Arkansas Administrative Code › Agency 067 - Board of Nursing › Rule 067.00.18-003 - Rules, Chapter 3

Current through Register Vol. 49, No. 6, June, 2024
CHAPTER
		  THREE
REGISTERED NURSE PRACTITIONER
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.
Rules 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 and under
		  the direction of a licensed 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; and
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 and under
		  the direction of a licensed 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.;
		  and
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; and 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;
		  and
(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; and
b. Documentation
		  in the medical record as specified in 4b.(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.