Page 9 - APP Collaboration - Assessing the Risk (Part Two)

SVMIC Advanced Practice Provider Collaboration: Assessing the Risk

Consider developing treatment guidelines and clinical triggers

for physician consultation; for example, guidance statements
such as the physician must be consulted if the patient presents

with the same symptoms, is treated for the same condition
within a designated time period, or is not responding to

treatment, or if a specific course of treatment fails (i.e., no
more than two rounds of antibiotics). If applicable, these and

similar directions or parameters should be considered in the
development of protocols. Discuss adding clarifying statements

such as, “The physician must be consulted if a patient is
transferred or sent to the emergency department”. Again,

those statements should be jointly developed and carefully
determined so as not to unduly limit the scope of practice of

the APP. Meet with the APPs regularly (some states require
quarterly meetings) to discuss the roles and expectations within

the practice. If applicable, perform competency assessments
and in all instances, document these efforts.

Mississippi Board of Nursing’s sample protocol contains

recommendations for such a consultation that could be adapted
for any physician-APP relationship including:
2

• Referrals to a specialist in another field

• Adverse drug reactions

• Prescribing patterns which require corrective action and/or

the removal of certain drugs from the prescribing abilities
of the APRN while in collaboration with the physician(s)

• Interpretation of conflicting or ambiguous diagnostic tests

• Hospitalization needs of certain patients

2 www.msbml.ms.gov

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