Section 120. Practice of licensed nurse practitioners other than certified registered nurse anesthetists or certified nurse midwives

Part III. Practice of Licensed Nurse Practitioners

A. A nurse practitioner licensed in a category other than certified registered nurse anesthetist or certified nurse midwife shall be authorized to render care in collaboration and consultation with a licensed patient care team physician as part of a patient care team.

B. The practice shall be based on specialty education preparation as an advanced practice registered nurse in accordance with standards of the applicable certifying organization, as identified in 18VAC90-30-90.

C. All nurse practitioners licensed in any category other than certified registered nurse anesthetist or certified nurse midwife shall practice in accordance with a written or electronic practice agreement as defined in 18VAC90-30-10.

D. The written or electronic practice agreement shall include provisions for:

1. The periodic review of patient charts or electronic patient records by a patient care team physician and may include provisions for visits to the site where health care is delivered in the manner and at the frequency determined by the patient care team;

2. Appropriate physician input in complex clinical cases and patient emergencies and for referrals; and

3. The nurse practitioner's authority for signatures, certifications, stamps, verifications, affidavits, and endorsements provided it is:

a. In accordance with the specialty license of the nurse practitioner and within the scope of practice of the patient care team physician;

b. Permitted by § 54.1-2957.02 or applicable sections of the Code of Virginia; and

c. Not in conflict with federal law or regulation.

E. The practice agreement shall be maintained by the nurse practitioner and provided to the boards upon request. For nurse practitioners providing care to patients within a hospital or health care system, the practice agreement may be included as part of documents delineating the nurse practitioner's clinical privileges or the electronic or written delineation of duties and responsibilities; however, the nurse practitioner shall be responsible for providing a copy to the boards upon request.

Historical Notes

Derived from VR495-02-1 and VR465-07-1 §§ 3.1 and 3.2, eff. June 22, 1989; amended, Volume 12, Issue 01, eff. November 1, 1995; Volume 15, Issue 07, eff. January 20, 1999; Volume 17, Issue 07, eff. January 17, 2001; Volume 21, Issue 21, eff. July 27, 2005; Volume 23, Issue 14, eff. April 18, 2007; Volume 24, Issue 10, eff. February 20, 2008; Volume 25, Issue 05, eff. December 25, 2008; Volume 31, Issue 21, eff. July 15, 2015; Volume 33, Issue 01, eff. October 5, 2016.

Statutory Authority

§§ 54.1-2400 and 54.1-2957 of the Code of Virginia.