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North Carolina State Board of
Nursing Up-Date: Liz Lawrence, RNC,
NNP
The information below is subject to change.
Please verify your information with the N.C. State Board of
Nursing.
NC Practice Update -
No new
updates
Reminders for Practice
from past
newsletters:
1) Each NNP/MD must have a
Collaborative Practice Agreement (CPA)
*
- "The arrangement for NP-physician
continuous availability to each
other for ongoing supervision, consultation, collaboration,
referral and
evaluation of care provided by the NP."
- "Based on the
premise that the primary or back-up supervising
physician and the NP shall be continuously available to
each other for
consultation by direct communication or
telecommunication."
2) Identify Your Primary
Supervising Physician
- ".... is the licensed physician who,
by signing the NP application,
shall provide supervision, collaboration, consultation, and
evaluation of
medical acts by the NP in accordance with the collaborative
practice
agreement."
3) List a Back-up Supervising
Physician
- ".....the licensed physician who, by
signing an agreement with the
NP and the Primary Supervising Physician, shall provide
supervision,
collaboration, consultation, and evaluation of medical acts
by the NP in
accordance with the collaborative practice agreement when
the Primary
Supervising Physician is not available."
Guidelines for the
CPA
- Shall by agreed upon and signed by
both the primary supervising
physician and the NP and maintained in each practice
site.
- 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 NP, appended to the
collaborative practice agreement and shall be available for
inspection by members or agents of
either board.
- Shall include the
drugs, devices, medical treatments, tests, and procedures
that may be prescribed, ordered, and performed by the NP
consistent with NC law.
- Shall include a
pre-determined plan for emergency services
Quality Improvement
Process
- "The Primary Supervising Physician and
the NP 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."
- "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 a specified
time frame."
"The Quality Improvement Process shall
include scheduled meetings
between the primary supervising physician and the NP at least
every 6
months."
Documentation of QA/QI/PI
- "Identify the clinical problems
discussed including progress toward
improving outcomes as stated in the rules and
recommendations for changes in
treatment plans."
- Be signed and dated by those who
attended.
- Be available for review by members or agents
of either Board for the previous 5 years and be retained by
both the NP and Primary Supervising Physician.
- A New NP and/or An
Additional Primary Supervising Physician
- "......minimum standards for
consultation between the NP and the Primary or Back-up
Supervising Physician: During the first 6 months of the
initial CPA: there shall be a review and
countersigning of notations of medical acts by a primary or
back-up supervising physician within 7
days. Meetings with the Primary Supervising
Physician will be on a weekly basis
for one month then at least monthly for a total of 6
months.
Documentation of
Meetings
- Identifying clinical
issues discussed and actions taken
- Be signed and dated by those who
attended
- Be available for review by the Board for the
previous 5 years and retained by both the NP and the
Primary Supervising Physician.
Educational Requirement
Reminder
- 100 contact hours of
continuing education is required every 2
years.
-
Remember alternative methods to document
contact hours include:
- 1 quarter
hour=10 contact hours
- 1 semester
hour=15 contact hours
- 1 CEU=10
contact hours
- 1 CME/AMA Category 1/ACOG cognate=1
hr
- Presentations=the same number
of hours as the recipients get
- Publications=5 contact hours for a
journal article or book chapter
- Primary or secondary author of a
book=15 contact hours
- Reviewers or writes of self assessment
modules=10 contact hours
National Council of State Boards of
Nursing: "Vision Paper" for the future
of APRN's
- 1) BON will be the sole
regulator of APN's.
- 2) APRN licensure will be in the categories
and titles of CRNA, CNM, NP. (No more CNS as an
APRN)
- 3) BON will approve APRN programs for purposes
of licensure.
- 4) All programs leading to APRN licensure
including clinical/practice doctorate and post masters
programs will meet established educational
requirements.
- 5)
Requirements for licensure as a nurse practitioner will
include successful completion of a core nurse practitioner
licensure examination and a residency program.
- 6) Evidence of continued competency will be
required for purposes of license renewal.
- 7) Fully licensed APRN's will be independent
practitioners, after licensure there will be no regulatory
requirements for supervision.
- 8) The Advanced Practice Compact will be the
regulatory model used to effect mutual recognition of
advanced practice nurses.
References
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