I am a family nurse practitioner with expertise in both primary and urgent care. I am a Fellow in the American Academy of Nursing and the American Association of Nurse Practitioners as well as the Institute for Regulatory Excellence. In addition to the College of Nursing at WSU, I hold affiliate appointments in Prevention Science and Public Affairs. I am also a long term preceptor and affiliate faculty with the Oregon State University College of Pharmacy in the PharmD program where I mentor the PharmD teaching residency and pharmacy student research projects. In January 2022 I became the Assistant Director of the Washington State University Center for Cannabis Policy, Research and Outreach (https://research.wsu.edu/cannabis/)
Fall 2023 (NURS 563) Advanced Pharmacology
Spring 2024 (NURS 573) Rational Prescribing
I have more than 20 years of experience in policy analysis and development at a state, regional, national and international level in addition to continuous clinical practice across the lifespan. My research concerns the interface between public policy and prescribing patterns as they relate to practitioner, patient and institutional factors.
My dissertation focused on the validation of competencies developed to enact statutory changes to Clinical Nurse Specialist prescriptive authority. These statutory changes first enabled and then expanded this authority in Oregon to include controlled substances. As part of my dissertation research and funding, I completed a four-year fellowship with the National Council of State Boards of Nursing’s Institute for Regulatory Excellence.
Alliance for Health Science Professional Educator Networking (ASPEN). Co-PIs Tracy Klein, PhD and Janessa Graves, PhD. Co-Is Dawn Dewitt, MD and Mary Paine, PhD, RPh. Consultant Patricia Pearce, PhD, MPH, FAANP. Washington State University Office of the Provost ($5,000). June 2022-June 2023.
Rethinking Education on Substance Use with Inter-Professional Education and Collaborative Teams using Medication-Assisted Treatment (RESPECT-MAT). PI Marion Wilson, PhD. Co-Is Brenda Bray, BPharm, MPH, Connie Remsberg, PharmD, PhD, Barbara Richardson, PhD, DawnElise DeWitt, MD, and Tracy Klein, PhD. US Department of HHS, Substance Abuse and Mental Health Services Administration ($199,687). September 2020-September 2022.
Covid-19 Health Professional Policy Persistence Study. Co-PIs Tracy Klein, PhD and Louise Kaplan, PhD. Washington State University Vancouver mini-grant ($5,000). July 2020-December 2021.
Washington State University Advanced Nursing Practice for Rural Underserved in Eastern Washington (WSU-ANEW2). PI Janet Purath, PhD. Co-Is Tracy Klein, PhD, Louise Kaplan, PhD, Marion Wilson, PhD, Tamara Odom-Maryon, PhD, andf Anne Mason, DNP. HRSA Divison of Nursing and Public Health ($2,772,188). July 2019- June 2023.
Rethinking Education on Substance Use through Interprofessional Education and Rural Community Training (RESPECT). HRSA Bureau of Health Workforce ($1,792,817). PI Dawnelise Dewitt, MD, Co-Is Brenda Bray, PharmD, Tracy Klein, PhD, Matthew Layton, MD, Connie Remsberg, PharmD PhD, Barbara Richardson, PhD and Marian Wilson, PhD. July 2019-March 2023.
Unintentional Marijuana Exposures Among Children: A National Policy Evaluation. DMAc Grant, State of Washington. PI Janessa Graves, PhD. ($29,149).Tracy Klein, PhD, Policy Consultant, Co-I. January 2019-August 2022.
Hiring, Credentialing, and Privileging Nurse Practitioners as Hospitalists. Co-PIs Tracy Klein, PhD and Louise Kaplan, PhD. National Council of State Boards of Nursing Center for Regulatory Excellence ($146,583) February 2019-July 2020.
Characteristics, Supply and Impact of Expanded Prescriptive Authority for Medication Assisted Therapy. PI Tracy Klein, PhD, Co-I Daniel Hartung, MPH, PharmD. Washington State University External Mentors Program ($4,000). November 2018-June 2019.
Knowledge, Practices and Attitudes Regarding Marijuana for Medical Conditions Among Washington State Healthcare Providers and Certified Medical Marijuana Consultants. PI Louise Kaplan, PhD. Co-Is Tracy Klein, PhD and Marian Wilson, PhD. DMAc Grant, State of Washington ($25,000). November 2017-November 2018.
