Arkansas Administrative Code › Agency 067 - Board of Nursing › Rule 067.00.97-001 - Chapter 3: Registered Nurse Practitioner

Current through Register Vol. 49, No. 6, June, 2024
SECTION
		  I
SCOPE OF PRACTICE
A.
REGISTERED NURSE
		  PRACTITIONER
A registered nurse practitioner is a licensed professional nurse
			 prepared in the manner stated herein who provides direct care to individuals,
			 families and other groups in a variety of settings, including homes, hospitals,
			 offices, industry, schools and other institutions and health care settings. The
			 service provided by the nurse practitioner is directed toward the delivery of
			 primary, secondary and tertiary care which focuses on the achievement and
			 maintenance of optimal functions in the population. The nurse practitioner
			 engages in independent decision making about the nursing care needs of clients
			 and collaborates with health professionals and others in making decisions about
			 other health care needs. The practitioner plans and institutes health care
			 programs as a member of the health care team. The nurse practitioner is
			 directly accountable and responsible to the recipient for the quality of care
			 rendered.
Regulations which apply to registered nurses are hereby
			 incorporated by reference.
B.
ACTS PROPER TO BE PERFORMED BY A
		  REGISTERED NURSE PRACTITIONER
1. The
		  Arkansas State Board of Nursing authorizes the registered nurse practitioner,
		  in collaboration with a licensed physician and under direction of the
		  physician, to perform particular acts at the advanced and specialized levels as
		  recognized by the nursing profession and which are in conformity with the Nurse
		  Practice Act.
a. Secures, records and
		  evaluates the health, psychosocial and developmental history of
		  patients.
b. Performs physical
		  examinations using techniques of observation, inspection, auscultation,
		  palpation and percussion, and uses appropriate diagnostic tests.
c. Discriminates between normal and abnormal
		  findings on the history and physical examination and refers the individuals who
		  need further evaluation or supervision.
d. Documents the processes of nursing care
		  delivery.
e. Contributes to the
		  comprehensive care of the ill in collaboration with the health care
		  team.
f. Coordinates health care
		  plans to enhance the quality of health care and diminish both fragmentation and
		  duplication of service.
g.
		  Contributes to the health education of individuals and groups and applies
		  methods designed to increase each person's motivation to assume responsibility
		  for his own health care.
h.
		  Facilitates entry into and through the health care system by appropriate
		  route.
i. Counsels with families
		  and/or individuals regarding family planning, pregnancy, child care, emotional
		  stresses, long term illness and general health problems,
j. Performs periodic health evaluations and
		  plans for health maintenance of clients,
k. Conducts community clinics for case
		  finding and screening for health problems.
2. The Arkansas State Board of Nursing
		  authorizes the registered nurse practitioner, in collaboration with a licensed
		  physician and under direction of the physician, to perform particular acts
		  recognized by the nursing profession and which are in conformity with the Nurse
		  Practice Act.
a. Assumes responsibility for
		  ongoing health maintenance and clinical management of stable chronically ill
		  patients.
b. Provides initial care
		  of emergencies and initiates arrangements for continuing definitive
		  care.
c. Identifies, manages and
		  initiates treatment for common medical problems by "Protocols" as described in
		  Section
		  I.C.
d. Evaluates progress and manages prenatal
		  and postpartum care.
C.
PROTOCOLS
1. Any nurse practicing as a registered nurse
		  practitioner shall practice in accordance with protocols developed in
		  collaboration with and signed by a licensed physician.
2. Protocols shall address:
a. Established procedures for the management
		  of common medical problems in the practice setting.
b. The degree to which collaboration,
		  independent action and supervision are required.
c. Acts including, but not limited to,
		  assessment, diagnosis, treatment and evaluation.
3. Protocols shall not include controlled
		  substances.
4. Documentation
a. Orders transmitted from protocols shall
		  be documented on the client's medical record.
b. Orders transmitted from protocols to
		  inpatient medical records shall contain:
(1)
		  Name of medication, therapeutic device or treatment.
(2) Strength
(3) Dose
(4) Length of time or amount
		  prescribed.
(5) Directions for use
(6) RNP Signature
(7) Physician's name, printed, followed by
		  notation "protocol."
5. Any deviation from written protocols shall
		  require:
a. A specific written or verbal
		  order from the collaborating physician before the order is transmitted or
		  implemented.
b. Documentation in
		  the medical record as specified in & b.(1)-(6) above, and notation that
		  order was by consultation, to be signed by the RNP.
6. Review of Protocols
a. The RNP shall document annual joint review
		  with the licensed physician, and revise when necessary.
b. The RNP shall, upon request, provide the
		  Board with current protocols.
7. Nothing in this regulation shall be
		  construed to prohibit any registered nurse practitioner from transmitting a
		  prescription order orally or telephonically, or from administering a legend
		  drug pursuant to a lawful direction of a licensed physician, dentist, or
		  advanced practice nurse who holds a certificate of prescriptive
		  authority.
D.
SERVICES AND RESPONSIBILITIES
The RNP shall, upon request of the Board, provide documentation
			 outlining the extent of services, responsibilities and required supervision of
			 nurse practitioners, and the accompanying responsibilities of collaborating
			 physicians.
E.
DELEGATED ACTS
The registered nurse practitioner shall demonstrate competence in
			 any act or procedure delegated by the collaborating physician.