Practice Agreement in Texas

Nurse practitioners practice roles are monitored by Texas board of Nursing (BON). In Texas, nurse practitioners (NP) should have a practice authority with the supervising physician that are developed by the NP and physician jointly. The practice authority agreement should be renewed every year by both parties under Tex. Admin. Code §22- 11-221.13. Under this rule, NPs are required to know and conform to the Texas Nursing Practice Act that is being up to date with current board rules, regulations, standards of professional nursing, all federal, state, and local laws, rules, and regulations affecting the advanced role and specialty area (Texas Administrative Code, n.d.). Another important state policy is the prescriptive authority. Under title 22 part 11 rule §222.5, APRN should have a good standing license to practice without any disciplinary action, should active without prohibition from BON prescriptive authority agreement with collaborating physician. A prescriptive authority must be in written form, sign and date by NP and supervising physician. It should also have the state, address, license number, nature of the practice, location, types of categories of drugs or devices that can be ordered and can not be ordered, provide general plan for addressing consultation and referral, provide a plan for addressing patient emergencies, state the general process of communication with NP and supervising physician (Texas Administrative Code, 2013). In Texas State, NPs are viewed and can work as primary care providers. Under section 62.551, notwithstanding any other law, including sections 843.312 and 1301.052, insurance code, the executive commissioner shall adopt rules to require a managed care organization or other entity to ensure that APRN and physician assistants (PA) are available as primary care providers in the organization’s or entity’s provider network and This study source was downloaded by from CourseH on :39:08 GMT -06:00 according this rules APRN and PA must be treated in the same manner as primary care physicians (Health and Safety Code, 2015). Two Major Barriers in NP practice and Care One of the major issues in State of Texas for NP is to not able to work in full extent with their training and education. Even though some research mentioned concerns regarding shortage of primary care health professionals in the United States, particularly given the expansion of insurance coverage under the Patient Protection and Affordable Care Act (National Academy of Sciences, 2016). The research further suggest that if NP are given a full independence to work in full extent of their education and practice, it can help build the workforce necessary to meet the country’s primary care needs and contribute their unique skills to the delivery of patient-centered, community-based health care. As the country is moving forward, many states are allowing the NP to work in their full extent to meet the growing demand of primary care. Another issues that NPs face in state of Texas is related to physician. Hain and Fleck (2014) mentioned in their research that some physician