February 14, 2025
North Carolina Nurse Practitioners (NPs) are required to have a Collaborative Practice Agreement (CPA) with a supervising physician, as outlined by the North Carolina Board of Nursing and the North Carolina Medical Board.
The CPA must address prescribing authority, emergency procedures, patient population, and a quality improvement process. The agreement should outline the drugs, devices, and treatments the NP may prescribe and include a plan for supervision, consultation, and evaluation. A written quality assurance plan is required for periodic review of patient care. The CPA must be reviewed and signed annually by both the NP and the physician and be available for inspection.
There are multiple organizations that have publicly shared North Carolina collaborative practice agreement examples:
A collaborative practice agreement Example is available from UNC School of Medicine here.
A collaborative practice agreement Example is available from NC Psychiatric Association here.
Yes, North Carolina requires that a nurse practitioner must have a collaborative practice agreement with a primary supervising physician licensed in North Carolina. 21 NCAC 36 .0804 - Process for Approval to Practice
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