I recently received a nurse practitioner scope of practice question from a surgical center practice manager. She wanted to know if nurse practitioners and physician assistants can perform endoscopy and colonoscopy. Is this in your scope of practice as an NP or PA?

While endoscopy and colonoscopy aren’t widely provided by NPs and PAs, there are some non-physician providers trained to perform these procedures. And, among those who are offering these services, it’s going quite well. Studies show that nurse practitioners and physician assistants have similar outcomes to physicians with upper and lower endoscopy. As demand for these GI procedures increases, it’s natural that practices are looking to NPs and PAs to help out in this area.

Scope of practice for nurse practitioners and physician assistants varies by state. You must check the specific guidelines for your location before performing procedures like endoscopy or colonoscopy. In general, however, there are some points to consider before providing these services. 

First, check your medical malpractice policy and that of your employer or facility where you practice. Not only do scope of practice laws specify the types of tasks that providers may delegate, oversee and perform, some malpractice carriers do as well. Liability insurance plans may require that certain procedures be performed only by providers who hold certain credentials. If you’re planning to do GI scopes as a nurse practitioner, make sure you’re covered. 

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Second, check your state’s scope of practice guidelines. Most states will not name procedures specifically so it can be difficult to get a straight answer about what’s allowed. Rather, state regulations will typically say something along the lines of “APRNs may order and perform diagnostic tests”. To make sure you’re within your scope of practice, you must update your collaborative practice agreement (if required in your state) to include these procedures. The updated collaborative practice agreement will need to be approved by the Board of Nursing. You may also need to submit evidence of your competency to perform such procedures. As with any procedure, you will need to be adequately trained and supervised per scope of practice regulations. 

Finally, since nurse practitioners and physician assistants are not widely performing endoscopy, colonoscopy and EGD, you may want to call your state Board of Nursing to get their opinion about how this fits into your scope of practice before moving forward. Getting the board’s approval in writing is also helpful in case your scope of practice is questioned later

Overall, performing endoscopy, colonoscopy and EGD may be within your scope of practice as a nurse practitioner or physician assistant. Before adding these services to your practice, however, you must make sure they comply with your state’s guidelines and are covered by your liability policy. 

Do you perform colonoscopy, endoscopy or EGD in your practice?

 

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