The answer to the question depends on practice. In institutional-based hospital practices and in practices that serve under-treated populations, there are no restrictions on the number of APRNAs or APAs to which a physician may delegate a prescriptive authority. However, a physician may delegate the prescription authority on an institution-based protocol to no more than one licensed hospital or no more than two long-term care centers. In all other practical parameters, a physician may not delegate more than seven full-time equivalent APRNs and PAs (1:7 FTE). Does my medical delegate have to practice in the same field as my field of activity to delegate the authority dictated to him? Although it is possible to use a normative authority agreement in a hospital or practice based on long-term care facilities, it is not necessary. You can use configuration protocols in these settings. The APRN must exercise normative authority within the framework of one of these delegation mechanisms. The agreement through the standards authority determines who can serve as an assistant physician when other medical supervision is used. When one or the other physicians participate in quality assurance and improvement meetings with the APRN, this information must be included in the Standardization Authority Agreement. 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. All NPAs are first licensed and must retain the RN licence to retain the extended exercise licence.
An APRN must not accept a transfer: within the scope of an RN [board rule 221.12 (2) (texreg.sos.state.tx.us/public/readtac TacPage? p_dir p_rloc-p_tloc-p_ploc-p_tac-ti-22-pt-11-ch-221-rl-12] When the APRN operates in the RN, the field of practice is limited to that of the RN. RNAs, which are also APRN, should not enter the APRN area and deal with activities such as medical diagnosis and control or prescribing during exercise in the RN. It is also important to note that an RN that holds the current licence as an APRN is maintained at the highest level of its training and skills. On the other hand, there may be a situation in which a nurse takes care of an RN patient and, because of her knowledge and skills in medical diagnosis and management, there may be signs and symptoms of a medical condition that is not easily visible for an RN that is not an NRPA. In this case, the RN has no right to diagnose and manage this particular patient, since he is at that time outside the scope of RNA practice, but must recognize the disease (based on his advanced practical training) and take appropriate care measures, for example. B notify an appropriate provider. The Boards 15.15 Boards` Jurisdiction Over a Nurse`s Practice in Any Role and Use of the Nursing Title (www.bon.texas.gov/practice_bon_position_statements_content.asp#15.15) provides further details. In addition, the dual-licence nurse should determine how she identifies when interacting with the public, based on the preference and installation policy.