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Orders/Prescriptive Authority Questions

• Are CRNAs required to check the Prescription Monitoring Program (PMP)?

  APRNs with prescriptive authority are required to check a patient’s PMP history before dispensing or prescribing opioids, benzodiazepines, barbiturates, or carisoprodol. In other words, CRNAs who prescribe pursuant to a Prescriptive Authority Agreement are required to check the PMP prior…

• Is a physician co-signature required for orders written in the perioperative period?

  There is no requirement in Texas state law or by the BON for a physician co-signature on orders written by a CRNA in the perioperative period.  Board Rule 221.15(a) establishes the legal basis for the ordering of drugs and devices by a CRNA in a licensed hospital or ambulatory surgical…

• Does the administration of preoperative antibiotics by a CRNA require a written order or can the antibiotic be administered routinely without a written order?

  Pursuant to an order for anesthesia or anesthesia-related services, it is within the scope of practice for a CRNA to order and administer antibiotics consistent with the needs of the patient, the type of case, and preferences of the surgeon or other physician caring for the patient. …

• Is a CRNA in Texas required to have prescriptive authority to order medications in the perioperative period?

  A CRNA in Texas is not required to have prescriptive authority to order medications in the perioperative period.  In Texas, a CRNA is required to have an order for anesthesia or anesthesia related services from a physician.  The physician’s order delegates the ordering of drugs and…

• Is a physician required to co-sign a Certified Registered Nurse Anesthetist’s anesthesia record or pre-anesthesia assessment?

  There is no Texas state law or Texas Board of Nursing regulation requiring physician co-signature of a CRNA's anesthesia record or pre-anesthesia assessment.  Whether a CRNA is practicing in a collaborative model with an anesthesiologist or practicing independently, the CRNA is responsible…