201 KAR 20:057. Scope and standards of practice of advanced practice registered nurses.

 

      RELATES TO: KRS 314.011(7), 314.042, 314.193(2)

      STATUTORY AUTHORITY: KRS 314.131(1), 314.193(2)

      NECESSITY, FUNCTION, AND CONFORMITY: KRS 314.131(1) authorizes the Board of Nursing to promulgate administrative regulations necessary to enable it to carry into effect the provisions of KRS Chapter 314. KRS 314.193(2) authorizes the board to promulgate administrative regulations establishing standards for the performance of advanced practice registered nursing to safeguard the public health and welfare. This administrative regulation establishes the scope and standards of practice for an advanced practice registered nurse.

 

      Section 1. Definitions. (1) "Collaboration" means the relationship between the advanced practice registered nurse and a physician in the provision of prescription medication and includes both autonomous and cooperative decision-making, with the advanced practice registered nurse and the physician contributing their respective expertise.

      (2) "Collaborative Agreement for the Advanced Practice Registered Nurse's Prescriptive Authority for Nonscheduled Legend Drugs (CAPA-NS)" means the written document pursuant to KRS 314.042(8).

      (3) "Collaborative Agreement for the Advanced Practice Registered Nurse's Prescriptive Authority for Controlled Substances (CAPA-CS)" means the written document pursuant to KRS 314.042(9).

 

      Section 2. The practice of the advanced practice registered nurse shall be in accordance with the standards and functions defined in the following scope and standards of practice statements for each specialty area:

      (1) Scope and Standards of Psychiatric-Mental Health Nursing Practice;

      (2) Nursing: Scope and Standards of Practice;

      (3) Scope and Standards for Nurse Anesthesia Practice;

      (4) Standards for Office-based Anesthesia Practice;

      (5) Standards for the Practice of Midwifery;

      (6) The Women's Health Nurse Practitioner: Guidelines for Practice and Education;

      (7) Scope and Standards of Practice: Pediatric Nurse Practitioner;

      (8) Standards of Practice for Nurse Practitioners;

      (9) Scope of Practice for Nurse Practitioners;

      (10) Standards of Clinical Practice and Scope of Practice for the Acute Care Nurse Practitioner;

      (11) Neonatal Nursing: Scope and Standards of Practice;

      (12) Scope of Practice and Standards of Professional Performance for the Acute and Critical Care Clinical Nurse Specialist; and

      (13) Statement on the Scope and Standards of Advanced Practice Nursing in Oncology.

 

      Section 3. In the performance of advanced practice registered nursing, the advanced practice registered nurse shall seek consultation or referral in those situations outside the advanced practice registered nurse's scope of practice.

 

      Section 4. Advanced practice registered nursing shall include prescribing medications and ordering treatments, devices, and diagnostic tests which are consistent with the scope and standard of practice of the advanced practice registered nurse.

 

      Section 5. Advanced practice registered nursing shall not preclude the practice by the advanced practice registered nurse of registered nursing practice as defined in KRS 314.011(5).

 

      Section 6. (1) A CAPA-NS shall include the name, address, phone number, and license number of both the advanced practice registered nurse and each physician who is a party to the agreement. It shall also include the specialty area of practice of the advanced practice registered nurse. An advanced practice registered nurse shall, upon request, furnish to the board or its staff, a copy of the CAPA-NS.

      (2) To notify the board of the existence of a CAPA-CS pursuant to KRS 314.042(9)(a), the APRN shall file with the board the "Notification of a Collaborative Agreement for the Advanced Practice Registered Nurse's Prescriptive Authority for Controlled Substances (CAPA-CS)".

      (3) For purposes of the CAPA-CS, in determining whether the APRN and the collaborating physician are qualified in the same or a similar specialty, the board shall be guided by the facts of each particular situation and the scope of the APRN's and the physician's actual practice.

 

      Section 7. Prescribing medications without a CAPA-NS or a CAPA-CS shall constitute a violation of KRS 314.091(1).

 

      Section 8. The board may make an unannounced monitoring visit to an advanced practice registered nurse to determine if the advanced practice registered nurse's practice is consistent with the requirements established by 201 KAR Chapter 20.

 

      Section 9. Incorporation by Reference. (1) The following material is incorporated by reference:

      (a) "Scope and Standards of Psychiatric-Mental Health Nursing Practice", 2007 Edition, American Nurses' Association;

      (b) "Nursing: Scope and Standards of Practice", 2004 Edition, American Nurses' Association;

      (c) "Standards for Office-based Anesthesia Practice", 2005 Edition, American Association of Nurse Anesthetists;

      (d) "Scope and Standards for Nurse Anesthesia Practice", 2007 Edition, American Association of Nurse Anesthetists;

      (e) "Standards for the Practice of Midwifery", 2003 Edition, American College of Nurse-midwives;

      (f) "The Women's Health Nurse Practitioner: Guidelines for Practice and Education", 2008 Edition, Association of Women's Health, Obstetric and Neonatal Nurses and National Association of Nurse Practitioners in Women's Health;

      (g) "Pediatric Nursing: Scope and Standards of Practice", 2008 Edition, National Association of Pediatric Nurse Practitioners;

      (h) "Standards of Practice for Nurse Practitioners", 2007 Edition, American Academy of Nurse Practitioners;

      (i) "Scope of Practice for Nurse Practitioners", 2007 Edition, American Academy of Nurse Practitioners;

      (j) "Scope and Standards of Practice for the Acute Care Nurse Practitioner", 2006 Edition. American Association of Critical Care Nurses;

      (k) "Neonatal Nursing: Scope and Standards of Practice", 2004 Edition, American Nurses Association/National Association of Neonatal Nurses;

      (l) "Scope of Practice and Standards of Professional Performance for the Acute and Critical Care Clinical Nurse Specialist", 2002 Edition, American Association of Critical-Care Nurses;

      (m) "Statement on the Scope and Standards of Advanced Practice Nursing in Oncology", 2003 Edition, Oncology Nursing Society; and

      (n) "Notification of a Collaborative Agreement for the Advanced Practice Registered Nurse's Prescriptive Authority for Controlled Substances (CAPA-CS)", 6/2010, Kentucky Board of Nursing.

      (2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Kentucky Board of Nursing, 312 Whittington Parkway, Suite 300, Louisville, Kentucky 40222, Monday through Friday, 8 a.m. to 4:30 p.m. (13 Ky.R. 2168; eff. 7-2-87; Am. 14 Ky.R. 231; eff. 9-10-87; 19 Ky.R. 2666; 20 Ky.R. 303; eff. 8-6-93; 3218; eff. 8-4-94; 22 Ky.R. 305; eff. 9-20-95; 23 Ky.R. 3606; 4176; 24 Ky.R. 62; eff. 6-18-97; 27 Ky.R. 819; eff. 11-17-2000; 29 Ky.R. 2120; 2449; eff. 4-11-03; 2943; eff. 8-13-03; 32 Ky.R. 285; eff. 10-19-05; 33 Ky.R. 511; 1069; eff. 10-18-06; 34 Ky.R. 1783; 2184; 2278; eff. 5-2-2008; 35 Ky.R. 2790; eff. 8-12-2009; 37 Ky.R 421; eff 10-20-2010.)