Prescribing Practices for Children with ADHD. Co–PIs Tracy Klein, PhD and Teri Woo, PhD. Fellows of the American Association of Nurse Practitioners ($3,000). June 2017-June 2018.
Nurse Practitioner Prescribing Standards: College of Registered Nurses of British Columbia. Contractor Tracy Klein, PhD, College of Registered Nurses of British Columbia ($7,500). Development of formulary standards for controlled substance prescribing for NPs in consultation with CRNBC policy staff and pharmacist Parkash Ragsdale, University of British Columbia. September 2016- February 2018.
The Scope of Inclusion of Academic Medical Center Conflict of Interest Policies. PI Tracy Klein PhD. Washington State University mini-grant ($2,480). June 2015-December 2017.
Nurse Practitioner Assessment and Management of Adolescent Concussion. PI Tracy Klein, PhD. American Nurses Foundation/Western Institute of Nursing ($5,000). October 2014-October 2015.
Recommendations for Adolescent Sports-Related Concussion Evaluation and Management.Co-PIs Janessa Graves, PhD and Tracy Klein, PhD. Washington State University seed grant ($27,135). May 2014-August 2015.
Nurse Practitioner Prescribing of Psychotropic Agents for Pediatric Patients. PI Tracy Klein, PhD. American Association of Nurse Practitioners, ($2500); Sigma Theta Tau Beta Psi Chapter ($2000) September 2013-September 2015.
Development of Nurse Practitioner Competencies for Prescribing Controlled Substances. Contractor Tracy Klein, PhD, College of Registered Nurses of British Columbia, ($8500). Competency development for regulatory agency for NP controlled substance prescribing October 2013-May 2014.
Prescribing Competencies for Autonomous APRN Prescriptive Authority: What Do Nurse Prescribers Need to Know? Tracy Klein, PhD fellowship. Institute of Regulatory Excellence, National Council of State Boards of Nursing ($3000) June 2008-August 2012. Dissertation Washington State University.
Graves, J., Dilley, J., Klein, T., Liebelt, E. (July 2023, under review). Xylazine exposures reported to poison centers—United States 2000-2022. JAMA.
Whitfield, M., Mimirinis, M., Macdonald, D., Klein, T., Wilson, R. (August 2023). Phenomenographic approaches to research about nursing. Global Qualitative Nursing Research.
Wilson, M., McKennon, S., Remsberg, C., Bindler, R., Anderson, J., Klein, T., Kobayashi, R., Miller, J., Dewitt, D. ( July 2023, in press). Interprofessional education to address substance use among adults with persistent pain: A pre-post program evaluation. Pain Management Nursing.
Klein, T., Brooks, O., Purath, J. (June 2023). Integration of bias consciousness in Advanced Pharmacology for NP students. The Journal for Nurse Practitioners, 19(6). [also published and accredited for CE] https://www.npjournal.org/article/S1555-4155(23)00137-X/fulltext
Whitfield, M., Bleah, P., Conception-Bachynski, J., Macdonald, D., Klein, T., Ross-White, A., Mimirinis, M., Wilson, R. (May 2023). Capability as a concept in advanced practice nursing education and practice: A scoping review. JBI Evidence Synthesis.
Graves, J., Dilley, J., Klein, T., Liebelt, E. (April 2023) Suspected suicidal cannabis exposures reported to United States poison control centers. JAMA Network Open. https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2803952.
Dilley, J., Graves, J., Dent, C., Klein, T., Liebelt, E., Hunt, L., Stupp, E., Schauer, G. (2022, under revision). Do cannabis edible poisonings happen at Halloween? An examination of exposures reported to US Poison Centers. Clinical Therapeutics.
Dilley, J., Graves, J., Dent, C., Klein, T., Liebelt, E. (2022, under revision). Does packaging matter? Effectiveness of Washington state’s policy to prevent cannabis edible related poisonings. Clinical Therapeutics.
