Page 8 - Part 2 Collaborating with Advanced Practice Providers - An Overview of State Rules

SVMIC Collaborating with Advanced Practice Providers

open and non-healing on her left arm. She was referred to a plastic

surgeon, Dr. Adams. Mrs. Jones stated that Dr. Adams agreed that the
nurse practitioner should never have used cryotherapy on that limb

because of the shunt. Ultimately, Mrs. Jones’ wounds required

extensive surgery and skin-grafting procedures performed at a local
hospital.

Developing Protocols and Collaborative Practice

Agreements

Several state boards of nursing and physician assistant boards including
Alabama, Arkansas, Georgia, Kentucky, Mississippi and Virginia provide

online sample protocols, collaborative practice agreements and

templates or forms for prescriptive authority that may be used to comply

with state regulations. However, in states without specific sample forms,

templates or guidelines, the protocols should be specific to the patient
population, define the scope of authority provided to the APP and

outline the standard of care. Some states offer lists of medical guidelines

that may be utilized by the APP. The Georgia Board of Nursing offers a 7-

page sample nurse protocol agreement which includes 26 provisions.

Reviewing it may be useful to physicians and APPs in other states as

2
well.
Consider developing treatment guidelines and clinical triggers for

physician consultation. For example, the physician must be consulted if

the patient presents with the same symptoms or treated for the same

condition within a designated time period or is not responding to

treatment, or a specific course of treatment fails (i.e., no more than two

2 www.medicalboard.georgia.gov

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