New York Codes, Rules and Regulations
Title 8 - EDUCATION DEPARTMENT
Chapter II - Regulations of the Commissioner
Subchapter B - Regulation of Professions
Part 64 - Nursing
Section 64.5 - Nurse practitioner practice
Universal Citation: 8 NY Comp Codes Rules and Regs ยง 64.5
Current through Register Vol. 46, No. 12, March 20, 2024
(a) Collaborative Practice
(1) A nurse
practitioner who has three thousand six hundred or fewer hours of experience
practicing as a licensed or certified nurse practitioner pursuant to the laws
of New York or any other state or as a nurse practitioner while employed by the
United States Veterans Administration, the United States Armed Forces or the
United States Public Health Service shall practice in collaboration with a
physician qualified in the specialty involved and in accordance with a written
practice agreement and written practice protocols.
(2) Practice agreements and practice
protocols shall be maintained in the practice setting of the nurse practitioner
and collaborating physician and shall be available to the department for
inspection.
(3) Practice agreements
shall include provisions for referral and consultation, coverage for emergency
absences of either the nurse practitioner or collaborating physician,
resolution of disagreements between the nurse practitioner and collaborating
physician regarding matters of diagnosis and treatment, and the review of
patient records at least every three months by the collaborating physician; and
may include such other provisions as determined by the nurse practitioner and
collaborating physician to be appropriate.
(4) Protocols shall identify the area of
practice to be performed by the nurse practitioner in collaboration with the
physician and shall reflect accepted standards of nursing and medical practice.
Protocols shall include provisions for case management, including diagnosis,
treatment, and appropriate recordkeeping by the nurse practitioner; and may
include such other provisions as are determined by the nurse practitioner and
collaborating physician to be appropriate. Such protocols may be updated
periodically.
(5) The department in
its discretion or upon request of a nurse practitioner or collaborating
physician may review practice protocols for the purpose of insuring that they
are in conformance with accepted medical and nursing practice and with the
statutes and regulations governing the practice of medicine, nursing, and the
prescribing of drugs, and may render an opinion which shall be binding upon the
parties to the protocol. A practice and protocol committee designated by the
Deputy Commissioner for the Professions shall review practice protocols and
shall recommend findings as to their adequacy and conformity with current
accepted medical and nursing practice. If the department determines that a
protocol is inadequate or contrary to current accepted medical and nursing
practice it shall communicate that determination, and the reasons therefor, to
the nurse practitioner to the collaborating physician in writing. The nurse
practitioner and collaborating physician shall conform to accepted medical and
nursing practice immediately, and shall submit a revised protocol within 30
days of receipt of the department's determination, unless an extension of time
is requested and granted by the department. Continuation of practice in
violation of the determination shall constitute unprofessional conduct by
either or both licensees.
(6) An
appeal from a determination that a practice protocol is inadequate or contrary
to current accepted medical and nursing practice may be taken within 30 days
after receipt of the notice of determination by a petition setting forth the
reasons for the appeal, and signed by both the nurse practitioner and the
collaborating physician. Such joint appeal shall be filed with the Division of
Professional Licensing Services and determined by the Committee on the
Professions whose determination shall be final.
(7) In addition to the requirements of
section
6810 of the
Education Law, prescription forms used by nurse practitioners shall be printed
with the name, nurse practitioner certificate number, office address, and
office telephone number of the nurse practitioner.
(b) Independent Practice. A nurse practitioner who has more than three thousand six hundred hours of experience practicing as a licensed or certified nurse practitioner pursuant to the laws of New York or any other state or as a nurse practitioner while employed by the United States Veterans Administration, the United States Armed Forces or the United States Public Health Service shall not be required to practice in collaboration with a physician qualified in the specialty involved and in accordance with a written practice agreement and written practice protocols as set forth in subdivision (a) of this section.
(c) Orders to dispense drugs to prevent human immunodeficiency virus (HIV) infection.
(1)
As used in this subdivision, HIV post-exposure prophylaxis drugs means drugs
approved by the Federal Food and Drug Administration to prevent and/or treat
HIV infection.
(2) A certified
nurse practitioner may issue a written non-patient specific order and protocol
for a licensed pharmacist to dispense up to a seven day supply of HIV
post-exposure prophylaxis drugs to prevent HIV infection in persons who have
potentially been exposed to HI V, provided that the requirements of this
subdivision are met.
(3) Order and
protocol.
(i) The non-patient specific order
shall include, at a minimum, the following:
(a) the name, license number and signature of
the certified nurse practitioner who issues the non-patient specific order and
protocol;
(b) the name and dose of
the specific drug(s) to be dispensed;
(c) a protocol for dispensing the drugs(s) or
a specific reference to a separate written protocol for dispensing the drug(s),
which shall meet the requirements of subparagraph (ii) of this
paragraph;
(d) the period of time
that the order is effective, including the beginning and ending
dates;
(e) a description of the
group(s) of persons who may receive the dispensed drugs, provided that the
group(s) of persons are located in New York State; and
(f) the name and license number of each
licensed pharmacist authorized to execute the non-patient specific order and
protocol or the name and address of the New York State licensed pharmacy that
employs or contracts with the licensed pharmacist(s) to execute the no
n-patient specific order and protocol.
(ii) The written protocol, incorporated into
the order prescribed in subparagraph (i) of this paragraph, shall, at a
minimum, require the licensed pharmacist to:
(a) screen each potential recipient, pursuant
to criteria i n the protocol, for conditions that would qualify or preclude the
potential recipient from receiving the dispensed drugs;
(b) offer counseling regarding the need for
follow-up care pursuant to criteria in the protocol and provide the counseling
if the recipient consents;
(c)
offer or provide in writing, the names and addresses of hospitals or other
health providers that offer follow-up care, which shall be identified in the
protocol; and
(d) document the
pharmacy services provided, including the offer or provision of counseling and
referral information described in this subparagraph, and maintain the
documentation in accordance with section
29.2(a)(3),
section 63.6(b)(7) and
section 63.6(b)(8) of this
Title.
(4) A
certified nurse practitioner may issue a written patient specific order or
prescription to a licensed pharmacist to dispense H IV postexposure prophylaxis
drugs pursuant to applicable law.
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