Thank you for your willingness to participate in our study on State policies governing Advanced Practice Nurse prescriptive practice: The impact on safe practices in pain management

Your participation to help us learn more about the APN attitudes and behaviors regarding opioid prescribing and management of patients with chronic pain and the influence of state policies governing practice.

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* 1. State in which you practice

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* 2. Age in years

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* 3. Gender

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* 4. Years in practice as an advanced practice nurse

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* 5. Type of practice

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* 6. Field of practice

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* 7. What percent of the patients that you treat are chronic non-cancer pain patients?

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* 8. What percent of patients that you treat have chronic cancer related pain?

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* 9. What percent of chronic non-cancer pain patients do you prescribe opioid analgesics?

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* 10. What percent of chronic cancer related pain patients do you prescribe opioid analgesics?

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* 11. What percent of non-cancer patients do you prescribe schedule II opioid analgesics? (e.g., morphine, oxycodone, hydromorphone, fentanyl)

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* 12. What percent of cancer patients do you prescribe schedule II opioid analgesics? (e.g., morphine, oxycodone, hydromorphone, fentanyl)

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* 13. Do you consider your ability to manage patients with chronic pain to be:

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* 14. Do you consider your training in co-managing patients with chronic pain and addictive disorders to be:

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* 15. Do you have a collaborative practice agreement with a physician?

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