delegation, On the Job, Scope of Practice

Standing Orders and Supervision Requirements

I welcome further questions about my blog posts because addressing those questions allows me to dive deeper into a pertinent topic for medical assistants who wish to better understand their scope of practice.

For instance, in response to my blog post “Standing Orders from an Overseeing Provider,” I received the following question:

Does a standing order change the supervision requirements for medical assistants? For example, if our state law requires the delegating licensed provider to be on the premises when a medical assistant is performing venipuncture, is this supervision requirement changed by a standing order from the provider?

A standing order does not change the supervision requirement established by state law. The supervision requirements apply regardless of whether the licensed provider issues a standing order, verbal order, or written order. If this were not the case, a provider could circumvent supervision requirements by issuing standing orders instead of verbal orders.

The purpose of supervision requirements is patient protection.

2 thoughts on “Standing Orders and Supervision Requirements”

  1. Have the laws changed in the state of Arkansas?? I work at a family practice with a aprn, can I room pts and take their vitals with out having a doctor on site??? Just to do that not taking any orders from aprn

    1. Thank you for your question. As is the case with most state laws, medical assistants are considered unlicensed allied health professionals under the Arkansas nursing law.

      Arkansas nursing law permits nurses (including registered nurses, licensed practical nurses, and advanced practice registered nurses (including nurse practitioners)) to delegate certain tasks to unlicensed professionals such as medical assistants. It is my legal opinion that the Arkansas nursing law permits nurse practitioners to delegate to knowledgeable and competent unlicensed professionals such as medical assistants working under their authority the rooming of patients and the measuring of vital signs. The Arkansas law does not require a physician to be on the premises when a medical assistant is performing these tasks that have been delegated to the medical assistant by a nurse practitioner.

      The AR nursing law does not permit nurses to delegate to unlicensed professionals the administration of medication.

      I hope this is helpful.

      Donald A. Balasa, JD, MBA
      Chief Executive Officer, Legal Counsel
      American Association of Medical Assistants
      Ph: 800/228-2262 | Fax: 312/899-1259 |
      The CMA (AAMA): Health Care’s Most Versatile Professional®

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