2018 Brings Promise and Opportunity to Advanced Practice Registered Nurses at Premier Health

Premier Nursing News     March 2018

By Debbi Matosky, CNP

Leaders within our organization continue to demonstrate their commitment to making Premier Health the preferred employer of advanced registered nurses in the Greater Dayton area. Here are some of the highlights of the past year: 

Utilization of APRNs has continued to grow across the network, in both the acute care and primary care environments. There are now more than 450 APRNs employed directly by Premier Health or  working throughone of our care partners. These clinical professionals participate in critical care, primary care, surgical and medical sub-specialties, as well as leadership and research roles. This growth has been facilitated by dedicated APRN recruiters and satisfied employees. 

In the past year, executive leadership has been reviewing  APRN benefits in an effort to bring our professional benefit offerings in line with that of our physician partners. Progress so far has yielded system unification around an annual continuing education stipend to maintain full clinical practice; APRN credentialing reimbursement; payment of DEA licensure-to facilitate prescribing and patient care; and competitive salaries for all Premier Health-employed APRNs. Additional benefits will be reviewed in the coming year.  

Self Governance is a key element of nursing practice across Premier Health, and the APRN group is an active part of that structure. An Advanced Practice Provider Leadership group comprised of clinical representatives from across the network meets monthly to discuss practice issues, legislative changes, regulatory concerns, and progress of APRN/PA performance across the network. The group also sponsors an annual Academic Practice Update for APRN/PA clinicians in Southwest Ohio and makes quarterly educational offerings available for Premier HealthAPRNs/PAs at no charge. 

Members of this group include designated APRN managers at our system hospitals, APRNs/PAs from primary/specialty care outpatient offices, as well as clinical practice providers. Additionally, several of these leaders participate in Premiere Health APRN credentialing committees, the Magnet Transformational Leadership group, division leadership groups, and statewide APRN organizations. Our chief nursing officer is a key element of this group and an active participant in topical discussions and decision making. 

An Advanced Practice Provider page within Sharepoint provides a communication platform for all. Updates on continuing education opportunities; state practice and prescribing information; personal accomplishments; and other key news useful to APRN practice can be found on the Premier Health intranet. 

Brief legislative update: 

  1. Opioid prescribing limits for APRNs remain in place per the Ohio Board of Nursing. The limit for prescribing opioids remains at 30 Morphine equivalents per day.  
  2. Requirements for documentation on pain scripts: Not only amount of pain meds, but written indication of intended duration of script. (EPIC team has already created documentation process for this.) 
  3. ICD 10 code must be identified, which justifies need for use of all narcotics and monitored analgesics. (Now a component of EPIC.) 
  4. Prescribing provider must have OARRS account and must document review of recent opioid prescriptions for patient monitoring website, i.e. OARRS/NarxCheck.  
  5. Neurontin is now monitored. 
  6. An APRN license- is no longer needed to have a CTP (e) or COA. The APRN licensure is inclusive of prescriptive authority and practice parameters. Please be aware of continuing education requirements for prescribing, and legislative, and general practices set forth by the Ohio Board of Nursing for licensure. 
  7. A Premier Health version of Standard Care Arrangements will be updated to reflect changes in licensure and prescribing rules. Expect a copy to be available to Premier Health APRNs in late January. 

As you can see, APRN practice at Premier Health is thriving, and we look forward to continued transformation in 2018. To quote Loretta Ford, founder of the nurse practitioner role:    

"I didn't think that we were involved in great change...but then change became the name of the game."                  

“Loretta Ford: A Disruptive Innovator,” January 2011

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