Ga. Comp. R. & Regs. R. 410-11-.14 - Regulation of Protocol Use By Advanced Practice Registered Nurses as Authorized by O.C.G.A. Section 43-34-26.3
(1) An advanced practice registered nurse
("APRN") who uses a protocol authorized by O.C.G.A. §
43-34-25shall:
(a) Hold a current license to practice
as a registered professional nurse in Georgia;
(b) Hold a current authorization to practice
as an advanced practice registered nurse in Georgia;
(c) Adhere to a written nurse protocol
agreement that is dated and signed by the APRN, the delegating physician, and
any other designated physician(s); the APRN's area of practice shall be in the
same or comparable specialty as that of the delegating physician; the protocol
shall specify the medical acts delegated to the APRN as provided by O.C.G.A.
§
43-34-25 and shall provide for immediate consultation with the delegating physician or a
designated physician if the delegating physician is not available;
and
(d) Document preparation and
performance specific to each medical act authorized by the written nurse
protocol agreement including ordering drugs, medical treatments or diagnostic
studies, medical devices, or, in life threatening situations, radiographic
imaging tests.
(2) An
APRN may practice under a nurse protocol agreement authorized by O.C.G.A.
§
43-34-25if the nurse protocol agreement adheres to the following criteria:
(a) Shall bear a current review date; be
available upon request; and specify parameters under which delegated medical
acts may be performed to include kinds of diagnostic studies which may be
ordered, the extent to which radio logic image tests may be ordered, provisions
for the reading and interpretation of such tests by a physician who is trained
in the reading and interpretation of the tests, circumstances under which
prescription drugs orders may be executed, number of refills which may be
ordered, include a frequency of follow up review of the patient by the
physician, including patients who are on controlled substances;
(b) Shall include a schedule for periodic
review of patient records by the delegating physician, which records review may
be achieved with a sampling of such records as determined by the delegating
physician;
(c) Shall be reviewed,
revised or updated annually by the APRN, the delegating physician, and any
designated physician;
(d) Shall
include a provision for immediate consultation with the delegating physician or
a physician designated in the absence of the delegating physician;
and
(e) Shall comply with the
provisions of O.C.G.A. §
43-34-25regarding prescription drug orders placed by an APRN for a drug or medical
device including, but not limited to, the following:
1.No prescription drug orders submitted by an
APRN for Schedule I or II controlled substances;
2.No refills of any drug for more than 12
months from the date of the original Order, except in the case of oral
contraceptives, hormone replacement therapy, or prenatal vitamins, which may be
refilled for a period of 24 months;
3.No drug order or medical device that may
result in the performance or occurrence of an abortion, including the
administration, prescription or issuance of a drug order that is intended to
cause an abortion to occur pharmacologically;
4.Written prescription drug orders shall be
signed by the APRN, be written on forms that comply with the nurse protocol
agreement, and such forms shall contain the information required by paragraph
(d) of O.C.G.A. §
43-34-25;
5.A written provision in the nurse protocol
agreement authorizing the APRN to request, receive, and sign for professional
samples, and to distribute them to patients in accordance with a list of
professional samples approved by the delegating physician that is maintained by
the office or facility where the APRN works and that requires the documentation
of each sample received and dispensed; and
6.Compliance with applicable state and
federal laws and regulations pertaining to the ordering, maintenance, and
dispensing of drugs.
(3) Only four (4) advanced practice
registered nurses may enter into a nurse protocol agreement with a delegating
physician at any one time under O.C.G.A §
43-34-25, except this limitation shall not apply to an APRN that is practicing in the
following settings:
(a) In a hospital
licensed under Title 31;
(b) In any
college or university as defined in Code Section
20-8-1;
(c) In the Department of Public
Health;
(d) In any county board of
health;
(e) In any free health
clinic;
(f) In a birthing
center;
(g) In any entity:
1.Which is exempt from federal taxes pursuant
to Section 501(c)(3) of the Internal Revenue Code, as defined in Code Section
48-1-2, and primarily serves uninsured or indigent Medicaid and Medicare patients;
or
2.Which has been established
under the authority of or is receiving funds pursuant to
42 U.S.C. Section 254 b or 254c of the United States Public
Health Service Act;
(h)
In any local board of education which has a school nurse program; or
(i) In a health maintenance organization that
has an exclusive contract with a medical group practice and arranges for the
provision of substantially all physician services to enrollees in health
benefits of the health maintenance organization.
Notes
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