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IDPR Publishes Advanced Practice Nursing Rules |
The Illinois Department of Professional Regulation promulgated rules governing the licensure requirements for Advanced Practice Nurses (APNs), as mandated by the Nursing and Advanced Practice Nursing Act of 1998. These new licensure regulations went into effect on March 15, 2001, and specify various requirements both for physicians and APNs working together.
Effective July 1, 2001, all Advanced Practice Nursing licensure applicants must be already licensed as registered professional nurses, hold a masters' degree from an appropriate nursing program, and be certified by an approved specialty organization. A grandfather provision allows current registered nurses to apply for Advanced Practice Nursing licenses before July 1, provided they have a current Illinois license, appropriate national certification from a specialty nursing council, and ten years' experience in practice as a nurse practitioner.
Advanced Practice Nursing licenses will be granted in four categories:
Once licensed, Advanced Practice Nurses may be granted, under a written collaborative agreement with a licensed physician, authority to provide a wide range of medical services, including the prescription of Schedule III, IV, and V drugs. While APNs will be allowed to work under the indirect oversight of a physician, collaborating physicians are required to work with the APN to define the APN's responsibilities. With the exception of CRNAs, the APN and physician must have a written collaborative agreement that documents and determines the limits of the APN's authority. Collaborative agreements must contain the following:
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APNs must work in collaboration with physicians who practice in a field relevant to their own professional expertise. For example, if a Family Practitioner does not perform deliveries, then the FP may not enter into a collaborative agreement with a nurse midwife to perform deliveries. Physicians who work with APNs (and vice versa) without clearly written collaborative agreements risk being disciplined by the Department of Professional Regulation. And, while a collaborative agreement delegates more diagnostic responsibility to APNs, physicians can have their licenses suspended, revoked, or face other disciplinary measures for inadequate medical direction of APNs.
In order to obtain prescribing privileges, APNs need their collaborating physician to delegate authority to prescribe in writing, and to file a copy with the Illinois Department of Professional Regulation. In that written delegation, physicians may specify what types or categories of prescriptions an APN may write. It is the responsibility of the collaborating physician to periodically review the APN's medication orders. If the physician delegates authority to prescribe and dispense controlled substances, then the APN also has to obtain a federal DEA mid-level practitioner number and an Illinois mid-level practitioner controlled substance license.
In order to minimize the liability risk for physicians, collaborative relationships and/or written guidelines between physicians and Advanced Practice Nurses need to be clearly defined, continually monitored, and modeled according to IDPR specifications. IDPR rules contain sample written collaborative and written practice agreements. See www.dpr.state.il.us for the complete text of the rules.
Learn more about potential liabilities facing physicians who work with APNs and PAs at "Sharing a Practice, Sharing the Risk: Loss Prevention Strategies for Group Practices," to be held at the following locations:
| July 19, 2001 9:00 a.m. - Noon |
Renaissance Hotel, Springfield |
| September 12, 2001 9:00 a.m. - Noon |
Holiday Inn Select, Naperville |
This seminar contains 3 hours of CME credit. To register, call 1-800-782-4767, ext. 1627, or use our secure online registration at www.ismie.com.