reglab/statecodes huggingface dataset:
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 30 - REGULATIONS GOVERNING THE LICENSURE OF ADVANCED PRACTICE REGISTERED NURSES › Part III - Practice of Licensed Advanced Practice Registered Nurses › Section 18VAC90-30-122

Current through Register Vol. 40, No. 24, July 15, 2024
Statutory Authority: §§ 54.1-2400 and 54.1-2957
						of the Code of Virginia.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 30 - REGULATIONS GOVERNING THE LICENSURE OF ADVANCED PRACTICE REGISTERED NURSES › Part III - Practice of Licensed Advanced Practice Registered Nurses › Section 18VAC90-30-123 - Practice of advanced practice registered nurses licensed as certified nurse midwives

Current through Register Vol. 40, No. 24, July 15, 2024
A. An advanced
				  practice registered nurse licensed in the category of certified nurse midwife
				  who has practiced fewer than 1,000 hours shall practice in consultation with a
				  licensed physician in accordance with a practice agreement between the advanced
				  practice registered nurse and the physician or with a certified nurse midwife
				  who has practiced for at least two years prior to entering into the practice
				  agreement. Such practice agreement shall address the availability of the
				  physician or the certified nurse midwife for routine and urgent consultation on
				  patient care.
B. The practice
				  agreement shall be maintained by the nurse midwife and provided to the boards
				  upon request. For nurse midwives providing care to patients within a hospital
				  or health care system, the practice agreement may be included as part of
				  documents delineating the nurse midwife's clinical privileges or the electronic
				  or written delineation of duties and responsibilities; however, the nurse
				  midwife shall be responsible for providing a copy to the boards upon
				  request.
C. An advanced practice
				  registered nurse licensed in the category of a certified nurse midwife shall
				  practice in accordance with the Standards for the Practice of Midwifery
				  (Revised 2011) defined by the American College of Nurse-Midwives.
Statutory Authority: §§
												54.1-2400 and
						54.1-2957 of the Code of
						Virginia.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 30 - REGULATIONS GOVERNING THE LICENSURE OF ADVANCED PRACTICE REGISTERED NURSES › Part III - Practice of Licensed Advanced Practice Registered Nurses › Section 18VAC90-30-124 - Direction and supervision of laser hair removal

Current through Register Vol. 40, No. 24, July 15, 2024
A. An advanced
				  practice registered nurse, as authorized pursuant to §
										54.1-2957 of the Code of
				  Virginia, may perform or supervise the performance of laser hair removal upon
				  completion of training in the following:
1.
				  Skin physiology and histology;
2.
				  Skin type and appropriate patient selection;
3. Laser safety;
4. Operation of laser device to be
				  used;
5. Recognition of potential
				  complications and response to any actual complication resulting from a laser
				  hair removal treatment; and
6. A
				  minimum number of 10 proctored patient cases with demonstrated competency in
				  treating various skin types.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 30 - REGULATIONS GOVERNING THE LICENSURE OF ADVANCED PRACTICE REGISTERED NURSES › Part III - Practice of Licensed Advanced Practice Registered Nurses › Section 18VAC90-30-125 - Practice of nurse practitioners licensed as clinical advanced practice registered nurses

Current through Register Vol. 40, No. 24, July 15, 2024
A. Advanced
				  practice registered nurses licensed in the category of clinical nurse
				  specialist shall practice in consultation with a licensed physician in
				  accordance with a practice agreement between the advanced practice registered
				  nurse and the licensed physician.
B. Such practice agreement shall address the
				  availability of the physician for routine and urgent consultation on patient
				  care. Evidence of a practice agreement shall be maintained by an advanced
				  practice registered nurse and provided to the boards upon request.
C. The practice of clinical nurse specialists
				  shall be consistent with the standards of care for the profession and with
				  applicable laws and regulations.
Statutory Authority: §§
												54.1-2400 and
						54.1-2957 of the Code of
						Virginia.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 30 - REGULATIONS GOVERNING THE LICENSURE OF ADVANCED PRACTICE REGISTERED NURSES › Part III - Practice of Licensed Advanced Practice Registered Nurses › Section 18VAC90-30-140 to 18VAC90-30-150

Current through Register Vol. 40, No. 24, July 15, 2024
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 30 - REGULATIONS GOVERNING THE LICENSURE OF ADVANCED PRACTICE REGISTERED NURSES › Part III - Practice of Licensed Advanced Practice Registered Nurses › Section 18VAC90-30-160 - Prohibited practice

Current through Register Vol. 40, No. 24, July 15, 2024
Practice as an advanced practice registered nurse shall be
					 prohibited if the license as an advanced practice registered nurse or a
					 registered nurse is lapsed, inactive, revoked, or suspended.
Statutory Authority: §§
												54.1-2400 and
						54.1-2957 of the Code of
						Virginia.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 30 - REGULATIONS GOVERNING THE LICENSURE OF ADVANCED PRACTICE REGISTERED NURSES › Part III - Practice of Licensed Advanced Practice Registered Nurses › Section 18VAC90-30-170 to 18VAC90-30-210

