Title 30 professions and occupations part msbn ms gov

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Title 30: Professions and Occupations

Part 2840: ADVANCED PRACTICE

Part 2840, Chapter 1: Advanced Practice Registered Nurses (APRNs)include Certified Nurse Midwives, Certified Registered Nurse Anesthetists, Certified Nurse Practitioners

Rule 1.1 Definitions of terms for Part 2840, Chapter 1.

A. Board: The Mississippi Board of Nursing. B. Advanced Practice Registered Nurse (APRN): Any person who holds certification and is

currently licensed to practice in Mississippi or currently licensed to practice under the Nurse Licensure Compact with a multistate licensure privilege to practice in Mississippi as a certified nurse midwife (CNM), certified registered nurse anesthetist (CRNA) or certified registered nurse practitioner (CNP). Certified nurse practitioners include acute, adult, pediatric, geriatric, family, psych-mental health, neonatal, and women's health. C. Collaborating Physician: A physician or dentist who has an unrestricted license to practice in the state of Mississippi and has a compatible practice or practice site as the APRN. D. DEA: United States Drug Enforcement Administration rules and regulations contained in Title 21 CFR, Part 1301 regarding the certified APRN's practice of prescribing controlled substances. E. Good Faith: The genuine interaction of a person or persons engaged in an agreement to deal honestly with one another. F. Mississippi Prescription Monitoring Program (PMP): The electronic system used to monitor the dispensing of controlled substances including Schedules II, III, IV and V, as required by Miss. Code Ann. ? 73-21-127. G. Quality Assurance/Quality Improvement (QA/QI) Plan: A formal quality assurance/ quality improvement plan to be utilized by the advanced practice registered nurse, as required by Miss. Code Ann. ? 73-15-20. H. Formal Collaborative Agreement: An agreement between the APRN and the collaborating physician which designates specific practice sites. I. Practice Site: The designated physical location in Mississippi which is the usual practice location as reported to the Board where the Board can conduct a site visit to evaluate the delivery of care by a licensee and compliance with laws and regulations regarding delivery of care by a licensee. This shall not include the patient's home. J. State Certification: The privilege to practice, as defined by MS Code Ann. ?73-15-5, issued to APRNs to practice in Mississippi to the full scope of education, training, and certification.

Source: Miss. Code Ann. ? 73-15-17 (1972, as amended).

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Rule 1.2 Certification, Renewal, Reinstatement, and Changes in Status.

A. Initial Mississippi Certification. Prior to Board certification allowing the RN to practice as an APRN, the RN must: 1) Be currently licensed as a RN in Mississippi. 2) Comply with criminal background checks and fingerprinting requirements in accordance with Miss. Code Ann. Section 73-15-19 (1). 3) Submit completed Board application via the online license management system. 4) Pay required nonrefundable application fee upon submission of application to the Board. 5) Submit official transcript of graduation from: (a) An accredited master's degree or higher program with a major in nursing, nurse anesthesia, or nurse midwifery. (b) An accredited educational program for APRNs if applicant graduated from an APRN program and was nationally certified as an APRN prior to December 31, 1993. 6) Submit official evidence of graduation from a master's degree or higher accredited program in one of the four recognized advanced practice roles in which clinical experience has occurred. APRN applicants graduating from an APRN program after December 31, 1998, will be required to submit official evidence of graduation from a graduate program with a concentration in the applicant's respective advanced practice nursing specialty. 7) Submit to the Board proof of completion of monitored practice hours by a

licensed physician, licensed dentist, and/or certified APRN who has had a

minimum of three (3) years active practice experience.

(a) Applicants with less than one (1) year (2,000 hours) of experience working as an RN prior to completion of an accredited APRN education program must complete two-thousand (2,000) hours of monitored clinical practice.

(b) Applicants with one (1) year (2,000 hours) or greater experience working as an RN prior to completion of an accredited APRN education program must complete one-thousand (1,000) hours of monitored clinical practice.

(c) Clinical hours earned during an accredited APRN educational program can be applied to the monitored clinical practice hour requirement, provided that national certification is obtained in the specialty area within two years of the date of program completion.

(d) 30 Miss. Admin. Code Pt. 2840, R. 1.2 (A) (7) shall become effective January 01st, 2018.

8) Submit current national certification as an APRN in a designated area of practice by a national certification organization recognized by the Board. (a) The Board retains the right to refuse to recognize a national accreditation organization. (b) The Board shall state sufficient grounds for refusing to recognize a national accreditation organization.

9) Submit required formal collaborative agreement to the Board prior to beginning practice.

