Practice and Advanced Practice

The Oklahoma Attorney General issued an Official Opinion on Thursday April 23, 2026, related to Pain Management, 2026 OK AG 6. The opinion has the force and effect of law and is binding upon all Oklahoma agencies. Pursuant to the opinion: “CRNAs are not authorized to perform radiofrequency ablation because such procedures (i) fall outside the scope of practice authorized by the Nursing Act, and (ii) are not otherwise permitted by the Pain Management Act.”

In addition, recent legislative changes to the Oklahoma Interventional Pain Management Act (HB 4336) clarify that failure to comply with the provisions of that Act by CRNAs shall be considered unprofessional conduct under the Oklahoma Nursing Practice Act. The changes also stipulate that any violation of that Act may be subject to the full range of penalties available under the Nursing Practice Act including but not limited to administrative fines or discipline up to revocation of a license.

Elective IV hydration therapy and cosmetic/aesthetic dermatological treatments continue to rise in popularity and availability in Oklahoma. The Oklahoma Board of Nursing recognizes the need for more detailed guidance for Oklahoma nurses in these practice areas to ensure the protection of the public. Key areas of concern include ensuring nurses understand and follow their personal and legal scope of practice and the proper establishment of the patient-provider relationship.

To address these concerns, the Oklahoma Board of Nursing approved two new guidelines at the March 2026 Board meeting: IV Hydration Guidelines and Cosmetic/Aesthetic Dermatological Procedures Guidelines. These guidelines were developed using evidenced-based practice (EBP) and national best practices for regulation in these practice areas. Oklahoma nurses who practice in these areas should review the guidelines thoroughly to ensure compliance with existing regulatory requirements.

IMPORTANT UPDATE REGARDING COMPOUNDING
The Board of Nursing is actively engaged in collaborative discussion with the Board of Pharmacy to update and clarify the terminology used in IV Hydration Guidelines and Cosmetic/Aesthetic Dermatological Procedures Guidelines including references to compounding by nurses. As we work to finalize updated guidance language, please note that all such guidance is intended to clarify existing laws, not change them. The scope of practice for an RN or LPN is neither narrowed nor expanded by these guidelines, and depends upon the experience, training, and education of the provider in accordance with currently accepted patient care standards, national nursing standards, and evidence-based nursing literature and research. Please monitor our website for additional information or clarification regarding these guidelines.

With the passage of HB 2298, effective Saturday, November 1, 2025, eligible Advanced Practice Registered Nurses meeting the requirements enumerated in the bill are eligible to apply for independent prescriptive authority recognition.

With the approval of emergency rules by the governor, with an effective date of November 1, 2025, OBN began accepting applications at 8:00 a.m. on Monday, November 3, 2025. For questions regarding the application process, please see the Frequently Asked Questions (FAQs) at the button below. A link to the application instructions can be accessed from the FAQs and also in the section on this webpage under Prescriptive Authority (APRN-CNP, APRN-CNS, APRN-CNM).

If you currently have prescriptive authority recognition, you must maintain a supervising physician until you have applied for and been granted independent prescriptive authority.

In addition, All APRNs are encouraged to review the requirements imposed by HB 2298 and the resulting amendments to the Nursing Practice Act, 59 O.S. § 567.1, et seq., to ensure their continued compliance with the legal requirements of the Act. New requirements created by HB 2298 include those governing independent prescriptive authority and malpractice insurance, among others. If you have questions about the legal requirements imposed by HB 2298, please consult with legal counsel and your employer to ensure your continued compliance.

In 1976, recognition of the Certified Registered Nurse Anesthetist was incorporated into the Oklahoma Nursing Practice Act. In 1980, recognition of the Certified Nurse Practitioner and Certified Nurse Midwife were added. Clinical Nurse Specialists were added to the Oklahoma Nursing Practice Act in 1994.

• National Certifying Bodies and APRN Certification Examinations Approved and No Longer Approved for Initial Licensure by the Oklahoma Board of Nursing

• Advanced Practice Registered Nurse Licensure Initial

• Advanced Practice Registered Nurse Licensure by Endorsement

• Advanced Practice Registered Nurse Licensure - Reinstatement Application Instructions
• Written Verification of APRN Licensure - Request Form

• Exclusionary Formulary
• New Initial Supervised Prescriptive Authority for the APRN-CNP, APRN-CNM, APRN-CNS: Instructions
• New Initial Independent Prescriptive Authority for the APRN-CNP, APRN-CNM, APRN-CNS: Instructions
• Reinstatement of Supervised Prescriptive Authority Recognition No Longer Active for the APRN-CNP, APRN-CNS, and APRN-CNM
• Agreement for Physician Supervising Advanced Practice Prescriptive Authority
• ALERT! Due Within 30 Days - Change in Supervising Physician(s) for Advanced Practice Prescriptive Authority: Application Instructions
• Formulary Advisory Council Procedure for Amending the Formulary
• Prescriptive Authority Continuing Education Tracking Form
• Request Form for Review of Pharmacology Contact Hours

• CRNA Inclusionary Formulary
• Prescriptive Authority APRN-CRNA (Authority to Select, Order, Obtain and Administer Drugs): Application Instructions
• Reinstatement of Prescriptive Authority APRN-CRNA (Authority to Select, Order, Obtain and Administer Drugs): Application Instructions
• Prescriptive Authority Continuing Education Tracking Form
• Request for Review of Pharmacology Contact Hours