NORTH CAROLINA GENERAL ASSEMBLY

1977 SESSION

 

 

CHAPTER 1194

HOUSE BILL 1553

 

 

AN ACT TO PROVIDE LIMITATIONS ON ASSISTANTS TO PHYSICIANS AND ON NURSE PRACTITIONERS, SO AS TO IMPLEMENT THE RECOMMENDATIONS OF THE LEGISLATIVE RESEARCH COMMISSION'S COMMITTEE ON PHYSICIANS' ASSISTANTS AND NURSE PRACTITIONERS.

 

The General Assembly of North Carolina enacts:

 

Section 1.  G.S. 90-18.1 is rewritten to read:

"§ 90-18.1.  Limitations on Physician Assistants. — (a) Any person who is approved under the provisions of G.S. 90-18(13) to perform medical acts, tasks or functions as an assistant to a physician may use the title 'Physician Assistant'. Any other person who uses the title in any form or holds out to be a Physician Assistant or to be so approved, shall be deemed to be in violation of this Article.

(b)        Physician Assistants are authorized to write prescriptions for drugs under the following conditions:

(1)        the Board of Medical Examiners has adopted regulations governing the approval of individual Physician Assistants to write prescriptions with such limitations as the board may determine to be in the best interest of patient health and safety;

(2)        the Physician Assistant has current approval from the board;

(3)        the Board of Medical Examiners has assigned an identification number to the Physician Assistant which is shown on the written prescription; and

(4)        the supervising physician has provided to the Physician Assistant written instructions about indications and contraindications for prescribing drugs and a written policy for periodic review by the physician of the drugs prescribed.

(c)        Physician Assistants are authorized to compound and dispense drugs under the following conditions:

(1)        the function is performed under the supervision of a licensed pharmacist; and

(2)        rules and regulations of the North Carolina Board of Pharmacy governing this function are complied with.

(d)        Physician Assistants are authorized to order medications, tests and treatments in hospitals, clinics, nursing homes and other health facilities under the following conditions:

(1)        the Board of Medical Examiners has adopted regulations governing the approval of individual Physician Assistants to order medications, tests and treatments with such limitations as the board may determine to be in the best interest of patient health and safety;

(2)        the Physician Assistant has current approval from the board;

(3)        the supervising physician has provided to the Physician Assistant written instructions about ordering medications, tests and treatments, and when appropriate, specific oral or written instructions for an individual patient, with provision for review by the physician of the order within a reasonable time, as determined by the Board, after the medication, test or treatment is ordered; and

(4)        the hospital or other health facility has adopted a written policy, approved by the medical staff after consultation with the nursing administration, about ordering medications, tests and treatments, including procedures for verification of the Physician Assistants' orders by nurses and other facility employees and such other procedures as are in the interest of patient health and safety.

(e)        Any prescription written by a Physician Assistant or order given by a Physician Assistant for medications, tests or treatments shall be deemed to have been authorized by the physician approved by the board as the supervisor of the Physician Assistant and such supervising physician shall be responsible for authorizing such prescription or order.

(f)         Any registered nurse or licensed practical nurse who receives an order from a Physician Assistant for medications, tests or treatments is authorized to perform that order in the same manner as if it were received from a licensed physician."

Sec. 2.  The General Statutes are amended by adding a new Section G.S. 90-18.2 to read:

"§ 90-18.2.  Limitations on Nurse Practitioners. — (a) Any nurse approved under the provisions of G.S. 90-18(14) to perform medical acts, tasks or functions may use the title 'Nurse Practitioner'. Any other person who uses the title in any form or holds out to be a Nurse Practitioner or to be so approved, shall be deemed to be in violation of this Article.

(b)        Nurse Practitioners are authorized to write prescriptions for drugs under the following conditions:

(1)        the Board of Medical Examiners and Board of Nursing have adopted regulations developed by a joint subcommittee governing the approval of individual Nurse Practitioners to write prescriptions with such limitations as the boards may determine to be in the best interest of patient health and safety;

(2)        the Nurse Practitioner has current approval from the boards;

(3)        the Board of Medical Examiners has assigned an identification number to the Nurse Practitioner which is shown on the written prescription; and

(4)        the supervising physician has provided to the Nurse Practitioner written instructions about indications and contraindications for prescribing drugs and a written policy for periodic review by the physician of the drugs prescribed.

(c)        Nurse Practitioners are authorized to compound and dispense drugs under the following conditions:

(1)        the function is performed under the supervision of a licensed pharmacist; and

(2)        rules and regulations of the North Carolina Board of Pharmacy governing this function are complied with.

(d)        Nurse Practitioners are authorized to order medications, tests and treatments in hospitals, clinics, nursing homes and other health facilities under the following conditions:

(1)        the Board of Medical Examiners and Board of Nursing have adopted regulations developed by a joint subcommittee governing the approval of individual Nurse Practitioners to order medications, tests and treatments with such limitations as the boards may determine to be in the best interest of patient health and safety;

(2)        the Nurse Practitioner has current approval from the boards;

(3)        the supervising physician has provided to the Nurse Practitioner written instructions about ordering medications, tests and treatments, and when appropriate, specific oral or written instructions for an individual patient, with provision for review by the physician of the order within a reasonable time, as determined by the board, after the medication, test or treatment is ordered; and

(4)        the hospital or other health facility has adopted a written policy, approved by the medical staff after consultation with the nursing administration, about ordering medications, tests and treatments, including procedures for verification of the Nurse Practitioners' orders by nurses and other facility employees and such other procedures as are in the interest of patient health and safety.

(e)        Any prescription written by a Nurse Practitioner or order given by a Nurse Practitioner for medications, tests or treatments shall be deemed to have been authorized by the physician approved by the boards as the supervisor of the Nurse Practitioner and such supervising physician shall be responsible for authorizing such prescription or order.

(f)         Any registered nurse or licensed practical nurse who receives an order from a Nurse Practitioner for medications, tests or treatments is authorized to perform that order in the same manner as if it were received from a licensed physician."

Sec. 3.  This act shall become effective July 1, 1978.

In the General Assembly read three times and ratified, this the 16th day of June, 1978.