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Instructions: Response must be at least 150 words. Must extend, refute/correct, or add additional nuanc. Must be written in current APA format with at least two academic references. References must be within the last five years.
     As advanced practice nurses (APRNs) become a mainstay for cost effective treatment for patients in the US their role and responsibilities have grown. Depending on the scope of practice allowed by each individual state, prescribing has become a large part of the APRNs treatment plan.  They are able to develop a plan that incorporates drug therapy to promote health and treat disease after considering many issues in order to achieve safe, appropriate, and effective therapy for their patients (Arcangelo et al., 2017).  They do this by promoting adherence to therapeutic treatment, conducting follow up measures and keeping up to date with the latest in drug research (Arcangelo et al., 2017). 
            The first responsibility of the APRN before prescribing any kind of therapy is to gather pertinent information about the patient by completing a thorough history and physical (Arcangelo et al., 2017).  Once all necessary data has been collected and an appropriate diagnosis has been made, the practitioner can create a treatment plan that most often includes over the counter as well as prescription medications (Arcangelo et al., 2017). 
            According to VandeWaa & Dolan (2020), prescribing is influenced by many complex factors including economic and social factors as well as how newly approved drugs get to the market.  A risk-benefit analysis must be conducted to compare therapeutic effects against potential risks (Arcangelo et al., 2017).  Potential side effects, drug interactions, efficacy, cost, and other considerations must be taken before selecting the most appropriate medication to avoid serious consequences (Arcangelo et al., 2017). 
            One major responsibility of the APRN in prescribing is patient education.  Informed consent means that the patient is fully educated and understands the benefits as well as all risks involved with specific medication treatment.  This includes the understanding of alternatives, allowing the patient to make an informed choice of taking or not taking the suggested medication.  When expectations are met with appropriate medication treatment plans, the patient is more likely to believe the medication will be effective and will more likely adhere to the treatment plan until finished (Arcangelo et al., 2017).  Education about medication treatment with specific disease process can also reduce pressure placed on prescribers to prescribe for the sake of prescribing such as the case with antibiotics for a viral cold (Arcangelo et al., 2017). 
            Prescriptive authority varies state by state and is typically overseen by the State Board of Nursing.  Depending on where the APRNs practice is held they can have full authority, collaborative practice, supervised practice, or delegated practice.  It is important for the APRN to understand their where their scope ends and what agreements must be met in order to legally write prescriptions (Arcangelo et al., 2017). 
            According to Mitchell & Oliphant (2016), ethical prescribing begins with the appropriate selection and dosing of medication specific to each individual patients needs in order to promote positive patient outcomes.  Many factors can affect this outcome and must be considered when prescribers are formulating a plan.  The expected outcomes of treatment as well as undesirable outcomes guide the treatment process.  When it is noted that the medication plan is unsuccessful the plan must then pivot to a second-line therapy plan in order to promote positive outcomes over time.
            The use of electronic prescribing helps the APRN write legible, easily recorded prescriptions that can be sent to the pharmacy in real time.  The use of this technology allows for better adherence to clearly identifiable licensing number as well as signature of the prescriber.  This technology also allows for the adherence of appropriate medication dosage and route by the prescriber (Arcangelo et al., 2017). 
            As advanced practice nurses move into a role of more autonomy, their responsibilities to ethically assess, diagnose and prescribe is paramount.  Considering factors like adherence, affordability, potential side effects and efficacy drive the practitioner’s action to successfully treat the patient as well as continued follow ups and assessment to maintain ongoing positive outcomes and change when needed.

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