Literature Review

Answer

Reviewing California’s State Practice and Regulatory Control

Identified State: California

State Practice Colour: Red

When it comes to nursing practice restrictions, California is a practice restricted state (American Association of Nurse Practitioners, n.d). This means that like in other states with such a restricted structure, the nursing practitioners have restrictions from their engagement in at least an element or area of nursing practice. The Californian state law then mandates their supervision by a physician or makes them subject to delegation or team management restrictions. California is part of American Association of Nurse Practitioners (AANP) region 9 which includes other states like AZ, CA, HI, NM, NV and the Pacific U.S Territories.

There are limitations to California’s prescriptive authority for registered nurses. Article 2 of California’s Business and Professions code offer a glimpse of the prescriptive power that registered nurses are accorded in California. Sections 2725.1 (a) states that notwithstanding any other provision of law, a registered nurse may dispense drugs or devices upon an order by a licensed physician and surgeon or an order by a certified nurse-midwife, nurse practitioner, or physician assistant (California Board of Registered Nursing, n.d). In the same vein, section 2725.1 (b) outlines that no clinic shall employ a registered nurse to perform dispensing duties exclusively. No registered nurse shall dispense drugs in a pharmacy, keep a pharmacy, open shop, or drugstore for the retailing of drugs or poisons. No registered nurse shall compound drugs (California Board or Registered Nursing, n.d).

The Standardized procedure Guidelines for registered nurses in California refer to  a set of regulations developed by the Board of Registered Nursing in conjunction with the Division of Allied Health Professions of the board of Quality Medical Assurance to jointly outline guidelines and procedures that are to be applied in organized health care systems within the state. The aims of this guideline in California are twofold; to protect consumers by providing evidence that the nurse has met all the regulatory standards for safe practice and to provide uniformity in the development of standardized procedures.

In California, these Standardized Guidelines are to be in writing and signed by a given health care system. The state mandates that the guidelines specify the standardized procedure roles that registered nurses may perform and the circumstances under which they may perform them (California Board of Registered Nursing, n.d). They also outline the requirements that registered nurses ought to follow while in the process of delivering given standardized procedure functions. The training, experience and education standards that ought to be met by the registered nurse are also provided within these guidelines. Within the guidelines, there are also specific methods for the first and subsequent evaluation of the competence of the nurses especially those who are permitted to do certain standardized procedures. Even while this is present, a record of the specific persons allowed to perform these standardized procedures as registered nurses is maintained and constantly updated under the above guidelines.

Even more importantly, the guidelines outline the scope of supervision during the performance of certain standardized procedure roles, for instance the immediate supervision by a physician. In doing so, the guidelines also expressly give registered nurses the conditions under which they are to instantly reach the physician assigned to a particular patient regarding their condition. It can be in line with their improvement or deterioration. There are also setting limitations that the procedures specify that have to be met for the procedure itself to be allowed to go on. Eventually, these standardized guidelines are reviewed to update the regulatory standards in line with emerging research and evidence-based practice (California Board of Registered Nursing, n.d).