Providing the authorizing physician is satisfied as to the
ability and competence of those for whom the physician is assuming
responsibility, and with due regard for the safety of the patient
and in keeping with sound medical practice, standing delegation orders
may be authorized for the performance of acts and duties which do
not require the exercise of independent medical judgment. Limitations
on the physician's use of standing delegation orders which are stated
in this section shall not apply to patient care delivered by physician
assistants or advanced practice registered nurses, as authorized by §§157.051
- 157.060 of the Act, or §§193.6 - 193.14 of this title
(relating to Delegation of Prescribing and Ordering Drugs and Devices;
Prescriptive Authority Agreements Generally; Prescriptive Authority
Agreements: Minimum Requirements; Delegation of Prescriptive Authority
at a Facility-Based Practice Site; Registration of Delegation and
Prescriptive Authority Agreements; Prescription Forms; Prescriptive
Authority Agreement Inspections; Delegation to Certified Registered
Nurse Anesthetists; and Delegation Related to Obstetrical Services).
When care is delivered under other circumstances, standing delegation
orders may include authority to undertake the following as listed
in paragraphs (1) - (8) of this section:
(1) the taking of personal and medical history;
(2) the performance of appropriate physical examination
and the recording of physical findings;
(3) the ordering of tests appropriate to the services
provided under such orders, such as tuberculin tests, skin tests,
VD tests, VDRL tests, gram stains, pap smears, and serological tests;
(4) the administration or providing of drugs ordered
by direct personal or voice communication by the authorizing physician
who shall assume responsibility for the patient's welfare, providing
such administration or provision of drugs shall be in compliance with
other state or federal laws and providing further that pre-signed
prescriptions shall be utilized by the authorizing physician only
under the following conditions shown in subparagraphs (A) - (D) of
this paragraph.
(A) The prescription shall be prepared in full compliance
with the Texas Health and Safety Code, §483.001(13) except for
the inclusion of the name of the patient and the date of issuance.
(B) The prescription shall be for one of the following
classes or types of drugs:
(i) oral contraceptives;
(ii) diaphragms and contraceptive creams and jellies;
(iii) topical anti-infectives for vaginal use;
(iv) oral anti-parasitic drugs for treatment of pinworms;
(v) topical anti-parasitic drugs; or
(vi) antibiotic drugs for treatment of venereal disease.
(C) The prescriptions may not be issued for any controlled
substance.
(D) The providing of the drugs shall be in compliance
with the Texas Pharmacy Act and rules adopted by the Texas State Board
of Pharmacy.
(5) the administration of immunization vaccines providing
the recipient is free of any condition for which the immunization
is contraindicated;
(6) the providing of information regarding hygiene
and the administration or providing of medications for health problems
resulting from a lack of hygiene, including the institution of treatment
for conditions such as scabies, ringworm, pinworm, head lice, diaper
rash and other minor skin disorders, provided the administration or
providing of drugs adheres to paragraph (4) of this section;
(7) the provision of services and the administration
of therapy by public health departments as officially prescribed by
the Department of State Health Services for the prevention or treatment
of specific communicable diseases or health conditions for which the
Department of State Health Services is responsible for control under
state law;
(8) the issuance of a nonprescription drug for the
symptomatic relief of minor illnesses provided that such medications
are packaged and labeled in compliance with state and federal laws
and regulations.
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