1. Direct Patient Services A. Health education for individuals, families, and groups. B. Counseling for individuals, families, and groups. C. Obtain medical histories and perform physical examinations. D. Perform sports physical, screening, and preoperative examinations. E. Provide well?child care, including screening and immunizations. F. Prenatal health care and education. G. Family planning services. H. Screening and diagnostic test interpretation. 1. Specific procedures in which the ARNP has been educated. J. Management of non?complex acute or chronic health problems. K. Prescription of legend and over?the?counter medications (with appropriate licensure; see section 4, "Prescriptive Authority"). L. Diagnose, treat, and monitor acute and chronic, non?complex diseases. M. Utilizes medical/nursing references and resources as needed.
2. Physician Consulation/Collaboration
a. The ARNP will consult with a physician when a client presents with a complex medical health problem.
b. Consultation will occur if the ARNP is unfamiliar with performing a particular procedure required in any given situation.
c. Consultation will occur if controlled substances in Schedules I through IV are required in providing appropriate health care to clients.
d. Referrals will by made by the ARNP to physician specialists for those clients requiring medical or surgical care beyond the ARNP's specialty.
3. Procedures Specific to Specialized Practice
a. ARNPs may perform procedures specific to each specialized practice in which he/she has been trained. Examples include, but are not limited to, Pap smears, HJD placement and removal, endometrial biopsy, culposcopy, cryotherapy, suturing, nail removal, and hyfrecation therapy.
4. Prescriptive Authority
a. In order to prescribe medications, an ARNP must hold a current Washington State license for prescriptive authority.
b. All medication prescriptions must be signed by the prescriber, followed by the initials "ARNP".
c. The ARNP may not prescribe controlled substances in Schedules I through IV.
d. The ARNP prescribing Schedule V controlled substances must register with the Washington State Board of Pharmacy and the Drug Enforcement Agency. (RCW 18.88.280(16), WAC 246?839?420).
a. The following elements will be included by the ARNP, appropriate to each client encounter. Not all elements will need to be included when documenting every client encounter.
(1) Accurate identification of client
(2) Pertinent social data
(3) Pertinent past medical/surgical history
(4) Description of the health status
(5) Accurate record of client allergies and current medication use
(6) Descriptions of medical/nursing/health education needs
(7) Summary of encounters, disposition, and patient instructions
(8) Diagnostic and laboratory reports
(9) Reports of consultations; required consent forms
(10) Signature and credentials of mid?level provider
b. Physician Review/Co?signature
(1) Not applicable; not required by law.
1. "Advanced Registered Nurse Practitioner" or "ARNP" must follow signature.
2. If desired, the title or abbreviation designated by the approved national certifying body may be placed following "ARNP
NOTE: This list of job functions is not intended to be all inclusive and may be expanded to include other functions that may be deemed necessary.
Master's degree in advanced nursing practice, or completion of at least one academic year in a non?graduate program for the training of an advanced registered nurse practitioner prior to January 1, 1995.
1. Current licensure as a registered nurse in the State of Washington.
2. Current licensure as an advanced registered nurse practitioner in the State of Washington.
3. Current certification by a national certifying body.
4. Current prescriptive authority licensure, only if current practice includes
a. prescribing medications.
b. (WACs 246?839?300, 246?839?305, 246?839?320, 246?839?400 &