Ala. Admin. Code r. 540-X-8-.01 - Definitions. The following definitions will apply to these rules:
(1) BOARD OF
MEDICAL EXAMINERS. The State Board Of Medical Examiners established pursuant to
Code of Ala. 1975, §
34-24-53.
(2) BOARD OF NURSING. The Board of Nursing
established under Code of Ala. 1975, §
34-21-2.
(3) ADVANCED PRACTICE NURSE. A registered
nurse who has gained additional knowledge and skills through successful
completion of an organized program of nursing education that prepares nurse for
advanced practice roles and has been approved by the Board of Nursing to engage
in the practice of advanced practice nursing. Two categories of advanced
practice nurses are subject to the requirements of collaborative practice:
(a) Certified registered nurse practitioners
(CRNP)
(b) Certified nurse midwives
(CNM)
(4) ADVANCED
PRACTICE NURSING - COLLABORATIVE PRACTICE. The delivery of health care services
by registered nurses who have gained additional knowledge and skills through
successful completion of an organized program of nursing education that
prepares nurses for advanced practice roles as certified registered nurse
practitioners or certified nurse midwives:
(a) Practice as a certified registered nurse
practitioner (CRNP) is the performance of nursing skills by a registered nurse
who has demonstrated by certification advanced knowledge and skills in the
delivery of nursing services within a health care system that provides for
consultation, collaborative management or referral as indicated by the health
status of the client.
(b) Practice
as a certified nurse midwife (CNM) is the performance of nursing skills by a
registered nurse who has demonstrated by certification advanced knowledge and
skills relative to the management of women's health care focusing on pregnancy,
childbirth, the post-partum period, care of the newborn, family planning and
gynecological needs of women, within a health care system that provides for
consultation, collaborative management or referral as indicated by the health
status of the client.
(5) COLLABORATION. A formal relationship
between one or more certified registered nurse practitioners or certified nurse
midwives and a physician or physicians under which these nurses may engage in
advanced practice nursing as evidenced by written protocols approved according
to the requirements of Code of Ala. 1975, §§
34-21-80,
et. seq. or exempted according to requirements of this statute. The term
collaboration does not require direct, on-site supervision of the activities of
a certified registered nurse practitioner or a certified nurse midwife by the
collaborating physician. The term does require such medical oversight and
direction as required by the rules and regulations of the Board of Nursing and
the State Board of Medical Examiners.
(6) PHYSICIAN OR COLLABORATING PHYSICIAN. A
doctor of medicine or a doctor of osteopathy licensed to practice medicine in
Alabama who agrees in writing to practice in collaboration with one or more
certified registered nurse practitioners or certified nurse midwives according
to the rules and regulations adopted by the Board of Nursing and the State
Board of Medical Examiners.
(7)
JOINT COMMITTEE OF THE BOARD OF NURSING AND THE STATE BOARD OF MEDICAL
EXAMINERS FOR ADVANCED PRACTICE NURSES. The Joint Committee of the Board of
Nursing and the State Board of Medical Examiners for Advanced Practice Nurses
is a committee composed of the following, pursuant to Code of Ala.
1975, §
34-21-80
et seq.
(a) Two physicians licensed to
practice medicine in the State of Alabama;
(b) One registered nurse licensed to practice
professional nursing in the State of Alabama;
(c) One licensed physician engaged in
collaborative practice with a certified registered nurse practitioner or a
certified nurse midwife in the State of Alabama;
(d) One certified registered nurse
practitioner engaged in advanced practice nursing with a physician in the State
of Alabama; and
(e) One certified
nurse midwife engaged in advanced practice with a physician in the State of
Alabama.
(8) LEGEND
DRUG. Any drug, medicine, chemical or poison bearing on the label the words,
"Caution, federal law prohibits dispensing without prescription" or similar
words indicating that such drug, medicine, chemical, or poison may be sold or
dispensed only upon the prescription of a licensed practitioner, except that
the term legend drug will not include any drug, substance, or compound which is
listed Schedules I through V of the Alabama Uniform Controlled Substances
Act.
(9) PRESCRIBE OR PRESCRIBING.
The act of issuing a prescription for a legend drug.
(10) PRESCRIPTION. An order for a legend drug
which is issued and signed by a practitioner authorized by law to prescribe and
administer such drugs and is intended to be filled, compounded, or dispensed by
a pharmacist.
(11) PROTOCOL. A
document approved according to Code of Ala. 1975,
§
34-21-81,
establishing the permissible functions and activities to be performed by
certified registered nurse practitioners and certified nurse midwives and
signed by collaborating physicians and any nurse practitioners or nurse
midwives practicing with those physicians.
(12) MEDICAL OVERSIGHT. Concurrent and
on-going collaboration between a physician and a CRNP or CNM and documentation
of time together in a practice site; may include but is not limited to direct
consultation and patient care, discussion of disease processes and medical
care, review of patient records, protocols and outcome indicators, and other
activities to promote positive patient outcomes.
(13) QUALITY ASSURANCE. Documented evaluation
of the clinical practice of the certified registered nurse practitioner or
certified nurse midwife against defined quality outcome measures, using a
selected, meaningful sample of patient records which will identify areas
needing improvement, set performance goals, and assess progress towards meeting
established goals, with a summary of findings, conclusions, and, if indicated,
recommendations for change. The physician's signature on the patient record
does not constitute quality improvement monitoring.
(14) PRINCIPAL PRACTICE SITE. The main
location at which the collaborating physician is engaged in the practice of
medicine.
(15) REMOTE PRACTICE
SITE. An approved site for collaborative practice without a collaborative or
covering physician on-site. The collaborating physician's principal practice
site, acute care hospitals, skilled nursing facilities, licensed, special-care
assisted living facilities and licensed assisted living facilities are not
remote practice sites for the purpose of these rules.
(16) READILY AVAILABLE. Response by the
collaborating or covering physician by telephone or telecommunication for
consultation, referral or direct medical intervention for a patient as
indicated by the needs of a patient and based on usual and customary standards
of medical practice.
(17) DIRECT
MEDICAL INTERVENTION. Physical presence of a physician to attend the patient as
defined in the collaborative practice protocol.
(18) COVERING PHYSICIAN. A doctor of medicine
or a doctor of osteopathy licensed to practice medicine in Alabama who agrees
in writing to be readily available to collaborate with and provide medical
oversight to one or more certified registered nurse practitioners or certified
nurse midwives and, if indicated, to provide direct medical intervention to
patients during the absence of the Collaborating Physician. The covering
physician shall be either a member of the same medical practice, practice
group, or multidisciplinary medical team, or of the same or similar practice
specialty as the collaborating physician and shall abide by the rules and
regulations adopted by the Board of Nursing and the Board of Medical
Examiners.
Notes
Author: Alabama Board of Medical Examiners
Statutory Authority: Code of Ala. 1975, §§ 34-24-53, 34-21-81.
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.