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My nurse practice act in Georgia is vague with regard to supervision/collaboration issues. There is no state where the law requires physicians to sign every one of a nurse practitioner's (NP's) charts. In Tennessee, a physician must sign 20% of an NP's charts every 30 days. In Arkansas, there is a requirement for physician cosignature of NP orders. Practice protocols or facility requirements must specify when NP's orders must be cosigned.
When a proposed treatment or procedure requires signature consent (e.g., anesthesia, surgery, blood product transfusion), the patientâs and practitionerâs signature on a VA-authorized. consent form must be witnessed by a third party.1 Current VHA policy on informed consent, however, does not specify who can appropriately serve as a witness, prompting some facilities.