Current through Register Vol. 40, No. 24, July 15, 2024
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 30 - REGULATIONS GOVERNING THE LICENSURE OF ADVANCED PRACTICE REGISTERED NURSES › Part IV - Discipline › Section 18VAC90-30-220 - Grounds for disciplinary action against the license of a licensed advanced practice registered nurse

Current through Register Vol. 40, No. 24, July 15, 2024
The boards may deny licensure or relicensure, revoke or
					 suspend the license, or take other disciplinary action upon proof that the
					 advanced practice registered nurse:
1.
				  Has had a license or multistate privilege to practice nursing in this
				  Commonwealth or in another jurisdiction revoked or suspended or otherwise
				  disciplined;
2. Has directly or
				  indirectly represented to the public that the advanced practice registered
				  nurse is a physician, or is able to, or will practice independently of a
				  physician;
3. Has exceeded the
				  authority as a licensed advanced practice registered nurse;
4. Has violated or cooperated in the
				  violation of the laws or regulations governing the practice of medicine,
				  nursing or advanced practice registered nurses;
5. Has become unable to practice with
				  reasonable skill and safety to patients as the result of a physical or mental
				  illness or the excessive use of alcohol, drugs, narcotics, chemicals, or any
				  other type of material;
6. Has
				  violated or cooperated with others in violating or attempting to violate any
				  law or regulation, state or federal, relating to the possession, use,
				  dispensing, administration, or distribution of drugs;
7. Has failed to comply with continuing
				  competency requirements as set forth in
				  18VAC90-30-105;
8. Has willfully or negligently breached the
				  confidentiality between a practitioner and a patient. A breach of
				  confidentiality that is required or permitted by applicable law or beyond the
				  control of the practitioner shall not be considered negligent or
				  willful;
9. Has engaged in
				  unauthorized use or disclosure of confidential information received from the
				  Prescription Monitoring Program, the electronic system within the Department of
				  Health Professions that monitors the dispensing of certain controlled
				  substances; or
10. Has engaged in
				  conversion therapy with a person younger than 18 years of age.
Statutory Authority: §§
												54.1-2400 and
						54.1-2957 of the Code of
						Virginia.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 30 - REGULATIONS GOVERNING THE LICENSURE OF ADVANCED PRACTICE REGISTERED NURSES › Part IV - Discipline › Section 18VAC90-30-230 - Administrative proceedings

Current through Register Vol. 40, No. 24, July 15, 2024
A. The
				  provisions of the Administrative Process Act (§
										2.2-4000 et seq. of the Code of
				  Virginia) shall govern proceedings on questions of violation of
				  18VAC90-30-220.
B. Except as provided in
				  18VAC90-30-240, the Committee of
				  the Joint Boards of Nursing and Medicine shall conduct all proceedings
				  prescribed herein and shall take action on behalf of the boards.
C. When a person's license to practice
				  nursing has been suspended or revoked by the Board of Nursing, the advanced
				  practice registered nurse license shall be suspended pending a hearing
				  simultaneously with the institution of proceedings for a hearing.
D. Sanctions or other terms and conditions
				  imposed by consent orders entered by the Board of Nursing on the license to
				  practice nursing may apply to the advanced practice registered nurse license,
				  provided the consent order has been accepted by the Committee of the Joint
				  Boards of Nursing and Medicine.
Statutory Authority: §§
												54.1-2400 and
						54.1-2957 of the Code of
						Virginia.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 30 - REGULATIONS GOVERNING THE LICENSURE OF ADVANCED PRACTICE REGISTERED NURSES › Part IV - Discipline › Section 18VAC90-30-240 - Delegation of proceedings

Current through Register Vol. 40, No. 24, July 15, 2024
A. Decision to
				  delegate. In accordance with subdivision 10 of §
										54.1-2400 of the Code of
				  Virginia, the Committee of the Joint Boards of Nursing and Medicine (committee)
				  may delegate an informal fact-finding proceeding to an agency
				  subordinate.
B. Criteria for
				  delegation. Cases that involve intentional or negligent conduct that caused
				  serious injury or harm to a patient may not be delegated to an agency
				  subordinate, except as may be approved by the chair of the committee.
C. Criteria for an agency subordinate.
1. An agency subordinate authorized by the
				  committee to conduct an informal fact-finding proceeding may include current or
				  past board members and professional staff or other persons deemed knowledgeable
				  by virtue of their training and experience in administrative proceedings
				  involving the regulation and discipline of health professionals.
2. The Executive Director of the Board of
				  Nursing shall maintain a list of appropriately qualified persons to whom an
				  informal fact-finding proceeding may be delegated.
3. The committee may delegate to the
				  executive director the selection of the agency subordinate who is deemed
				  appropriately qualified to conduct a proceeding based on the qualifications of
				  the subordinate and the type of case being heard.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 30 - REGULATIONS GOVERNING THE LICENSURE OF ADVANCED PRACTICE REGISTERED NURSES › Form - FORMS (18VAC90-30)

