Orthopaedic Specialty Protocol Revised
Effective May 21, 2021, the Alabama Board of Nursing (ABN) and the Alabama Board of Medical Examiners have revised the Orthopaedic Specialty Protocol to include the following changes in the competency validation process for joint injections:
  • Eliminate the aggregate supervised practice requirement (25 total injections).
  • Raise the per-joint supervised practice requirement from 3 procedures per joint to 10 per joint.
  • Require 5 procedures per joint, per year for annual competency validation.
  • Require 10 procedures per joint for future additional joint requests.
  • Grandfather CRNPs currently working under the protocol but require 10 procedures per joint to add joints (5 per year for annual competency validation).
This represents major progress for Alabama CRNPs, who previously were required to document 25 new procedures for initial competency AND 25 procedures any time a new injection site was requested. From this point forward, each injection site will require 10 documented procedures, whether the nurse is newly requesting the protocol or simply adding sites to an existing collaboration. Likewise, annual competency maintenance will require 5 documented procedures per site, regardless of whether the nurse is adding sites or maintaining existing skills. Please note: documentation of annual competency validation must be maintained at each practice site, but you are not required to submit the documentation, unless the ABN requests it.
 Please feel free do direct any questions or comments to advancedpractice@abn.alabama.gov.
Click here to download the revised protocol.
There is power in numbers! As the only statewide organization for all NPs in Alabama, NPAA continues to advocate for the reduction of barriers to NP practice. We need the help of every NP in the State to speak in one voice.