Advanced Practice

Demographic, Education, and Practice Characteristics of Advanced Registered Nurse Practitioners in Washington State: Results of a 2008 Survey

Department of Labor & Industries Adopts Changes to the Washington Administrative Code

The amended WACs will do the following:

  • Allow psychiatric ARNPs to treat injured workers, and
  • Clarify that concurrent care providers can prescribe medication while providing care to injured workers.

Downloads:

 

HB 2497: Removal of the 72 Hour Limitation on Dispensing Schedule II-IV Drugs

History

In 2000, SSB 5805 passed allowing ARNPs to have prescriptive authority for Schedule II-IV drugs. Schedule II-IV medications are controlled substances that include pain medications like Tylenol #3 and Vicodin, sleep aids such as Ambien, and anti-anxiety medications such as Xanax.

In addition to a Joint Practice Agreement with a physician, the bill created a 72 hr limit on schedule II-IV medications dispensed (not prescribed) byARNPs (for example, samples).

  • Proponents of this restriction argue it would reduce criminal activity such as theft from clinics owned by ARNPs, diversion and black market sales

In 2005, HB 1479 passed eliminating the Joint Practice Agreement and extending schedule II-IV authority to certified registered nurse anesthetists.  This law granted ARNPs full prescriptive authority. 

  • The 72 hour dispensing limitation was not a major barrier to care in 2005
  • To assure passage of the 2005 bill, elimination of the dispensing restriction was not included

Facts
  • Since 2005, several scheduled drugs are now being distributed as samples and packaged in more than 72 hours worth of dosing.  These include samples of Lunesta, Ambien, and Provigil.
  • Patients’ access to medications is affected when we cannot dispense more than 72 hours of Schedule II-IV medications essential to improving health outcomes.
  • No disciplinary action involving dispensing controlled substances has been taken against a Washington ARNP.
  • Eliminating the restriction on dispensing controlled substances will assure ARNP practice is comparable to that of other independent health care providers.

Read more about this and other significant new legislation, in the April 2008 edition of ARNP Care, (the newsletter of ARNPs United of Washington State).

 

Abrika / Actavis Recall

Actavis Inc. announced a nationwide recall of certain lots of Fentanyl transdermal system CII Patches sold in the United States and labelled with an Abrika or Actavis label. The product may have a fold-over defect which can cause the patch to leak and expose patients or caregivers directly to the fentanyl gel. Exposure to fentanyl gel may lead to serious adverse events, including respiratory depression and possible overdose, which may be fatal. The lots covered by this recall include doses of 25, 50, 75, and 100 mcg/hr and are listed in the firm's press release.

See the complete MedWatch 2008 safety summary, including a link to the firm's press release, at: http://www.fda.gov/medwatch/safety/2008/safety08.htm#Fentanyl

 

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