Current through Register Vol. 40, No. 24, July 15, 2024
Instructions
				  for Licensure -- Nurse Practitioner (rev. 2/2009)
Application
				  for Licensure as a Nurse Practitioner (rev. 6/2011)
Application
				  for Reinstatement of License as a Nurse Practitioner (rev.
				  6/2011)
License
				  Verification Form (rev. 7/2007)
Application
				  for Restricted Volunteer License (eff. 7/2015)
Statutory Authority: § 54.1-2400 of the Code of
					 Virginia.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 30 - REGULATIONS GOVERNING THE LICENSURE OF ADVANCED PRACTICE REGISTERED NURSES › Section (18VAC90-30) - DOCUMENTS INCORPORATED BY REFERENCE

Current through Register Vol. 40, No. 24, July 15, 2024
Application for Licensure as a Nurse Practitioner, available
				  online at
https://www.dhp.virginia.gov/Boards/Nursing/PractitionerResources/Forms/
Checklist
				  Instructions: Application for Licensure - Nurse Practitioner (LNP) (rev.
				  7/2020)
Instructions:
				  Application - Attestation/Authorization for Autonomous Practice - Licensed
				  Nurse Practitioner (LNP) (rev. 1/2019)
Checklist
				  Instructions Reinstatement Application (rev. 8/2018)
Checklist
				  Instructions for Reinstatement Application Following Suspension or Revocation
				  (rev. 8/2018)
Checklist
				  Instructions Application for Restricted Volunteer License (rev.
				  8/2018)
Statutory Authority: §§ 54.1-2400 and 54.1-2957
					 of the Code of Virginia.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 40 - Regulations for Prescriptive Authority for Advanced Practice Registered Nurses › Part I - General Provisions › Section 18VAC90-40-20 - Authority and administration of regulations

Current through Register Vol. 40, No. 24, July 15, 2024
A. The statutory
				  authority for this chapter is found in §§
										54.1-2957.01,
				  54.1-3303,
				  54.1-3401, and
				  54.1-3408 of the Code of
				  Virginia.
B. Joint boards of
				  nursing and medicine.
1. The Committee of the
				  Joint Boards of Nursing and Medicine shall be appointed to administer this
				  chapter governing prescriptive authority.
2. The boards hereby delegate to the
				  Executive Director of the Virginia Board of Nursing the authority to issue the
				  initial authorization to those persons who meet the requirements set forth in
				  this chapter and to grant extensions or exemptions for compliance with
				  continuing competency requirements as set forth in subsection E of
				  18VAC90-40-55. Questions of
				  eligibility shall be referred to the committee.
3. All records and files related to
				  prescriptive authority for advanced practice registered nurses shall be
				  maintained in the office of the Board of Nursing.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 40 - Regulations for Prescriptive Authority for Advanced Practice Registered Nurses › Part II - Approval for Prescriptive Authority › Section 18VAC90-40-30 - Authority to prescribe, general

Current through Register Vol. 40, No. 24, July 15, 2024
A. No licensed
				  advanced practice registered nurse shall have authority to prescribe certain
				  controlled substances and devices in the Commonwealth of Virginia except in
				  accordance with this chapter and as authorized by the boards.
B. The boards shall approve prescriptive
				  authority for applicants who meet the qualifications set forth in
				  18VAC90-40-40.
Statutory Authority: §§
												54.1-2400 and
						54.1-2957 of the Code of
						Virginia.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 40 - Regulations for Prescriptive Authority for Advanced Practice Registered Nurses › Part II - Approval for Prescriptive Authority › Section 18VAC90-40-40 - Qualifications for initial approval of prescriptive authority

Current through Register Vol. 40, No. 24, July 15, 2024
An applicant for prescriptive authority shall meet the
					 following requirements:
1. Hold a
				  current, unrestricted license as an advanced practice registered nurse in the
				  Commonwealth of Virginia;
2.
				  Provide evidence of one of the following:
a.
				  Continued professional certification as required for initial licensure as an
				  advanced practice registered nurse;
b. Satisfactory completion of a graduate
				  level course in pharmacology or pharmacotherapeutics obtained as part of the
				  advanced practice registered nurse education program within the five years
				  prior to submission of the application;
c. Practice as an advanced practice
				  registered nurse for no less than 1,000 hours and 15 continuing education units
				  related to the area of practice for each of the two years immediately prior to
				  submission of the application; or
d. Thirty contact hours of education in
				  pharmacology or pharmacotherapeutics acceptable to the boards taken within five
				  years prior to submission of the application. The 30 contact hours may be
				  obtained in a formal academic setting as a discrete offering or as noncredit
				  continuing education offerings and shall include the following course content:
(1) Applicable federal and state
				  laws;
(2) Prescription
				  writing;
(3) Drug selection,
				  dosage, and route;
(4) Drug
				  interactions;
(5) Information
				  resources; and
(6) Clinical
				  application of pharmacology related to specific scope of practice;
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 40 - Regulations for Prescriptive Authority for Advanced Practice Registered Nurses › Part II - Approval for Prescriptive Authority › Section 18VAC90-40-50

