Prescriptive authority in Texas, Obtaining the DEA number and safe prescribing practices

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Introduction

Family nurse practitioners (FNP) provide primary care and acute care services while focusing on health promotion and disease prevention. FNPs work in the community setting, nursing homes, clinics, and hospitals to diagnose, make appropriate prescriptions, perform examinations, and provide patient education (Gadbois et al., 2015). In Texas, nurse practitioners attend a high number of patients. Healthcare professionals are assigned with DEA numbers that allow one to prescribe drugs, and this includes legal prescription of controlled substances. This paper will discuss the appropriate prescriptive authority for Lori, a new FNP in Texas. additionally, the process of obtaining the DEA number will be described as well as the safe prescribing practices for Lori as a nurse practitioner.

Appropriate Prescriptive Authority

Lori will require a written agreement with the supervising physician outlining the medications and devices she may prescribe. In Texas, physicians can delegate prescribing and ordering of prescription medications, nonprescription medications, and medical devices and equipment to an APRN. In addition, the supervising can also delegate the prescribing and ordering of Schedules III-V Controlled Substances and Schedule II Controlled Substances to Lori as an APRN, with the specific requirements (Peterson, 2017).

DEA Registration Process

Lori will apply for the DEA number online. She will go to www.deadiversion.usdoj.gov website and then follow all the guiding steps during the application. During application, Lori will need to fill all the six sections that include personal information; practicing state; practice information; background; prescription schedules; and charges. Lori will also need to fill the drug schedules she intends to prescribe (Tierney et al, 2015). After applying, Lori will wait for three business days and the application will be availed for editing or approved Prescriptive authority in Texas, Obtaining the DEA number and safe prescribing practices.To confirm the approval of the DEA number or make any inquiries, Lori can call 800.882.9539. Lori is required to have an active license from the state she intends to practice when applying for the DEA number.

DEA will allow Lori to prescribe mediations classified as ‘controlled substances’ (Tierney et al, 2015). It is therefore clear that DEA regulates and controls prescription of controlled substances by ensuring that APRNs only prescribe the drugs they have authority to prescribe and also prevent APRNs from making illegal prescriptions.

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Lori will have various responsibilities after obtaining her DEA number. Once Lori obtains the DEA number, it will be her responsibility to ensure that she accurately and appropriately prescribes the controlled substances. Texas allows APRNs to prescribe some schedule medications, and as per the agreement with the supervising physician. Therefore, Lori should ensure that she prescribes only the authorized schedule drugs (Dineen & DuBois, 2016).

It is also the responsibility of Lori to make sure that she does not do any illegal prescription and that she prescribes controlled substances on cases that are medically allowed and appropriate. Moreover, Lori will need to enquire if the prescription monitoring program (PMP) allows her to obtain any information regarding the prescription of the controlled substances (Marco et al, 2016). If she is allowed, she had the duty of obtaining the information to determine if there have been illegal prescriptions that have been dispensed utilizing her DEA number. In case she notes illegal prescriptions under her DEA numbers, she should report and forward the information to DEA for further investigations (Tierney et al, 2015).

 

Safe Prescribing Practices

Safe prescribing practices include Lori ensuring that she only prescribes the medications she is authorized to and as per her scope of practice. If Lori intends to prescribe the controlled substances, she should ensure that she registers with DEA (Green & Stacey, 2015).

Before prescribing opioids, barbiturates or benzodiazepines, Lori should ensure that she checks the history of the patient in the prescription monitoring program (PMP) because there is a PMP in Texas. the PMP collects information from pharmacists and other healthcare providers to facilitate safe patient care during prescription and use of controlled substances. Additionally, the PMP monitors the prescribing of controlled substances to establish if there is any misuse or abuse. Lori will be needed to confirm with the PMP for all prescriptions of the controlled substances to prevent any duplication of their prescriptions (Elder et al, 2018).

Conclusion

A written agreement with the supervising physician indicating the medications and devices Lori can prescribe will be necessary according to the Texas laws. Lori can obtain her DEA number online to allow her to prescribe medications, including controlled substances. Finally, Lori will need to prescribe according to her scope of practice and follow the required prescriptive laws Prescriptive authority in Texas, Obtaining the DEA number and safe prescribing practices.

 

 

References

Dineen K & DuBois J. (2016). Between a Rock and a Hard Place: Can Physicians Prescribe Opioids to Treat Pain Adequately While Avoiding Legal Sanction? Am J Law Med. 42(1), 7–52.

Elder J, Garett D & Pines. (2018). Optimal Implementation of Prescription Drug Monitoring Programs in the Emergency Department. West J Emerg Med. 19(2), 387–391.

Gadbois, E. A., Miller, E. A., Tyler, D., & Intrator, O. (2015). Trends in state regulation of nurse practitioners and physician assistants, 2001 to 2010. Medical care research and review: MCRR, 72(2), 200–219. https://doi.org/10.1177/1077558714563763.

Green S & Stacey P. (2015). Optimizing the Use of State Prescription Drug Monitoring Programs for Public Safety. Journal of Nursing Regulation. 6(3), 4–10.

Marco C, Venkat A &Baker EF, et al. (2016). Prescription drug monitoring programs: ethical issues in the emergency department. Ann Emerg Med. 68(5), 589–98.

Peterson M. E. (2017). Barriers to Practice and the Impact on Health Care: A Nurse Practitioner Focus. Journal of the advanced practitioner in oncology, 8(1), 74–81.

Tierney M, Finnell D, Naegle M, LaBelle C & Gordon A. (2015). Advanced Practice Nurses: Increasing Access to Opioid Treatment by Expanding the Pool of Qualified Buprenorphine Prescribers. Substance Abuse. 36(4) Prescriptive authority in Texas, Obtaining the DEA number and safe prescribing practices.