State-Specific Prescribing Laws and Regulations Quiz Overview

State-Specific Prescribing Laws and Regulations Quiz Overview

Question 1: Prescriptive Authority Statutes in California

Autonomy for nurse practitioners in California has been increasingly lenient over the past years, most especially with the prescriptive authority. One of the most significant changes took place on January 1, 2023, which allowed qualifying NPs to practice independently and no longer under supervision from physicians. The grant of this opportunity requires an NP to complete a three-year transition-to-practice period; the granting of prescriptive authority includes controlled substances without the requirements of physician oversight. This further expanded the NPs’ role in providing health care, particularly in underserved areas (California Board of Registered Nursing, 2023).

In addition, California law permits NPs to prescribe controlled substances from Schedules II-V but only after achieving the needed certification. For this to be achieved, NPs are also required to undergo further education in the prescription of controlled substances and achieve state and federal registrations. This dual certification process helps ensure that NPs are well-prepared to safely prescribe these medications within the lawfully permitted scope of practice. These statutes are significant because they demonstrate California’s commitment to both the empowerment of NPs and, at the same time, the maintenance of patient safety and regulatory oversight.

Question 2: 2022 CDC Clinical Practice Guidelines for Safe Opioid Prescribing

The 2022 CDC Clinical Practice Guidelines for Prescribing Opioids for Pain provide important updates to improve the care and safety of patients. One of the most important is personalized assessment. It is essential to perform thorough patient assessment before prescribing opioids, which includes pain level and functional capacity, quality of life, and any potential pre-existing conditions that may raise the risk factors associated with opioid use. Individualizing the approach in the determination of the potential benefits and harms of opioid therapy would go a long way (Dowell et al., 2022). This “tailored” approach is important for preventing opioid misuse while at the same time being sure to effectively manage pain.

A further recommendation of key guideline status when prescriptions for opioids are made is to order the lowest possible effective dose of medication and to do so for the shortest period possible, thereby minimizing the risk for opioid dependency and its related harms. By limiting the quantity and potency of prescribed opioids, practitioners will still be able to address the pain management needs of patients while reducing the chances of misuse and addiction (Dowell et al., 2022). These new guidelines harken a transition to a more vigilant and prudent approach to opioid prescribing, one that is crucial to abate the crisis.

Question 3: Prescription Drug Monitoring Program (PDMP) in California

A Prescription Drug Monitoring Program (PDMP) is a vital program regarding the control of prescriptions and controlled substances delivered through these prescriptions. The goal of such a system is to promote careful, appropriate prescribing by practitioners while, at the same time, guarding against overprescribing and diversion. In California, this system is referred to as the Controlled Substance Utilization Review and Evaluation System, or CURES. It provides an electronic database for healthcare providers to access the history of controlled substance prescriptions relative to a patient, thereby enhancing the providers’ decision-making on whether to prescribe any medication. A prescriber also uses the CURES database to detect drug-seeking behaviors or potential unintentional duplicate therapy (California Department of Justice, 2023).

All California licensed prescribers are required to utilize CURES prior to prescribing Schedule II-IV controlled substances. There are, however, specific exceptions. To reduce this risk of opioid abuse and improve patient safety even further, as their healthcare provider can see a complete clinical view to help guide treatment decisions for the patient, California allows for mandatory use of the PDMP (California Department of Justice, 2023). Generally, the PDMP in California is a crucial measure for protecting the crisis on opioids and ensuring there is responsible prescription.

References

California Board of Registered Nursing. (2023). Nurse Practitioner Practice. https://www.rn.ca.gov/pdfs/regulations/npr-b-23.pdf

California Department of Justice. (2023). Controlled substance utilization review and evaluation system. https://oag.ca.gov/cures

Dowell, D., Ragan, K. R., Jones, C. M., Baldwin, G. T., & Chou, R. (2022). CDC clinical practice guideline for prescribing opioids for pain—United States, 2022. MMWR Recommendations and Reports, 71(3), 1–95. https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm

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Week 1
State-Specific Prescribing Laws and Regulations
Quiz
Overview
Family nurse practitioner (FNP) practice is largely defined by state statutes, including the Nurse Practice Act, and governed by the state Board of Nursing, though other laws, regulations, and boards may inform practice. FNPs must abide by prescribing laws and regulations in their state of practice, including prescriptive authority, the use of prescription drug monitoring programs (PDMPs), and federal prescribing guidelines for controlled substances. The purpose of this quiz is to examine state-specific prescribing laws and regulations.

State-Specific Prescribing Laws and Regulations Quiz Overview

Total Points Possible
This quiz is worth a total of 25 points.
Preparing for the Quiz
The State Specific Prescribing Laws and Regulations Quiz contains 3 questions: two fill-in questions worth 10 points each and one validation question worth 5 points. You will have one (1) attempt with no time limit to complete the quiz.
I. Examine the following resources:
a. Prescriptive authority statutes for your intended state of practiceLinks to an external site.
b. PDMP guidelines for your intended state of practiceLinks to an external site.
c. Federal prescribing guidelinesLinks to an external site.
Question 1 10 pts
Identify and explain 2-3 items learned about prescriptive authority statues in the state(s) CALIFORNIA in which you plan to practice. Include at least one citation and reference. (10 points)
Question 2 10 pts
Identify and explain 2-3 things you learned about the 2022 CDC Clinical Practice
Guidelines for the safe prescribing of opioids that you will apply to your practice. Include at least one citation and reference. (10 points)
Question 3 5 pts
Explain what a Prescription Drug Monitoring Program (PDMP) does. In addition, does the state in which you intend to practice have a PDMP? If so, detail what you learned. Include at least one citation and reference (5 points)