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The role of the advanced practice nurse was presented as a solution to aid physicians and met the needs of people seeking medical aid, access to resources, and healthcare (Fong Yeong Woo et al., 2017). Advanced practice nurses are considered a vital source in the health care system because they provide and coordinate overall effective care as well as ensure safety (Fong Yeong Woo et al., 2017). The purpose of this assignment is to examine and explore the role and requirements of an advanced practice nurse in Texas, discuss practice agreements in the state of Texas, and examine regulations and barriers that may impact an advanced practice nurse independent practice, as well as identify any surprising findings in the research.  
Practice Agreements in Texas
The Texas Board of Nursing (BON) initiated the regulation of education, practice agreements, eligibility, and requirements for an advanced practice nurse in 1978 (Peck, 2013). Texas mandates that every advanced practice nurse (APRN) operating under a collaborating agreement with a physician in order to practice in any healthcare setting (Peck, 2013). Healthcare providers such as an APRN has the responsibility to maintain current licensure along with prescriptive authority as well as obtaining and managing a valid controlled substance registration under the Texas Department of Public Safety (Watson, 2015). In addition, an advanced practice nurse is permitted to practice under the care of a physician that is registered with the Texas Medical Board (Watson, 2015). An advanced practice nurse utilizes the Texas Board of Nursing website https://www.bon.texas.gov/, in order to authenticate and complete the application for the license, and prescriptive abilities (Watson, 2015). 
In order to obtain a DEA registration, the advanced practice nurse must complete an application to access and register a DEA licensure (Watson, 2015). In addition, all APRN prescribers in the state of Texas are required to register with Texas DPS Controlled Substances in order to monitor and efficiently regulate scheduled 2 controlled substances and promote public safety (Watson, 2015).
There is promotion of the Texas PMP that can be utilized as a clinical intervention and is also considered challenging for prescribers related to the clinician informing their clients about using Texas PMP to check their prescription history (Mackert et al., 2020). In addition, it is an important aspect for the promotion of Texas PMP to not stigmatize any clients that receive prescription opioids or controlled substances (Mackert et al., 2020).
Barriers that Impact Nurse Practitioner Independent Practice
Unfortunately, there are significant barriers that can impact the process of advanced practice nurses initiating an independent practice in the state of Texas. Texas continues to limit advanced practice nurses from practicing with full means because this State requires physician delegation which has hindered occurrences of advanced practice nurse-owned practice (Watson, 2015). In the state of Texas, there are restrictions in the State’s practices and licensure laws, which can modify specific regulations and authorities to evaluate, diagnose, and direct care, as well as exclusively prescribing certain medications (Watson, 2015).
Findings from Research
Studies suggest there is a need to increase the demand for advanced practice nurses in order to ensure access to patient-centered, quality, and cost-effective care for all populations, especially in chronic diseases and older adults (Cypress, 2020). In addition, studies suggest there will be a projected growth with advanced practice nurses in the health care setting (Cypress, 2020). For advanced practice nurses, credentialing with insurances companies, hospitals, and healthcare practices can be considered challenging and requires various current and past identifying information from the provider (Watson, 2015).
Cypress, B. S. (2020). An Assessment of the Graduate Nursing Education Demonstration
Project. Nursing Economic$, 38(2), 65–85.
Fong Yeong Woo, B., Xin Yu Lee, J., Wai San Tam, W., Woo, B. F. Y., Lee, J. X. Y., & Tam,
W. W. S. (2017). The impact of the advanced practice nursing role on quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings: a systematic review. Human Resources for Health, 15, 1–22. https://doi-org.ezp.waldenulibrary.org/10.1186/s12960-017-0237-9.
Mackert, M., Pounders, K., Brown, L. E., Kirtz, S., Wagner, J. H., Ring, D., Hill, L., Wilcox, G.,
Murthy, D., Tierney, W., Innerarity, S., McGlone, M., Holleran Steiker, L. K., DeSalvo, K., Bernhardt, J. M., & Pretorius, K. (2020). Development of a health communication campaign to promote the Texas prescription monitoring program. Health Marketing Quarterly, 37(3), 222–231. https://doi-org.ezp.waldenulibrary.org/10.1080/07359683.2020.1802967
Peck, J. L. (2013). Addressing the texas health care crisis: Effective use of advanced practice
registered nurses. The Journal for Nurse Practitioners, 9(2), 116-121. doi:http://dx.doi.org.ezp.waldenulibrary.org/10.1016/j.nurpra.2012.12.006.
Watson, M. (2015). Basic principles to consider when opening a nurse practitioner-owned

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