What is the Procedure for NPs Work Review by Physicians in States where Physician's Supervision is Required?

Nurse practitioners are nurses who have completed the NP program and hold an MSN or DNP degree.

NPs are specialized in providing care to a specific population.

In some states, nurse practitioners are allowed to practice independently or have special limitations within their scope of practice and reduced or restricted practice.

In other states, a physician’s supervision is required.

Bear in mind that the difference in the nursing field, between reduced and restricted practice, is the amount of required supervision and scope of practice.

Each state has its Board of Nursing that determines the conditions in which NP is allowed to practice, limitation, and requirements.

You can find more information about the NP scope of practice differences by states on the website of the American Nurse Practitioner Association website.

The oversight requirements vary in restricted states.

For example, healthcare facilities in California need to adopt a set of standardized procedures for NPs.

California’s Board of Registered Nursing describes and determines the guidelines.

The procedures must include a specified scope of required supervision on performing procedures.

For example, it needs to be clear what procedures require immediate and live physician’s supervision.

In other words, the organization must be clear in which situations NP is supervised.

Therefore, NPs practicing in California are under supervision, but the organization determines how NP is supervised.

For example, in some facilities physicians review chars of nurse practitioners and NP documentation.

That way, physicians review whether the patient has proper diagnoses and receives proper treatment.

Some organizations offer written audit tools to ensure that essential elements of healthcare are properly documented.

In other facilities, NP is supervised during the physical exam, to make sure that diagnostic, treatment, and documentation are meeting set standards of care.

Organization and insurance career determine the charts and required audits.

Even though NP supervision is required, standardized procedures that determine the supervision scopes are created by NPs and physicians collaboration.