KY Collaborative Agreement for Advanced Practice Registered Nurse Prescriptive Authority for Non‐Scheduled Drugs (CAPA‐NS) Form 2023-2025 free printable template
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CollaborativeAgreementforAdvancedPracticeRegisteredNurse
PrescriptiveAuthorityforNonScheduledDrugs(CAPANS)Form
THISCOLLABORATIVEPRESCRIBINGAGREEMENT(the"Agreement")isenteredintothis___dayofthe
monthof___intheyear___,byand
between___APRN,hereinafterthe"APRN",
and___M.D./D.O.,hereinafterthePhysician".
WHEREAS,theAPRNandthephysiciandesiretoenterintoaCollaborativePrescribingAgreement
pursuanttoKRS314
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How to fill out ky collaborative agreement 2023-2025
How to fill out KY Collaborative Agreement for Advanced Practice Registered Nurse
01
Begin by obtaining a copy of the KY Collaborative Agreement form, which can be found on the Kentucky Board of Nursing website.
02
Fill in the basic information at the top of the form, including the names and contact details of both the Advanced Practice Registered Nurse (APRN) and the collaborating physician.
03
Clearly specify the scope of practice for the APRN and detail the services that the APRN will provide.
04
Outline the responsibilities of both the APRN and the collaborating physician, ensuring that it aligns with Kentucky regulations.
05
Include any relevant qualifications of the APRN and the collaborating physician that support their ability to engage in the collaborative agreement.
06
Make sure all parties sign and date the agreement in the designated areas.
07
Review the completed agreement for completeness and accuracy before submission.
08
Submit the signed agreement to the Kentucky Board of Nursing, adhering to any additional submission guidelines provided.
Who needs KY Collaborative Agreement for Advanced Practice Registered Nurse?
01
Any Advanced Practice Registered Nurse (APRN) in Kentucky who intends to practice in a collaborative environment with a physician.
02
Healthcare facilities or entities that wish to employ APRNs under a collaborative practice framework.
03
Physicians who are interested in collaborating with APRNs to ensure compliance with state regulations.
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What is KY Collaborative Agreement for Advanced Practice Registered Nurse?
The KY Collaborative Agreement for Advanced Practice Registered Nurse is a formal agreement that outlines the collaborative practice between an Advanced Practice Registered Nurse (APRN) and a collaborating physician in Kentucky. It defines the scope of practice and establishes procedures for patient care.
Who is required to file KY Collaborative Agreement for Advanced Practice Registered Nurse?
Advanced Practice Registered Nurses (APRNs) in Kentucky who wish to practice with prescriptive authority must file a Collaborative Agreement with a licensed physician.
How to fill out KY Collaborative Agreement for Advanced Practice Registered Nurse?
To fill out the KY Collaborative Agreement, APRNs must complete the forms provided by the Kentucky Board of Nursing, including information about the APRN and the collaborating physician, their scope of practice, and any protocols or guidelines for collaboration.
What is the purpose of KY Collaborative Agreement for Advanced Practice Registered Nurse?
The purpose of the KY Collaborative Agreement is to ensure that APRNs work collaboratively with physicians to provide safe, effective patient care while complying with state regulations and enhancing access to healthcare.
What information must be reported on KY Collaborative Agreement for Advanced Practice Registered Nurse?
The KY Collaborative Agreement must report information such as the names and license numbers of the APRN and the collaborating physician, their areas of practice, the nature of the collaborative arrangement, and any specific protocols or guidelines that will be followed.
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