Current through Register Vol. 39, No. 6, September 16, 2024
The following are the quality assurance standards for a
collaborative practice agreement:
(1)
Availability: The primary or back-up supervising physician(s) and the nurse
practitioner shall be continuously available to each other for consultation by
direct communication or telecommunication.
(2) Collaborative Practice Agreement:
(a) shall be agreed upon, signed, and dated
by both the primary supervising physician and the nurse practitioner, and
maintained in each practice site;
(b) shall be reviewed at least yearly. This
review shall be acknowledged by a dated signature sheet, signed by both the
primary supervising physician and the nurse practitioner, appended to the
collaborative practice agreement, and available for inspection by either
Board;
(c) shall include the drugs,
devices, medical treatments, tests, and procedures that may be prescribed,
ordered, and performed by the nurse practitioner consistent with Rule .0109 of
this Subchapter; and
(d) shall
include a pre-determined plan for emergency services.
(3) The nurse practitioner shall demonstrate
the ability to perform medical acts as outlined in the collaborative practice
agreement upon request by members or agents of either Board.
(4) Quality Improvement Process:
(a) The primary supervising physician and the
nurse practitioner shall develop a process for the ongoing review of the care
provided in each practice site, including a written plan for evaluating the
quality of care provided for one or more frequently encountered clinical
problems.
(b) This plan shall
include a description of the clinical problem(s), an evaluation of the current
treatment interventions, and if needed, a plan for improving outcomes within an
identified time frame.
(c) The
quality improvement process shall include scheduled meetings between the
primary supervising physician and the nurse practitioner for a minimum of every
six months. Documentation for each meeting shall:
(i) identify clinical problems discussed,
including progress toward improving outcomes as stated in Sub-Item (4)(b) of
this Rule, and recommendations, if any, for changes in treatment
plan(s);
(ii) be signed and dated
by those who attended; and
(iii) be
available for review by either Board for the previous five calendar years and
be retained by both the nurse practitioner and primary supervising
physician.
(5) Nurse Practitioner-Physician
Consultation. The following requirements establish the minimum standards for
consultation between the nurse practitioner and primary supervising
physician(s):
(a) During the first six months
of a collaborative practice agreement between a nurse practitioner and the
primary supervising physician, there shall be monthly meetings to discuss
practice-relevant clinical issues and quality improvement measures.
(b) Documentation of the meetings shall:
(i) identify clinical issues discussed and
actions taken;
(ii) be signed and
dated by those who attended; and
(iii) be available for review by either Board
for the previous five calendar years and be retained by both the nurse
practitioner and primary supervising physician.
Authority
G.S.
90-5.1(a)(3);
90-8.1;
90-8.2;
90-18(c)(14);
90-18.2;
90-171.23(b)(14);
Eff. January 1, 1991;
Amended Eff. August 1, 2004; May 1, 1999;
January 1, 1996; March 1, 1994;
Recodified from Rule .0109 Eff.
August 1, 2004;
Amended Eff. December 1, 2009;
Pursuant
to G.S.
150B-21.3A rule is necessary without
substantive public interest Eff. March 1, 2016;
Amended Eff. June
1, 2021.
