What must be in a California NP collaborative practice agreement?

A California NP collaborative practice agreement must be set out as Standardized Procedures (or Protocols) that meet specific content requirements. The agreement must be written, dated, and signed; define the NP functions and circumstances of performance; specify supervision parameters; include competency evaluation, recordkeeping, and methods for development and periodic review¹.

At minimum, Standardized Procedures must include¹:

• A written description of the method used to develop and approve the procedures, including how revisions are made.
• Identification of which functions NPs may perform and under what circumstances.
• Any specific requirements to be followed when performing those functions.
• Experience, training, and/or education requirements for authorized functions.
• Methods for initial and ongoing evaluation of NP competence.
• A system to maintain a written record of individuals authorized to perform the functions.
• The scope of supervision required (e.g., immediate physician supervision).
• Special circumstances requiring immediate communication with a physician.
• Any limitations on settings where functions may be performed.
• Patient record-keeping requirements.
• A method for periodic review of the Standardized Procedures.

If prescribing/furnishing authority is included, the Standardized Procedure/Protocol must also specify which drugs/devices may be ordered, the circumstances for use, the extent of physician supervision, and the method of periodic review of the NP’s competence (including peer review) and of the procedure’s provisions². For Schedule II substances, the protocol must be patient-specific and authorized by the treating/supervising physician, must address the diagnosis for which the Schedule II is furnished, and a copy of the Standardized Procedure must be presented to the dispensing pharmacist upon request².