Register June 2006 No. 606
Chapter N 8
CERTIFICATION OF ADVANCED PRACTICE NURSE PRESCRIBERS
N 8.01 Authority and intent.
N 8.03 Qualifications for certification as an advanced practice nurse prescriber.
N 8.04 Application procedure.
N 8.05 Continuing education.
N 8.06 Prescribing limitations.
N 8.07 Prescription orders.
N 8.08 Malpractice insurance coverage.
N 8.10 Case management and collaboration with other health care professionals.
N 8.01
N 8.01
Authority and intent. N 8.01(2)
(2) The intent of the board of nursing in adopting rules in this chapter is to specify education, training or experience that a registered nurse must satisfy to call himself or herself an advanced practice nurse; to establish appropriate education, training and examination requirements that an advanced practice nurse must satisfy to qualify for a certificate to issue prescription orders; to define the scope of practice within which an advanced practice nurse prescriber may issue prescription orders; to specify the classes of drugs, individual drugs or devices that may not be prescribed by an advanced practice nurse prescriber; to specify the conditions to be met for a registered nurse to administer a drug prescribed or directed by an advanced practice nurse prescriber; to establish procedures for maintaining a certificate to issue prescription orders, including requirements for continuing education; and to establish the minimum amount of malpractice insurance required of an advanced practice nurse prescriber.
N 8.01 History
History:
Cr.
Register, February, 1995, No. 470, eff. 3-1-95.
N 8.02
N 8.02
Definitions. As used in this chapter:
N 8.02(1)
(1) "Advanced practice nurse'' means a registered nurse who possesses the following qualifications:
N 8.02(1)(a)
(a) The registered nurse has a current license to practice professional nursing in this state, or has a current license to practice professional nursing in another state which has adopted the nurse licensure compact;
N 8.02(1)(b)
(b) The registered nurse is currently certified by a national certifying body approved by the board as a nurse practitioner, certified nurse-midwife, certified registered nurse anesthetist or clinical nurse specialist; and,
N 8.02(1)(c)
(c) For applicants who receive national certification as a nurse practitioner, certified nurse-midwife, certified registered nurse anesthetist or clinical nurse specialist after July 1, 1998, the registered nurse holds a master's degree in nursing or a related health field granted by a college or university accredited by a regional accrediting agency approved by the board of education in the state in which the college or university is located.
N 8.02(2)
(2) "Advanced practice nurse prescriber'' means an advanced practice nurse who has been granted a certificate to issue prescription orders under s.
441.16 (2), Stats.
N 8.02(3)
(3) "Board'' means the board of nursing.
N 8.02(4)
(4) "Clinical pharmacology/therapeutics'' means the identification of individual and classes of drugs, their indications and contraindications, their likelihood of success, their side-effects and their interactions, as well as, clinical judgment skills and decision-making, based on thorough interviewing, history-taking, physical assessment, test selection and interpretation, pathophysiology, epidemiology, diagnostic reasoning, differentiation of conditions, treatment decisions, case evaluation and non-pharmacologic interventions.
N 8.02(5)
(5) "Collaboration'' means a process which involves 2 or more health care professionals working together, in each other's presence when necessary, each contributing one's respective area of expertise to provide more comprehensive care than one alone can offer.
N 8.02(6m)
(6m) "One contact hour" means a period of attendance in a continuing education program of at least 50 minutes.
N 8.03
N 8.03
Qualifications for certification as an advanced practice nurse prescriber. An applicant for initial certification to issue prescription orders shall be granted a certificate by the board if the applicant complies with all of the following:
N 8.03(1)
(1) Has a current license to practice as a professional nurse in this state or has a current license to practice professional nursing in another state which has adopted the nurse licensure compact.
N 8.03(2)
(2) Is currently certified by a national certifying body approved by the board as a nurse practitioner, certified nurse-midwife, certified registered nurse anesthetist or clinical nurse specialist.
N 8.03(3)
(3) For applicants who receive national certification as a nurse practitioner, certified nurse-midwife, certified registered nurse anesthetist or clinical nurse specialist after July 1, 1998, holds a master's degree in nursing or a related health field granted by a college or university accredited by a regional accrediting agency approved by the state board of education in the state in which the college or university is located.
N 8.03(4)
(4) Has completed at least 45 contact hours in clinical pharmacology/therapeutics within 3 years preceding the application for a certificate to issue prescription orders.
N 8.03(5)
(5) Has passed a jurisprudence examination for advanced practice nurse prescribers.
N 8.04
N 8.04
Application procedure. An applicant for a certificate to practice as an advanced practice nurse prescriber shall file a completed notarized application on a form provided by the board. The application shall include:
N 8.04(1)
(1) The signature of the applicant.
N 8.04(3)
(3) Evidence of current certification by a national certifying body approved by the board as a nurse practitioner, certified nurse-midwife, certified registered nurse anesthetist or clinical nurse specialist.
N 8.04(4)
(4) For applicants who receive national certification as a nurse practitioner, certified nurse-midwife, certified registered nurse anesthetist or clinical nurse specialist after July 1, 1998, certification of the grant of a master's degree in nursing or a related health field from, and submitted directly to the board by a college or university accredited by a regional accrediting agency approved by the state board of education in the state in which the college or university is located.
N 8.04(5)
(5) Satisfactory evidence of completion of at least 45 contact hours in clinical pharmacology/therapeutics within 3 years preceding the application for a certificate.
