OCCUPATIONS AND PROFESSIONS
NURSE PRACTICE ACT
In this chapter:
I. "Advanced practice registered nurse" or "APRN" means a registered nurse currently licensed by the board under RSA 326-B:18.
I-a. "Advanced practice registered nurse-patient relationship" means a medical connection between a licensed APRN and a patient that includes an in-person or face-to-face 2-way real-time interactive communication exam, a history, a diagnosis, a treatment plan appropriate for the licensee's medical specialty, and documentation of all prescription drugs including name and dosage. A licensee may prescribe for a patient whom the licensee does not have an APRN-patient relationship under the following circumstances: writing admission orders for a newly hospitalized patient; for a patient of another licensee for whom the prescriber is taking call; for a patient examined by another licensed practitioner; or for medication on a short-term basis for a new patient prior to the patient's first appointment.
II. "Board" means the New Hampshire board of nursing established in RSA 326-B:3.
III. "Continuing competence" means integrated learning by which a licensee gains, maintains, or refines practice knowledge, skills, and abilities. This development may occur through a formal education program, continuing education, and clinical practice, and is expected to continue throughout the practitioners' career.
IV. "Licensed nursing assistant" or "LNA" means an individual who holds a current license to provide client care under the direction of a registered nurse or licensed practical nurse.
V. "Licensed practical nurse" or "LPN" means an individual who holds a current license to practice practical nursing as defined in paragraph IX.
VI. "Medication nursing assistant" means a licensed nursing assistant holding a currently valid certificate authorizing the delegation to the nursing assistant of tasks of medication administration.
VII. "Nursing" means assisting clients or groups of clients to attain or maintain optimal health by implementing a strategy of care to accomplish defined goals and by evaluating responses to nursing care and medical treatment. Nursing includes basic health care that helps both clients and groups of clients cope with difficulties in daily living associated with their actual or potential health or illness status and also those nursing activities that require a substantial amount of scientific knowledge or technical skill.
VII-a. "Nurse" means a person authorized to practice nursing and who holds a current license to provide care as an APRN, RN, or LPN.
VIII. "Nursing-related activities" means client care provided by a licensed nursing assistant directed by an APRN, an RN, or an LPN.
IX. "Practical nursing" means the practice of nursing as defined in paragraph VII by a person who:
(a) Uses sound nursing judgment based on preparation, knowledge, skills, understanding, and past nursing experience.
(b) Works under the direction of a registered nurse, advanced practice registered nurse, dentist, or physician.
(c) Functions as a member of a health care team and contributes to the assessment, planning, implementation, and evaluation of client care.
X. "Registered nurse" or "RN" means an individual who holds a current license to practice registered nursing as defined in paragraph XI.
XI. "Registered nursing" means the application of nursing knowledge, judgment, and skill drawn from broad in-depth education in the biological, psychological, social, and physical sciences in assessing and diagnosing the health status of a client, and in planning, implementing, and evaluating client care which promotes the optimum health, wellness, and independence of the individual, the family, and the community.
XII(a) "Telemedicine" means the use of audio, video, or other electronic media for the purpose of diagnosis, consultation, or treatment.
(b) An out-of-state APRN providing services by means of telemedicine shall be deemed to be in the practice of medicine and shall be required to be licensed under this chapter.
(c) It shall be unlawful for any person to prescribe by means of telemedicine a controlled drug classified in schedule II through IV.
(d)(1) The prescribing of a non-opioid controlled drug classified in schedule II through IV by means of telemedicine shall be limited to prescribers as defined in RSA 329:1-d, I and RSA 326-B:2, XII(a), who are treating a patient with whom the prescriber has an in-person practitioner-patient relationship, for purposes of monitoring or follow-up care, or who are treating patients at a state designated community mental health center pursuant to RSA 135-C or at a Substance Abuse and Mental Health Services Administration (SAMHSA)-certified state opioid treatment program, and shall require an initial in-person exam by a practitioner licensed to prescribe the drug. Subsequent in-person exams shall be by a practitioner licensed to prescribe the drug at intervals appropriate for the patient, medical condition and drug, but not less than annually.
(2) The prescribing of an opioid controlled drug classified in schedule II through IV by means of telemedicine shall be limited to prescribers as defined in RSA 329:1-d, I and RSA 326-B:2, XII(a), who are treating patients at a SAMHSA-certified state opioid treatment program. Such prescription authority shall require an initial in-person exam by a practitioner licensed to prescribe the drug and subsequent in-person exams shall be by a practitioner licensed to prescribe the drug at intervals appropriate for the patient, medical condition, and opioid, but not less than annually.
(e) An APRN providing services by means of telemedicine directly to a patient shall:
(1) Use the same standard of care as used in an in-person encounter;
(2) Maintain a medical record; and
(3) Subject to the patient's consent, forward the medical record to the patient's primary care or treating provider, if appropriate.
(f) Under this section, Medicaid coverage for telehealth services shall comply with the provisions of 42 C.F.R. section 410.78 and RSA 167:4-d.
Source. 2005, 293:1. 2009, 54:4, 5. 2011, 245:1. 2015, 246:7, 8. 2016, 221:4, eff. Aug. 8, 2016. 2020, 27:15, eff. July 21, 2020.