SECTION 221.14. Nurse-Midwives Providing Controlled Substances

(a) In this section "provide" means to supply, for a term not to exceed 48 hours, one or more unit doses of a controlled substance for the immediate needs of a patient;

(b) An advanced practice registered nurse recognized by the Board as a nurse-midwife may provide one or more unit doses of a controlled substance during intra-partum or immediate post-partum care subject to the following conditions:

(1) Physician delegation of authority to provide controlled substances must be made through a physician's order, medical order, standing delegation order, prescriptive authority agreement, or protocol that requires adequate and documented availability for access to medical care. Delegation may not include the use of a prescription sticker or the use or issuance of an official prescription form or the authority to issue an electronic prescription under §481.075, Health and Safety Code;

(2) The physician's orders, medical orders, standing delegation orders, prescriptive authority agreements, or protocols must require the reporting of or monitoring of each patient's progress, including complications of pregnancy and delivery and the administration and provision of controlled substances by the nurse-midwife to the patient;

(3) Delegation is limited to seven nurse-midwives or physician assistants or their full-time equivalents and the designated facility at which the nurse-midwife or physician assistant provides care; and

(4) The controlled substance must be supplied in a suitable container that is labeled in compliance with the applicable drug laws and must include:

(A) the patient's name and address;

(B) the drug to be provided;

(C) the name, address, and telephone number of the physician;

(D) the name, address, and telephone number of the nurse-midwife; and

(E) the date.

Source Note: The provisions of this §221.14 adopted to be effective February 25, 2001, 26 TexReg 1509; amended to be effective August 24, 2021, 46 TexReg 5187