Klein, T., Bindler, R., Kaplan, L. (November, 2022). NP practice under the Covid public health emergency: Did policy change persist? Journal of the American Association of Nurse Practitioners (online ahead of press) https://journals.lww.com/jaanp/Abstract/9900/Nurse_practitioner_practice_under_the_Covid_19.53.asp
Klein, T. & Clark, C. (November, 2022). Therapeutic use of cannabis in the US. The Nurse Practitioner. 47(12), 16-25. doi: 10.1097/01.NPR.0000884880.81603.c5. https://europepmc.org/article/med/36399143
Klein, T. (in press, 2022). Cannabis. In Woo, T.M. and Robinson, ML. Pharmacotherapeutics for Advanced Practice Nurse Prescribers, 5th ed. FA Davis: Philadelphia, PA
Wilson, M. & Klein, T. (in press, 2022) Cannabis use in pain management. In Turner, H. & Czarnecki, M. Core Curriculum for Pain Management Nursing (4th Edition). Elsevier: New York.
Whitfield, M., Bleah, P., Conception-Bachynski, J., Macdonald, D., Klein, T., Ross-White, A., Wilson, R. (August, 2022). Capability as a concept in advanced practice nursing education and practice: A scoping review protocol. JBI Evidence Synthesis. https://journals.lww.com/jbisrir/Abstract/2022/08000/Capability_as_a_concept_in_advanced_practice.13.aspx
Klein, T., Dilley, J., Graves, J., Liebelt, E. (July, 2022). Synthetic cannabinoid poisonings and access to the legal cannabis market: Findings from US National Poison Center data 2016-2019. Clinical Toxicology. https://doi.org/10.1080/15563650.2022.2099887.
Klein, T., Graves, J., Panther, S. (February, 2022). Trazodone prescribing for children with Attention Deficit Hyperactivity Disorder on medicaid in Oregon. Journal of Pediatric Pharmacology and Therapeutics.
Klein, T., Hartung, D., Markwardt, S. (January, 2022). The impact of CARA mandates on nurse practitioner controlled substance prescribing in Oregon: A Cohort study. Substance Abuse Treatment, Prevention and Policy. https://substanceabusepolicy.biomedcentral.com/articles/10.1186/s13011-022-00431-z
Klein, T. & Bindler, R. (August 2021). Ask your provider about cannabis: Increasing nurse practitioner knowledge and confidence. Cannabis and Cannabinoid Research (online ahead of print) https://www.liebertpub.com/doi/10.1089/can.2021.0061
Graves, J. M., Dilley, J. A., Terpak, L., Brooks‐Russell, A., Whitehill, J. M., Klein, T. A., & Liebelt, E. (2021). Kratom exposures among older adults reported to US poison centers, 2014–2019. Journal of the American Geriatrics Society.
Kaplan, L. & Klein, T. (2021). Nurse practitioner hospitalists: An empowered role. Nursing Outlook.
Klein, T. & Pearce, P. (2021). Dissemination: Writing for publication. In Murphy, M., Staffileno, B. & Bucholtz, S. Research for Advanced Practice Nurses. Springer: New York.
Pietz K, Graves JM, Klein TA, Weybright E, Pinkleton B. (2021). Concussions at school: experiences and knowledge among school nurses. American Journal of Nursing.
Kaplan, L. & Klein, T. (2020). Characteristics and perceptions of the US nurse practitioner hospitalist workforce. Journal of the American Association of Nurse Practitioners.
Wilson, M., Klein, T., Bindler, R., Kaplan, L. (2020). Shared decision-making for patients using cannabis for pain symptom management. Pain Management Nursing.
Klein, T., Geddes, J., Hartung, D. (2020). The geographic impact of buprenorphine expansion to nurse practitioner prescribers in Oregon. The Journal of Rural Health.
Klein, T. A., Kaplan, L., Stanik-Hutt, J., Cote, J., & Brooks, O. (2020). Hiring and Credentialing of Nurse Practitioners as Hospitalists: A National Workforce Analysis. Journal of Nursing Regulation, 11(3), 33-43. https://www.sciencedirect.com/science/article/abs/pii/S2155825620301320
Kaplan, L., Klein, T., Wilson, M. & Graves, J. (2019). Knowledge, practices and attitudes of Washington state health professionals regarding medical marijuana use. Cannabis and Cannabinoid Research. doi:10.1089/can.2019.0051
Deichman, J., Graves, J., Klein, T. & Mackelsprang, J. (published online, December 2019). Characteristics of youth who leave the emergency department without being seen following sports related concussion. Concussion. https://doi.org/10.2217/cnc-2019-0010
Kaplan, L., Klein, T., Wilson, M. & Graves, J. (2019). Knowledges, practices and attitudes of marijuana consultants in Washington state. University of Toronto Medical Journal, 96(3), 6-12.
