Arkansas Administrative Code › Agency 067 - Board of Nursing › Division 01 - Registered Nurse Division › Rule 067.01.22-002 - ASBN Rules, 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.
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, childcare, 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.