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Nurse Practitioner: Malpractice and Duties in Pennsylvania

What is a nurse practitioner?
What is considered nurse practitioner malpractice?
What are the duties of a nurse practitioner or CRNP?
Can a nurse practitioner prescribe drugs?

nurse practitioner

What is a nurse practitioner (NP)? What is CRNP?

A nurse practitioner is a registered nurse (RN) who has completed advanced education (minimum of a master's degree) and training in the diagnosis and management of common medical conditions. Nurse practitioners provide a broad range of healthcare services. They provide some of the same care that doctors do and maintain close working relationships with doctors.

Nurse practitioners can also serve as a patient's regular healthcare provider. Nurse practitioners make prevention, wellness, and patient education priorities which translate into fewer prescriptions and less expensive treatments. In addition to healthcare, nurse practitioners conduct research and are frequently active in patient advocacy activities.

What is considered nurse practitioner malpractice?

  • Medical negligence failing to uphold a standard of conduct set forth by nurse practitioner regulations
  • Duty requiring a nurse practitioner to conform to a standard of conduct that protects others from unreasonable risk of harm
  • Breach of that duty (i.e., the person's failure to conform to the standard of conduct)
  • Causal connection between the breach of the duty and the resulting injury
  • Resulting injury or damage which results in measurable physical, emotional or economic harm

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What are the duties of a nurse practitioner or CRNP?

Because the nurse practitioner profession is state regulated, duties vary. In Pennsylvania, nurse practitioners are referred to as CRNP (certified registered nurse practitioners). Their duties encompass:

  • Perform comprehensive assessments of patients and establish medical diagnoses;
  • Order, perform, and supervise diagnostic tests for patients and, to the extent the interpretation of diagnostic tests is within the scope of the CRNP's specialty and consistent with the collaborative agreement, may interpret diagnostic tests;
  • Initiate referrals to and consultations with other licensed professional health care providers, and consult with other licensed professional health care providers at their request;
  • Develop and implement treatment plans, including issuing orders to implement treatment plans. However, only a CRNP with current prescriptive authority approval may develop and implement treatment plans for pharmaceutical treatments;
  • Complete admission and discharge summaries;
  • Order blood and blood components for patients;
  • Order dietary plans for patients;
  • Order home health and hospice care;
  • Order durable medical equipment;
  • Issue oral orders to the extent permitted by the health care facilities' by-laws, rules, regulations, or administrative policies and guidelines;
  • Make physical therapy and dietitian referrals;
  • Make respiratory and occupational therapy referrals;
  • Perform disability assessments for the program providing temporary assistance to needy families (TANF);
  • Issue homebound schooling certifications; and
  • Perform and sign the initial assessment of methadone treatment evaluations, provided that any order for methadone treatment shall be made only by a physician;

The above provisions are subject to limitation as set forth in State Board of Nursing/Certified Registered Nurse Practitioner section 8.2(c.2) of the act (63 P.?S. § 218.2(c.2)), regarding the authority of state agencies and health care facilities.

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CRNP Prescribing Drugs

After a long wait in Pennsylvania, nurse practitioners may now practice under the expanded authority awarded in a law passed in 2007. Highlights of the new regulations include removal of the 4:1 NP-to-physician ratio, removal of the requirement to have a collaborating physician's name on prescription pads, and requirement that collaborative agreements are in writing.

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