What New NPs Need to Know - Beginning Your NP Practice in Texas

16 Pages·2015·2.4 MB·English

9/28/15

What
 New
 NPs
 Need
 to

Know:
 Beginning
 Your
 NP

Practice
 in
 Texas

Monica Aleman DNP, MSN-FNP, APRN
Rachelle Campbell, RN, MS, FNP-C
Texas Nurse Practitioner Conference
Dallas, Texas
2015
OUTLINE

O Certification
O Licensure
O Prescriptive Authority Board of Nursing
O Prescriptive Authority: DEA and Texas Control
substances
O Credentialing
O National Provider Number (NPI)
O Negotiating Nurse Practitioner Contract
O Landing that first job
O Independent practice
O Salary
Common
 Certification
 Exam

Questions

O Which certification exam am I eligible to sit
for?
O What are the costs of each ANCC and AANP
certification exams?
O When can I apply to sit for the ANCC or AANP
board certification exam?
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Getting
 started

O 3-6 months before anticipated graduation
begin the process of selecting which
organization you want to apply to take the
national NP certification exam
O AANP-American Association of Nurse
Practitioners Certification Program AANPCP
(http://www.aanpcert.org/ptistore/control/index)
O ANCC-American Nurses Credentialing Center
(http://www.nursecredentialing.org/certification.aspx#specialty)
ANCC
 Certifications

O NP certifications: O CNS certifications:
Acute Care, Adult NP, O Adult Health CNS
Adult Gero Acute O Adult Gero CNS
Care NP, Adult Gero O Adult Psychiatric Mental
Health CNS
Primary care NP, O Child/Adol Psychiatric
Adult Psychiatric Mental Health CNS
Mental Health NP, O Gero CNS
FNP, Gero NP, PNP, O Home Health CNS
Psychiatric Mental O Pediatric CNS
Heatlh NP, School NP O Public Community Health
CNS
AANPCP
 Certification

O Adult Nurse Practitioner (retired Dec. 2016)
O Family Nurse Practitioner
O Adult Gerontology Primary Care NP
http://www.graduatenursingedu.org/texas/
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2015
 Costs
 for
 NP
 Certification

Exam

O ANCC costs for initial certification exam:
O  Nonmember 395
O ANA member 270
O AANP member 340
O AANP student member 290
O AANP costs for initial certification exam:
O AANP nonmembers 315
O AANP members 240
Steps
 for
 Certification
 Exam

O First apply to sit for the board exam
O Applying begins the process towards certification
O Once you apply to sit for the exam, the certifying
body (ANCC or AANPCP) will review your
application and notify you if you are pending or
lacking any documentation
O When application is complete and all
documentation has been received and
approved, you will be given permission to sit
(test) for the exam
O Once you receive permission to test, you can
schedule your exam testing date and time

AANPCP
 Eligibility

Requirements

O Successful completion of all didactic NP program
coursework and all faculty-supervised clinical
practice hours required for the NP program.
O Successful completion of graduate level courses in
advanced physical assessment, advanced
pharmacology, and advanced pathophysiology.
O a current active RN license in a state/territory of the
United States or respective province of Canada
O a transcript showing academic “work-to-date”, or a
final official transcript showing your degree awarded
(conferred)
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Required
 Documentation

O Clinical Hours
O Didactic hours
O Course numbers
O Course titles
O Dates
O Preceptors
Graduation

O Once you have graduated and completed all
of your clinical and didactic work, your
school will send the certifying body notice
that your degree was conferred
O If the remainder of your application was
completed, submitted, reviewed and cleared
then you will be given permission or
authorization to schedule your board
certification exam
For
 Exam:
 Preparation
 is
 Key

O Options include:  
O Purchase study books
O Board certification exam review course
O Consider the costs associated with each
option and if time and travel expenses can
be factored into your budget

http://www.graduatenursingedu.org/texas/
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NP
 Certification
 Exam
 Review

O Review books
O Live or recorded board review courses
available, such as APEA Adult and Family NP
review courses (Amalie Hollier), Fitzgerald
Health Education Associates NP Certification
Exam Review (Margaret Fitzgerald), and
Barkley Review
O If purchasing a review course, recommend
you schedule the course at least 3 months
prior to graduation
http://www.npcentral.net/ce/review.shtml
Tips
 to
 scheduling
 your
 exam

O Schedule the exam within a month of
graduation
O Schedule study time daily in the weeks
leading up to the exam
O Stop studying 24-48 hours before the exam
Your
 results

O You passed!!! Now begin the process of
applying to your state board of nursing for
your APRN license (if aanpcp, now use credential NP-C)

O You did not pass-give yourself a few days to
reflect on the results and then begin a new
plan of study
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NP
 Recertification

O AANPCP-5 years
O ANCC-5 years
Steps
 to
 APRN
 Licensure

O Once your are certified in your specialty, you
are considered certified but you are not
licensed to practice
O You may not practice until you apply for and
receive your APRN license from your state
board of nursing
Texas
 APRN
 License

