Application Processes and Regulations in West Virginia
The application process for state boards differs from state to state and depends on the state’s specific regulations. State regulations for prescriptive authority also lack uniformity.
In some states, prescriptive authority is granted to APRN’s only while working in collaboration with a physician. In contrast, other states allow the APRN to work and prescribe independently with specific stipulations (Buppert, 2019).
State Board Application Process
The application process for the APRN to sit for boards in West Virginia involves several steps. First, the APRN candidate must complete an accredited graduate program (Nursinglicensure, n.d.). Upon successful completion of the accredited graduate program, the APRN candidate may submit a completed application, along with the required fees, to the state board of nursing via an online portal (Nursinglicensure, n.d.). The APRN candidate will need to furnish the state board with supporting documents such as official transcripts (Nursinglicensure, n.d.). Additionally, if the APRN candidate answers yes to any application questions regarding criminal convictions, professional discipline, drug use, or conditions that may cause impairment, he or she will need to explain and provide supporting documentation (Nursinglicensure, n.d.). Once the completed application is submitted, required fees are paid, and the board receives all supporting documentation, they will schedule the APRN candidate a date and time to test (Nursinglicensure, n.d.).
Application for Prescriptive Authority
In West Virginia, the APRN may apply for and be granted prescriptive authority, either in collaboration with a physician or independently, depending on the APRN’s level of experience (Buppert, 2019). For both independent and collaborative prescriptive authority, the APRN must have completed at least 45 hours of board-approved, graduate-level advanced pharmacology contact hours, have a license in good standing, submit a completed application, and pay all required fees (Buppert, 2019). For the first three years of his or her practice, the APRN may apply for and be granted collaborative prescriptive authority (Buppert, 2019). To apply for and be granted collaborative prescriptive authority, the APRN must be able to show documentation of the use of pharmacotherapy in clinical practice, during his or her educational program (Buppert, 2019). The APRN will need to provide written verification of the collaborative agreement with a physician licensed in West Virginia, who holds an unencumbered license for prescriptive practice (Buppert, 2019). After the three years of collaborative prescriptive authority, the APRN may apply for and be granted independent prescriptive authority (Buppert, 2019). In addition to the completion of the three-year collaborative agreement, the APRN must provide documentation of 15 contact hours in advanced pharmacology completed within two years before the application (Buppert, 2019).
Impact of Prescriptive Authority
The restrictions and stipulations placed on the APRN related to prescriptive authority are in place to help ensure patient safety. States such as West Virginia that require the APRN to complete a specific period of collaborative prescriptive authority, before granting independent prescriptive authority, are taking steps to maintain patient safety. Completing a required collaborative period will help to ensure patient safety by allowing the APRN to gain hands-on experience while being supervised by a licensed physician. Mandating collaboration between the APRN and physician, allows the APRN to prescribe medications under the supervision of a licensed physician.
Impact of Prescriptive Authority, Credentialing, and Clinical Privilege
Regulations and criteria requirements for prescriptive authority, credentialing, and clinical privilege are in place to ensure patient safety. The criteria requirements and regulations are there to confirm that the APRN has met the minimum requirements of eligibility and competence. Without regulation and criteria requirements, there would be no way to verify that the APN has completed the necessary education or determines the extent of the APRNs ability, knowledge, and skills.
Prescriptive authority is defined as the APRN’s ability and authority to prescribe medications (Scope of Practice Policy, 2020). There is a lack of uniformity across the United States regarding the APRN’s ability to prescribe medications. Additionally, several professional nursing organizations offer varying position statements regarding prescriptive authority for the APRN. For example, the American Association of Nurse Practitioners (2020) position is that the state board of nursing, in accordance with the APRN’s role, education, and certification, should solely regulate prescriptive authority. In contrast, the American Nurses Association position is that all APRNs should be granted full practice authority, including the ability to prescribe medications (NursingWorld, n.d.).
Credentialing refers to the mechanisms of regulation, collection, and verification of the APRN’s professional qualifications (Hamric et al., 2018). National level credentialing for the APRN is achieved by meeting the standards for eligibility and then passing a national certification exam (Hamric et al., 2018). Likewise, state-level credentialing for the APRN is obtained with licensure, after eligibility criteria are met (Hamric et al., 2018). Eligibility criteria for state-level APRN credentialing include the completion of required graduate education and successful results on a national certification exam (Hamric et al., 2018).
Clinical privilege can be described as an authorization granted to the APRN to provide treatment or specific care in a particular setting (Summers, 2017). Clinical privileges for the APRN are based on licensure, training, education, health status, judgment, competence, and experience (Summers, 2017). Authorization of clinical privilege is granted to the APRN by authorities such as human resources or medical staff (Summers, 2017).
Advanced practice registered nurse (APRN) requirements in West Virginia. (n.d.). Nursinglicensure.org, https://www.nursinglicensure.org/np-state-/west-virginia-nurse practitioner.html
Buppert, C. (2019). Nurse Practitioner’s Business Practice and Legal Guide, 5th Edition [Bookshelf Ambassadored]. https://ambassadored.vitalsource.com/#/books/9781284143003/
Hamric, A., Hanson, C., Tracy, M., & O’Grady, E. (2019). Advanced Practice Nursing: An Integrative Approach. Fifth Edition. Elsevier. ISBN 978-1-4557-3980-6.
Keeling, A. W. (2015). Historical perspectives on an expanded role for nursing. The Online Journal of Issues in Nursing, 20(2), Manuscript 2. Doi: 10.3912/OJIN.Vol20No02Man02
Nurse practitioners overview. (2020). Scope of Practice Policy, https://scopeofpracticepolicy.org/pratitioners/nurse-practitioners/
Nurse practitioner prescriptive authority. (2020). American Association of Nurse Practitioners, https://www.aanp.org/advocacy/advocacy-resource/position-statement/nurse-practitioner prescriptive-privilege
Summers, L. (2020). Clinical privileges: Opening doors for APRNs. American Nurse, 44(1): 10.