Ga. Comp. R. & Regs. 410-11-.14

Current through Rules and Regulations filed through June 17, 2024

Rule 410-11-.14 - Regulation of Protocol Use By Advanced Practice Registered Nurses as Authorized by O.C.G.A. Section 43-34-26.3

(1) An advanced practice registered nurse ("APRN") who uses a protocol authorized by O.C.G.A. § 43-34-25 shall:

(a) Hold a current license to practice as a registered professional nurse in Georgia;

(b) Hold a current authorization to practice as an advanced practice registered nurse in Georgia;

(c) Adhere to a written nurse protocol agreement that is dated and signed by the APRN, the delegating physician, and any other designated physician(s); the APRN's area of practice shall be in the same or comparable specialty as that of the delegating physician; the protocol shall specify the medical acts delegated to the APRN as provided by O.C.G.A. § 43-34-25 and shall provide for immediate consultation with the delegating physician or a designated physician if the delegating physician is not available; and

(d) Document preparation and performance specific to each medical act authorized by the written nurse protocol agreement including ordering drugs, medical treatments or diagnostic studies, medical devices, or, in life threatening situations, radiographic imaging tests.

(2) An APRN may practice under a nurse protocol agreement authorized by O.C.G.A. § 43-34-25 if the nurse protocol agreement adheres to the following criteria:

(a) Shall bear a current review date; be available upon request; and specify parameters under which delegated medical acts may be performed to include kinds of diagnostic studies which may be ordered, the extent to which radio logic image tests may be ordered, provisions for the reading and interpretation of such tests by a physician who is trained in the reading and interpretation of the tests, circumstances under which prescription drugs orders may be executed, number of refills which may be ordered, include a frequency of follow up review of the patient by the physician, including patients who are on controlled substances;

(b) Shall include a schedule for periodic review of patient records by the delegating physician, which records review may be achieved with a sampling of such records as determined by the delegating physician;

(c) Shall be reviewed, revised or updated annually by the APRN, the delegating physician, and any designated physician;

(d) Shall include a provision for immediate consultation with the delegating physician or a physician designated in the absence of the delegating physician; and

(e) Shall comply with the provisions of O.C.G.A. § 43-34-25 regarding prescription drug orders placed by an APRN for a drug or medical device including, but not limited to, the following:

1.No prescription drug orders submitted by an APRN for Schedule I or II controlled substances;

2.No refills of any drug for more than 12 months from the date of the original Order, except in the case of oral contraceptives, hormone replacement therapy, or prenatal vitamins, which may be refilled for a period of 24 months;

3.No drug order or medical device that may result in the performance or occurrence of an abortion, including the administration, prescription or issuance of a drug order that is intended to cause an abortion to occur pharmacologically;

4.Written prescription drug orders shall be signed by the APRN, be written on forms that comply with the nurse protocol agreement, and such forms shall contain the information required by paragraph (d) of O.C.G.A. § 43-34-25;

5.A written provision in the nurse protocol agreement authorizing the APRN to request, receive, and sign for professional samples, and to distribute them to patients in accordance with a list of professional samples approved by the delegating physician that is maintained by the office or facility where the APRN works and that requires the documentation of each sample received and dispensed; and

6.Compliance with applicable state and federal laws and regulations pertaining to the ordering, maintenance, and dispensing of drugs.

(3) Only four (4) advanced practice registered nurses may enter into a nurse protocol agreement with a delegating physician at any one time under O.C.G.A § 43-34-25, except this limitation shall not apply to an APRN that is practicing in the following settings:

(a) In a hospital licensed under Title 31;

(b) In any college or university as defined in Code Section 20-8-1;

(c) In the Department of Public Health;

(d) In any county board of health;

(e) In any free health clinic;

(f) In a birthing center;

(g) In any entity:

1.Which is exempt from federal taxes pursuant to Section 501(c)(3) of the Internal Revenue Code, as defined in Code Section 48-1-2, and primarily serves uninsured or indigent Medicaid and Medicare patients; or

2.Which has been established under the authority of or is receiving funds pursuant to 42 U.S.C. Section 254 b or 254c of the United States Public Health Service Act;

(h) In any local board of education which has a school nurse program; or

(i) In a health maintenance organization that has an exclusive contract with a medical group practice and arranges for the provision of substantially all physician services to enrollees in health benefits of the health maintenance organization.

Ga. Comp. R. & Regs. R. 410-11-.14

O.C.G.A. §§ 43-1-25, 43-26-2, 43-26-3, and 43-26-5.

Original Rule entitled "Regulation of Protocol Use By Advanced Practice Registered Nurses as Authorized by O.C.G.A. § 43-34-26.3 " adopted. F. Aug. 24, 2015; eff. Sept. 13, 2015.