| (5) Continuation or modification of the use of medications
for pain management shall be based on an evaluation of progress toward
treatment plan goals, as well as evaluation and consideration of any
new factors that may influence the treatment plan.
(A) Progress or lack of progress in relieving pain
and meeting treatment objectives shall be documented in the patient
record. Progress may be indicated by the patient's decreased pain,
increased level of function, and/or improved quality of life.
(B) Objective evidence of improved or diminished function
shall be monitored. Information from the patient, family members,
or other caregivers should be considered in determining the patient's
response to treatment.
(C) If the patient's progress is unsatisfactory, the
current treatment plan should be reevaluated, with consideration given
to the use of other therapeutic modalities and/or services of other
providers.
(6) Continuation of the use of scheduled drugs shall
include consultation with the delegating physician and documentation
of such consultation in the patient record, as required for delegation
of prescriptive authority for controlled substances pursuant to §157.0511
and §168.201, Occupations Code.
(h) Consultation and Referral. In certain situations,
further evaluation and treatment may be indicated.
(1) Patients who are at risk for substance use disorders
or addiction require special attention. Consideration should be given
to consultation with and/or referral to a provider who is an expert
in the treatment of patients with substance use disorders.
(2) Patients with chronic pain and histories of substance
use disorders or with co-existing psychological and/or psychiatric
disorders may require consultation with and/or referral to an expert
in the treatment of such patients. Consideration should be given to
consultation with and/or referral to a provider who is an expert in
the treatment of patients with these histories and/or disorders.
(3) Information regarding the consideration of consultation
and/or referral under this subsection should be documented in the
patient record
(i) Pain management clinics in the state of Texas.
Prior to providing pain management services in these settings, APRNs
who practice in pain management clinics shall verify that the clinic
has been properly certified as a pain management clinic by the Texas
Medical Board and that the certification is current.
(1) The APRN shall ensure that s/he is in compliance
with all other requirements for delegation of prescriptive authority
for medications as set forth in Board rule and the Occupations Code
Chapter 157.
(2) APRNs shall not own or operate a pain management
clinic, as that term is defined by the Occupations Code Chapter 168
and any applicable rules promulgated by the Texas Medical Board.
|