Current through Register Vol. 40, No. 24, July 15, 2024
Statutory Authority: §§
												54.1-2400
						and 54.1-2957.1 of the Code of Virginia.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 40 - Regulations for Prescriptive Authority for Advanced Practice Registered Nurses › Part II - Approval for Prescriptive Authority › Section 18VAC90-40-55 - Continuing competency requirements

Current through Register Vol. 40, No. 24, July 15, 2024
A. A licensee
				  with prescriptive authority shall meet continuing competency requirements for
				  biennial renewal as a licensed advanced practice registered nurse. Such
				  requirements shall address issues such as ethical practice, an appropriate
				  standard of care, patient safety, and appropriate communication with
				  patients.
B. An advanced practice
				  registered nurse with prescriptive authority shall obtain a total of eight
				  hours of continuing education in pharmacology or pharmacotherapeutics for each
				  biennium in addition to the minimal requirements for compliance with subsection
				  B of 18VAC90-30-105.
C. The advanced practice registered nurse
				  with prescriptive authority shall retain evidence of compliance and all
				  supporting documentation for a period of four years following the renewal
				  period for which the records apply.
D. The boards shall periodically conduct a
				  random audit of their licensees to determine compliance. The advanced practice
				  registered nurses selected for the audit shall provide the evidence of
				  compliance and supporting documentation within 30 days of receiving
				  notification of the audit.
E. The
				  boards may delegate to the committee the authority to grant an extension or an
				  exemption for all or part of the requirements for circumstances beyond the
				  control of the licensee, such as temporary disability, mandatory military
				  service, or officially declared disasters.
Statutory Authority: §§
												54.1-2400 and
						54.1-2957 of the Code of
						Virginia.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 40 - Regulations for Prescriptive Authority for Advanced Practice Registered Nurses › Part II - Approval for Prescriptive Authority › Section 18VAC90-40-60

Current through Register Vol. 40, No. 24, July 15, 2024
Statutory Authority: §§
												54.1-2400
						and 54.1-2957.1 of the Code of Virginia.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 40 - Regulations for Prescriptive Authority for Advanced Practice Registered Nurses › Part II - Approval for Prescriptive Authority › Section 18VAC90-40-70 - Fees for prescriptive authority

Current through Register Vol. 40, No. 24, July 15, 2024
The following fees have been established by the
					 boards:
1. Initial issuance of prescriptive
								authority
$35
2. Return check charge
$35
Statutory Authority: §§
												54.1-2400
						and 54.1-2957.1 of the Code of Virginia.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 40 - Regulations for Prescriptive Authority for Advanced Practice Registered Nurses › Part III - Practice Requirements › Section 18VAC90-40-90 - Practice agreement

Current through Register Vol. 40, No. 24, July 15, 2024
A. With the
				  exceptions listed in subsection E of this section, an advanced practice
				  registered nurse with prescriptive authority may prescribe only within the
				  scope of the written or electronic practice agreement with a patient care team
				  physician.
B. At any time there are
				  changes in the patient care team physician, authorization to prescribe, or
				  scope of practice, the advanced practice registered nurse shall revise the
				  practice agreement and maintain the revised agreement.
C. The practice agreement shall contain the
				  following:
1. A description of the
				  prescriptive authority of the advanced practice registered nurse within the
				  scope allowed by law and the practice of the advanced practice registered
				  nurse.
2. An authorization for
				  categories of drugs and devices within the requirements of §
											54.1-2957.01 of the Code of
				  Virginia.
3. The signature of the
				  patient care team physician who is practicing with the r advanced practice
				  registered nurse or a clear statement of the name of the patient care team
				  physician who has entered into the practice agreement.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 40 - Regulations for Prescriptive Authority for Advanced Practice Registered Nurses › Part III - Practice Requirements › Section 18VAC90-40-100

Current through Register Vol. 40, No. 24, July 15, 2024
Statutory Authority: §§ 54.1-2400 and
						54.1-2957.01 of the Code of Virginia.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 40 - Regulations for Prescriptive Authority for Advanced Practice Registered Nurses › Part III - Practice Requirements › Section 18VAC90-40-110 - Disclosure

Current through Register Vol. 40, No. 24, July 15, 2024
A. The advanced
				  practice registered nurse shall include on each prescription issued or
				  dispensed his signature and the Drug Enforcement Administration (DEA) number,
				  when applicable. If the advanced practice registered nurse's practice agreement
				  authorizes prescribing of only Schedule VI drugs and the advanced practice
				  registered nurse does not have a DEA number, he shall include the prescriptive
				  authority number as issued by the boards.
B. The advanced practice registered nurse
				  shall disclose to patients at the initial encounter that he is a licensed
				  advanced practice registered nurse. Such disclosure may be included on a
				  prescription pad or may be given in writing to the patient.
C. The advanced practice registered nurse
				  shall disclose, upon request of a patient or a patient's legal representative,
				  the name of the patient care team physician and information regarding how to
				  contact the patient care team physician.
Statutory Authority: §§
												54.1-2400 and
						54.1-2957 of the Code of
						Virginia.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 40 - Regulations for Prescriptive Authority for Advanced Practice Registered Nurses › Part III - Practice Requirements › Section 18VAC90-40-120 - Dispensing

