Regulation of Nursing Professional Nursing

1
Regulation of Nursing Professional Nursing
2
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

3

• 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

4
Professional Regulation of Nursing practice
begins with the Professions Definition of
Nursing.

• Who Defines the Profession of Nursing?
• Nurse Theorist
• ANA
• BRN
• NLN
• The Public
• ANA Nursings Social Policy Statement

5
How Does Professional Regulation Benefit Nurses?

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

6
Regulation Provides Accountability

• Scope and Standards of Nursing Practice,
  developed by ANA on behalf of the profession.
• The Scope and Standards create the foundation for
  specialty practice standards and inform the State
  Nurse Practice Acts, which provide a second layer
  of accountability.
• Rules and regulations promulgated by individual
  states, based upon each states nurse practice
  act.
• Accountability to the institution or agency for
  whom she/he employed, via institutional policies
  and procedures.
• A final level of accountability for RN practice
  occurs via the individual nurses own
  self-determination of those aspects of practice
  she/he believes herself competent to perform.

7
The ANA

• Nursing is the protection, promotion, and
  optimization of health and abilities, prevention
  of illness and injury, alleviation of suffering
  through the diagnosis and treatment of human
  response, and advocacy in the care of
  individuals, families, communities, and
  populations.
• (Nursing's Social Policy Statement, Second
  Edition, 2003, p. 6 Nursing Scope and
  Standards of Practice, 2004, p. 7)

8

• 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.

9
Nurse Theorist

• Florence Nightingale, in her Notes on Nursing
  What It Is and What It Is Not, defined nursing as
  having charge of the personal health of somebody
  and what nursing has to do is to put the
  patient in the best condition for nature to act
  upon him.
• Virginia Henderson, nurses help people, sick or
  well, to do those things needed for health or a
  peaceful death that people would do on their own
  if they had the strength, will, or knowledge.

10
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.
• Controls Eligibility for Medicare and Medical
  Payments
• State Government
• By licensure of New Grads
• Certification of Advance Practitioners
• Nurse Practice Act Scope of Practice

11
Government Regulation

• Defined by Statute

• 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 Interest ANA Nursing Social Policy
  Statement
• Legal Contract between the Profession and Society
  

12
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.

13
THE BRN

• The California Board of Registered Nursing (BRN)
  regulates the practice of registered nursing and
  certified advanced practice nurses in order to
  protect the public. The Board exists to protect
  the health and safety of consumers and promote
  quality registered nursing care in California.
• http//www.rn.ca.gov/

14
CALIFORNIA NPA

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

15
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

16
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

17
WHO IS THE BRN

• 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.
• http//www.rn.ca.gov/npa/pdf/b-p.pdf

18

• 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

19

• WHAT DOES THE NPA TELL US?

20
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

21

• 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.

22

• 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.

23

• 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.

24

• 2725C Defines Standardized Procedures 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.

25

• 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.
• http//www.rn.ca.gov/npa/pdf/b-p.pdf

26
The BRNS Role In Nursing Education

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

27
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

28
Other Regulatory Agencies

• California Department of Public Health (CDPH)
  Licensing and Certification Program (LC)
• LC is responsible for ensuring health care
  facilities comply with state laws and
  regulations.
• Ensures that facilities accepting Medicare and
  Medi-Cal payments meet federal requirements.
• http//www.cdph.ca.gov/programs/Pages/LnC.aspx

29
The U.S. Department of Health and Human Services

• Health Information Privacy (HIPAA)
• Dissemination of CDC guidelines and other Health
  related information
• http//www.hhs.gov/

30
The Joint Commission

• The Joint Commission has been accrediting
  hospitals for more than 50 years.
• Accreditation is a nationwide seal of approval
  that indicates a hospital meets high performance
  standards.
• http//www.jointcommission.org/

31
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.

32
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.
• Advance practice certification for RNs Magnet
  Status Certification for Hospitals
• ANCC certifications are highly regarded across
  the nation by federal, state and local agencies

33
Professional Organization

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

34
Leadership - Professional Organization Group
Projects Instructions are on Web CT My Website

• Groups Must Have
• at Least 5 Members
• No More Then Six (no exceptions)
• 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 Blackboard
• Group leaders will post their info before
  midnight on Monday 9/8
• Groups will attempt to not duplicate what their
  peers are doing.

35

• Our First Online Discussion Is Posted

36
Welcome Dr. Malloy Under Graduate
Coordinator smalloy_at_son.sjsu.edu