RNs Prescribing Medication via Established Protocol Following Telephone Triage

In December 2004, the Board advised that nurses do not have authority to issue a prescription drug order, or to submit a prescription to a pharmacist if the “prescription drug order” does not meet the definition in KRS 315.010(23).  This statute defines “prescription drug order” as:

An original or new order from a practitioner for drugs, drug-related devices or treatment for a human or animal, including orders issued through collaborative care agreements.  Lawful prescriptions result from a valid practitioner-patient relationship, are intended to address a legitimate medical need, and fall within the prescribing practitioner’s scope of professional practice.”

Concern was expressed that if a valid practitioner-patient relationship has not been established, then the nurse does not have the legal authority to issue the prescription in question.

Concern was further expressed that a protocol should hold the prescriber/provider accountable for the medical diagnosis and treatment of the patient.  In addition, from a public safety perspective, the protocol should provide for health education, care, and follow-up for the patient population.