Chapter 360-32 NURSE PROTOCOL AGREEMENTS PURSUANT TO O.C.G.A. SECTION 43-34-25
| (1) |
The delegating physician shall file the
nurse protocol agreement and a Board approved form with the Board for review
and submits the requisite fee for review established in the Board's fee
schedule. Fees are non-refundable. |
| (2) |
In addition to submitting the nurse
protocol agreement to the Board for review, the delegating physician shall
obtain from the APRN and submit to the Board current verification from the
Georgia Board of Nursing that the APRN is approved to practice as an APRN and
whether the APRN has had any disciplinary action taken against him or her by
the Georgia Board of Nursing. |
| (3) |
If, after review, the Board determines that the nurse protocol agreement fails
to meet accepted standards of medical practice, the delegating physician will
be so notified and be required to amend the agreement in order to comply with
such accepted standards. |
| (4) |
The
delegating physician shall file with the Board amendments to nurse protocol
agreements previously reviewed by the Board within 30 days of the date the
amendment was executed. |
| (5) |
Nurse
protocol agreements must be received by the Board within 30 days from the date
of execution of the agreement. |
| (6) |
Incomplete protocols that have been on file with the Board for more than three
months shall be deemed invalid. No further action will take place on the
protocol requests that have been incomplete for more than three months and a
new protocol and fee will be required. |
| (1) |
A
physician whose medical license is restricted shall not enter into a nurse
protocol agreement, unless the physician has received prior written approval
from the Board. |
| (2) |
No physician
shall delegate to an individual pursuant to the provisions of Code Section
43-34-25,
unless the individual is fully approved by the Georgia Board of Nursing to
practice as an APRN. |
| (3) |
No
physician may enter into a nurse protocol agreement with an APRN whose
specialty area or field is not comparable to the physician's specialty area or
field. |
| (4) |
Unless specifically
exempted by paragraphs (g), (g.1), or (g.2) of Code Section
43-34-25,
a delegating physician may not enter into a nurse protocol agreement with more
than four APRN's at any one time. A delegating physician meeting the provisions
of Code section
43-34-25
(g.1) or (g.2) may enter into a nurse protocol agreement not with more than
eight APRN's at any one time, but may only supervise up to four APRN's at any
one time. |
| (5) |
Except for practice
settings identified in paragraph (7) of subsection (g) of Code Section
43-34-25,
a physician shall not be an employee of an APRN, alone or in combination with
others, if the physician delegates to and/or is required to supervise the
employing APRN. |
| (6) |
No delegating
physician shall delegate to an APRN the ability to prescribe controlled
substances for the delegating physician, for the members of the delegating
physician's immediate family, for the APRN himself or herself, or for the
APRN's immediate family. For purposes of this rule,"immediate family" shall
include spouses, children, siblings and parents. |
| (1) |
The delegating
physician shall be available for immediate consultation with the advanced
practice registered nurse. If the delegating physician is not available, the
delegating physician for purposes of consultation may designate another
physician who concurs with the terms of the nurse protocol agreement as
provided in O.C.G.A.
43-34-25. |
| (2) |
The delegating physician shall document
and maintain a record of onsite observation and review of medical records on a
quarterly basis to monitor quality of care being provided to the
patients. |
| (3) |
The delegating
physician shall make certain that the medical acts provided by the APRN
pursuant to the protocol agreement are:
| (a) |
Commensurate with the education, training, experience and competence of the
APRN:
| 1. |
A delegating physician shall
therefore ensure that an APRN to whom he delegates prescriptive receives
pharmacology training appropriate to the delegating physician's scope of
practice at least annually. Documentation of such training shall be maintained
by the physician and provided to the Board upon request. |
| 2. |
A delegating physician who fails to comply
with subparagraph (3)(a)1. of this rule by delegating prescriptive to an APRN
who has not received pharmacology training appropriate to the delegating
physician's scope of practice at least annually may be subject to disciplinary
action. |
|
| (b) |
Within the
scope of practice, specialty area or field and certification of the
APRN; |
| (c) |
Within the comparable
specialty area or field of the delegating physician; and |
| (d) |
Well documented in accurately maintained
patient specific medical records. |
|
| (4) |
The delegating physician is responsible
for all the medical acts performed by the APRN. |
| (5) |
A delegating physician shall notify the
Board within ten (10) working days of the date of termination of a nurse
protocol agreement with the delegating physician and APRN. |
| (6) |
In the event of the death or departure of
a delegating physician, an APRN must notify the Board within 7 days. If a
designated physician is available according to an approved protocol agreement,
he or she may serve as the delegating physician for up to 60 days (from the
date of death of departure) until a new protocol agreement is approved by the
Board. In the event that there is no designated physician, the APRN will not
have prescriptive authority until a new signed protocol agreement is submitted
to the Board. |
| (7) |
The Board may
request at any time to review the nurse protocol agreement and any supporting
documentation. Failure to provide this written information to the Board within
30 days shall be a basis for and may result in disciplinary action. The Board
may require changes in these documents if the Board determines that they do not
comply with O.C.G.A.
43-34-25
and/or accepted standards of medical practice. |
A delegating or other designated physician may be disciplined
for failure to comply with this Chapter.
Nothing in this rule shall be construed to require a physician
to delegate prescriptive or prohibit a physician from utilizing the protocol
granted under O.C.G.A. § 43-34-23.
