What must be in a Texas NP collaborative practice agreement?

A Texas NP collaborative practice agreement is the prescriptive authority agreement. It must be in writing, signed and dated, identify the parties and practice, specify drug/device categories allowed and prohibited, and outline consultation, emergency, communication, alternates (if any), and quality assurance processes¹.

At minimum, include:¹

• Names, addresses, and license numbers of the physician and APRN; nature of the practice and practice locations/settings.
• Types/categories of drugs or devices that may be prescribed and those that may not be prescribed.
• Plans for consultation and referral, handling patient emergencies, and the process for communication and sharing patient-care information.
• Designation of any alternate supervising physician(s) and their role in temporary supervision and participation in QA meetings (if alternates are used).
• A prescriptive authority quality assurance and improvement plan, with documentation methods, including the number of chart reviews (as determined by the parties) and periodic physician–APRN meetings.

Delegations within the agreement do not need step-by-step protocols and may be framed by drug categories that may or may not be prescribed². The agreement must be reviewed at least annually, re-dated and signed, and be available to the Texas Medical Board and/or Board of Nursing within three business days of a request; the physician and APRN must meet at least monthly, and each meeting should be documented¹.