Permitted duties of advanced practice nurse

10. a. In addition to all other tasks which a registered professional nurse may, by law, perform, an advanced practice nurse may manage preventive care services, diagnose, monitor, and manage deviations from wellness and long-term illnesses, consistent with the needs of the patient and within the defined scope of practice of that advanced practice nurse, by: (1) initiating laboratory and other diagnostic tests; (2) prescribing, authorizing, or ordering medications and devices, as authorized by subsections b., c., g., or h. of this section; and (3) prescribing or ordering treatments, including referrals to other licensed health care professionals, and performing specific procedures in accordance with the provisions of this section. b. An advanced practice nurse may order medications and devices in the inpatient setting, subject to the following conditions: (1) the collaborating physician and advanced practice nurse shall address in the joint protocols whether prior consultation with the collaborating physician is required to initiate an order for a controlled dangerous substance; (2) the order is written in accordance with standing orders or joint protocols developed in agreement between a collaborating physician and the advanced practice nurse, or pursuant to the specific direction of a physician; (3) the advanced practice nurse authorizes the order by signing the nurse's own name, printing the name and certification number, and printing the collaborating physician's name; (4) the physician is present or readily available through electronic communications; (5) the charts and records of the patients treated by the advanced practice nurse are reviewed by the collaborating physician and the advanced practice nurse within the period of time specified by rules adopted by the Commissioner of Health pursuant to section 13 of P.L.1991, c.377 (C.45:11-52); (6) the joint protocols developed by the collaborating physician and the advanced practice nurse are reviewed, updated, and signed at least annually by both parties; and (7) the advanced practice nurse has completed six contact hours of continuing professional education in pharmacology related to controlled substances, including pharmacologic therapy, addiction prevention and management, and issues concerning prescription opioid drugs, including responsible prescribing practices, alternatives to opioids for managing and treating pain, and the risks and signs of opioid abuse, addiction, and diversion, in accordance with regulations adopted by the New Jersey Board of Nursing. The six contact hours shall be in addition to New Jersey Board of Nursing pharmacology education requirements for advanced practice nurses related to initial certification and recertification of an advanced practice nurse as set forth in N.J.A.C.13:37-7.2. c. An advanced practice nurse may prescribe medications and devices in all other medically appropriate settings, subject to the following conditions: (1) the collaborating physician and advanced practice nurse shall address in the joint protocols whether prior consultation with the collaborating physician is required to initiate a prescription for a controlled dangerous substance; (2) the prescription is written in accordance with standing orders or joint protocols developed in agreement between a collaborating physician and the advanced practice nurse, or pursuant to the specific direction of a physician; (3) the advanced practice nurse writes the prescription on a New Jersey Prescription Blank pursuant to P.L.2003, c.280 (C.45:14-40 et seq.), signs the nurse's own name to the prescription, and prints the nurse's name and certification number; (4) the prescription is dated and includes the name of the patient and the name, address, and telephone number of the collaborating physician; (5) the physician is present or readily available through electronic communications; (6) the charts and records of the patients treated by the advanced practice nurse are periodically reviewed by the collaborating physician and the advanced practice nurse; (7) the joint protocols developed by the collaborating physician and the advanced practice nurse are reviewed, updated, and signed at least annually by both parties; and (8) the advanced practice nurse has completed six contact hours of continuing professional education in pharmacology related to controlled substances, including pharmacologic therapy, addiction prevention and management, and issues concerning prescription opioid drugs, including responsible prescribing practices, alternatives to opioids for managing and treating pain, and the risks and signs of opioid abuse, addiction, and diversion, in accordance with regulations adopted by the New Jersey Board of Nursing. The six contact hours shall be in addition to New Jersey Board of Nursing pharmacology education requirements for advanced practice nurses related to initial certification and recertification of an advanced practice nurse as set forth in N.J.A.C.13:37-7.2. d. The joint protocols employed pursuant to subsections b. and c. of this section shall conform with standards adopted by the Director of the Division of Consumer Affairs pursuant to section 12 of P.L.1991, c.377 (C.45:11-51) or section 10 of P.L.1999, c.85 (C.45:11-49.2), as applicable. e. (Deleted by amendment, P.L.2004, c.122.) f. An attending advanced practice nurse may determine and certify the cause of death of the nurse's patient and execute the death certification pursuant to R.S.26:6-8 if no physician is available to do so and the nurse is the patient's primary caregiver. g. (1) Except as otherwise provided in paragraph (2) of this subsection, an advanced practice nurse may authorize qualifying patients for the medical use of cannabis and issue written instructions for medical cannabis to registered qualifying patients, subject to the following conditions: (a) the collaborating physician and advanced practice nurse shall address in the joint protocols whether prior consultation with the collaborating physician is required to authorize a qualifying patient for the medical use of cannabis or issue written instructions for medical cannabis; (b) the authorization for the medical use of cannabis or issuance of written instructions for cannabis is in accordance with standing orders or joint protocols developed in agreement between a collaborating physician and the advanced practice nurse, or pursuant to the specific direction of a physician; (c) the advanced practice nurse signs the nurse's own name to the authorization or written instruction and prints the nurse's name and certification number; (d) the authorization or written instruction is dated and includes the name of the qualifying patient and the name, address, and telephone number of the collaborating physician; (e) the physician is present or readily available through electronic communications; (f) the charts and records of qualifying patients treated by the advanced practice nurse are periodically reviewed