
In Tennessee, collaborative protocols between nurse practitioners and supervising physicians must be reviewed and updated biennially (every two years)1. These protocols are the written guidelines for medical management that constitute the collaborative agreement2.
Protocols must be jointly developed and approved, specific to the patient population, dated and signed, include formulary/classes of drugs, be maintained at the practice site, and be available for inspection by the appropriate boards3. NPs must also keep a copy of the protocol and formulary at each practice location and make them available upon request4, and the supervising physician must also develop clinical guidelines in collaboration with the NP to include methods for documenting consultation and referral5.