Current through Register Vol. 40, No. 24, July 15, 2024
An advanced practice registered nurse may dispense only
					 those manufacturers' samples of drugs that are included in the written or
					 electronic practice agreement.
Statutory Authority: §§
												54.1-2400 and
						54.1-2957 of the Code of
						Virginia.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 40 - Regulations for Prescriptive Authority for Advanced Practice Registered Nurses › Part III - Practice Requirements › Section 18VAC90-40-121 - Prescribing for self or family

Current through Register Vol. 40, No. 24, July 15, 2024
A. Treating or
				  prescribing shall be based on a bona fide practitioner-patient relationship,
				  and prescribing shall meet the criteria set forth in §
										54.1-3303 of the Code of
				  Virginia.
B. An advanced practice
				  registered nurse shall not prescribe a controlled substance to himself or a
				  family member, other than Schedule VI as defined in §
										54.1-3455 of the Code of
				  Virginia, unless the prescribing occurs in an emergency situation or in
				  isolated settings where there is no other qualified practitioner available to
				  the patient, or it is for a single episode of an acute illness through one
				  prescribed course of medication.
C.
				  When treating or prescribing for self or family, the advanced practice
				  registered nurse shall maintain a patient record documenting compliance with
				  statutory criteria for a bona fide practitioner-patient relationship.
Statutory Authority: §§
												54.1-2400 and
						54.1-2957 of the Code of
						Virginia.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 40 - Regulations for Prescriptive Authority for Advanced Practice Registered Nurses › Part IV - Discipline › Section 18VAC90-40-122 - Waiver for electronic prescribing

Current through Register Vol. 40, No. 24, July 15, 2024
A. Beginning July 1, 2020, a prescription for
				  a controlled substance that contains an opioid shall be issued as an electronic
				  prescription consistent with § 54.1-3408.02 of the Code of Virginia,
				  unless the prescription qualifies for an exemption as set forth in subsection C
				  of § 54.1-3408.02.
B. Upon
				  written request, the boards may grant a one-time waiver of the requirement of
				  subsection A of this section for a period not to exceed one year, due to
				  demonstrated economic hardship, technological limitations that are not
				  reasonably within the control of the prescriber, or other exceptional
				  circumstances demonstrated by the prescriber.
Statutory Authority: §§ 54.1-2400 and
						54.1-3408.02 of the Code of Virginia.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 40 - Regulations for Prescriptive Authority for Advanced Practice Registered Nurses › Part IV - Discipline › Section 18VAC90-40-130 - Grounds for disciplinary action

Current through Register Vol. 40, No. 24, July 15, 2024
A. The boards
				  may deny approval of prescriptive authority, revoke or suspend authorization,
				  or take other disciplinary actions against an advanced practice registered
				  nurse who:
1. Exceeds the advanced practice
				  registered nurse's authority to prescribe or prescribes outside of the written
				  or electronic practice agreement with the patient care team physician or, for
				  certified nurse midwives, the practice agreement with the consulting
				  physician;
2. Has had his license
				  as r an advanced practice registered nurse suspended, revoked, or otherwise
				  disciplined by the boards pursuant to
				  18VAC90-30-220; or
3. Fails to comply with requirements for
				  continuing competency as set forth in
				  18VAC90-40-55.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 40 - Regulations for Prescriptive Authority for Advanced Practice Registered Nurses › Part IV - Discipline › Section 18VAC90-40-140 - Administrative proceedings

Current through Register Vol. 40, No. 24, July 15, 2024
A. Except as
				  provided for delegation of proceedings to an agency subordinate in
				  18VAC90-30-240, the Committee of
				  the Joint Boards of Nursing and Medicine shall conduct all hearings prescribed
				  herein and shall take action on behalf of the boards.
B. The advanced practice registered nurse
				  with prescriptive authority shall be subjective to the grounds for disciplinary
				  action set forth in
				  18VAC90-30-220.
C. When the license of an advanced practice
				  registered nurse has been suspended or revoked by the joint boards,
				  prescriptive authority shall be suspended pending a hearing simultaneously with
				  the institution of proceedings for a hearing.
D. Any violation of law or of this chapter
				  may result in disciplinary action including the revocation or suspension of
				  prescriptive authority and may also result in additional sanctions imposed on
				  the license of the advanced practice registered nurse by the joint boards or
				  upon the license of the registered nurse by the Board of Nursing.
Statutory Authority: §§
												54.1-2400 and
						54.1-2957 of the Code of
						Virginia.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 40 - Regulations for Prescriptive Authority for Advanced Practice Registered Nurses › Part V - Management of Acute Pain › Section 18VAC90-40-150 - Evaluation of the patient for acute pain

