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49 Pa. Code § 21.251. Definitions.


§ 21.251. Definitions.

 The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise:

   Act—The Professional Nursing Law (63 P.S. § §  211—225.5).

   Board—The State Board of Nursing of the Commonwealth.

   CRNP—Certified Registered Nurse Practitioner—A professional nurse licensed in this Commonwealth who is certified by the Board in a specialty and who, while functioning in the expanded role as a professional nurse, performs acts of medical diagnosis or prescription of medical therapeutic or corrective measures in collaboration with a physician licensed to practice in this Commonwealth and in accordance with the act and this subchapter. Nothing in this subchapter is to be deemed to limit or prohibit a professional nurse from engaging in those activities which constitute the practice of professional nursing as defined in section 2 of the act (63 P.S. §  212).

   Certification—The authorization granted by the Board to a professional nurse who has demonstrated the qualifications for recognition as a CRNP.

   Collaboration—A process in which a CRNP works with one or more physicians to deliver health care services within the scope of the CRNP’s expertise. The process includes the following:

     (i)   Immediate availability of a licensed physician to a CRNP through direct communications or by radio, telephone or telecommunications.

     (ii)   A predetermined plan for emergency services.

     (iii)   A physician available to a CRNP on a regularly scheduled basis for referrals, review of the standards of medical practice incorporating consultation and chart review, drug and other medical protocols within the practice setting, periodic updating in medical diagnosis and therapeutics and cosigning records when necessary to document accountability by both parties.

   Collaborative agreement—The written and signed agreement between a CRNP and a collaborating physician in which they agree to the details of their collaboration including the elements in the definition of collaboration.

   Initial certification—The first certification or licensure as a nurse practitioner that an individual receives in any jurisdiction.

   National certification—Certification by a Board-recognized National certification organization which required passing a nurse practitioner National certifying examination in a specialty.

   Prescriptive authority collaborative agreement—The written and signed agreement between a CRNP with prescriptive authority and a collaborating physician in which they agree to the details of their collaboration.

   Specialty—The area of practice or population in which a CRNP is certified by the Board.


   The provisions of this §  21.251 adopted July 22, 1977, effective July 23, 1977, 7 Pa.B. 2063; amended December 11, 2009, effective December 12, 2009, 39 Pa.B. 6994. Immediately preceding text appears at serial pages (335543) to (335544).

Notes of Decisions

   Chart Review

   Physicians may render an opinion based on a review of records. Therefore, the physician was justified in formulating a medical opinion based on the information provided by the certified registered nurse practitioner and the suspension of the petitioner’s license based on incompetence under 67 Pa. Code §  83.5 was justified. Satler v. Department of Transportation, 670 A.2d 1205 (Pa. Cmwlth. 1996).

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