Home >  Articulated Plan Sample Template Instructions The Nurse-Physician Advisory Taskforce for Colorado Healthcare (NPATCH) has created a template

Articulated Plan Sample Template Instructions The Nurse-Physician Advisory Taskforce for Colorado Healthcare (NPATCH) has created a template

Articulated Plan Sample Template


The Nurse-Physician Advisory Taskforce for Colorado Healthcare (NPATCH) has created a template to help Advance Practice Nurses create an articulated plan for safe prescribing.

C.R.S. ��12-38-111.6(4.5)(b)(II)(A-D) states ��(a)n Articulated plan��shall include at least the following:

  • A mechanism for consultation and referral for issues regarding prescriptive  
  • A quality assurance plan;
  • Decision support tools; and,
  • Documentation of ongoing continuing education in pharmacology and safe prescribing.��

The four parts of the Plan should be customized by the APN to fit the setting, population focus, certification, and other unique attributes of his or her practice.

The Board of Nursing has created rules for Articulated Plans.  

This template, along with the examples of possible customized language, was created to give you ideas to create the best plan for yourself.  

The examples provided are neither required nor inclusive. Each APN may choose to include some, all, or none of the examples provided. Examples will not be relevant to each APN��s practice.


Use what is useful, ignore what is not.  

The Children��s Hospital Template 

The Children��s Hospital has created the attached template specifically for use by APN��s at TCH. The four required sections each have two components: The first includes generic examples of tools and opportunities available at TCH to support safe prescribing and second, an area to allow each APN or department to customize to their areas. 

Next Steps: 

  • Complete your customized articulated plan and have it signed by a MD partner/mentor. Plans may be customized to an individual or by department.
  • Complete your ��Attestation of Development of an Articulated Plan form�� with appropriate signatures and return to the State Board of Nursing.
  • Submit a copy of your signed articulated plan to the TCH Nursing Credential Review Board.
  • Review and update your personal Articulated Plan annually. The state will conduct random audits which could result is loss of prescriptive authority if the Articulated Plan is not current.
  • Deadline for APN��s with current Prescriptive Authority to complete the above is 7/1/11. It is recommended that you complete this process as soon as your Articulated Plan is complete.

Articulated Plan  

The Children��s Hospital 

Advanced Practice Nurse ______________________________________________  

TCH Department ____________________________________________________ 

License Number RXN Number __________________________________________  

DEA Number (if applicable) ____________________________________________


Certification ________________________________________________________



Consultation and Referral Plan 

As we practice in an academic medical center this setting affords us many resources for consultation and collaboration with physicians, APN��s and other health care providers in all Pediatric sub-specialties, as well as other resources for information/guidance regarding safe prescribing.

These resources include but are not limited to:

  1. Practice within an academic medical center that is devoted to ongoing education and training of health care providers in a context of life-long learning.
  2. On-site pharmacists (adult and pediatric) 24 hours per day.  Prescribing providers also have access to health care professionals working in pharmacy clinical trials and Pharm. D. health professionals.
  3. Pediatrics sub-specialists who are able to provide guidance/protocols for prescribing and patient care.
  4. Lexi-Comp – an internet-based platform delivering time sensitive drug information on an easy-to-use interface.  This program works well for multi-user groups in a networked system and is linked to our electronic medication record (EPIC).  The system provides information regarding method of action, dosing, adverse effects, contraindications, interactions, compatibility, toxicology and patient education.
  5. Hospital Formulary which is linked to our electronic medical record. The hospital formulary is a compilation of pharmaceuticals and other information that reflects the current clinical judgment of a hospital's medical staff.  The hospital formulary is governed by the Pharmacy and Therapeutics Committee. 
  6. Medical Libraries.  There is a medical library on-site and in close proximity to the outpatient clinic.  Prescribing providers also have access to the University of Colorado on-campus medical libraries.
  7. Reference Materials.  Most all clinical areas stock reference books which include pharmacological text books/references.  University of Colorado Medical Bookstore on campus.  Personal annual budget for purchase of updated pharmacy handbooks/references.
  8. Certifying Organizations. Certain nurse practitioner certifying organizations require a certain amount of documented pharmacology continuing education.  Self study modules have led to informal nurse practitioner study groups.
  9. Professional Journals offering pharmacy self study modules.
  10. Divisional medication protocols that offer specific guidelines to prescribing.  For example, ��Guide to Anticonvulsant Drug Usage�� within the Division of Neurology.

