What must be in a North Carolina NP collaborative practice agreement?

A North Carolina NP collaborative practice agreement must, at minimum, list the drugs, devices, medical treatments, tests, and procedures the NP may use at each practice site, and include a pre-determined plan for emergency services¹. The agreement is the arrangement that ensures continuous availability between the NP and supervising physician for supervision, consultation, collaboration, referral, and evaluation of the NP’s care².

Administrative requirements include:

• The signed agreement must be maintained at the practice site by both the supervising physician and the NP³.
• The agreement must be reviewed at least annually, with the review acknowledged by a dated signature sheet signed by both parties and available for inspection by either Board⁴.

If the NP will prescribe controlled substances, the agreement must establish that authority and the NP must meet additional requirements (e.g., have a DEA number; the physician must hold the same or higher schedules)⁵. Prescribing a drug or device not included in the agreement is allowed only on a specific written or verbal order from a supervising physician, documented in the patient record and signed by both the NP and physician⁶.