ARNP Prescriptive Authority for Nonscheduled Legend Drugs and CAPA-NS

For more information, please review KRS 314.011(8); 314.042(8); and 201 KAR 20:057.

An ARNP with a CAPA-NS for prescriptive authority must maintain a copy of the agreement and provide it to KBN upon request. 

Once an ARNP has entered into a written CAPA-NS that defines the scope of prescribing authority for the ARNP, and it is signed by a physician, the ARNP may write prescriptions for nonscheduled legend medications.  Prescribing nonscheduled legend medications without a written CAPA-NS is considered a violation of the Kentucky Nursing Laws and could subject the ARNP to disciplinary action.  There is no KBN application process for an ARNP to complete in order to prescribe nonscheduled legend drugs; consequently, KBN has neither developed nor distributed a format for the CAPA-NS.  Section 6 of 201 KAR 20:057 lists the items that must be in this agreement.

The Kentucky Coalition of Nurse Practitioners and Nurse Midwives has developed a "model" Collaborative Prescribing Agreement (CAPA-NS) Form that may be modified to accommodate an ARNP's specialty area of practice and setting.  Go to their website at www.kcnpnm.org/prescribing.html  and click on "Forms" to obtain a copy of this document.  Individuals may also obtain additional information and a copy of the form by contacting the Kentucky Coalition of Nurse Practitioners and Nurse Midwives, 1017 Ash Street, Louisville, KY 40217, Telephone:  502-333-0076.

...See History of CAPAs

It appears that questions concerning an ARNP’s scope of practice stem, most often, from the requirement defining an ARNP’s scope of prescribing authority.  An ARNP’s scope of practice is determined by the following factors:

• The ARNP's post basic nursing education.
• The type of advanced nursing practice certification.
• The scope and standards of practice of the ARNP's national nursing certification organization that credentials the ARNP.

Further, 201 KAR 20:057 incorporates by reference the various scopes and standards for advanced nursing practice published by the various national nursing organizations thereby giving the incorporated scopes and standards of advanced nursing practice the force and effect of law.  All of these elements in combination provide the framework for the individual ARNP’s "scope of practice."

In addition, KRS 314.021(2) imposes individual responsibility upon a nurse to undertake the performance of acts for which the nurse is educationally prepared and clinically competent to perform in a safe, effective manner.  This section holds nurses individually responsible and accountable for rendering safe, effective nursing care to clients and for judgments exercised and actions taken in the course of providing care. For example, if an ARNP doubts his/her ability to appropriately and safely prescribe a particular medication for a patient, then the ARNP should not prescribe the medication. The ARNP should consult with a collaborating physician concerning the appropriate medication or refer the patient to the appropriate health care provider for further evaluation and treatment.  In addition, the ARNP has a legal responsibility to acquire the necessary education and supervised clinical practice that would validate his/her competence in prescribing medications in the future.  ARNPs should only prescribe medications that are within their "scope of practice" and for which they have the knowledge and competence to prescribe.

All ARNPs are required to earn 5 contact hours of approved nursing continuing education in pharmacology.  This requirement applies regardless of whether or not the ARNP’s practice includes prescribing nonscheduled legend and/or controlled substance medications. The 5 contact hours may be included in the total 14 contact hours of approved nursing continuing education required for licensure renewal.

...more on Pharmacology CE