§ 18.21. Definitions.

 The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise:

   Boards—The State Board of Nursing of the Commonwealth and the Board.

   Certified Registered Nurse Practitioner (C.R.N.P.)—A registered nurse licensed in this Commonwealth who is certified by the Boards in a particular clinical specialty area and who, while functioning in the expanded role as a professional nurse, performs acts of medical diagnosis or prescription of medical therapeutic or corrective measures in collaboration with and under the direction of a physician licensed to practice medicine in this Commonwealth. Nothing in this subchapter limits or prohibits a nurse from engaging in activities which normally constitute the practice of nursing as defined in section 2 of The Professional Nursing Law (63 P. S. §  212).

   Direction—The incorporation of physician supervision to the certified registered nurse practitioner’s performance of medical acts in the following ways:

     (i)   Immediate availability of a licensed physician through direct communications or by radio, telephone or telecommunications.

     (ii)   A predetermined plan for emergency services which has been jointly developed by the supervising physician and the certified registered nurse practitioner.

     (iii)   A physician available on a regularly scheduled basis for:

       (A)   Referrals.

       (B)   Review of the standards of medical practice incorporating consultation and chart review.

       (C)   Establishing and updating standing orders and drug and other medical protocols within the practice setting.

       (D)   Periodic up-dating in medical diagnosis and therapeutics.

       (E)   Co-signing records when necessary to document accountability by both parties.