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

 

      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 registered nursing practice to safeguard the public health and welfare. This administrative regulation establishes the scope and standards of practice for an advanced registered nurse practitioner.

 

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

      (2) "Collaborative Agreement for the Advanced Registered Nurse Practitioner'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 Registered Nurse Practitioner'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 registered nurse practitioner 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 registered nursing practice, the advanced registered nurse practitioner shall seek consultation or referral in those situations outside the advanced registered nurse practitioner's scope of practice.

 

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

 

      Section 5. Advanced registered nursing practice shall not preclude the practice by the advanced registered nurse practitioner 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 or registration number of both the advanced registered nurse practitioner and each physician who is a party to the agreement. It shall also include the specialty area of practice of the advanced registered nurse practitioner. An advanced registered nurse practitioner 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 ARNP shall file with the board the "Notification of a Collaborative Agreement for the Advanced Registered Nurse Practitioner's Prescriptive Authority for Controlled Substances (CAPA-CS)".

      (3) For purposes of the CAPA-CS, in determining whether the ARNP 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 ARNP'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 registered nurse practitioner to determine if the advanced registered nurse practitioner'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", 2000 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", 2005 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", 2002 Edition, Association of Women's Health, Obstetric and Neonatal Nurses and National Association of Nurse Practitioners in Women's Health;

      (g) "Scope and Standards of Practice: Pediatric Nurse Practitioner", 2004 Edition, National Association of Pediatric Nurse Practitioners;

      (h) "Standards of Practice for Nurse Practitioners", 2006 Edition, American Academy of Nurse Practitioners;

      (i) "Scope of Practice for Nurse Practitioners", 2006 Edition, American Academy of Nurse Practitioners;

      (j) "Standards of Clinical Practice and Scope of Practice for the Acute Care Nurse Practitioner", 1995 Edition. American Nurses' Association/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 Registered Nurse Practitioner's Prescriptive Authority for Controlled Substances (CAPA-CS)", 8/2006, 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.)