APRN Role & Population
Focus APRN License Number
O Nurse Practitioner O Regardless of the role
O Certified Nurse and population,
Midwife approved applicants
O Certified Registered will receive one APRN
Nurse Anesthetists License Number, for
O Clinical Nurse example, AP99999
Specialists
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Texas
 APRN
 application

O APRN license: $100.00
O APRN license with Rx authority: $150.00
O Must already have a current active Texas RN license
O Must have completed APRN accredited program
O Must have nat’l certification in role and population
focus congruent with educational preparation
O Completion of minimum of 500 hours of practice in
APRN role within the last 24 calendar months or
completion of program in last 24 months
O Completion of minimum of 20 hours of CE in advanced
role & population focus within last 24 mo.
Texas
 RN
 License

O  If your RN license is about to expire, renew it
which will cost around $100
O If you are moving to a new state, you will
need to become licensed as a registered
nurse in the state where you plan to practice
(unless you are licensed in a compact state and moving to another
compact state) 
Nurse
 Licensure
 Compact

O Agreement between states that allows a
nurse to obtain an RN license in the nurse's
primary state of residence and allows the
nurse to practice as an RN in any other
Compact state without obtaining an RN
license in that state
O If you hold a current valid Compact RN lic,
you are not req to obtain a TX RN license
before applying for APRN licensure in Texas
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APRN
 license
 in
 other

states

O Similar to how you have obtained a license to
work as a registered nurse in your state,
once you graduate from your NP program
and receive certification, you must obtain a
state advanced practice nursing (APN or
APRN) license in the state you plan to
practice
Prescriptive
 Authority
 in

Texas

O Prescriptive authority-optional authority for
those who qualify and wish to write
prescriptions
O Prescriptive authority agreements in Texas:
APRNs and PAs are req. to have delegated
authority agreements to provide medical
aspects of patient care, i.e., protocol or
other written authorization

Required
 Elements
 of
 a

Prescriptive
 Authority
 Agreement

O Name, address, and all professional license numbers of all
parties to the agreement
O State the nature of the practice, practice location or practice
settings
O Identify the types of categories or drugs or devices that may be
prescribed OR the types or categories of drugs or devices that
may not be prescribed
O Provide a general plan for addressing consultations and referrals
O Provide a plan for addressing patient emergencies
O State the general process for communication and sharing
information related to the care and treatment of patients
O Describe a quality assurance and improvement plan and how it
will be implemented. The plan must include plans for chart
reviews and periodic face to face meetings.
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Prescriptive
 Authority

O TMB Rule 193.6 physicians may delegate
ordering and prescribing nonprescription drugs,
prescription drugs and medical devices
(dangerous drugs) and DME to an APRN
O Must be delegated by a physician to APRN
through a written document (PAA or facility
based protocols must have CSR #’s from DEA
and DPS)
O Schedules III through V controlled substances can
be rx’d
O What is a Dangerous Drug?
A
 bit
 about
 controlled

substances….

O Currently, an APRN who writes a prescription
for a controlled substance in TX must have a
state controlled substances registration
(CSR) issued by the Texas Department of
Public Safety (DPS) and a federal Drug
Enforcement Agency (DEA) number
O There are five steps each APRN must
complete before signing a prescription for a
controlled substance
Steps
 to
 prescribing
 controlled

substances

1.  Must be licensed to practice as APRN in TX
2.  Delegating physician must agree to
delegate authority to rx controlled
substances & affirm agreement in the
prescriptive authority agreement (PAA) or
facility based protocol
3.  APRN must register with TX DPS. All CSR
applications must be completed and
submitted with a 25.00 fee *all CSRs will expire on
Aug. 31, 2016
http://www.txdps.state.tx.us/RSD/ControlledSubstances/csforms.htm
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Step
 4
 Obtaining
 a
 DEA

number
 in
 Texas

O APRNs with full licensure and prescriptive
authority must submit an application for a
controlled substances registration to the TX
DPS
O After the controlled substance permit has
been issued, the APRN may apply for a DEA
registration number
O Application fee: $731.00 for 3 years
https://www.deadiversion.usdoj.gov/webforms/
Step
 5
 Writing
 the
 RX
 for

Controlled
 Substances

O APRN’s name and professional credentials (i.e.
RN, FNP)
O APRN's BON prescriptive authority number
O APRN's practice address and phone number
where the prescription was issued
O Delegating physician's name and professional
credentials
O Delegating physician's business address and
phone number (if different than APRN's)
O APRN's and delegating physician's  and
APRN's DEA number if prescription is for a CS
Controlled
 Substances

Registration

O Must have TX APRN license to apply for CSR
O Complete application form for CSR (
http://www.dps.texas.gov/InternetForms/
Forms/NAR-77-78.pdf)
O SB 195 eliminates the requirement for
APRNs to have CSR in Texas effective Sep. 1,
2016
O All new registrations will continue to be
accepted and processed but all will expire
Aug. 31, 2016
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