NRPAS must have delegated authority to provide medical aspects of patient care. Historically, this delegation has been made by protocol or other written authorization. Instead of having two documents, this delegation can now be included in an agreement on the authority of standards, if both parties agree to do so. Written consent is required between the NNP and the supervisory physician. Protocols should be developed and revised together each year. Tex. Administrator. Code No. 22-11-221.13 The main opponents of extending full practice to NPs remain physician groups. In the article mentioned above in the Texas Tribune of 2017, Don explained. R. Read, MD – the president of the Texas Medical Association – that the TMA continues to believe that the “team care” approach (i.e.
physician compensation for collaborative agreements) “best serves patients.” Texas Nurse Practitioners agree that they are part of a health team; However, their concept of “team care” is more mature and goes beyond the costly and prohibitive contracts they are supposed to put in place with physician supervision. Texas NPs can only prosper fully if they are granted the right to practice independently. Are doctors willing to forego costly cooperation agreements to expand access to health care? That would be a truly patient-centered approach. The treatment of acute pain with drugs programmed through telemedicine services is permitted, unless federal and national law prohibits others. APRNs should be aware that acute pain is time-limited and refers to the normal physiological response predicted to a stimulus such as trauma, illness and surgery. The APRN must be authorized to prescribe the controlled substance through a valid standardization agreement with a delegated physician and the current registration of the DEA. NRPAs should not prescribe controlled substances for chronic pain through telemedicine services, unless specifically permitted by federal or national law. Chronic pain is a condition in which pain can persist beyond the usual course of an acute illness or the healing of an injury and be associated with a chronic pathological process causing continuous or intermittent pain for months or years. Senate Act 406, effective 11/1/2013, requires a normative authority agreement between a doctor and an AFN, which has been delegated mandatory authority. Senate Bill 406 (including new rules) on the online registration system will be available in January 2014. Do I have to submit my regulatory-based agreement or protocol to the board if I sign a new protocol? Is a prescriptive authority agreement required in a hospital or long-term care practice? If RNAs practice in environments where they write recipes, such as an RNAC.
B who could work with a pain management specialist, the CNA must have a normative authority and all requirements for delegation of the prescribed authority must be met. These include the requirement for an agreement through a standard-setting authority or, where appropriate, an institution-based protocol and the registration of the medical delegation on the Texas Medical Board website.