Department Specific Additions may be added here:

Articulated Plan

Quality Assurance Plan 

Quality Assurance Plan:

  1. Use of standardized practice guidelines specifically for your area of practice, examples as follows, please customize as appropriate for your area of practice:
    1. Asthma Care Guideline
    2. Bronchiolitis Care Guideline
    3. Home Oxygen Care Guideline
    4. Diastat guideline
    5. Hypoglycemia guideline
    6. ______________________________
  1. Participation in educational offerings with specific pediatric pharmacology content, examples as follows, please customize as appropriate: 
    1. PNCB pediatric pharmacology SAE
    2. Conference attendance for specific pediatric and/or disease pharmacology content
    3. TCH sponsored pharmacology continuing education conference/ meeting, etc
  1. Use of order sets approved by the Pharmacy and Therapeutics Committee with standard dosing options 
  1. Pediatric/Adult Pharmacist available 24 hours a day for phone consultation and rounding with sub-specialties 
  1. Sub-specialist consultation available as needed with documentation of same 
  1. Use of computer generated CORE sheets specific to child��s weight  
  1. Department based Quality Initiatives may include: 
    1. Department Specific Quality Initiatives related to medication safety
    2. Peer review/ chart audit
      1. Audited by NP peer or MD
      2. Evaluating:
        1. Current weight on chart
        2. Allergies documented
        3. Appropriate medication choice
        4. Medications prescribed right dose, right strength, right interval, etc.
        5. Documentation of discussion of side effects with family

Articulated Plan

Decision Support Tools 

The following decision support tools for pharmaceutical information are available to all APNs affiliated with The Children��s Hospital either in print or on the TCH intranet website:

ON-LINE and/or PRINT resources:

    EPIC computerized system for order entry

Formulary and Drug Dosing Handbook (Lexi-Comp) –     Pediatric, adult, and Natural Therapeutics



 Patient/Family Education: Medication Handouts



PDR online  



Center for Disease Control immunization guidelines


  Other Services/Resources  
  Drug Information Sites

  Evidence-Based Practice Resources

  Family Health Library

  Government / Statistical Sites

  Health Dictionaries

  Health Images

  Health Sciences Library (UCHSC)

  Nursing Research Sites

  Style Manuals, Writing Guides


  Pediatric Red Book

  Up to Date on-line

  MD Consult on- line

  Library search tools available on-line.

TCH and UCH library: professional journals, textbooks, and resource materials.  Many are available on-line.

 Harriett Lane Handbook

In-Person resources:

In-house pharmacists available 24 hours a day

Specialty services available for formal and informal consultation (i.e. Infectious Disease, Renal, Acute Pain Service)

Physician consultation

In addition, specific resources for my division and subspecialty include:                                             

Articulated Plan

Documentation of Continuing Education in Pharmacology and safe Prescribing 

    Documentation of the RXN��s ongoing continuing education in pharmacology and safe prescribing is required.

     ��Such documentation shall include a personal record of the RXN��s participation in programs with content relevant to the RXN��s prescribing practice. This may include academic courses, programs by entities offering continuing education credit under nationally recognized educational program standards (e.g. ANCC), and educational content on safe prescribing-pharmacology offered by professional healthcare organizations and associations, and programs with relevant content. Certificates of attendance, information on program content, and objectives or copies of presentations may serve as verification documents."

    Additionally, documentation shall include publications and lectures that the RXN has prepared or offered that involves pharmacology.


Key: Type of education with content relevant to RXN��s prescribing practice: 

    1. Professional Association CE Content
    2. Academic Courses
    3. Certification Maintenance Pharmacology offerings
    4. Pharmacology Related education: TCH conferences, (departmental or housewide) and/or external programs
    5. Publications or lectures provided by RXN

    Verification Documentation: 

      1. Certificate of attendance
      2. Information on course content
      3. Copy of presentation
      4. List of objectives


    Type of Education  Date  Organization/Publisher  Verification  


    Articulated Plan 

    Signature Page


    RXN Signature: _____________________________________________________

    Date: _____________________________________________________________ 

    Physician Mentor Name: _____________________________________________

    Date: ___________________ Signature: __________________________________


    RXN Mentor Name (if applicable):

    Date: ___________________ Signature: __________________________________


    RXN Plan Review (at least annually)

    Review on (date) ____________________________________________________

    Review on (date) ____________________________________________________

    Review on (date) ____________________________________________________

    Review on (date) ____________________________________________________

    Review on (date) ____________________________________________________

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