Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 9 - TEXAS MEDICAL BOARD › Chapter 193 - STANDING DELEGATION ORDERS › Section 193.4 - Scope of Standing Delegation Orders

Current through Reg. 49, No. 28; July 12, 2024
Providing the authorizing physician is satisfied as to the
				  ability and competence of those for whom the physician is assuming
				  responsibility, and with due regard for the safety of the patient and in
				  keeping with sound medical practice, standing delegation orders may be
				  authorized for the performance of acts and duties which do not require the
				  exercise of independent medical judgment. Limitations on the physician's use of
				  standing delegation orders which are stated in this section shall not apply to
				  patient care delivered by physician assistants or advanced practice registered
				  nurses, as authorized by §§ 157.051 - 157.060 of the Act, or
				  §§
									193.6-
				  193.14
				  of this title (relating to Delegation of Prescribing and Ordering Drugs and
				  Devices; Prescriptive Authority Agreements Generally; Prescriptive Authority
				  Agreements: Minimum Requirements; Delegation of Prescriptive Authority at a
				  Facility-Based Practice Site; Registration of Delegation and Prescriptive
				  Authority Agreements; Prescription Forms; Prescriptive Authority Agreement
				  Inspections; Delegation to Certified Registered Nurse Anesthetists; and
				  Delegation Related to Obstetrical Services). When care is delivered under other
				  circumstances, standing delegation orders may include authority to undertake
				  the following as listed in paragraphs (1) - (8) of this section:
(1) the taking of personal and medical
				history;
(2) the performance of
				appropriate physical examination and the recording of physical
				findings;
(3) the ordering of tests
				appropriate to the services provided under such orders, such as tuberculin
				tests, skin tests, VD tests, VDRL tests, gram stains, pap smears, and
				serological tests;
(4) the
				administration or providing of drugs ordered by direct personal or voice
				communication by the authorizing physician who shall assume responsibility for
				the patient's welfare, providing such administration or provision of drugs
				shall be in compliance with other state or federal laws and providing further
				that pre-signed prescriptions shall be utilized by the authorizing physician
				only under the following conditions shown in subparagraphs (A) - (D) of this
				paragraph.
(A) The prescription shall be
				prepared in full compliance with the Texas Health and Safety Code, §
										483.001(13)
				except for the inclusion of the name of the patient and the date of
				issuance.
(B) The prescription
				shall be for one of the following classes or types of drugs:
(i) oral contraceptives;
(ii) diaphragms and contraceptive creams and
				jellies;
(iii) topical
				anti-infectives for vaginal use;
(iv) oral anti-parasitic drugs for treatment
				of pinworms;
(v) topical
				anti-parasitic drugs; or
(vi)
				antibiotic drugs for treatment of venereal disease.
(C) The prescriptions may not be issued for
				any controlled substance.
(D) The
				providing of the drugs shall be in compliance with the Texas Pharmacy Act and
				rules adopted by the Texas State Board of Pharmacy.