing?

7
NCSBNs Definition of Telenursing
  • The practice of nursing over distance using
    electronic means

8
Vision Statement
  • A state nursing license recognized nationally
    and enforced locally

9
Solution MUTUAL RECOGNITION
  • MSR Task Force
  • Surveys, interviews, conferences
  • Best model to protect public decrease barriers

10
History of Mutual Recognition
  • 1994 1997 NCSBN task forces studied
    regulatory models and telehealth.
  • 1997 NCSBN Delegate Assembly endorsed mutual
    recognition model for nursing regulation for
    RN/LPN and APRN at a later date.
  • 1997 Special session of NCSBN Delegate Assembly
    approved model RN/LPN compact language.

11
History (continued)
  • 1998 Utah became the first state to adopt the
    RN/LPN compact.
  • 2000 The RN/LPN compact becomes effective among
    Utah, Maryland, Arkansas, Texas RN, Texas VN, and
    North Carolina.
  • 2001 2003 APRN Compact Development
    Subcommittee charged with developing model
    language.

12
History (continued)
  • 2002 NCSBN Delegate Assembly approved the model
    APRN compact language.
  • 2004 Utah became the first state to adopt the
    APRN compact.

13
Basic Concepts of Mutual Recognition
  • Allows nurse to have one license in state of
    residence and practice in party states
  • Nurse is subject to each states practice laws
    and discipline
  • Practice allowed physically or electronically
  • Each state must enter into
    interstate compact

14
Interstate Compact
  • Agreement between 2 or more states to remedy a
    problem of multistate concern
  • Each state enacts a compact via legislation
  • Mutual recognition of those who enact the
    legislation
  • Example - Drivers License Model

15
General Purposes of the Compact
  • Facilitate the states responsibility to protect
    the publics health and safety
  • Ensure and encourage the cooperation of party
    states
  • Facilitate the exchange of information
    between party states

16
Purposes of the Compact (continued)
  • Promote compliance with the laws governing the
    practice of nursing in each jurisdiction
  • Invest all party states with the authority to
    hold a nurse accountable

17
Model APRN Compact Addresses
  • General Provisions and Definitions
  • Jurisdiction
  • Discipline
  • Information Sharing
  • Compact Administration

18
1. General Provisions Definitions
  • APRN means a CRNA, NP, CNM, or CNS to the extent
    a party state licenses or grants authority to
    practice in that APRN role and title.
  • APRN Licensure/Authority to Practice means
    the regulatory mechanism used by a party
    state to grant legal authority to
    practice as an APRN.

19
General Provisions (continued)
  • APRN Uniform Licensure/Authority to Practice
    Requirements means those agreed upon minimum
    uniform licensure, education, and examination
    requirements adopted by licensing boards for the
    recognized APRN role and title.

20
General Provisions (continued)
  • State Practice Laws means a party states laws
    and regulations that govern APRN practice, define
    the scope of advanced nursing practice
    including prescriptive authority and create the
    methods and grounds for imposing discipline.
  • State Practice Laws does not include the
    requirements to obtain or retain
    licensure/authority.

21
General Provisions (continued)
  • All APRN compact party states must participate in
    the RN/LPN compact (Nurse Licensure Compact).
  • A state may not enter into the APRN compact until
    it adopts at a minimum the APRN Uniform
    Licensure/Authority to Practice Requirements.

22
General Provisions (continued)
  • The APRN multistate advanced practice privilege
    does not include prescriptive authority. A state
    may grant prescriptive authority on the basis of
    a multistate advanced practice privilege to the
    extent permitted by state laws.

23
2. Jurisdiction
  • APRN is licensed in the state of
    residence home state.
  • APRN may only have one compact license.
  • APRN is granted the privilege (via the compact)
    to practice in other party states (remote states)
    under the same role and title as authorized in
    the home state, provided the remote state
    recognizes that role and title.

24
Jurisdiction (continued)
  • An APRN practicing in a party state must comply
    with the state practice laws of the state in
    which the patient is located at the time care is
    provided.

25
3. Discipline
  • The home state or remote state may take
    disciplinary action.
  • Only the home state can take action on the
    license.
  • The remote state (where the violation
    occurred) may take action allowed by the
    state.
  • Any party state can deny authority to
    practice.

26
4. Information Sharing NURSYS
  • A comprehensive information system containing
    data on all nurses
  • Coordinates existing and future nurse databases
  • Used to verify nursing
  • licenses

27
5. Compact Administration
  • Authorizes the formation of Compact
    Administrators Group.
  • Authorizes the development of rules and
    regulations to administer the Compact.

28
Benefits of an APRN Compact
  • Promotes adoption of Uniform APRN
    Licensure/Authority to Practice Requirements.
  • Promotes standardization of scope of practice
    prescriptive practice.

29
Benefits (continued)
  • Increases practice site opportunities.
  • Decreases costs to the APRN.
  • Provides consistency with todays practice
    environment.
  • Promotes public protection grants jurisdiction
    to a board over all APRNs practicing in its
    state.

30
Issues of Concern
  • A limited number of states eligible to enter into
    an APRN compact
  • Differing implementation dates for uniform
    requirements
  • Prescriptive practice collaborative/supervisory
    relationships

31
Impact of Mutual Recognition
  • Nurses
  • Public
  • Health Care Institutions
  • Government
  • Revenue

32
How Can You Stay Informed?
  • National Council of State Boards of Nursing
    www.ncsbn.org
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