Texas law allows certain physicians to delegate prescriptive authority to facility-based APRNs through protocols instead of a Prescriptive Authority Agreement (PAA) because the quality assurance requirements in the PAA are often impractical in facilities. The following types of physician may delegate using protocols in hospital facility-based practices.
- Medical director,
- Chief of medical staff,
- Chair of the credentialing committee,
- Department chair in the department in which the APRN practice, or
- a physician who consents to the request of the medical director or chief of medical staff to delegate prescribing or ordering drugs or devices.
In long-term care facility-based practices, only the facility’s medical director may delegate to facility-based APRNs.
CNAP’s Facility-Based Protocols details requirements for prescriptive authority in facility-based practices. Users should copy and paste pages 8-13 into a separate document and modify it to fit the individual practice. Instructions guide users through the options, and a glossary explains important concepts.
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