N 8.04 Note
Note: Application forms are available on request to the Board of Nursing, 1400 East Washington Avenue, P.O. Box 8935, Madison, WI 53708.
N 8.04 History
History:
Cr.
Register, February, 1995, No. 470, eff. 3-1-95.
N 8.05
N 8.05
Continuing education. N 8.05(1)
(1) Every advanced practice nurse prescriber shall submit to the board evidence of having completed an average of at least 8 contact hours per year in clinical pharmacology/therapeutics relevant to the advanced practice nurse prescriber's area of practice.
N 8.05(2)
(2) Evidence of completion of continuing education meeting the requirements of
sub. (1) shall be submitted to the board on a schedule consistent with the schedule for submission of evidence of continuing education hours established by the advanced practice nurse prescriber's national certifying body.
N 8.05(3)
(3) Every advanced practice nurse prescriber shall retain for a minimum period of 4 years, and shall make available to the board or its agent upon request, certificates of attendance issued by the program sponsor for all continuing education programs for which he or she claims credit for purposes of renewal of his or her certificate.
N 8.06
N 8.06
Prescribing limitations. The advanced practice nurse prescriber:
N 8.06(1)
(1) May issue only those prescription orders appropriate to the advanced practice nurse prescriber's areas of competence, as established by his or her education, training or experience.
N 8.06(2)
(2) May not issue a prescription order for any schedule I controlled substance.
N 8.06(3)
(3) May not prescribe, dispense or administer any amphetamine, sympathomimetic amine drug or compound designated as a schedule II controlled substance pursuant to the provisions of s.
961.16 (5), Stats., to or for any person except for any of the following:
N 8.06(3)(a)
(a) Use as an adjunct to opioid analgesic compounds for the treatment of cancer-related pain.
N 8.06(3)(d)
(d) Treatment of drug-induced brain dysfunction.
N 8.06(3)(f)
(f) Treatment of depression shown to be refractory to other therapeutic modalities.
N 8.06(4)
(4) May not prescribe, order, dispense or administer any anabolic steroid for the purpose of enhancing athletic performance or for other nonmedical purpose.
N 8.06(5)
(5) Shall, in prescribing or ordering a drug for administration by a registered nurse or licensed practical nurse under s.
441.16 (3) (cm), Stats., present evidence to the nurse and to the administration of the facility where the prescription or order is to be carried out that the advanced practice nurse prescriber is properly certified to issue prescription orders.
N 8.06 History
History:
Cr.
Register, February, 1995, No. 470, eff. 3-1-95; correction in (3) made under s. 13.93 (2m) (b) 7., Stats.,
Register, October, 2000, No. 538.
N 8.07
N 8.07
Prescription orders. N 8.07(1)(1) Prescription orders issued by an advanced practice nurse prescribers shall:
N 8.07(1)(b)
(b) Specify the name and address of the patient.
N 8.07(1)(c)
(c) Specify the name, address and business telephone number of the advanced practice nurse prescriber.
N 8.07(1)(d)
(d) Specify the name and quantity of the drug product or device prescribed, including directions for use.
N 8.07(1)(e)
(e) Bear the signature of the advanced practice nurse prescriber.
N 8.07(2)
(2) Prescription orders issued by advanced practice nurse prescribers for a controlled substance shall be written in ink or indelible pencil or shall be typewritten, and shall contain the practitioner's controlled substances number.
N 8.07 History
History:
Cr.
Register, February, 1995, No. 470, eff. 3-1-95.
N 8.08
N 8.08
Malpractice insurance coverage. N 8.08(1)(1) Advanced practice nurse prescribers who prescribe independently shall maintain in effect malpractice insurance evidenced by one of the following:
N 8.08(1)(b)
(b) Coverage under a group liability policy providing individual coverage for the nurse in the amounts set forth in s.
655.23 (4), Stats. An advanced practice nurse prescriber covered under one or more such group policies shall certify on forms provided by the board that the nurse will independently prescribe only within the limits of the policy's coverage, or shall obtain personal liability coverage for independent prescribing outside the scope of the group liability policy or policies.
N 8.08(2)
(2) Notwithstanding
sub. (1), an advanced practice nurse prescriber who practices as an employee of this state or a governmental subdivision, as defined under s.
180.0103, Stats., is not required to maintain in effect malpractice insurance coverage, but the nurse shall certify on forms provided by the board that the nurse will prescribe within employment policies.
N 8.08(3)
(3) An advanced practice nurse prescriber who prescribes under the supervision and delegation of a physician or CRNA shall certify on forms provided by the board that the nurse complies with
s. N 6.03 (2) and
(3), regarding delegated acts.
N 8.08(4)
(4) An advanced practice nurse prescriber who prescribes in more than one setting or capacity shall comply with the provisions of
subs. (1),
(2) and
(3) applicable to each setting or capacity. An advanced practice nurse prescriber who is not an employee of this state or a governmental subdivision, and who prescribes independently in some situations and prescribes under the supervision and delegation of a physician or CRNA in other situations, shall meet the requirements of
sub. (1) with respect to independent prescribing and the requirements of
sub. (3) with respect to delegated prescribing.
N 8.08 Note
Note: Forms are available from the board office located at 1400 East Washington Avenue, P.O. Box 8935, Madison, Wisconsin 53708.
N 8.08(5)
(5) Every advanced practice nurse who is certified to issue prescription orders shall annually submit to the board satisfactory evidence that he or she has in effect malpractice insurance required by
sub. (1).
