The information that must be included in an order and on an order form can be found in Rule 222.4 of the BON. Applications for prescriptive authority numbers and other important information for RPANs are posted on the BON Advanced Practice Nursing webpage. Frequently asked questions about the prescriptive authority that the BON and the TMB have jointly developed can be found on the BON and TMB websites. (For the TMB FAQ, click „Laws and Rules“ in the left navigation column.) It depends on when the agreement was signed. For limitation agreements entered into before September 1, 2019, factors such as the type of delegate licence and the time spent under an agreement determined the frequency and type of meetings required. In the case of such agreements, the period during which an APRN or PA was exercised under the delegated prescriptive authority of a physician under a prescriptive authorization agreement includes the period of time before November 1, 2013 under the delegated prescriptive authority of the same physician. It should be noted that if a licensee`s authority to supervise, delegate or prescribe equipment is limited by an order of the Board, the Licensee may enter into a prescriptive authorization agreement and practice under the Agreement only to the extent permitted by the Order of the Board. The prescriptive authority agreement determines who can serve as an alternative physician when using alternative medical supervision. If one or two locum physicians attend quality assurance and improvement sessions with the APRN or PA, this information must be included in the prescriptive authority agreement.
There are two main restrictions on mandatory authority for Registered Advanced Practice Nurses (APRN) in Texas. For agreements reached on or after 1 September 2019, face-to-face meetings are no longer strictly necessary and how meetings can be conducted is determined by the parties. This may include the physical presence of participants in the same room or remote methods, including conference call or video. Yes, as agreed by the parties to the agreement on the prescribed authority. They may meet more often than required by law. They should not meet less frequently than required by law. APRNs and APAs must have the delegated authority of an authorized physician to provide medical aspects of patient care. In the past, this delegation was done by protocol or other written approval. Instead of requiring multiple documents, delegation protocols can now be included in a prescriptive authority agreement document. However, the prescriptive authorization agreement does not have to describe the exact actions that a nurse or physician assistant must take with respect to each particular condition, disease or symptom. Since the introduction of SB 406 on November 1, 2013, Texas physicians have been able to delegate normative powers to APRNs. Location and distance restrictions no longer exist, and medical surveillance requirements are now the same for all physicians who delegate under a Prescribing Authority Agreement (PAA).
(9) Describe a normative quality assurance and improvement plan for the Authority and how it will be implemented. The plan should require panel reviews and regular meetings. The law does not provide for a specific number or percentage of graphs to be checked. Rather, the law provides that the number of tables to be reviewed is determined by the parties to the prescriptive authority agreement. The number may vary from one exercise parameter to another. Factors such as the length of the practice of the APRN or MA, the duration of the joint practice of the physician and the APRN or MA, whether the parties to the prescriptive authority agreement practice together in the same practice setting, and the complexity of patient care needs should be taken into account in this Decision […].