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Alaska State Board of Nursing ANP Advisory Opinions Explanatory Statement about Advisory Opinions An advisory opinion adopted by the Alaska Board of Nursing is an interpretation of what the law requires. While an advisory opinion is not law, it is more than a recommendation. In other words, an advisory opinion is an official opinion the Alaska Board of Nursing regarding the practice of nursing as it relates to the health and safety of the Alaska healthcare consumer. Facility policies may restrict practice further in their setting and/or require additional expectations related to competency, validation, training and supervision to assure safety of their patient. Topic Opinion Interested Party Date ACLS Administering ACLS The Board's position that an FNP can administer drugs Teresa Frazier, FNP October-12 Drugs in Remote Locations that are part of the Advanced Cardiac Life Support (ACLS) current protocols if the FNP is currently certified in ACLS. The same would hold true for Pediatric Advanced Life Support (PALS) or Advanced Trauma Life Support (ATLS) medications. Advanced Nurse Practitioner/CRNA temporary license Alaska Neonatology Associates The Board s interpretation of current license is temporary or permanent Alaska nursing license. The Board of Nursing for the State of Alaska approves the expanded scope of practice to perform infant circumcision to Alaska Neonatology Associates, Neonatal Nurse Practitioners, upon completion of the approved expanded scope of practice information submitted to the BON in April 2013. Kristin Birdsong and Carol Greene Neonatal Nurse Practitioners June-02 April-13

APRN Consensus Model The Board determined that a nurse who would like to practice under the APRN designation would need to meet the educational requirements outlined in the Consensus Model when implemented. American Holistic Nurses Credentialing Corporation October-13 Botox--- prescription and use of Botox and dermal fillers The Board interprets AS 08.68.410 and 12 AAC 12.44.440 to allow this prescriptive authority for ANPs Adele M.K. Gilpin, JD, PhD April-09 Colonoscopy administration at ANMC CRNAs with specified fluoroscopic training The Board approved the request by Lisa An, ANP to perform colonoscopies at ANMC based on her proposal and the mentoring of Claudia Christiansen, ANP who was previously approved by the Board. The Board of Nursing for the State of Alaska has determined that CRNAs with specified fluoroscopic training and a minimum of 10 hour of instruction in the safe operation of the fluoroscope may operate medical fluoroscopic equipment under authority AS 18.60.475, AS 18.60.485 and 7 AAC 18.420(c). Lisa An, ANP April-15 April-11 Delegation decision tree the board adopted the Ohio and National Council of State Boards of Nursing decision trees to aide NPs in judgments December-07

Expansion of list of injectables South central ANPs can delegate to CMAs The Board of Nursing for the State of Alaska having South central Foundation reviewed the South central Foundation list of additional medications approved that the ANP can delegate to CMAs the injectables for administration in the outpatient clinical setting to include: LA Bicillin, Rocephin, Kenalog, Rhogam, Imitrex, Clindamycin, Reglan. Beginning January 2013 South central Foundation will annually submit a medication administration report for adverse events of injectables medications delegated by an ANP. July-12 Expedited Partner Therapy The Board prepared an advisory opinion stating that it is within the scope of practice for ANPs with prescriptive authority to use Expedited Partner Therapy (EPT) in accordance with 12 AAC 44.440 and 44.447. EPT is the practice of treating sexual partners of individuals who have been clinically diagnosed with Chlamydia or Gonorrhea by writing prescriptions for patients to give their partners or by directly giving patients the medications for themselves and their partners along with the proper patient education materials. While EPT is not intended to be the first or best choice of treatment of partners with Chlamydia or Gonorrhea, the Board supports the practice of EPT by ANPs as an optional form of sexually transmitted infection (STI) case management to address the statewide and national increase of Chlamydia and Gonorrhea morbidity. January-12

Eyelash extensions The Board determined that it would not be regulating cosmetic procedures such as these and that RNs who wished to receive cosmetic or aesthetic type certifications should consult with the appropriate governing boards. Lori McAffe, RN April-13 PICC line insertion BON approves the educational program submitted by Ketchikan Medical Center, called RN PICC line insertion with ultrasound guidance, micro introducer, assessment of chest radiographs for PICC line tip placement, with subsequent clearance of the catheter for use by RN Ketchikan Medical Center January-15 Prescribing ---ANP can prescribe & dispense only within SOP based on certification. 12 AAC 44.447(a) states an advanced nurse practitioner or ANP with prescriptive and dispensing authority may dispense a prescription within the ANP s scope of practice only. October-09 Prescribing for self or family The Board finds that 12 AAC 44.770(10) requires a professional relationship, exemplified by a written client encounter which documents problem identified and interventions prescribed. Further, 12 AAC 44.770 (27) specifies that the activity must be within the ANPs scope of practice. information from the Federal DEA, related to controlled substance prescribing supports the above. pharmacist April-09 Scope of practice decision tree the board adopted the Arizona decision tree to aide NPs in making judgments December-07

Uterine Aspiration Board allows Joanne Fortier ANP, to perform uterine Joanne Fortier, Advanced aspirations at the Planned Parenthood Clinic located in Nurse Practitioner Anchorage Alaska following the clinic s policy and procedures. June-06 Uterine re-aspirations Request for ANPs to perform uterine reaspirations to manage early pregnancy loss. On a motion carried unanimously, The Board of Nursing declines the petition filed by Planned Parenthood of the Great Northwest. Planned Parenthood of the Great Northwest Laura Einstein, chief legal counsel October-13 X-RAYS Taking of X-Rays the Board of Nursing for the State of Alaska, has determined it is beyond the scope of practice for an ANP, RN, LPN, or CNA to perform x-rays and radiological procedures involving the use of contrast media, use of fluoroscopic equipment, mammography, tomography, magnetic resonance imaging (MRI), bone densitometry using ionizing radiation, nuclear medicine, radiation therapy, or computed tomography imaging (CT scan). April-10 revised July 2014