South Carolina — Edition 22
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Required Written Protocols For The Advanced Practice Registered Nurse And Certified Registered Nurse Anesthetist

An APRN is a registered nurse prepared for an advanced practice registered nursing role by virtue of additional knowledge and skills gained through an advanced formal education program of nursing in a specialty area that is approved by the Board. The categories of APRN are nurse practitioner (NP), certified nurse midwife (CNM), clinical nurse specialist (CNS), and certified registered nurse anesthetist (CRNA).

An APRN may perform delegated medical acts pursuant to approved, written protocols which are established between the APRN and supervising physician and must be established prior to practice.

An NP, CNM, or CNS may perform delegated medical acts pursuant to approved written protocol between the nurse and the physician and must include, but is not limited to the following:

(a) general information:

(i) name, address and South Carolina license number of the nurse;

(ii) name, address and South Carolina license number of the physician;

(iii) nature of practice and practice locations of the nurse and physician;

(iv) date the protocol was developed and dates the protocol was reviewed and amended;

(v) description of how consultation with the physician is provided and provision for backup consultation in the physician’s absence;

(b) this information for delegated medical acts: (i) the medical conditions for which therapies may be initiated,Continued or modified; (ii) the treatments that may be initiated, continued or modified; (iii) the drug therapies that may be prescribed;

(iv) situations that require direct evaluation by or referral to the physician.

The CRNA must practice pursuant to approved written guidelines developed with the supervising licensed physician or dentist or by the medical staff within the facility where practice privileges have been granted and must include, but is not limited to the following:

(a) general information:

(i) name, address and South Carolina license number of the registered nurse;

(ii) name, address and South Carolina license number of the supervising physician, dentist or the physician director of anesthesia services or the medical director of the facility;

(iii) dates the guidelines were developed, and dates the guidelines were reviewed and amended;

(iv) physical address of the primary Practice and any additional practice sites;

(b) these requirements for providing anesthesia services:

(i) documentation of clinical privileges in the institutions where anesthesia services are provided, if applicable;

(ii) copy of job description;

(iii) policies and procedures that outline the pre anesthesia evaluation, induction, intra operative maintenance and emergence from anesthesia;

(iv) evidence of outcome evaluation for anesthesia services.

Please also note that the original protocol and any amendments to the protocol are to be reviewed at least annually and signed and dated by the nurse and physician. If the licensee changes practice settings or physicians, the licensee is to notify the Board of the change within 15 business days and provide verification of approved written protocols. Also, licensees who discontinue their practices mustnotify the Board within 15 business days. The Change of Practice form may be found on the Board’s website at http://www.llr. state.sc.us/POL/Nursing/, Applications/ Forms, Advanced Practice Registered Nurse (APRN), Notification of Change of Practice. You will find more information on our website under Laws/Policies, Nurse Practice Act, Chapter 33, please see Section 40 33 34. Performance of delegated medical acts; qualifications; protocols; prescriptive authorization; anesthesia care.
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