Current through Register Vol. 40, No. 24, July 15, 2024
A. The requirements of this part shall not
				  apply to:
1. The treatment of acute pain
				  related to (i) cancer, (ii) sickle cell, (iii) a patient in hospice care, or
				  (iv) a patient in palliative care;
2. The treatment of acute pain during an
				  inpatient hospital admission or in a nursing home or an assisted living
				  facility that uses a sole source pharmacy; or
3. A patient enrolled in a clinical trial as
				  authorized by state or federal law.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 40 - Regulations for Prescriptive Authority for Advanced Practice Registered Nurses › Part V - Management of Acute Pain › Section 18VAC90-40-160 - Treatment of acute pain with opioids

Current through Register Vol. 40, No. 24, July 15, 2024
A. Initiation of opioid treatment for
				  patients with acute pain shall be with short-acting opioids.
1. A prescriber providing treatment for a
				  patient with acute pain shall not prescribe a controlled substance containing
				  an opioid in a quantity that exceeds a seven-day supply as determined by the
				  manufacturer's directions for use, unless extenuating circumstances are clearly
				  documented in the medical record. This shall also apply to prescriptions of a
				  controlled substance containing an opioid upon discharge from an emergency
				  department.
2. An opioid prescribed
				  as part of treatment for a surgical procedure shall be for no more than 14
				  consecutive days in accordance with manufacturer's direction and within the
				  immediate perioperative period, unless extenuating circumstances are clearly
				  documented in the medical record.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 40 - Regulations for Prescriptive Authority for Advanced Practice Registered Nurses › Part V - Management of Acute Pain › Section 18VAC90-40-170 - Medical records for acute pain

Current through Register Vol. 40, No. 24, July 15, 2024
The medical record shall include a description of the pain,
					 a presumptive diagnosis for the origin of the pain, an examination appropriate
					 to the complaint, a treatment plan, and the medication prescribed or
					 administered to include the date, type, dosage, and quantity prescribed or
					 administered.
Statutory Authority: §§
												54.1-2400
						and
						54.1-2957
						of the Code of Virginia.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 40 - Regulations for Prescriptive Authority for Advanced Practice Registered Nurses › Part VI - Management of Chronic Pain › Section 18VAC90-40-180 - Evaluation of the chronic pain patient

Current through Register Vol. 40, No. 24, July 15, 2024
A. The requirements of this part shall not
				  apply to:
1. The treatment of chronic pain
				  related to (i) cancer, (ii) sickle cell, (iii) a patient in hospice care, or
				  (iv) a patient in palliative care;
2. The treatment of chronic pain during an
				  inpatient hospital admission or in a nursing home or an assisted living
				  facility that uses a sole source pharmacy; or
3. A patient enrolled in a clinical trial as
				  authorized by state or federal law.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 40 - Regulations for Prescriptive Authority for Advanced Practice Registered Nurses › Part VI - Management of Chronic Pain › Section 18VAC90-40-190 - Treatment of chronic pain with opioids

Current through Register Vol. 40, No. 24, July 15, 2024
A. Nonpharmacologic and non-opioid treatment
				  for pain shall be given consideration prior to treatment with
				  opioids.
B. In initiating opioid
				  treatment for all patients, the practitioner shall:
1. Carefully consider and document in the
				  medical record the reasons to exceed 50 MME per day;
2. Prior to exceeding 120 MME per day, the
				  practitioner shall document in the medical record the reasonable justification
				  for such doses or refer to or consult with a pain management
				  specialist;
3. Prescribe naloxone
				  for any patient when risk factors of prior overdose, substance misuse, doses in
				  excess of 120 MME per day, or concomitant benzodiazepine are present;
				  and
4. Document the rationale to
				  continue opioid therapy every three months.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 40 - Regulations for Prescriptive Authority for Advanced Practice Registered Nurses › Part VI - Management of Chronic Pain › Section 18VAC90-40-200 - Treatment plan for chronic pain

Current through Register Vol. 40, No. 24, July 15, 2024
A. The medical record shall include a
				  treatment plan that states measures to be used to determine progress in
				  treatment, including pain relief and improved physical and psychosocial
				  function, quality of life, and daily activities.
B. The treatment plan shall include further
				  diagnostic evaluations and other treatment modalities or rehabilitation that
				  may be necessary depending on the etiology of the pain and the extent to which
				  the pain is associated with physical and psychosocial impairment.
C. The prescriber shall record in the medical
				  records the presence or absence of any indicators for medication misuse or
				  diversion and take appropriate action.
Statutory Authority: §§
												54.1-2400
						and
						54.1-2957
						of the Code of Virginia.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 40 - Regulations for Prescriptive Authority for Advanced Practice Registered Nurses › Part VI - Management of Chronic Pain › Section 18VAC90-40-210 - Informed consent and agreement for treatment of chronic pain

