Section 848IAC5-4-4. Evaluation and risk stratification by advanced practice nurses with prescriptive authority

   (a) The advanced practice nurse with prescriptive authority shall do his or her own evaluation and risk stratification of the patient by doing the following in the initial evaluation of the patient:

(1) Performing an appropriately focused history and physical exam and obtain or order appropriate tests, as indicated.

(2) Making a diligent effort to obtain and review records from previous health care providers to supplement the advanced practice nurse with prescriptive authority's understanding of the patient's chronic pain problem, including past treatments, and documenting this effort.

(3) Asking the patient to complete an objective pain assessment tool to document and better understand the patient's specific pain concerns.

(4) Assessing both the patient's mental health status and risk for substance abuse using available validated screening tools.

(5) After completing the initial evaluation, establishing a working diagnosis and tailoring a treatment plan to meaningful and functional goals, with the patient reviewing them from time to time.

  (b) Where medically appropriate, the advanced practice nurse with prescriptive authority shall utilize nonopioid options instead of or in addition to prescribing opioids. (Indiana State Board of Nursing; 848 IAC 5-4-4; filed Aug 10, 2016, 1:52 p.m.: 20160907-IR-848150380FRA)