Nurse practitioners: scope of practice: practice without standardized procedures.
(1) Existing law, the Nursing Practice Act, provides for the certification and regulation of nurse practitioners by the Board of Registered Nursing. Existing law authorizes a nurse practitioner who meets certain education, experience, and certification requirements to perform, in certain settings or organizations, specified functions without standardized procedures, including, but not limited to, conducting an advanced assessment; ordering, performing, and interpreting diagnostic procedures, as specified; and prescribing, administering, dispensing, and furnishing controlled substances.
Existing law, beginning January 1, 2023, authorizes a nurse practitioner to perform the functions described above without standardized procedures outside of the specified settings or organizations, in accordance with certain conditions and requirements, if the nurse practitioner holds an active certification issued by the board. Existing law requires those nurse practitioners to obtain physician consultation as specified in the individual protocols and under certain circumstances, including acute decompensation of patient situation. Existing law also requires those nurse practitioners to establish a referral plan for complex medical cases and emergencies to a physician and surgeon or other appropriate healing arts provider that addresses various circumstances, including a patient that has acute decomposition or rare condition.
This bill would refer to practice protocols instead of individual protocols and would delete the requirement to obtain physician consultation in the case of acute decompensation of patient situation. The bill would revise the requirement to establish a referral plan, as described above, and would require the referral plan to address the circumstance of a patient that has acute and unexpected decompensation or rare condition.
This bill would include references and incorporate nurse practitioners who function pursuant to the above-described provisions without standardized procedures into various provisions of law regulating healing arts licensees.
(2) Existing law exempts from discovery as evidence the proceedings and records of specified organized committees of health care professionals and review committees having the responsibility of evaluation and improvement of the quality of care.
This bill would extend this exemption, for purposes of civil proceedings only, to the proceedings and records of nurse practitioner organized committees and review committees, as specified.