State-Specific Guidelines for Prescribing Controlled Substances and Medical Devices
State of Planned NP Clinical Practice: Florida
- Sources should be obtained directly from the state’s regulatory organization(s) and must be cited appropriately.
- It is recommended that you keep a copy of this paper to provide to potential employers or your Board of Nursing in order to demonstrate your knowledge of your state laws.
| Guidelines and recommendations for your state:
In response to the opioid epidemic, individual states have developed and adopted voluntary guidelines or recommendations for the treatment of acute and chronic non-cancer pain. Based on research done on the state where you will practice clinically, include the following: |
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| Provide the name of your practicing state’s organization, group, or task force that created guidelines or recommendations for pain management therapies and education. |
The Florida Board of Medicine |
https://flboardofmedicine.gov |
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| Briefly describe an overview of its development and include a web address where this information can be found. If your state does not have guidelines, discuss a federal guideline. (Note: you may need to contact your state’s board of nursing, pharmacy, or medicine if you cannot locate it on your own). | The medical guidelines for the management of pain using dangerous drugs and controlled substances were developed in consultations with the Agency for Health Care Administration (AHCA), The Florida Pain Commission, The Florida Board of Medicine, and The Florida Board of Osteopathic Medicine. The guideline follows the regulations of the Florida Health Care and Insurance Reform Act of 1993. It aims to provide the medical practice parameters and clinical practice guidelines for pain management using opioids.
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https://druglibrary.org/schaffer/asap/florida_guide.htm | |
| Some states have multiple organizations or initiatives (ex, Ohio) in place to combat the opioid epidemic and advocate for safer opioid prescribing. Explore whether your state has other resources, groups, or organizations where prescribers can reference best practices for pain management treatment. If applicable, provide a brief overview of the group’s recommendations or initiatives. If your state does not have another state-specific resource, discuss the guidelines published by the American Pain Society OR Centers for Disease Control and Prevention. | The Florida Board of Osteopathic Medicine monitors, disciplines, and educates osteopathic physicians to ensure competency. The board recommends starting pain management treatment with short-acting opioid medications and having a better understanding of the federal and state regulations on the use of opioids in pain management.
https://floridasosteopathicmedicine.gov/resources/
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Centers for Disease Control and Prevention guidelines on pain management include guidance on the assessment of the need for opioids, the selection of opioids and usage, determination of use duration, and continuous risk assessment
https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm
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| Discuss when the use of opioids is appropriate and for what duration they should be prescribed. Provide a reference for your response. (This question is worth 10 points. 4 points for when opioids are appropriate, 4 points for a safe duration of use, and 2 points for a current edition APA formatted reference.) | Prescriptions for opioids are appropriate only if the assessed benefits of prescribing the opioids for the management of pain and improving function are more than the risks associated with the opioid prescription (CDC, n.d.).
Patients should be informed of known risks and realistic benefits of opioid therapy and patient and clinician responsibilities for managing therapy. The recommended duration for the prescription of opioids is three or fewer days (Dowell, 2021). References CDC. (n.d.). Guideline for Prescribing Opioids for Chronic Pain. Retrieved January 16, 2023, from https://www.cdc.gov/drugoverdose/pdf/prescribing/Guidelines_factsheet-a.pdf Dowell, D. (2021). Draft Updated CDC Guideline for Prescribing Opioids: Background, Overview, and Progress. National Center for Injury Prevention and Control. https://www.cdc.gov/injury/pdfs/bsc/BSC_Background_Overview_Progress-GL-Update_6_28_cleared_final_D_Dowell-508-fx.pdf |
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| State-specific laws on controlled substance prescribing for the nurse practitioner:
Research your state laws on advanced practice nurses’ authority to prescribe controlled substances. Based on research done on the state where you will practice clinically, include the following: |
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| Identify the law, rule, code, or statute that describes the advanced practice nurse’s authority to prescribe controlled substances in your state. | The 2022 Florida Statute, Chapter 464, part 012
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Advanced practice nurses in Florida are authorized to prescribe, dispense, administer, or order controlled substances as defined only if they have a master’s degree or above and have specialized practitioner skills. | |
| Discuss the provisions of the law, rule, code, or statute regarding the following: | Conditions or limits on prescribing schedule I-V controlled substances.
No refilling prescriptions more than five within six months. |
Requirements (if any) in documentation for treating acute and chronic pain. If your state has no requirements for this, confirm with a link to where you found this information.
A practitioner’s prescription is required.
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| Are there specific requirements for advanced practice nurses to reference the state’s prescription drug monitoring database before prescribing a controlled substance? | Yes or No
Yes. |
If yes, what are they? If not, how would they be helpful?
An APN must be a graduate with a master’s or a doctoral degree as well as specialty training in the prescription of opioids. |
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| State Prescription Drug Monitoring Program (PDMP): Research your state’s PDMP* and provide the following information: | |||
| Name of the state’s program. | The Florida Prescription Drug Monitoring Program, known as E-FORCSE® (Electronic-Florida Online Reporting of Controlled Substance Evaluation Program) | ||
| Website for the state PMDP. | https://florida.pmpaware.net/ | ||
| Discuss the registration requirements and process. | Be a registered practitioner in Florida,
Create an account,
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| Discuss the standards and procedures for the access and review of database information. | Talk to the patient, review and confirm E-FORCSE® information with the patient, discuss risks and concerns, and use E-FORCSE® information to prescribe or dismiss the patient.