Current through Register Vol. 40, No. 24, July 15, 2024
A. The practitioner
				  shall document in the medical record informed consent, to include risks,
				  benefits, and alternative approaches, prior to the initiation of opioids for
				  chronic pain.
B. There shall be a
				  written treatment agreement, signed by the patient, in the medical record that
				  addresses the parameters of treatment, including those behaviors that will
				  result in referral to a higher level of care, cessation of treatment, or
				  dismissal from care.
C. The
				  treatment agreement shall include notice that the practitioner will query and
				  receive reports from the Prescription Monitoring Program and permission for the
				  practitioner to:
1. Obtain urine drug screen
				  or serum medication levels, when requested; and
2. Consult with other prescribers or
				  dispensing pharmacists for the patient.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 40 - Regulations for Prescriptive Authority for Advanced Practice Registered Nurses › Part VI - Management of Chronic Pain › Section 18VAC90-40-220 - Opioid therapy for chronic pain

Current through Register Vol. 40, No. 24, July 15, 2024
A. The practitioner shall review the course
				  of pain treatment and any new information about the etiology of the pain or the
				  patient's state of health at least every three months.
B. Continuation of treatment with opioids
				  shall be supported by documentation of continued benefit from the prescribing.
				  If the patient's progress is unsatisfactory, the practitioner shall assess the
				  appropriateness of continued use of the current treatment plan and consider the
				  use of other therapeutic modalities.
C. Practitioners shall check the Prescription
				  Monitoring Program at least every three months after the initiation of
				  treatment.
D. The practitioner
				  shall order and review a urine drug screen or serum medication levels at the
				  initiation of chronic pain management and thereafter randomly at the discretion
				  of the practitioner but at least once a year.
E. The practitioner shall regularly evaluate
				  for opioid use disorder and shall initiate specific treatment for opioid use
				  disorder, consult with an appropriate health care provider, or refer the
				  patient for evaluation for treatment if indicated.
Statutory Authority: §§
												54.1-2400
						and
						54.1-2957
						of the Code of Virginia.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 40 - Regulations for Prescriptive Authority for Advanced Practice Registered Nurses › Part VI - Management of Chronic Pain › Section 18VAC90-40-230 - Additional consultation

Current through Register Vol. 40, No. 24, July 15, 2024
A. When
				  necessary to achieve treatment goals, the prescriber shall refer the patient
				  for additional evaluation and treatment.
B. When a practitioner makes the diagnosis of
				  opioid use disorder, treatment for opioid use disorder shall be initiated or
				  the patient shall be referred for evaluation and treatment.
Statutory Authority: §§
												54.1-2400
						and
						54.1-2957
						of the Code of Virginia.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 40 - Regulations for Prescriptive Authority for Advanced Practice Registered Nurses › Part VI - Management of Chronic Pain › Section 18VAC90-40-240 - Medical records

Current through Register Vol. 40, No. 24, July 15, 2024
The prescriber shall keep current, accurate, and complete
					 records in an accessible manner and readily available for review to
					 include:
1. The medical history and
				  physical examination;
2. Past
				  medical history;
3. Applicable
				  records from prior treatment providers or any documentation of attempts to
				  obtain those records;
4.
				  Diagnostic, therapeutic, and laboratory results;
5. Evaluations and consultations;
6. Treatment goals;
7. Discussion of risks and
				  benefits;
8. Informed consent and
				  agreement for treatment;
9.
				  Treatments;
10. Medications,
				  including date, type, dosage and quantity prescribed, and refills;
11. Patient instructions; and
12. Periodic reviews.
Statutory Authority: §§
												54.1-2400
						and
						54.1-2957
						of the Code of Virginia.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 40 - Regulations for Prescriptive Authority for Advanced Practice Registered Nurses › Part VII - Prescribing of Buprenorphine › Section 18VAC90-40-250 - General provisions

Current through Register Vol. 40, No. 24, July 15, 2024
A. Practitioners
				  engaged in office-based opioid addiction treatment with buprenorphine shall
				  have obtained a waiver from SAMHSA and the appropriate U.S. Drug Enforcement
				  Administration registration.
B.
				  Practitioners shall abide by all federal and state laws and regulations
				  governing the prescribing of buprenorphine for the treatment of opioid use
				  disorder.
C. Advanced practice
				  registered nurses who have obtained a SAMHSA waiver shall only prescribe
				  buprenorphine for opioid addiction pursuant to a practice agreement with a
				  SAMHSA-waivered doctor of medicine or doctor of osteopathic medicine unless the
				  advanced practice registered nurse has been authorized by the boards for
				  autonomous practice.
D.
				  Practitioners engaged in medication-assisted treatment shall either provide
				  counseling in their practice or refer the patient to a mental health service
				  provider, as defined in §
										54.1-2400.1 of the Code of
				  Virginia, who has the education and experience to provide substance misuse
				  counseling. The practitioner shall document provision of counseling or referral
				  in the medical record.
Statutory Authority: §§
												54.1-2400 and
						54.1-2957 of the Code of
						Virginia.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 40 - Regulations for Prescriptive Authority for Advanced Practice Registered Nurses › Part VII - Prescribing of Buprenorphine › Section 18VAC90-40-260 - Patient assessment and treatment planning

