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The Iowa Board of Nursing: the NPI conducts its field of activity on the basis of its education and the standards and policies established by its national certification body (for example). B american Nurses Credentialing Center, American Academy of Nurse Practers). In Iowa, an NPE can practice independently. However, an NPE may have a co-operation agreement with a doctor or doctor if their practice warrants it, but this agreement is not a requirement of the Iowa Board of Nursing. Vermont Board of Nursing: Graduates under 24 months and 2,400 hours of active practice of licensed advanced care in an initial role and demographic orientation less than 12 months and 1,600 hours for each additional role and demographic orientation must have a formal agreement with a cooperating provider, as required by the board rule. As part of the practical guidelines, APRNs must have signed and dated copies of all necessary cooperation agreements and keep them. An APRN that meets the conditions for solo practice informs the board that these requirements have been met. According to the CMHA, states that have not signed cooperation agreements facilitate better effective relationships between health care professionals, allowing nurses and doctors to work together, while providing quality care within their respective fields of practice. Delaware Board of Nursing: All new APRN graduates and nurses who wish to acquire an independent practice must practice for 2 years and at least 4000 hours full-time as part of a cooperation agreement. Standards for the practice of midwifery clearly establish that midwifery care is based on written practice guidelines, which include advice, cooperation and referral, but do not require cooperative agreements signed with physicians. Nebraska Health and Human Services: CNMs have the right to provide the mother and newborn with delegated medical procedures, including treatment management during pregnancy, labour, childbirth and the postnatal phase, in accordance with the provisions of a written practice agreement with a cooperating licensed practitioner.