SB 42 - The act modifies provisions relating to the licensing of advanced practice registered nurses and collaborative practice arrangements.
The act repeals provisions of law which require a written collaborative practice arrangement between a collaborating physician and an advanced practice registered nurse (APRN) to include the following: 1) a list of all offices where the physician has authorized the APRN to prescribe drugs; 2) a requirement that there must be at each location where the APRN is authorized to prescribe a notice informing patients that they may be seen by an APRN and that they have a right to see the physician; 3) all specialty and board certifications of the physician and APRN; 4) the manner of collaboration between the physician and the APRN, which includes the maintenance of geographic proximity; 5) a description of the APRN's prescriptive authority; 6) a list of other practice agreements of the collaborating physician and the APRN; 7) the duration of the practice agreement; 8) a description of the time and manner of the physician's review of the APRN's delivery of services, which must include that the APRN is to submit at least 10% of the charts to the physician for review; and 9) that the physician must review every 14 days at least 20% of the charts in which the APRN prescribed controlled substances.
The State Board of Registration for the Healing Arts and the Board of Nursing are no longer allowed to jointly promulgate rules regarding a collaborative practice arrangement's coverage of geographic areas, methods of treatment, and requirements for review of services. Any previously adopted rules regulating the use of collaborative practice arrangements that are not limited to delegating authority to prescribe controlled substances are null and void.
The State Board of Registration for the Healing Arts shall, rather than may, make certain information regarding physicians engaged in collaborative practice agreements available to the public.
No longer are physicians limited to entering into collaborative practice arrangements with no more than 3 full-time APRNs. Also, APRNs do not have to practice for one month with the collaborating physician present before practicing without the physician continuously present.
The act repeals the provision which states that a collaborative practice arrangement shall not supersede hospital licensing regulations governing hospital medication orders under protocols or standing orders for the purpose of delivering inpatient or emergency care within a hospital if such protocols or standing orders have been approved by the hospital's medical staff and pharmaceutical therapeutics committee. Additionally, the provision which states that no contract shall limit the collaborating physician's ultimate authority over the delegation of the physician's authority to an APRN is repealed.
The act creates a license for advanced practice registered nursing and specifies that the practice of advanced practice nursing includes the practice of professional nursing, conducting advanced assessments beyond those authorized for a registered nurse, ordering and interpreting diagnostic procedures, establishing primary and differential diagnoses, prescribing, ordering, administering, dispensing, and furnishing therapeutic measures, and providing referrals. APRNs must wear identification that clearly identifies the nurse as an APRN when providing patient care.
An APRN has the authority to prescribe, dispense, and administer nonscheduled legend drugs and nonscheduled legend drug samples. Currently, the Board of Nursing may grant a certificate of controlled substance prescriptive authority to an APRN who completes an advanced pharmacology course, a minium of three hundred clock hours preceptorial experience in the prescription of drugs, and a minimum of one thousand hours of practice in an advanced practice nursing category, and has a controlled substance prescribing authority delegated in a collaborative practice arrangement. This act provides that the Board may grant a certificate of controlled substance prescriptive authority to an advanced practice registered nurse who successfully completes an advanced pharmacology course to prescribe certain scheduled drugs within the parameters of a collaborative practice arrangement.
A certified registered nurse anesthetist may administer certain controlled substances for the purposes of providing care that is within the certified registered nurse anesthetist's scope of practice without a certificate of controlled substance prescriptive authority.
In addition to other requirements, the applicant for an APRN license shall complete the required post graduate education as provided in the act and provide documentation of certification in one of the four APRN roles from a nationally recognized certifying body.
This act is similar to SB 826 (2016), HCS/HB 1465 (2016), and HCS/HB 1866 (2016).