New Federal Framework to Rate Medication Impact
A new federal evaluation framework for rating the impact of medications on health outcomes is currently under public inspection. While not specific to maternity care, such frameworks influence prescribing practices and regulatory policy. Nurse-midwives will be expected to integrate these evolving standards into perinatal care.
- The Centers for Medicare & Medicaid Services (CMS) has recently focused on the misclassification of drugs under the Medicaid Drug Rebate Program, allowing the agency to correct misclassifications and penalize manufacturers. This is part of a broader effort to ensure the accuracy of drug information and the integrity of the program. - In Virginia, licensed certified nurse-midwives have the authority to prescribe Schedules II through VI controlled substances under regulations from the Boards of Medicine and Nursing. However, their practice, including prescriptive authority, often requires a collaborative agreement with a physician. - Professional organizations like the American College of Nurse-Midwives (ACNM) advocate for midwives to practice to the full extent of their education and training, opposing mandatory collaborative agreements for licensure, reimbursement, or prescriptive authority. The ACNM establishes standards of practice that are often referenced in state regulations. - Medication reviews are a key component of optimizing prescribing practices to reduce risks of adverse drug reactions, improve patient safety, and manage costs. Studies have shown that pharmacist-led medication reviews can lead to a decrease in the number of prescriptions and overall medication costs. - The World Health Organization (WHO) provides core drug use criteria to assess prescribing patterns, with a recommendation of an average of less than two drugs per prescription to avoid the risks associated with polypharmacy. - The American Association of Colleges of Nursing (AACN) has established core competencies for professional nursing education that are designed to prepare nurses for the evolving healthcare landscape, which includes a greater emphasis on disease prevention and chronic disease care. - Ethical considerations in nursing, as outlined by the American Nurses Association (ANA) Code of Ethics, require nurses to be accountable for their practice, make decisions that promote optimal patient care, and maintain their personal and professional growth.
