Committee refers APRN questions on x‑ray orders and ketamine prescribing to APR panel

The Kansas State Board of Nursing Practice Committee voted to refer two scope‑of‑practice questions about advanced practice registered nurses to the APR committee: whether APRNs with full practice authority can order x‑rays without a collaborative agreement, and whether APRNs may prescribe ketamine in outpatient settings without additional supervision or monitoring.

Committee members described a practice‑call in which KDHE replied that ordering x‑rays could require supervision or a collaborative agreement and said hospital licensing rules create complexity for APRNs operating in ambulatory clinics. The committee approved moving the x‑ray question to the APR committee for review and recommendations.

Separately, members raised safety concerns about outpatient ketamine prescribing for mental‑health indications. "KSA 21‑5701 is ... the criminal code," counsel Charles Meshears said while noting that statute provides definitions around controlled substances and is a reasonable place to start. The committee asked Meshears to examine KSA 21‑5701 and related statutes and to clarify whether ketamine is controlled in the relevant context and who has responsibility for a patient's post‑administration care.

The committee requested APR committee consideration with an initial review to begin by March 2026 and directed counsel to return with findings to guide further committee action. Members emphasized the public‑safety dimension, citing instances where patients required hospital care after outpatient ketamine administration and the need to clarify monitoring and ownership of medical care following administration.