Bill Text: NY A06030 | 2023-2024 | General Assembly | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft

---

Bill Title: Authorizes physicians to prescribe non-patient specific orders that a registered professional nurse may perform including electrocardiogram tests to detect signs and symptoms of acute coronary syndrome, administering point-of-care blood glucose tests to evaluate acute mental status changes in persons with suspected hypoglycemia, administering tests and intravenous lines to persons that meet severe sepsis and sepsis shock criteria, and pregnancy tests.

Spectrum: Partisan Bill (Democrat 3-0)

Status: (Passed) 2023-07-19 - signed chap.193 [A06030 Detail]

Download: New_York-2023-A06030-Introduced.html

---

                STATE OF NEW YORK
        ________________________________________________________________________

                                          6030

                               2023-2024 Regular Sessions

                   IN ASSEMBLY

                                     March 30, 2023
                                       ___________

        Introduced by M. of A. PAULIN -- read once and referred to the Committee
          on Health

        AN ACT to amend the public health law and the education law, in relation
          to standing orders in hospitals

          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:

     1    Section 1. The public health law is amended by adding  a  new  section
     2  2803-v-1 to read as follows:
     3    § 2803-v-1. Standing orders in a hospital. 1. A hospital may establish
     4  standing  orders  for  the  care  of patients in the hospital, which may
     5  authorize an attending nurse to provide services and care to a  patient.
     6  Notwithstanding  this  section,  section twenty-eight hundred three-v of
     7  this article shall apply in the case of standing orders for the care  of
     8  newborns in the hospital.
     9    2. As used in this section, unless the context clearly requires other-
    10  wise:
    11    (a)  "Hospital"  means  a  hospital  that  routinely  provides care to
    12  patients that is the subject of the standing order.
    13    (b) "Attending practitioner" means the physician, nurse  practitioner,
    14  physician  assistant  or  midwife  or  other  health  care  professional
    15  licensed, certified or otherwise  authorized  to  practice  under  title
    16  eight  of  the  education law, acting within his or her lawful scope and
    17  terms of practice, attending a patient in a hospital.
    18    (c) "Attending nurse" means a registered nurse attending to a patient,
    19  acting within his or her lawful scope of practice.
    20    (d) "Standing order" means a non-patient specific order for  the  care
    21  of a patient in the hospital, established under this section.
    22    3. A standing order may be implemented in the case of any patient when
    23  (a)  directed  by the attending practitioner, or (b) in the absence of a
    24  specific direction by the attending practitioner,  the  attending  nurse
    25  determines,  in  his or her professional judgment, that implementing the

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD10534-01-3
        A. 6030                             2

     1  standing order for the patient is clinically appropriate and  consistent
     2  with  the  standing  order, the hospital's policies and applicable regu-
     3  lations. The standing order shall not be implemented in a specific situ-
     4  ation  where  the hospital's policies, the standing order, or applicable
     5  regulations provide otherwise.
     6    4. (a) A standing order shall provide for the circumstances  in  which
     7  the  condition  or  change in condition of the patient, or other circum-
     8  stances relating to providing services and care to the patient,  require
     9  departure from the terms of the standing order.
    10    (b)  Where  an  attending  nurse implementing a standing order becomes
    11  aware of circumstances  that,  in  his  or  her  professional  judgment,
    12  reasonably  indicate  a  need  to  depart from the terms of the standing
    13  order, he or she shall so advise the  attending  practitioner.  In  such
    14  circumstances,  if the attending nurse determines, in his or her profes-
    15  sional judgment, that the health of the patient requires departing  from
    16  the standing order prior to receiving direction from the attending prac-
    17  titioner,  the  attending  nurse  may  do so, consistent with his or her
    18  lawful scope of practice, the hospital's policies and  applicable  regu-
    19  lations.
    20    (c)  The standing order shall provide, including the times and manner,
    21  that an attending practitioner shall review and acknowledge  in  writing
    22  the  services  and care provided to the patient under the standing order
    23  and the condition of the patient.
    24    5. (a) A standing order may provide  for  circumstances  in  which  it
    25  shall not be implemented, or implemented only at the order of an attend-
    26  ing practitioner.
    27    (b) A standing order shall be dated, timed, and authenticated promptly
    28  in  the patient's medical record by the attending practitioner acting in
    29  accordance with law, including scope-of-practice  laws,  hospital  poli-
    30  cies, and medical staff bylaws, rules and regulations.
    31    6. A standing order may be implemented only if the implementing hospi-
    32  tal:
    33    (a)  establishes  that the order has been reviewed and approved by the
    34  hospital's medical staff and nursing and pharmacy leadership, and signed
    35  by a physician affiliated with the hospital;
    36    (b) demonstrates that the order is consistent with  nationally  recog-
    37  nized evidence-based guidelines; and
    38    (c)  ensures  that  the  periodic  and  regular review of the order is
    39  conducted by the hospital's medical staff and nursing and pharmacy lead-
    40  ership to determine the continuing usefulness and safety of the order.
    41    7. A standing order is a medical regimen; it shall be consistent  with
    42  the lawful scope of practice of a registered nurse.
    43    8.  The  commissioner may make regulations governing the terms, proce-
    44  dures and implementation of standing orders.
    45    § 2. Subdivision 9 of section 6909 of the education law, as  added  by
    46  chapter 366 of the laws of 2018, is  amended to read as follows:
    47    9.  A  registered  professional nurse may execute (a) a standing order
    48  for newborn care in a hospital established  under  section  twenty-eight
    49  hundred  three-v  of the public health law, as provided in that section,
    50  and (b) a standing order established under section twenty-eight  hundred
    51  three-v-1  of  the  public health law, as provided in that section.  The
    52  commissioner may make regulations relating  to  implementation  of  this
    53  subdivision.
    54    § 3. This act shall take effect immediately.