Читать книгу The Advanced Practice Registered Nurse as a Prescriber - Группа авторов - Страница 8

Louise Kaplan and Marie Annette Brown

Today’s healthcare transformations herald unprecedented opportunities for advanced practice registered nurses (APRNs) to provide and model patient‐centered, evidence‐based healthcare. As APRNs across the country increasingly secure full practice authority, they must seize the opportunity to become pacesetters for ethical, rational, and responsible prescribing. The vast majority of APRNs (nurse practitioners, nurse midwives, nurse anesthetists, and clinical nurse specialists) work with prescription medications on a daily basis. Many are unable to imagine a practice that does not include the ability to prescribe, provide, and/or manage medications for at least some of their patients. A goal of most APRNs, however, is utilization of a wide range of therapeutic modalities in the process of patient‐centered care. This may include, but is not focused solely, on medications. Health promotion and disease prevention continue to be a hallmark of APRN practice.

At the same time, as the demand for prescriptive medications increases, prescriptive authority becomes an even more vital component of APRN practice. The number of prescriptions dispensed in 2018 was 5.8 billion, an increase of 2.7% from the prior year. During the same one‐year period, opioid prescription use decreased by 17.1% (The IQVIA Institute, 2019). In order to appropriately meet the prescribing needs of patients, APRNs must have unencumbered, full prescriptive authority and practice.

Practice in today’s complex, fast‐paced healthcare delivery system in which there is a constant barrage of information can be overwhelming. Selection and monitoring of medication appropriate for patients is only one aspect of the complex process of prescribing. This book serves as an easily accessible reference to guide practicing APRNs through these challenges and supplements pharmacotherapeutic knowledge about specific medications. APRN students can also benefit from the content of this book. Standards for APRN programs specify a pharmacotherapeutic course as well as analysis of the APRN role (National Organization of Nurse Practitioner Faculties [NONPF], 2016). Educators must focus on teaching the essential knowledge about pharmacokinetics, pharmacodynamics, and evidence‐based drug treatment recommendations. Consequently, an in‐depth discussion of the APRN’s role as a prescriber is not usually found in the curriculum. The information included in this book has been compiled by experts to facilitate this discussion. The authors have used their clinical and professional experience to synthesize and organize key ideas on a wide variety of subjects. These include:

 What it means to be a prescriber

 The many facets of the prescriber role

 The legal, regulatory, and ethical responsibilities of APRNs who prescribe medications

 Who is a prescriber globally

 Managing difficult patient situations

 Strategies for assessing and addressing special considerations with controlled substances

 Authorizing medical marijuana