1. (a) General Provisions: The advanced practice nurse with a valid prescription authorization number:

   1. (1) shall carry out or sign prescription drug orders for only those drugs that are:

      1. (A) classified as dangerous drugs;
      2. (B) authorized by Protocols or other written authorization for medical aspects of patient care; and
      3. (C) prescribed for patient populations within the accepted scope of professional practice for the advanced practice nurse's specialty area.
   2. (2) shall not authorize or issue prescriptions for controlled substances; and
   3. (3) shall comply with the requirements for adequate physician supervision published in the rules of the Board of Medical Examiners relating to Delegation of the Carrying Out or Signing of Prescription Drug Orders to Physician Assistants and Advanced Practice Nurses as well as other applicable laws,

2. (b) Protocols or other written authorization shall be defined in a manner that promotes the exercise of professional judgement by the advanced practice nurse commensurate with the education and experience of that person.

   1. (1) A protocol or other written authorization:

      1. (A) is not required to describe the exact steps that the advanced practice nurse must take with respect to each specific condition, disease, or symptom; and
      2. (B) may state types or categories of medications that may be prescribed or contain the types or categories of medications that may not be prescribed.

   2. (2) Protocols or other written authorization:

      1. (A) shall be written, agreed upon and signed by the advanced practice nurse and the physician;
      2. (B) reviewed and signed at least annually; and
      3. (C) maintained in the practice setting of the advanced practice nurse.

3. (c) Prescription Information: The format and essential elements of the prescription shall comply with the requirements of the Texas Board of Pharmacy. The following information must be provided on each prescription:

   1. (1) the patient's name and address;
   2. (2) the name, strength, and quantity of the dangerous drug to be dispensed;
   3. (3) directions to the patient regarding taking of the drug and the dosage;
   4. (4) the intended use of the drug, if appropriate;
   5. (5) the name, address, and telephone number of the delegating physician;
   6. (6) address and telephone number of the site at which the prescription drug order was carried out or signed;
   7. (7) the date of issuance;
   8. (8) the number of refills permitted; and

   9. (9) the name, prescription authorization number, and original signature of the advanced practice nurse signing or co-signing the prescription drug order.

      1. (A) For written prescriptions, there must be two signature lines of equal prominence, side by side, and under either signature line shall be printed clearly the words "product" selection "permitted" and under the other signature line shall be printed clearly. "dispense as written."
      2. (B) An appropriate signature on one of the two signature lines shall convey instructions to the pharmacist regarding authority to dispense a generically equivalent drug if available.

Source Note:The provisions of this §222.4 adopted to be effective February 25, 2001, 26 TexReg 1512.