Regulation of Nursing Professional Nursing

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Regulation of Nursing Professional Nursing
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The Role of The Professional Nurse

• Direct Care Provider
• Clinical Leader
• Client and Family Advocate
• Researcher
• Educator

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OBJECTIVES

• Define the Roles of the Following Agencies
• The BRN
• The National League of Nursing
• American Association of Colleges of Nursing
• California Nurses Association
• Explain the Differences Between
• Accreditation
• Licensure
• Certification

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• Explain the Differences Between
• Professional Regulation
• Government Regulation
• Understand the Role of the BRN as it Applies to
  Disciplinary Actions
• Understand Your Responsibilities as a Student
  Nurse and Explain Your Professional Liability.
• Understand the Student Code of Conduct for SJSU
• Including Requirements for Progression to
  Semester Four
• The SON Chain of Command
• SON Dress Code

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Professional Regulation of Practice

• Defines Nursing
• Establishes a Code of Ethics
• Establishes Laws and Defines Scope of Practice
• Certifies Advanced Nursing Practice
• In Clinical Specialties i.e. Critical Care,
  Psychiatric Nursing, Obstetrics

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Professional Nursing

• What Defines a Profession?
• BRN
• ANA
• ANA/C
• NLN
• Professional Regulation of Nursing practice
  begins with the Professions Definition of
  Nursing.
• ANA Nursings Social Policy Statement

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• Provision of a caring relationship that
  facilitates health and healing.
• Attention to the range of human experiences and
  responses to health and illness within the
  physical and social environments.
• Integration of objective data with knowledge
  gained from an appreciation of the patient's or
  group's subjective experience.
• Application of scientific knowledge to the
  processes of diagnosis and treatment through the
  use of judgment and critical thinking.
• Advancement of professional nursing knowledge
  through scholarly inquiry.
• Influence on social and public policy to promote
  social justice.
• From ANA's Nursing's Social Policy Statement,
  Second Edition, 2003.

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Government Regulation of Practice

• Federal Government
• Protect Privacy with HIPAA The Health Insurance
  Portability and Accountability Act Legislation
• Address Health and Safety Issues Such as the
  Regulation which Determines which Drugs are OTC
  and which are not.
• Tele-health has become the subject of debate
  among health care providers, professional
  associations, and government officials because it
  raises concerns about multi-state licensure,
  state versus federal control, reimbursement, and
  liability.
• Controls Eligibility for Medicare and Medical
  Payments
• State Government
• By licensure of New Grads
• Certification of Advance Practitioners
• Nurse Practice Act Scope of Practice

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Government Regulation

• Defined by Statute

• Legal Contract between the Profession and Society
  
• State Nurse Practice Acts are the Codification of
  Regulations and Statues which Grant Nurses the
  Right to Practice Require Them to Act in the
  Publics Best Intrest ANA Nursing Social Policy
  Statement

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Scope of Practice
In all 50 States

• There are Legal Requirements for Nursing
  Practice.
• Which exists to assure the health, safety, and
  welfare of the general public and to protect the
  integrity of the nursing profession.

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The Legal Definition of Nursingis Defined in the
Nurse Practice Acts

• Regulation of practice is defined in the Nurse
  Practice Act (NPA) of each state.
• NPAs are statutes that outline the rules and
  regulations that govern the practice of nursing.
• NPA's are developed by state jurisdictions each
  state has its own Nurse Practice Act.
• Note many nursing practice acts are patterned
  after the Model Nursing Act and Rules (National
  Council of State Boards of Nursing, 2004) many
  aspects similar information.

http//nursingworld.org/mods/mod995/canlegalnrsful
l.htmreg Legal Basics for Professional Nursing
Nurse Practice Actsby Mable H. Smith, RN, JD, PhD
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CALIFORNIA NPA

• California Legislature Enacts All Changes to the
  Nurse Practice Act
• Board of Registered Nurses Protects the Public
  and Enforces the Statues

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Nurse Practice Act

• The Nursing Practice Act (NPA) is the body of
  California law that mandates the Board to set out
  the scope of practice and responsibilities for
  RNs.
• The Practice Act is located in the California
  Business and Professions Code starting with
  Section 2700.
• Regulations which specify the implementation of
  the law appear in the California Code of
  Regulations. http//www.rn.ca.gov/npa/npa.htm

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BRN Membership

• NPA 2702 Each member of the board shall be a
  citizen of the United States and a resident of
  the State of California. Four members shall
  represent the public at large, and shall not be
  licensed under any board under this division or
  any board referred to in Section 1000 or 3600 and
  shall have no pecuniary interests in the
  provision of health care services. Two members
  shall be licensed registered nurses under the
  provisions of this chapter, each of whom shall be
  active in the practice of his or her profession
  engaged primarily in direct patient care with at
  least five continuous years of experience, and
  who shall not be engaged as an educator or
  administrator of a nursing education program
  under the provisions of this chapter. One member
  shall be a licensed registered nurse who shall be
  active as an advanced practice registered nurse
  as defined in Section 2725.5. One member shall be
  a licensed registered nurse under the provisions
  of this chapter who shall be active as an
  educator or administrator in an approved program
  to train registered nurses. One member shall be a
  licensed registered nurse who is an administrator
  of a nursing service with at least five
  continuous years of experience.
• http//www.rn.ca.gov/npa/pdf/b-p.pdf