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10) An individual can obtain an APRN privilege to practice without having a formal collaborative agreement; however, in order to begin practice, the formal collaborative agreement must be submitted to the Board.

B. Renewal of State Certification. The APRN must: 1) Submit renewal application via the online license management system. 2) Pay required nonrefundable application fee upon submission of application to the Board. 3) Submit updated formal collaborative agreement. 4) Maintain documentation of current national certification as an APRN in a designated area of practice by a national certification organization recognized by the Board. In the case of a lapse in certification, the APRN must notify the Mississippi Board of Nursing. The APRN must stop practicing immediately until such time as certification is renewed. 5) Maintain documentation of DEA licensure (if applicable). In case of lapse in DEA licensure the APRN must notify the Mississippi Board of Nursing immediately. The APRN must stop prescribing controlled substances until such time as the DEA licensure is renewed and notifies Mississippi Board of Nursing of DEA licensure renewal. 6) An individual can obtain an APRN license without having a formal collaborative agreement; however, in order to begin practice, the formal collaborative agreement must be submitted to the Board.

C. Reinstatement of lapsed State Certification. APRNs may reinstate a lapsed state certification online only and must: 1) Submit documentation of a current, active Mississippi RN license; and 2) Comply with criminal background checks and fingerprinting in accordance with Miss. Code Ann. Section 73-15-19 (1); and 3) Submit reinstatement application via the online license management system. 4) Pay required nonrefundable application fee upon submission of application to the Board. 5) An individual can obtain an APRN license without having a formal collaborative agreement; however, in order to begin practice, the formal collaborative agreement must be submitted to the Board; and 6) Submit a formal collaborative agreement; and 7) Submit documentation of current national certification as an APRN in a designated area of practice by a national certification organization recognized by the Board; and 8) Submit documentation of at least forty (40) contact hours (four [4] continuing education units), or equivalency, related to the advanced clinical practice of the APRN which have been obtained within the previous two (2) year period. Five (5) of the forty (40) contact hours must be directly related to controlled substances. 9) Submit documentation of DEA licensure (if applicable). 10) In case of lapse in DEA licensure the APRN must notify the Mississippi Board of Nursing immediately. The APRN must stop prescribing controlled substances until such time as the DEA licensure is renewed and notifies Mississippi Board of Nursing of DEA licensure renewal. 11) Participate in the Mississippi Prescription Monitoring Program (PMP).

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D. Changes in status. 1) Relationship with collaborating physician/dentist: The APRN shall notify the Board immediately regarding changes in the collaborative relationship with a licensed physician/dentist. (a) In the event the collaborative physician/dentist is unable to continue his/her role as collaborative physician/dentist, the APRN may be allowed to continue to practice for a 90-day grace period while the APRN attempts to secure a primary collaborative physician. The Mississippi State Board of Medical Licensure or its designee will serve as the APRN's collaborative physician/dentist with the agreement of the Mississippi Board of Nursing. (b) If a collaborative physician/dentist has not been secured at the end of the 90-day grace period, an additional 90-day extension may be granted by mutual agreement of the executive committee of the Mississippi Board of Nursing and the executive committee of the Mississippi State Board of Medical Licensure. During this additional 90-day extension, the above described practice agreement will continue. 2) Practice site: Changes or additions regarding practice sites shall be submitted with a fee to the Board by the APRN on forms supplied by the Board. The APRN may not practice at a site prior to approval by the Board. 3) Formal collaborative agreement guidelines: Revisions of formal collaborative agreement shall be submitted with a fee to the Board prior to implementation.

E. Fees are nonrefundable.

Source: Miss. Code Ann. ? 73-15-17 (1972, as amended).

Rule 1.3 Practice Requirements.

A. The APRN shall practice according to standards and guidelines of the national certification organization for which he is certified.

B. The APRN shall practice according to the rules and regulations as established by the Mississippi Board of Nursing.

C. The APRN shall practice in a collaborative relationship with a Mississippi licensed physician whose practice is compatible with that of the APRN. The APRN must be able to communicate reliably with a collaborating physician while practicing. CRNAs may also collaborate with licensed dentists.

D. Each APRN shall participate in a formal quality assurance/quality improvement (QA/QI) program which shall be maintained on site and shall be available for inspection by representatives of the Board. 1) The QA/QI program must be sufficient to provide a valid evaluation of the practice and be a valid basis for change, if any. 2) QA/QI shall encompass Board-approved components according to specific areas of practice which may be found at msbn..

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3) The Advanced Practice committee will maintain review of these components and update as necessary.

