New Kentucky State Law Grants Advanced Practice Registered Nurses (APRNs) Prescribing Authority

As reported by Modern Healthcare, a new Kentucky state law expanding prescribing authority for advanced practice registered nurses (APRNs) took effect on July 15, 2014. After years of debate, the law was the result of compromise on behalf of various stakeholders including the Kentucky Medical Association, Kentucky Academy of Family Physicians and the Kentucky Coalition of Nurse Practitioners and Nurse Midwives.

The new law permits nurse practitioners to prescribe independently after they have prescribed under physician supervision for four years. If a nurse practitioner from another state has been prescribing independently or under physician supervision for four years, then they too are considered eligible to prescribe in Kentucky. The law also created a six person “Collaborative Prescribing Agreement Joint Advisory Committee” that is composed of three APRNs with prescribing experience and three physicians with APRN-supervision experience.

The Kentucky law took effect at the same time that a study was published outlining the benefits of nurse-managed care for patients with chronic conditions. The study, funded by the Veterans Affairs Department and published in the Annals of Internal Medicine on July 15, reviewed 18 previous studies where a nurse following a protocol adjusted patient medication levels. The report suggested that nurses are in “an ideal position to collaborate” with other healthcare-team members for effective chronic disease care and that this type of “team approach” may have positive effects on outpatient management of adults with chronic conditions.

Inclusion of prescriptive authority in the scope of practice for APRNs varies considerably among the states, with some states authorizing APRNs with an independent authority to prescribe while others restrict prescribing of controlled substances or require collaboration with a physician. While the specific parameters vary, a number of states give APRNs authority to independently prescribe, including Alaska, Arizona, Arkansas, Colorado, Delaware, Washington D.C., Hawaii, Idaho, Iowa, Maine, Montana, New Hampshire, New Mexico, North Dakota, Oregon, Rhode Island, Utah, Washington, and Wyoming. That said, the scope of practice for APRNs continues to change in many states and individuals are advised to determine the specific requirements for the scope of practice for their state.

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