by the collaborating physician and the advanced practice nurse; (g) the joint protocols developed by the collaborating physician and the advanced practice nurse are reviewed, updated, and signed at least annually by both parties; and (h) the advanced practice nurse complies with the requirements for authorizing qualifying patients for the medical use of cannabis and for issuing written instructions for medical cannabis established pursuant to P.L.2009, c.307 (C.24:6I-1 et al.). (2) Subject to the requirements for authorizing qualifying patients for the medical use of cannabis and for issuing written instructions for medical cannabis established pursuant to P.L.2009, c.307 (C.24:6I-1 et al.), an advanced practice nurse who is authorized to practice advanced practice nursing within a population focus of family or individual across the lifespan, adult gerontology, pediatrics, women’s health, or behavioral health shall be exempt from subsections b. and c. of this section and may authorize qualifying patients for the medical use of cannabis and issue written instructions for medical cannabis to registered qualifying patients without a joint protocol with a collaborating physician, provided that: (a) the advanced practice nurse has more than 5,000 hours of licensed, active, advanced nursing practice in a role with the applicable population focus; (b) the advanced practice nurse is providing primary health care or behavioral health care; (c) the advanced practice nurse is not providing health care services in the area of general obstetrics; (d) the advanced practice nurse is not providing elective aesthetic or cosmetic services; and (e) the advanced practice nurse, to the extent the advanced practice nurse is providing behavioral health care services, takes appropriate action to facilitate the timely referral, transfer, or admission to a higher level of care in the event the advanced practice nurse determines, based upon clinical judgment, that a patient requires such level of care. The determination shall be based upon a documented clinical assessment. h. (1) Pursuant to this subsection, an advanced practice nurse who is authorized to practice advanced practice nursing within a population focus of family or individual across the lifespan, adult gerontology, pediatrics, women’s health, or behavioral health shall be exempt from subsections b. and c. of this section and shall be authorized to practice without a joint protocol with a collaborating physician, provided that: (a) the advanced practice nurse has more than 5,000 hours of licensed, active, advanced nursing practice in a role with the applicable population focus; (b) the advanced practice nurse is providing primary health care or behavioral health care; (c) the advanced practice nurse is not providing health care services in the area of general obstetrics; (d) the advanced practice nurse is not providing elective aesthetic or cosmetic services; and (e) the advanced practice nurse, to the extent the advanced practice nurse is providing behavioral health care services, takes appropriate action to facilitate the timely referral, transfer, or admission to a higher level of care in the event the advanced practice nurse determines, based upon clinical judgment, that a patient requires such level of care. The determination shall be based upon a documented clinical assessment. (2) An advanced practice nurse who meets the exemption criteria provided pursuant to paragraph (1) of this subsection may order medications and devices, subject to the following conditions: (a) the advanced practice nurse shall issue a prescription on a New Jersey Prescription Blank in accordance with the provisions of P.L.2003, c.280 (C.45:14-40 et seq.) and include on the prescription blank the advanced practice nurse’s signature, printed name, certification number, and patient information and any other information required pursuant to regulations adopted by the New Jersey Board of Nursing; (b) the advanced practice nurse shall have completed 14 contact hours of continuing professional education in pharmacology related to controlled substances, including pharmacologic therapy and addiction prevention and management. Of the 14 contact hours, eight hours shall be in addition to New Jersey Board of Nursing controlled dangerous substance pharmacology education requirements for advanced practice nurses related to initial certification of an advanced practice nurse as set forth in regulations adopted by the New Jersey Board of Nursing at the time of the effective date of P.L.2026, c.6 (C.45:11-48.1 et al.); (c) the advanced practice nurse shall have completed 10 contact hours of continuing professional education in pharmacology each biennial period; (d) the advanced practice nurse, who is practicing independently, shall be held to the same standard of care as other independent health care practitioners. (e) the advanced practice nurse shall be required to be covered by malpractice liability insurance or, if such liability coverage is not available, by a letter of credit for at least the minimum amount applicable to a licensed physician. The advance practice nurse shall notify the Board of Nursing of the name and address of the insurance carrier or the institution issuing the letter of credit; (f) if the advanced practice nurse does not provide services to beneficiaries of the Medicare program established pursuant to section 1801 of the Social Security Act (42 U.S.C. s.1395 et seq.), the advanced practice nurse shall, if applicable, prominently display in the advanced practice nurse’s office an appropriate notice and inform, in writing, the Board of Nursing; and (g) the advanced practice nurse shall immediately notify the Board of Nursing if the advanced practice nurse is: (i) is incapable, for medical or any other good cause, of discharging the functions of the advanced practice nurse in a manner consistent with the public's health, safety, and welfare; (ii) is indicted or convicted of a crime involving moral turpitude or a crime adversely relating to the advanced practice nurse’s practice; (iii) is named as a defendant or respondent in a civil, criminal, or administrative investigation, complaint, or judgment involving alleged malpractice, negligence, or misconduct relating to the advanced practice nurse’s practice; (iv) is the subject of any voluntary license or certification surrender or any disciplinary action or order by any state or Federal agency, board, or commission, including any order of limitation or preclusion; or (v) fails to maintain or renew any certification which is required by law as a condition of practice or as a condition of license or certification renewal. i. Any provision of State law or regulation that requires the signature, stamp, verification, affidavit, or endorsement of a physician shall be deemed to require the signature, stamp, verification, affidavit, or endorsement of a physician or an advanced practice nurse to the extent consistent with the scope of practice of an advanced practice nurse.