246-840-485  <<  246-840-487 >>   246-840-490

WAC 246-840-487

ConsultationExemptions for exigent and special circumstances.

An advanced registered nurse practitioner is not required to consult with a pain management specialist as defined in WAC 246-840-493 when the advanced registered nurse practitioner has documented adherence to all standards of practice as defined in WAC 246-840-460 through 246-840-493, and when any one or more of the following conditions apply:
(1) The patient is following a tapering schedule;
(2) The patient requires treatment for acute pain, which may or may not include hospitalization, requiring a temporary escalation in opioid dosage with expected return to their baseline dosage level or below;
(3) The advanced registered nurse practitioner documents reasonable attempts to obtain a consultation with a pain management specialist and the circumstances justifying prescribing above one hundred twenty milligrams morphine equivalency dosage (MED) per day without first obtaining a consultation; or
(4) The advanced registered nurse practitioner documents the patient's pain and function is stable, and the patient is on a nonescalating dosage of opioids.
[Statutory Authority: RCW 18.79.800 and 2017 c 297. WSR 18-20-086, § 246-840-487, filed 10/1/18, effective 11/1/18. Statutory Authority: RCW 18.79.400. WSR 11-10-064, § 246-840-487, filed 5/2/11, effective 7/1/11.]
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