Independent Prescribing and APRNs
Independent prescribing (also called "prescriptive authority") is the ability of advanced practice registered nurses (APRNs) to prescribe, without limitation, legend (prescription) and controlled drugs, devices, adjunct health/medical services, durable medical goods, and other equipment and supplies. Independent prescribing does not require collaboration with a physician and is a key element of scope of practice for APRNs, as well as being part of the APRN Consensus Model, which seeks to achieve uniformity of state regulation of APRN practice.
Many states have made, and many are considering making, changes to existing laws that regulate scope of practice for APRNs, including independent prescribing privileges. Despite the existence of the consensus model, there are extensive disparities among the states with respect to prescriptive authority. In some states, prescriptive authority is granted at the time of APRN licensure; in others, the APRN must apply separately for these privileges. Differences exist in how much and what type of advanced pharmacology and pharmacotherapeutics education is required, and whether and how much supervision of prescribing practice must take place before independent prescriptive authority is granted. Variation in prescribing laws also include whether all, or only some, APRN roles can be granted prescriptive authority; restrictions on prescribing controlled substances or the schedules of controlled drugs included; and the requirements for collaboration with a physician.
With so much potential for change and the high level of recent activity on the legislative front, it is challenging to maintain a current, up-to-date resource with accurate information about independent prescribing laws in each state. The information in this resource was obtained from the state's statutes and regulations, state Board of Nursing websites, or direct communication from the state Boards of Nursing staff. As new laws are enacted, revisions can be sent to the Editor and this resource will be updated accordingly.
In response to the national opioid crisis, many states have adopted new rules or passed new laws or regulations related to the prescribing of opioids and pain management. In many cases, the details of these updated rules and regulations are too extensive to include in this resource. Prescribing APRNs should consult their state boards of nursing and/or state legislatures for the latest information on prescribing controlled substances. The National Council on State Boards of Nursing also has an Opioid Toolkit to address the problem of opioid overprescribing.
Other resources for state legislation governing APRN prescribing authority can be found below.
APRN Campaign for Consensus: Moving Toward Uniformity in State Laws
The National Council of State Boards of Nursing has an initiative to assist states in aligning their APRN regulation with the major elements of the Consensus Model for APRN Regulation, one of which is independent prescribing. A US map showing the status of implementation of the Consensus Model in each state is available.
American Association of Nurse Practitioners (AANP)
AANP: State Practice Environment is a state-by-state listing of regulatory requirements for nurse practitioners. It includes a regulatory map of the United States.
The schedule of controlled substances is available online.
To view a brief summary of nurse practitioner prescribing law in a particular state or Washington, DC, click on the state name in the following list.
|Abbreviations used in this resource:|
|ANP: advanced nurse practitioner||APN: advanced practice nurse|
|APNP: advanced practice nurse prescriber||APPN: advanced practice professional nurse|
|APRN: advanced practice registered nurse||ARNP: advanced registered nurse practitioner|
|BNDD: Board of Narcotics and Dangerous Drugs||BOM: Board of Medicine|
|BOME: Board of Medical Examiners||BON: Board of Nursing|
|BOPh: Board of Pharmacy||CAPA: collaborative agreement for prescriptive authority|
|CDS: Controlled Dangerous Substances||CE: continuing education|
|CME: continuing medical education||CNM: certified nurse-midwife|
|CNP: certified nurse practitioner||CNS: clinical nurse specialist|
|CRNP: certified registered nurse practitioner||CSR: Controlled Substances Registration|
|CSVF: Controlled Substance Verification Form||DEA: Drug Enforcement Administration|
|IDFPR: Illinois Department of Financial and Professional Regulation||KASPER: Kentucky All Schedule Prescription Electronic Reporting System|
|LNP: licensed nurse practitioner||NA: nurse anesthetist|
|NED: Narcotics Enforcement Division||NP: nurse practitioner|
|NPA: Nurse Practice Act||NYSED: New York State Education Department|
|OARRS: Ohio Automated Rx Reporting System||PCNS: psychiatric clinical nurse specialist|
|PDMP: prescription drug monitoring program||PMP: prescription monitoring program|
|QACSC: Quality Alabama Controlled Substance Certificate||RNP: registered nurse practitioner|
|VPMS: Vermont Prescription Monitoring System||WCPA: written collaborative practice agreement|
Medscape Nurses © 2013
Cite this: APRN Prescribing Law: A State-by-State Summary - Medscape - Jul 25, 2013.