It may be within the scope of practice of the competent and appropriately trained registered nurse to prepare allergenic extracts as compounded sterile preparations under the direction of an authorized health care practitioner. A prescription or order from an authorized health care practitioner is required. The registered nurse must follow the WAC 246-878 Compounding Practices and the United States Pharmacopeia (USP) compounding guidelines. The registered nurse should use the Scope of Practice Decision Tree to determine if performing compounding medications and preparing allergenic extracts is within the registered nurse’s regulatory and individual scope of practice. See the Compounding Medications by Licensed Practical Nurses, Registered Nurses, and Advanced Registered Nurse Practitioners Advisory Opinion for more information.