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| State-specific laws on medical devices prescribing for the nurse practitioner:
Research your state laws on advanced practice nurses’ authority to prescribe medical devices. These are also called Durable Medical Equipment (DME). Based on research done on the state where you will practice clinically, include the following: |
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| Identify the law, rule, code, or statute that describes the advanced practice nurse’s authority to prescribe medical devices or DME in your state. | Link to where you found law, rule, code, or statute for your state regarding prescribing DME in your state. | What does the law, rule, code, or statute say regarding prescribing DME in your state?
Only an attending physician or a specialty physician can write a DME order upon referral from the beneficiary’s attending physician. |
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| Discuss the provisions of the law, rule, code, or statute regarding the following: | Conditions or limits on prescribing medical devices or DME.
A reference for a prescription from a face-to-face encounter. |
Requirements (if any) in documentation needed to support the order of medical devices or DME.
Beneficiary name, item description, amount, practitioner’s name, NPI, order date, and practitioner’s signature. |
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References
CDC. (n.d.). Guideline for Prescribing Opioids for Chronic Pain. Retrieved January 16, 2023, from https://www.cdc.gov/drugoverdose/pdf/prescribing/Guidelines_factsheet-a.pdf
Dowell, D. (2021). Draft Updated CDC Guideline for Prescribing Opioids: Background, Overview, and Progress. National Center for Injury Prevention and Control. https://www.cdc.gov/injury/pdfs/bsc/BSC_Background_Overview_Progress-GL-Update_6_28_cleared_final_D_Dowell-508-fx.pdf
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Question 
State-Specific Guidelines for Prescribing Controlled Substances and Medical Devices
The State Specific Guidelines for Prescribing Controlled Substances & Medical Devices assignment is worth 125 points and will be graded on the quality of required components as summarized in the directions and grading criteria/rubric.
Follow the directions and the grading criteria located in the rubric closely. Any questions about this assignment may be posted under the Q & A Forum or emailed to your faculty.
The document provided should be used, and your answers should be delivered within the table provided in this document. Links to an external site.
Sources/links should be obtained directly from the state’s regulatory organization(s).
It is recommended that you keep a copy of this assignment to provide to potential employers or your Board of Nursing to demonstrate your knowledge of your state laws.
Requirements:
Guidelines and recommendations for your state:
In response to the opioid epidemic, individual states have developed and adopted voluntary guidelines or recommendations for the treatment of acute and chronic non-cancer pain. Based on research done on the state where you will practice clinically, include the following:
Provide the name of your practicing state’s organization, group, or task force that created guidelines or recommendations for pain management therapies and education.
Briefly describe an overview of its development and include a web address where this information can be found. If your state does not have guidelines, discuss a federal guideline. (Note: you may need to contact your state’s board of nursing, pharmacy, or medicine if you cannot locate it on your own).
Some states have multiple organizations or initiatives (ex, Ohio) in place to combat the opioid epidemic and advocate for safer opioid prescribing. Explore whether your state has other resources, groups, or organizations where prescribers can reference best practices for pain management treatment. If applicable, provide a brief overview of the group’s recommendations or initiatives. If your state does not have another state-specific resource, discuss the guidelines published by the American Pain Society OR Centers for Disease Control and Prevention.
Discuss when the use of opioids is appropriate and for what duration they should be prescribed. Provide a reference for your response. (This question is worth 13 points. 5 points for when opioids are appropriate, 5 points for a safe duration of use, and 3 points for a current edition APA formatted reference.)
State-specific laws on controlled substance prescribing for the nurse practitioner:
Research your state laws on advanced practice nurses’ authority to prescribe controlled substances. Based on research done on the state where you will practice clinically, include the following:
Identify the law, rule, code, or statute that describes the advanced practice nurse’s authority to prescribe controlled substances in your state.
Discuss the provisions of the law, rule, code, or statute with regard to the following:
Conditions or limits on prescribing schedule I-V controlled substances.
Requirements (if any) in documentation for treating acute and chronic pain.
Are there specific requirements for advanced practice nurses to reference the state’s prescription drug monitoring database before prescribing a controlled substance? If so, what are they?
State Prescription Drug Monitoring Program (PDMP):
Research your state’s PDMP* and provide the following information:
Name of the state’s program.
Website for the state PMDP.
Discuss the registration requirements and process.
Discuss the standards and procedures for the access and review of database information.
State-specific laws on medical devices prescribing for the nurse practitioner:
Research your state laws on advanced practice nurses’ authority to prescribe medical devices. These are also called Durable Medical Equipment (DME). Based on research done on the state where you will practice clinically, include the following:
Identify the law, rule, code, or statute that describes the advanced practice nurse’s authority to prescribe medical devices or DME in your state.
Discuss the provisions of the law, rule, code, or statute regarding the following:
Conditions or limits on prescribing medical devices or DME.