Klein, T., Woo, T., Panther, T., Odom-Maryon, T., & Daratha, K. (2019). Somnolence producing agents: A five year study of prescribing for Medicaid insured children with Attention Deficit Hyperactivity Disorder. Journal of Pediatric Health Care, 33(3), e1-8. https://doi.org/10.1016/j.pedhc.2018.10.002
Klein, T., & Lugo, Rogelio (Nov/Dec. 2018). Evaluation of prescribing within nurse practitioner residency and fellowship programs. Journal for Nurse Practitioners, 14(10).
Klein, T., & Graves, J. (2018). The scope of inclusion of academic conflict of interest policies. Journal of Academic Ethics, 1-14. https://doi.org/10.1007/s10805-017-9298-6.
Graves JM, Klein TA, Panther SG, Moore M, Abshire DA, Graham JY (August, 2018). Nurse practitioners’ recommendations for pharmacotherapy in the management of adolescent concussion. Journal of the American Association of Nurse Practitioners. doi: 10.1097/JXX.0000000000000070.
Panther, S., Knotts, A., Odom-Maryon, T., Daratha, K., Woo, T., & Klein, T. (November-December, 2017). Off-label prescribing trends for ADHD medications for young and very young children on Medicaid. The Journal of Pediatric Pharmacology and Therapeutics. Vol. 22, No. 6, pp. 423-429. https://doi.org/10.5863/1551-6776-22.6.423.
Klein, T., Graves, J., & Graham, J. (2016). Driving following adolescent concussion: Advice by nurse practitioners in absence of standardized recommendations. Journal of Pediatric Health Care. doi: 10.1016/j.pedhc.2016.11.004
Graves, J.M., & Klein, T. (2016). The impact of patient characteristics on nurse practitioners’ assessment and management of adolescent concussion. Journal of the American Association of Nurse Practitioners. doi:10.1002/2327-6924.12431.
Kaplan, L., Klein, T., Skillman, S., & Andrilla, C. H. (2016). Faculty supervision of NP program practicums: A comparison of rural and urban site differences. The Nurse Practitioner, 41(7), 36-42.
Graves, J. M., & Klein, T. A. (2016). Nurse Practitioners’ comfort in treating work-related injuries in adolescents.(June, 2016, online ahead of print). Workplace Health & Safety. doi: 10.1177/2165079916653612.
Klein, T. & Graves, J. (September 2016, online ahead of print). Psychiatric nurse practitioner diagnosis and cognitive recommendations for mild traumatic brain injury. Journal of the American Psychiatric Nurses Association.doi: 10.1177/1078390316668992.
Wainwright, A., Klein, T. & Daly, C. (August 2016, online ahead of print). Competency development to support nurse practitioner prescribing of controlled drugs and substances in British Columbia. Policy, Politics and Nursing Practice. doi: 10. 1177/1527154416665099.
Klein, T., Panther, S., Woo, T., Odom-Maryon, T. & Daratha, K. (2016) Prescriber variance in childhood ADHD treatment: Findings from Oregon Medicaid 2012. Journal of Child and Adolescent Psychopharmacology, 26(6), 548-554. doi:10.1089/cap.2015.0255.
Klein, T. (May/June, 2015). Clinical nurse specialist prescriber characteristics and challenges in Oregon. Clinical Nurse Specialist. doi: 10.1097/NUR.0000000000000125.
Klein, T. ( Oct-Dec. 2014). Philanthropic dilemmas and the nurse administrator role. Nursing Administration Quarterly, 38(4), 319-326.
Klein, T. (2012). Implementing autonomous clinical nurse specialist prescriptive authority: A competency based transition model. Clinical Nurse Specialist, 26(5). doi: 10.1097/NUR.0b013e318263d753.
Klein, T. & Kaplan, L. (2010). Prescribing competencies for advanced practice registered nurses. The Journal for Nurse Practitioners, 6(2), 119-122.
- MS Medical Cannabis Science and Therapeutics, 2023, University of Maryland School of Pharmacy
- PhD Nursing, 2011, Washington State University
- Post Masters FNP, 2002, Washington State University
- MS Family Nursing/ Women’s Health NP, 1993, Oregon Health and Sciences University
- BSN, 1991, Linfield College
- BA, 1985 ,English Literature and Creative Writing Reed College