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2725. Legislative intent Practice of nursing
defined

• (a) In amending this section at the 1973-74
  session, the Legislature recognizes that
• nursing is a dynamic field, the practice of which
  is continually evolving to include more
• sophisticated patient care activities. It is the
  intent of the Legislature in amending this
• section at the 1973-74 session to provide clear
  legal authority for functions and
• procedures that have common acceptance and usage.
  It is the legislative intent also to
• recognize the existence of overlapping functions
  between physicians and registered
• nurses and to permit additional sharing of
  functions within organized health care systems
• that provide for collaboration between physicians
  and registered nurses. These organized
• health care systems include, but are not limited
  to, health facilities licensed pursuant to
• Chapter 2 (commencing with Section 1250) of
  Division 2 of the Health and Safety Code,
• clinics, home health agencies, physicians'
  offices, and public or community health
• services. http//www.rn.ca.gov/npa/pdf/b-p.pdf

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• 2725b Further defines Dependent and independent
  nursing practice.
• 2725b 1,2,4a Defines Independent practice i.e.
  those things that RN may do independent of other
  Practitioners such as Direct and indirect
  patient care services that ensure the safety,
  comfort, personal
• hygiene, and protection of patients and the
  performance of disease prevention and restorative
  measures.
• 2725b2,4p Define Dependent Practice such as
  Direct and indirect patient care services,
  including, but not limited to, the
• administration of medications and therapeutic
  agents, necessary to implement a treatment,
  disease prevention, or rehabilitative regimen
  ordered by and within the scope of licensure of a
  physician, dentist, podiatrist, or clinical
  psychologist, as defined by Section 1316.5 of the
  Health and Safety Code.
• 2725C Defines Standardized Procedures

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• 2750 Defines Discipline and modes of discipline
• 2761 Outlines grounds for disciple such as
  Except for good cause, the knowing failure to
  protect patients by failing to follow infection
  control guidelines of the board, thereby risking
  transmission of blood-borne infectious diseases
  from licensed or certified nurse to patient, from
  patient to patient, and from patient to licensed
  or certified nurse.
• 2762. Drug-related transgressions
• 2770. Legislative intent
• It is the intent of the Legislature that the
  Board of Registered Nursing seek ways and means
  to identify and rehabilitate registered nurses
  whose competency may be impaired due to abuse of
  alcohol and other drugs, or due to mental illness
  so that registered nurses so afflicted may be
  rehabilitated and returned to the practice of
  nursing in a manner which will not endanger the
  public health and safety. It is also the intent
  of the Legislature that the Board of Registered
  Nursing shall implement this legislation by
  establishing a diversion program as a voluntary
  alternative to traditional disciplinary actions.

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Regulations

• Statements Issued by the BRN carry the weight of
  the Law
• The BRN regulates nursing schools
• Sets Standards for Competent Performance
• Sets continuing education requirements
• Sets standards and issues Certification for
  Nurse-Midwives, NP, and Public Heath Nurses

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The BRNS Role In Nursing Education

• Review and Approval of Initial and on-going
  Nursing Education Programs
• Regulation of Continuing Education for RNs

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Professional Regulation of Education

• National League of Nursing
• American Association of Colleges of Nursing
• Professional Association Accredit Nursing
  Programs But Do Not Standardize the Curriculum

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Accreditation of Hospitals

• The Joint Commission evaluates and accredits
  nearly 15,000 health care organizations and
  programs in the United States. An independent,
  not-for-profit organization, The Joint Commission
  is the nations predominant standards-setting and
  accrediting body in health care

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California Department of Health Services

• Licensing 30 different types of health care
  facilities and providers (a total of over 6,000)
  so that they can legally do business in
  California.
• Certifying to the federal government health care
  facilities and providers that are eligible for
  payments under the Medicare and Medicaid
  (Medi-Cal) programs.

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American Nurses Credentialing Center

• The largest and most prestigious nursing
  credentialing organization in the United States
• Provides programs that establish respect for
  nurses and the profession.
• ANCC certifications are highly regarded across
  the nation by federal, state and local agencies

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Professional Organization

• Professional Nursing Organizations
• Broad Spectrum Organizations
• ANA, ANA-C, CNA
• Specialty Practice Organizations
• Such as APNA, AORN

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Leadership - Professional Organization Group
Projects Instructions are on Web CT My Website

• Groups Must Have
• at Least 5 Members
• No More Then Six
• Groups Will
• Designate a Group Leader
• Chose a Name for Their Group
• The Group Leader Will Post
• The Groups Name
• List of Members and
• Choice of Organization in the Discussion section
  of WebCt

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Something to Think AboutThe on Going Debate

• Entry in to Practice
• All RNs Must Pass the NCLEX Exam
• But Educational Prepartion Varies
• Diploma programs, Associated Degree Programs, BSN
  Programs, Masters Degree Programs
• Doctoral Prepared Nurses
• Should a BSN Be Required for all Nurses

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