Since 2013, several states have seen progress in the ability of pharmacists to work with physicians and other prescription people to provide patients with advanced care. Currently, 48 states, plus the District of Columbia, allow some degree of cooperation between pharmacists and other health care providers. The signing of the Senate substitution for HB 2146 on April 10, 2014, reported a total of 47 to 48. The terms used for services provided under a cooperation agreement are as follows: currently, in 22 states and two U.S. territories, registered nurses have full practical power in advanced practice. 11 other states do not allow the APRN to exercise full power of practice, but to impose fewer restrictions than Wisconsin. The Academy of Medicine and the National Council of State Boards of Nursing recommend the comprehensive practice model. The intent of this practice agreement is to authorize -[name CRNA-APNP] to practice as a certified Nurse Anesthetist (CRNA) member as part of the State of Wisconsin for RNA – Advanced Practice Prescrib Nurseer (APNP). The CRNA APNP, in collaboration with certified medical staff from the hospital` (name of hospital)- will play the role of the CNA. This agreement serves as a documentation for a collaborative relationship. The Wisconsin Nursing Practices Act: Nurse anaesthetists who provide independent anesthesia care in Wisconsin are certified as professional nurses (see 441.001 (4)) and must also be certified as Advanced Practice Nurse Prescribers (see p. 441.16). If a nurse`s anaesthetist is not as APNP, the anaesthetist must practice under the authority or direction of a physician or other health care provider whose field of activity is anesthesia.
Examples for these other providers would be dentists or podiatrists. The Wisconsin Board of Nursing has adopted management rules to interpret the APNP Act. These are in Wisconsin`s administrative code No. 8. In particular, the Wisconsin Medical Society has drawn the attention of its members to the fact that nurse anaesthetists, who are also APPPs, can practice without medical supervision. Cooperation: Almost all health care providers work with other providers if necessary for the well-being of the patient. This applies to registered nurses, APPPs and nurse anaesthetists. Administrative rule No. 8 of the care committee applies to all APPPs, including nurse anaesthetists. It defines the collaborative relationship as “a process in which two or more health professionals work together, in the presence of one or the other, each bringing their respective expertise to ensure a broader management than can be offered alone.” The APRN tragen are responsible for safeguarding the cooperation agreement.
Under current legislation, NRPA practices under their own licences and assumes full responsibility for patient care.