<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".03" citation="COMAR 10.27.07.03" title_num="10" subtitle_num="27" chapter_num="07" heading="Nurse Practitioner — Scope and Standards of Practice.">
  <paragraph num="A.">
    <text>A nurse practitioner may independently perform the following functions:</text>
    <paragraph num="(1)">
      <text>A comprehensive physical assessment of patients;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>In accordance with Family Law Article, §2-301, Annotated Code of Maryland, certify to the clerk of the court that a:</text>
      <paragraph num="(a)">
        <text>16 or 17 year old individual, who wants to get married without parental consent, has been examined and found to be pregnant or has given birth to a child; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>15 year old individual, who has parental consent to be married, has been examined and found to be pregnant or has given birth to a child;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>In accordance with Transportation Article, §13-704, Annotated Code of Maryland, certify to the Department of Transportation that an individual needs special consideration for certain health reasons;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>In accordance with Health-General Article, §4-208, Annotated Code of Maryland, complete the date of birth and medical information required on a birth certificate;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>In accordance with Health-General Article, §4-212, Annotated Code of Maryland, complete a death certificate if:</text>
      <paragraph num="(a)">
        <text>The medical examiner does not take charge of the body; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The deceased was under the care of the nurse practitioner;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(6)">
      <text>Establish medical diagnosis for common short-term and chronic stable health problems;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>In accordance with Health-General Article, §4-212, Annotated Code of Maryland, file a replacement death certificate;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>In accordance with Health-General Article, §5-601, Annotated Code of Maryland, issue a do not resuscitate order on a Maryland Emergency Medical Services form.</text>
    </paragraph>
    <paragraph num="(9)">
      <text>Order, perform, and interpret laboratory and diagnostic tests;</text>
    </paragraph>
    <paragraph num="(10)">
      <text>Order and perform diagnostic, therapeutic, and corrective measures;</text>
    </paragraph>
    <paragraph num="(11)">
      <text>Prescribe drugs;</text>
    </paragraph>
    <paragraph num="(12)">
      <text>Provide emergency care;</text>
    </paragraph>
    <paragraph num="(13)">
      <text>Refer patients to appropriate licensed physicians or other health care providers as needed;</text>
    </paragraph>
    <paragraph num="(14)">
      <text>In accordance with COMAR 20.31.03.01, certify that the utility client has a serious illness or the need for life-support equipment; and</text>
    </paragraph>
    <paragraph num="(15)">
      <text>In accordance with Health-General Article, §5-602, Annotated Code of Maryland, witness an advance directive.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>A psychiatric nurse practitioner together with a physician is authorized to sign applications:</text>
    <paragraph num="(1)">
      <text>In accordance with Health-General Article, §10-615, Annotated Code of Maryland, to admit a minor to a facility for treatment of a mental disorder; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>In accordance with Health-General Article, §10-616, Annotated Code of Maryland, to admit an individual on an involuntary basis to a facility for treatment of a mental disorder.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>A nurse practitioner may practice only in the area of specialization in which certified.</text>
  </paragraph>
  <paragraph num="D.">
    <text>Nothing in this chapter limits or prohibits a registered nurse from performing those functions which constitute the practice of registered nursing as defined by law.</text>
  </paragraph>
  <paragraph num="E.">
    <text>A nurse practitioner has a right and obligation to refuse to perform any delegated act, oral or written, if in the nurse practitioner's judgment it is unsafe or an invalidly prescribed medical act.</text>
  </paragraph>
  <paragraph num="F.">
    <text>An individual certified under this chapter shall be subject to disciplinary sanctions set forth in Health Occupations Article, §8-316, Annotated Code of Maryland.</text>
  </paragraph>
  <paragraph num="G.">
    <text>A nurse practitioner shall maintain medical records in accordance with Health-General Article, Title 4, Subtitle 4, Annotated Code of Maryland.</text>
  </paragraph>
</regulation>