E. APRNs must hold a Board-approved National Certification to designate one's self as holding a subspecialty. This does not prevent an APRN without a subspecialty designation from practicing in a specialty or subspecialty area.

Source: Miss. Code Ann. ? 73-15-17 (1972, as amended).

Rule 1.4 Prescribing. Prescribing Controlled Substances and Medications by certified APRNs:

A. Scope. These regulations apply to all individuals authorized to practice as an APRN in the State of Mississippi. Pursuant to these regulations, authorized certified APRNs may prescribe Schedules II, III, IV, or V. Application for this privilege requires an additional fee. Additionally, an application must be submitted to the Drug Enforcement Administration (DEA).

B. Definitions of terms for Part 2840, Chapter 1, Rule 1.4. 1) The words "administer", "controlled substances", and "ultimate user", shall have the same meaning as set forth in Miss. Code Ann. Section 41-29-105, unless the context otherwise requires. 2) The word "prescribe" shall mean to designate or order by means of either a written, electronic, faxed, or oral prescription, the delivery of a controlled substance or legend drug to an ultimate user. 3) The word "sample" shall mean a pre-packaged not-for-sale medication delivered to the provider by an authorized agent of the manufacturer for purposes of providing a patient with only enough medication to determine effectiveness in treating a diagnosed condition. 4) The word "distribute" shall mean to deliver a not-for-sale prepackaged device or sample to a patient. 5) The words "prescription drug" or "legend drug" shall mean a drug required under federal law to be labeled with the following statement prior to being dispensed or delivered; Rx Only or Caution: Federal law prohibits dispensing without prescription," or a drug which is required by any applicable federal or state law or regulation to be dispensed on prescription only or is restricted to use only by those authorized to prescribe. 6) The words "electronic prescribing" or E-prescribing" shall mean the electronic entry of a prescription by a practitioner, the secure electronic transmission of the prescription to a pharmacy, the receipt of an electronic message by the pharmacy and E-prescription renewal requests sent electronically by the pharmacy to the practitioner. Electronic transmissions may be computer to computer or computer to facsimile in accordance with DEA guidelines.

C. Prescription Guidelines - All Medications. 1) No certified APRN shall prescribe any medication without a good faith agreement subsequent to examination and medical indication thereof.

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(a) Every written prescription delivered to a patient, or delivered to any other person on behalf of a patient, must be signed on the date of issuance by the certified APRN. Electronic prescription transmissions are allowed using standards established and approved by the United States Department of Health and Human Services - Agency for Healthcare Research and Quality (HHS-AHRQ). This does not prohibit the transmission of electronic prescriptions and telefaxed (but not emailed) prescriptions to the pharmacy of the patient's choice. Electronic transcription that complies with federal DEA language is allowed.

(b) All prescriptions shall contain a designation indicating whether it shall be dispensed as written or whether substitution is permissible.

(c) Every written prescription issued by a certified APRN should clearly state whether or not each medication should be refilled, and if so, the number of authorized refills and/or the duration of therapy.

(d) Written prescriptions issued by a certified APRN, bearing more than one noncontrolled medication, shall clearly indicate the intended refill instructions for each medication.

(e) Any unused lines on a multi-line prescription blank shall be clearly voided by the issuing certified APRN.

(f) A certified APRN shall not permit any prescription to be signed by any other person in the place of or on behalf of the APRN.

(g) A certified APRN shall not pre-sign blank prescription pads or order forms under any circumstances.

2) Drug Maintenance, Labeling and Distribution Requirements. (a) A certified APRN may receive and distribute not-for-sale prepackaged devices or samples for which the certified APRN has prescriptive authority. (b) The patient's record shall reflect the lot number, expiration date, and instructions for use of any not-for-sale prepackaged device or sample. (c) A certified APRN may delegate a licensed nurse to provide for the patient the not-for-sale prepackaged device or sample. (d) A certified APRN shall not sell or trade any not-for-sale prepackaged device or sample. (e) A certified APRN shall not distribute out-of-date not-for-sale prepackaged devices or samples. Out-of-date prepackaged devices and samples shall be promptly removed and properly disposed. (f) The drug storage area shall be locked and maintained in a sanitary environment. (g) A certified APRN shall not accept the return of any drugs. (h) All drug products shall be maintained, stored, and distributed in such a manner as to maintain the integrity of the product.

3) Maintenance of Patient Records. (a) Patient Record. A certified APRN, who prescribes any device or medication, including controlled substances, shall maintain a complete record of the patient's examination, evaluation, and treatment plan. Documentation of the patient shall include the diagnosis and reason for

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