Nurse Practitioner Scope of Practice: Kentucky

With the derby right around the corner, is only seems right to feature Kentucky for this week’s scope of practice review. Kentucky is rich in culture. From bourbon and bluegrass to fried chicken and Churchill Downs, the state makes an attractive destination both for visitors and residents. But, do laws regulating nurse practitioners in Kentucky keep up with these positive vibes?

Kentucky’s Nurse Practitioner Supervision Laws

Technically speaking, nurse practitioners in Kentucky are allowed to practice independently, free from physician oversight. As long as the nurse practitioner holds the appropriate national and state certification and licensure, he/she may engage in medical practice consistent with the standards of advanced practice nursing.

While this legal standing seems it would give NPs freedom in their practice, prescribing regulations place significant limitations on NPs ability to practice in the Bluegrass State.

Kentucky’s Nurse Practitioner Prescribing Laws

Nurse practitioners must have two separate collaborative practice agreements with a physician in order to prescribe medication to the full extent allowed by Kentucky law. One collaborative practice agreement permits the NP to prescribe non scheduled drugs and the other gives the nurse practitioners the ability to prescribe controlled substances. These collaborative practice agreements are referred to as CAPA-NS documents by the Kentucky Board of Nursing. In order to prescribe controlled substances, the NP must also be certified and licensed as an advanced practice nurse for at least one year.

Collaborative practice prescribing regulations also extend to the dispensing, including accepting and distributing of, medication samples. A nurse practitioner practicing without a collaborative practice agreement may not accept drug samples from a pharmaceutical representative, and, may not give medication samples to patients.

All nurse practitioners practicing in Kentucky are required to earn five hours of continuing education credit in pharmacology in order to renew their state license. This applies to NPs with and without a collaborative practice agreement allowing them to prescribe medications.

Last year, Kentucky Senate Bill 43 proposed the rescinding the collaborative practice requirement giving nurse practitioners ultimate freedom in their practice. The bill, however did not pass.

Other Scope of Practice Laws in Kentucky

Nurse practitioners practicing in Kentucky are officially recognized by state law as primary care providers. They are permitted to sign workers’ comp claims as well as sign handicap parking permits. Nurse practitioners in Kentucky are not allowed to sign death certificates.

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