Background: As a measure of quality control, the Alabama Board of Nursing subjected the regulations for mandatory continuing education (MCE) for licensure to an evaluation of their impact and effectiveness. This study focused on licensees' perceptions of the regulations regarding reasonableness, access, and value. Method: Evaluation research methods were used to answer research questions related to the rules governing continuing education (CE) requirements for nursing licensure. Data were obtained from a survey of a random sample (N = 406) of RNs and licensed practical nurses. Both qualitative and quantitative methods were applied to data analysis. Findings: Requirements for CE were perceived as reasonable; however, concerns were identified related to cost, access, and quality of presentations. Licensees perceived CE to be of value, and applied CE to decision-making and action in nursing practice. Chi-square analysis was significant to license type related to selected variables (e.g., rights and responsibilities). Qualitative analysis provided insight regarding licensees' concerns and recommendations for change. Conclusion: Mandatory continuing education (MCE) plays a significant role in promoting competence in nursing practice and is a mechanism for enhancing public protection. A high noncompliance rate on the MCE audit has ramifications for enforcement regulations.
The Mayday Scholars Program for 2001-2002 provided an opportunity to boards of nursing to present their experiences in monitoring the prescribing practices of advanced practice nurses and to research ways for improving their own investigation processes as professional disciplinary agencies for prescribing practices related to pain management. The Alabama Board of Nursing was interested in participating in the program based on its commitment to accountability for public protection. A gradual increase in disciplinary cases involving violations of prescribing practices by certified registered nurse practitioners (CRNPs) prompted our inquiry as to whether a proactive monitoring system was needed to determine compliance with regulations for advanced practice nurses in collaborative practice.In this article, we discuss selected elements related to pain management and regulatory factors, including nursing, that affect the treatment of pain. We present a brief overview of the evolution of advanced practice nursing, with an emphasis on the nurse practitioners movement, and prescription practices and pain management by nurse practitioners.
Health care delivery competence and accountability have typically been defined from providers' perspectives, rather than those of consumers as purchasers of services. In 1999, in the face of broad public concern about nursing competence the Alabama Board of Nursing developed an accountability model that established consumers at the center of the model and placed accountability for competent nursing practice at all levels of providers including regulatory agencies, health care organizations, educators, and licensees. The Board then authorized two research projects involving first, consumers perceptions on nursing competence and regulation, and second, comparing their perceptions with those of licensees, nurse educators, and organizational leaders (N = 1,127). Comparative data evidenced significant differences between consumers' and other participants' perceptions. This article highlights how policy implications derived from research resulted in regulatory changes for nursing competence. Five years of progress in policy changes made in the interest of public safety are summarized.
Nurses are on the front lines of pain management, yet in Alabama and eleven other states they are not legally authorized to prescribe any controlled pain medications. In this survey of certified registered nurse practitioners in Alabama, 83 percent of the nurses responding to a question about the connection between prescriptive authority and pain management said that the lack of prescriptive authority for controlled substances delays pain management treatment, and 88 percent of those proffering an opinion about the importance of prescriptive authority said that expanding their prescriptive authority to include those medications would improve patient outcomes.At the same time, however, many nurses indicated that they are not adequately prepared to prescribe and manage pain medications. Fifty-five percent of the nurses responding to a question about whether they were prepared to make decisions when working under protocols related to controlled substances answered no. And 44 percent of the respondents to a question about the nurse practitioner educational curricula said that they did not feel their education had adequately prepared them for prescribing controlled pain medications.
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