49 Pa. Code § 18.5 - Collaborative agreements
(a) A
nurse-midwife may not engage in midwifery practice without having entered into
a collaborative agreement and having filed the collaborative agreement with the
Board.
(b) A nurse-midwife shall
only engage in midwifery practice in accordance with the midwife practice
guidelines and collaborative agreements.
(c) A collaborative agreement must contain
either an acknowledgement that the nurse-midwife shall practice under the
midwife practice guidelines, or that the nurse-midwife shall practice under the
midwife practice guidelines as expanded or modified in the collaborative
agreement.
(d) Expansions and
modifications of the midwife practice guidelines agreed to by the nurse-midwife
and the collaborating physician shall be set forth, in detail, in the
collaborative agreement.
(e) If the
collaborating physician intends to authorize the nurse-midwife to relay to
other health care providers medical regimens prescribed by that physician,
including drug regimens, that authority, as well as the prescribed regimens,
shall be set forth in the collaborative agreement.
(f) The physician with whom a nurse-midwife
has a collaborative agreement shall have hospital privileges or a formal
arrangement for patient admission to a hospital and shall practice in the
specialty area of the care for which the physician is providing collaborative
services.
(g) Collaborative
agreements must meet the following requirements:
(1) The agreement must provide a
predetermined plan for emergency services, and immediate availability of a
physician to the nurse-midwife by direct communication or by radio, telephone
or other telecommunication for consultation, co-management, or transfer of care
as indicated by the health status of the patient.
(2) The agreement must identify and be signed
by at least one collaborating physician and the nurse-midwife.
(3) A physician providing coverage need not
be signatory to the collaborative agreement, but shall agree to adhere to the
terms of the collaborative agreement, and shall be identified by name of
physician, or name of group, or name of service.
(4) A physician providing interim coverage
need not be signatory to the collaborative agreement, but shall agree to adhere
to the terms of the collaborative agreement.
(5) Both the collaborating physician and the
nurse-midwife are responsible to assure adherence to the terms and conditions
of the collaborative agreement by themselves, others as appropriate within
their practice groups, and physicians providing coverage.
(h) The collaborative agreement must satisfy
the substantive requirements set forth in subsections (a)-(e) and be consistent
with relevant provisions of the act and this subchapter, and must be filed with
the Board. For a nurse-midwife with prescriptive authority, the collaborative
agreement with a physician must identify the categories of drugs from which the
nurse-midwife may prescribe or dispense and any restrictions thereto.
(i) A nurse-midwife or collaborating
physician shall provide immediate access to the collaborative agreement to any
client, pharmacist, licensed health care facility, licensed health care
provider, physician, or the Board seeking to confirm the scope of the
nurse-midwife's authority, and the nurse-midwife's ability to prescribe or
dispense a drug.
Notes
The provisions of this § 18.5 amended under section 2 of the act of April 4, 1929 (P. L. 160, No. 155) (63 P. S. § 172); and sections 8, 12 and 35(a) of the Medical Practice Act of 1985 (63 P. S. §§ 422.8, 422.12 and 422.35(a)).
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