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Texas Occupations Code - Section 157.054. Prescribing At Facility-Based Practice Sites

Legal Research Home > Texas Lawyer > Occupations Code > Texas Occupations Code - Section 157.054. Prescribing At Facility-Based Practice Sites

§ 157.054. PRESCRIBING AT FACILITY-BASED PRACTICE 
SITES.  (a) A physician licensed by the board may delegate, to one 
or more physician assistants or advanced practice nurses acting 
under adequate physician supervision whose practice is 
facility-based at a licensed hospital or licensed long-term care 
facility, the administration or provision of a drug and the 
carrying out or signing of a prescription drug order if the 
physician is:
		(1)  the medical director or chief of medical staff of 
the facility in which the physician assistant or advanced practice 
nurse practices;
		(2)  the chair of the facility's credentialing 
committee;                   
		(3)  a department chair of a facility department in 
which the physician assistant or advanced practice nurse practices;  
or
		(4)  a physician who consents to the request of the 
medical director or chief of medical staff to delegate the carrying 
out or signing of a prescription drug order at the facility in which 
the physician assistant or advanced practice nurse practices.
	(b)  A physician's authority to delegate under Subsection 
(a) is limited as follows:
		(1)  the delegation must be made under a physician's 
order, standing medical order, standing delegation order, or 
another order or protocol developed in accordance with policies 
approved by the facility's medical staff or a committee of the 
facility's medical staff as provided by the facility bylaws;
		(2)  the delegation must occur in the facility in which 
the physician is the medical director, the chief of medical staff, 
the chair of the credentialing committee, or a department chair;
		(3)  the delegation may not permit the carrying out or 
signing of prescription drug orders for the care or treatment of the 
patients of any other physician without the prior consent of that 
physician;
		(4)  delegation in a long-term care facility must be by 
the medical director and is limited to the carrying out and signing 
of prescription drug orders to not more than three advanced 
practice nurses or physician assistants or their full-time 
equivalents;  and
		(5)  a physician may not delegate at more than one 
licensed hospital or more than two long-term care facilities unless 
approved by the board.
	(c)  Physician supervision of the carrying out and signing of 
prescription drug orders must conform to what a reasonable, prudent 
physician would find consistent with sound medical judgment but may 
vary with the education and experience of the particular advanced 
practice nurse or physician assistant.  A physician shall provide 
continuous supervision, but the constant physical presence of the 
physician is not required.
	(d)  An alternate physician may provide appropriate 
supervision on a temporary basis as defined and established by 
board rule.

Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.  Amended 
by Acts 2003, 78th Leg., ch. 88, § 5, eff. May 20, 2003.

Last modified: August 10, 2007