What is a standing order and how does it relate to PA practice?

• A. Standing orders require physician approval for each patient.
• B. Standing orders require physician approval for each patient.
• C. A standing order is an order for all patients to be treated the same regardless of condition.
• D. Standing orders are illegal in PA practice.

Answer: (D)

Standing orders are pre-approved, physician-authored protocols that let a PA initiate specific actions for defined groups of patients without needing a new physician order for every individual. The PA uses the protocol, applies it only when the patient meets the stated criteria, and carries out the allowed intervention—such as administering a vaccine, providing a routine medication, or ordering a screening test—within the defined limits of the protocol. This approach relies on structured pathways and physician oversight, staying within the PA’s scope of practice and the facility’s policies and the applicable state regulations.

Standing orders improve efficiency and consistency of care, especially in busy clinics or urgent care settings, because care can be started quickly for appropriate patients while still maintaining safety through predefined criteria. They require ongoing collaboration with the supervising physician and periodic review and updates to ensure they reflect current guidelines and local practice.

An example is a standing order to administer an influenza vaccine to eligible patients who meet age and contraindication criteria, without a separate physician sign-off for each patient. Another is a protocol for rapid strep testing and antibiotic treatment for patients with compatible symptoms and a positive test, within specified criteria.

They are legal and widely used when properly designed and supervised; if a patient doesn’t meet the protocol’s criteria or has contraindications, a direct physician order should be used.