How will your minimum standards for consultation between you as a nurse and your primary supervisory physician be applied, as described at 21 HAC 36.0810 (e) (1) (A) (A) (B) (B) (B) (2) (A) (C) and 21 HAC 32M (e) (1) (A)-:2) (A) (3)). This nurse practitioner/doctor counsel will be different for the new graduate, new nurse practitioner with the first authorization to practice in North Carolina compared to a collaborative practice agreement later approved by a nurse practitioner previously to practice in North Carolina and another primary supervisory physician. How will you proceed with the new rules for prescribing and dispensing drugs and devices that are not included in the agreement on cooperative practice under Rule 21 NCAC366.0809 (b) (3) (A) (B) and 21 NCAC32M.0109 (b) (3) (A) (B)? What medications and devices will you prescribe in each place of exercise? You can list certain drugs or certain categories of drugs. A complete description of the categories of drugs and devices to treat common health problems in your particular practice can be developed. For example: categories of drugs, such as anti-Semitic drugs, hypoglycemics-oral/insulin, oral hormones and contraceptives, cephalosporins, aminoglycosides, antivirals, antiasthmatics, diuretics, antihypertensivus, etc. may be indicated. Exceptions may be granted by classes of drugs or certain drugs in a class or administration routes. A nurse practitioner could make a combination of the above or use another approach to describe in the collaborative practice agreement the prescribing authority for the nurse practitioner. It is necessary to describe in the collaborative practice agreement, the drugs and devices that can be prescribed by the nurse practitioner in any practice site, as described in Rule 21 NCAC32M.0109 “prescription authority” and in the Board of Directors of Law 21 NCAC36.0809 “prescription authority”. Rules 21NCAC36.0810 (b) (1) (2) and 21 NCAC32M.0110(b) (1) (2) “Quality Assurance Standards for a Collaborative Practice Agreement” conclude and maintain the agreement on collaborative practice by both the primary physician and the specialist and maintained at each place of practice. What will be your process, developed by the nurse and primary supervisor for the ongoing review of care at each training site, including a written plan to assess the quality of care provided for one or more common clinical problems? No agreement on common practice can effectively cover any clinical situation.
Therefore, the collaborative practice agreement is not intended to replace the exercise of a professional assessment with the nurse and should not be. There are situations where patient care is both frequent and unusual and requires the individual exercise of the nurse-practitioner`s clinical judgment. North Carolina Board of Nursing 21 NCAC36.0800 “Approval and Practice Parameters for Nurse Practitioners” and similar Medical Board Rule 21 NCAC32M.0100 “Approval of Nurse Practitioners” came into effect on August 1, 2004. What should be included in the collaborative practice agreement? The joint subcommittee of the Care Committee and the Medical Commission does not require a specific format to be used by the care practitioner.