Delaware APRN State-Level Regulations: Practice Authority Guide

Comparison of APRN Board of Nursing Regulations

In my state of Delaware, the Board of Nursing serves as an APRN through strict rules concerning scope and license issues, among other things. Drawing a parallel with California on these issues, it emerges that there are a number of differences between states with regard to APRNs’ autonomy and prescriptive authorities (Margo et al., 2022). These differences have influenced how APRNs have been allowed to conduct practice within the concerned states.

Independent Practice Authority

APRNs in the state of Delaware are accorded full practice authority where, upon licensure and certification, APRNs can practice independently without any collaboration or supervision by physicians. This includes independent diagnosis, treatment, and prescription of medications upon meeting the licensure and certification requirements. On the other hand, California recently implemented APRN-independent practice in primary care settings, although such APRN-independent practice in California should be accorded to APRNs who have completed the transition-to-practice requirements. In California, physician oversight is still required for other areas of care.

Example: Once fully licensed, the APRN in Delaware practices independently without physician oversight, as compared with California, where this is really a more autonomous role (Nguyen et al., 2021). In California, under AB-890, APRNs practice independently in primary care, though transition requirements remain; other specialties continue to maintain physician oversight. Several years into their clinical experience, APRNs still need to be independent in all cases within California.

Prescriptive Authority

APRNs in Delaware have prescribing authority for controlled substances in Schedule II through Schedule V without needing a written agreement with a collaborating physician. This, in turn, means greater independence in care provided and prescribing practices. APRNs from California also have prescriptive authority, but their practice should be conducted under standardized procedures agreed upon by the supervising physician.

Example: APRNs in Delaware, with the appropriate licensure, can independently prescribe opioids or other controlled substances. However, APRNs in California are required to follow very strict protocols set by the overseeing physician when prescribing these controlled substances (Sheer B., 2023). This ultimately means fewer independent decisions in prescription settings compared to Delaware.

Application to APRN Practice

These regulations explain, to a great degree, the scope of practice of APRNs within their jurisdictions (Zhong et al., 2024). For example, Delaware permits an APRN to increase his independence in primary care and specialty practices. On the other hand, APRNs in California remain under more restrictive supervision for patient care decisions and prescriptive undertakings. Delaware APRN State-Level Regulations

References

Margo Brooks Carthon, Brom, H., Nikpour, J., Todd, B., Aiken, L., & Lusine Poghosyan. (2022). Supportive Practice Environments Are Associated With Higher Quality Ratings Among Nurse Practitioners Working in Underserved Areas. Journal of Nursing Regulation, 13(1), 5–12. https://doi.org/10.1016/s2155-8256(22)00028-x Links to an external site.

Nguyen, T., Muench, U., Andraka-Christou, B., Simon, K., W. David Bradford, & Spetz, J. (2021). The Association Between Scope of Practice Regulations and Nurse Practitioner Prescribing of Buprenorphine After the 2016 Opioid Bill. Medical Care Research and Review, 79(2), 290–298. https://doi.org/10.1177/10775587211004311 Links to an external site.

Sheer, B. (2023). Evolution in Healthcare: The Journey from a U.S. Demonstration Project to an International Concept. Advanced Practice in Nursing, pp. 3–39. https://doi.org/10.1007/978-3-031-20762-4_1 Links to an external site.

Zhong, E. H., Martin, B., O’Hara, C., Kaminski-Ozturk, N., Buck, M., Livanos, N., & Alexander, M. (2024). Advanced Practice Registered Nurses’ Views of the APRN Compact: Survey Findings From Five U.S. States. Journal of Nursing Regulation, 14(4), 5–12. https://doi.org/10.1016/s2155-8256(23)00154- Links to an external site. Delaware APRN State-Level Regulations