What must be in a Virginia NP collaborative practice agreement?

A Virginia NP collaborative practice agreement must outline the NP’s specialty scope, procedures, and prescriptive authority, and include specific collaboration provisions with a patient care team physician¹. In Virginia, this written or electronic agreement is jointly developed by the NP and the patient care team physician and describes the acts appropriate to the NP’s specialty and the NP’s prescriptive authority¹.

At minimum, the agreement must include: (1) periodic chart or electronic record review by the patient care team physician (and may specify site visits); (2) processes for physician input in complex cases, emergencies, and referrals; and (3) the NP’s authority for signatures, certifications, stamps, verifications, affidavits, and endorsements, as permitted by law and within scope²⁴⁵. The agreement must be maintained by the NP and provided to the Boards upon request; in hospitals or health systems, it may be embedded in privileging documents but must still be producible².

If the NP prescribes controlled substances, the agreement must specify which Schedule II–IV drugs the NP is or is not authorized to prescribe and may restrict that authority³. More broadly, the agreement should reflect the NP’s prescriptive authority applicable to their practice area¹.