Current through Register Vol. 40, No. 24, July 15, 2024
A. A practitioner shall perform and document
				  an assessment that includes a comprehensive medical and psychiatric history,
				  substance misuse history, family history and psychosocial supports, appropriate
				  physical examination, urine drug screen, pregnancy test for women of
				  childbearing age and ability, a check of the Prescription Monitoring Program,
				  and, when clinically indicated, infectious disease testing for human
				  immunodeficiency virus, hepatitis B, hepatitis C, and tuberculosis.
B. The treatment plan shall include the
				  practitioner's rationale for selecting medication assisted treatment, patient
				  education, written informed consent, how counseling will be accomplished, and a
				  signed treatment agreement that outlines the responsibilities of the patient
				  and the practitioner.
Statutory Authority: §§
												54.1-2400
						and
						54.1-2957
						of the Code of Virginia.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 40 - Regulations for Prescriptive Authority for Advanced Practice Registered Nurses › Part VII - Prescribing of Buprenorphine › Section 18VAC90-40-270 - Treatment with buprenorphine

Current through Register Vol. 40, No. 24, July 15, 2024
A.
				  Buprenorphine without naloxone (buprenorphine mono-product) shall not be
				  prescribed except:
1. When a patient is
				  pregnant;
2. When converting a
				  patient from methadone or buprenorphine mono-product to buprenorphine
				  containing naloxone for a period not to exceed seven days;
3. In formulations other than tablet form for
				  indications approved by the FDA; or
4. For patients who have a demonstrated
				  intolerance to naloxone; such prescriptions for the mono-product shall not
				  exceed 3.0% of the total prescriptions for buprenorphine written by the
				  prescriber, and the exception shall be clearly documented in the patient's
				  medical record.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 40 - Regulations for Prescriptive Authority for Advanced Practice Registered Nurses › Part VII - Prescribing of Buprenorphine › Section 18VAC90-40-280 - Special populations

Current through Register Vol. 40, No. 24, July 15, 2024
A. Pregnant
				  women may be treated with the buprenorphine mono-product, usually 16 milligrams
				  per day or less.
B. Patients
				  younger than the age of 16 years shall not be prescribed buprenorphine for
				  addiction treatment unless such treatment is approved by the FDA.
C. The progress of patients with chronic pain
				  shall be assessed by reduction of pain and functional objectives that can be
				  identified, quantified, and independently verified.
D. Practitioners shall (i) evaluate patients
				  with medical comorbidities by history, physical exam, and appropriate
				  laboratory studies and (ii) be aware of interactions of buprenorphine with
				  other prescribed medications.
E.
				  Practitioners shall not undertake buprenorphine treatment with a patient who
				  has psychiatric comorbidities and is not stable. A patient who is determined by
				  the practitioner to be psychiatrically unstable shall be referred for
				  psychiatric evaluation and treatment prior to initiating medication-assisted
				  treatment.
Statutory Authority: §§
												54.1-2400
						and
						54.1-2957
						of the Code of Virginia.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 40 - Regulations for Prescriptive Authority for Advanced Practice Registered Nurses › Part VII - Prescribing of Buprenorphine › Section 18VAC90-40-290 - Medical records for opioid addiction treatment

Current through Register Vol. 40, No. 24, July 15, 2024
A. Records shall be timely, accurate,
				  legible, complete, and readily accessible for review.
B. The treatment agreement and informed
				  consent shall be maintained in the medical record.
C. Confidentiality requirements of 42 CFR
				  Part 2 shall be followed.
Statutory Authority: §§
												54.1-2400
						and
						54.1-2957
						of the Code of Virginia.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 40 - Regulations for Prescriptive Authority for Advanced Practice Registered Nurses › Form - FORMS (18VAC90-40)

Current through Register Vol. 40, No. 24, July 15, 2024
Application
				  for Prescriptive Authority for Licensed Nurse Practitioners (rev.
				  6/11)
.
Prescriptive
				  Authority for Licensed Nurse Practitioners Practice Agreement (rev.
				  3/11)
.
Application
				  for Reinstatement of Prescriptive Authority (rev.
				  7/07)
.
Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 90 - BOARD OF NURSING › Chapter 50 - REGULATIONS GOVERNING THE LICENSURE OF MASSAGE THERAPISTS › Part I - General Provisions › Section 18VAC90-50-10 - Definitions

Current through Register Vol. 40, No. 24, July 15, 2024
A. The following
				  words and terms when used in this chapter shall have the meanings ascribed to
				  them in § 54.1-3000 of the Code of Virginia:
"Board"
"Massage therapist"
"Massage therapy"
B. The following word when used in this
				  chapter shall have the following meaning unless the context clearly indicates
				  otherwise:
"NCBTMB" means the National Certification Board for
					 Therapeutic Massage and Bodywork.
Statutory Authority: §§ 54.1-2400 and 54.1-3005
						of the Code of Virginia.