APRN Autonomy and Full Prescriptive Authority: Washington State--A Case Study
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Prescriptive authority is an essential component of fully autonomous practice for advanced practice registered nurses (APRNs). In 2005 Washington State APRNs obtained complete prescriptive authority and became fully autonomous. This paper describes a survey that examined the prescribing patterns of Washington APRNs one year after the law passed. Results of the study revealed the extent to which responders were prescribing scheduled drugs before and after elimination of a Joint Practice Agreement (JPA), perceptions and circumstances contributing to varying levels of adoption of the new scope of practice, and sense of educational preparedness for full prescriptive authority. Also, themes emerged identifying factors that enhance or moderate autonomy for APRNs. Findings conclude that education and preparation for changes in scope of practice must be assured in order to achieve optimal levels of adoption. Washington State serves as a model for advancement of scope of practice among APRNs across the nation.