Kentucky Board of Nursing: Laws and Regulations

Nursing is a profession that requires specialized training, knowledge, skills, and judgment to foster an independent decision making. Practicing nursing is a right granted by the state to safeguard those in need of care and efficient nursing practice is substantiated by the state Nurse Practice Act (NPA). The NPA is ratified by each state based on set guidelines and passed by the state legislature (Russell, 2012). The NPA serves as a corner stone in regulating the duties and responsibilities of the professional nurse. The NPA is founded on set guidelines, however, the states’ board of nursing (BON) has the authority to modify the laws and regulations to fit the desired practice expectations set forth (Russell, 2012). The state of Virginia (VA), where this writer currently practices, has laws and regulations that govern the nursing practice of the Registered Nurse (RN) and the Clinical Nurse Specialist (CNS). The purpose of this paper is to discuss the similarities and differences between the role of the RN and the advanced practice nurse as well as to identify if the Virginia NPA identifies the role of an infection prevention nurse specialist.

The Arizona State Board of Nursing (AZBN) is an organization that protects the public by ensuring that all nurses holding a license or certificate are competent to practice safely. The board approves education programs and also regulates the practice of nursing (Arizona State Board of Nursing, 2012). The board holds a meeting almost every month to discuss issues and rule on present cases. The purpose of this paper is to identify and discuss agenda items of the attended Arizona State Board of Nursing’s monthly professional meeting.

This organization was designed to secure the services of prominent members of appropriate professions in the examination of policy matters relating to the health of the public. “The Institute acts to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education” (Institute of Medicine [IOM], 2010, p. 5) In October 2010, The IOM (Institute of Medicine) released the report, The Future of Nursing: Leading Change, Advancing Health. This report examines the changing roles of nursing in healthcare, changes in nursing education and

Changes in the Health Care System and the Practice of Nursing have become complex. Technological changes, complicated client needs, short hospital length of stay, and departure from acute care to community based care, all these changes have underscore the need for professional nurses to think critically in order to provide safe and effective client care. A better educated nursing workforce can provide good health education to patients and their families. The affordable care of 2010 has required the need for nurses to expand their role of practice to meet complicated patient demands. This has prompted the Institute Of Medicine to review the “Future of Nursing, Leading change and Advancing Health”. {Creasia & Fribery,2011}

The Institute of Medicine’s 2010 report on The Future of Nursing: Leading Change, Advancing Health acknowledges the changing healthcare sector in the US and describes future vision of healthcare and the role of nurses to fulfill that vision. The United States always strives to provide affordable and quality healthcare to the entire population of the country. In order to achieve this goal an overall restructuring of the healthcare system was necessitated. Nurses are considered to be the central part of the healthcare system to provide high quality and safe patient care. Nursing in the US is the single largest segment of the healthcare workforce with almost 3 million nurses working in different areas across the county. The changing

Nursing satisfaction has criteria for change; as documented in the Future of Nursing’s report, by the Institute of Medicine in cooperation with the Robert Wood Johnson Foundations’, Campaign for Action. (IOM, 2010) (RWFF, 2010) Both reports lay the groundwork that influences NC current nursing shortage. At the same time; to make health care more affordable, the Affordable Care Act was entered into law (ACA, 2010). Additionally, hospitals and other health care facilities are applying for, and meeting criteria for accreditation and is very clear about implementing a mandatory, entry level, BSN

Nursing practice is controlled by the individual, state’s Board of Nursing, which oversees and defines the nurses’ scope of practice; hence, ensures that nursing practice is guided by the nurse practice act of that state. Legislation also influences nursing practice, with technology facilitating new break-through in scientific research; the need for changes and or advances in healthcare are detrimental to new and improved regulations within the individual states or at a national level. Additionally, private and or public corporations also affect the practice of nursing in different ways; the policies and funding within these entities may limit the resources

Healthcare systems and the way safe, quality health care is delivered are continually changing to better serve patients and communities. Professional nursing practice is a large component in the healthcare system today. Back in the 1960s, professional nursing leaders tried to adopt the bachelor degree programs as the only educational track to become a registered nurse (Creasia & Friberg, 2011). Due to nursing shortages and demands this motive did not hold fast. Individuals entering the nursing profession today must first decide which educational pathway to take to become a Registered Nurse (RN).

The Nurse Practice Act of Illinois State is 225 ILCS 65. IL offers an APN to diagnose, interpret labs and order diagnostic tests. APNs is able to provide counseling and education for prevention of illness and promotion of health. They can provide palliative and end of life care, and can supervise and delegate to task to LPNs and RNs. APNs have prescriptive authority if they have a written collaborative agreement with a physician and are limited to 30 days (IGA, 2014). In order to practice as an APN in IL one must have a current unrestricted RN license, have a masters degree approved by the State Board of Nursing in the specialty of choice and a national certification. State Board of nursing is the regulatory authority of IL APN practice, and they accept certification from ANCC or AANP or certification from specialty agencies. APNs in IL requires 50 hours of continuing education in a 2-year license renewal period. IL is one of the States that offers versatile certification opportunities for APN in addition to advocating for the full practice authority of APNs. A systemic review done by Kuethe (2013) finds it is better for an NP to manage chronic diseases such as asthma and diabetes for their better control and healthcare cost reduction as physicians do not have enough time to provide comprehensive care (p. 5).

With an ever-increasing body of knowledge in the field of nursing, more education is being required to enter the field of nursing. Many healthcare institutions are raising the educational requirements in order to become employed or maintain employment in their facilities. Healthcare organizations are transitioning to hiring registered nurses (RN) who have a higher level of education, such as, a graduate from a Baccalaureate Degree Nursing (BSN) program. The goal of these institutions is to have nurses with a broader array of skills that can meet the growing demands of our patient population. BSN prepared nurses are recognized for their well-rounded skills in critical thinking, management, case management and health promotion versus Associate Degree nurses (ADN)/Diploma nurses that focus on direct patient care.

The College of Nurses of Ontario’s mission statement is to “protect the public’s right to quality nursing services by providing leadership to the nursing profession in self-regulation” (CNO, 2012). The College of Nurses recognizes that self-regulation is a privilege granted by proving that they are capable of putting the interests of the public before their own. By establishing a number of requirements for entry to practice, articulating and promoting practice standards, administering quality assurance, and enforcing standards of practice and conduct, the College fulfills it’s

The first consideration a registered nurse should determine is if “The Right Task (Cherry 355-356)” is being delegated to the right staff member. Delegation to the right staff member must be in their scope of practice and have proven to competent to complete. An individuals’ scope of practice will be set forth by the facility in which they work. In addition to individual facility polices the nurse must adhere to the scope of delegation set forth in the Nurse Practice Act of Maryland. Per the Nurse Practice Act of Maryland the task to be delegated must be “within the area of responsibility of the nurse delegating the act (Code of Maryland Regulations 10.27.11.03).” An example of incorrect delegating would be having an unlicensed individual, CNA or LPN to

According to the American Nursing Association, “ 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” (Association, Scope and Standards of Practice, 2010).

“Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles” (ICN 2010)

In November of 2010, the Institute of Medicine (IOM) released “The Future of Nursing: Leading Change, Advancing Health”. This special report examined the current state of nursing and changing landscape of the American healthcare system and offered recommendations for the future role nurses should play. The committee that released the report, Committee on the Robert Wood Johnson Foundation, divided it into three parts. Part II of the study, focused on transforming the nursing profession in order to improve America’s healthcare system. In order to achieve this transformation, the committee recommended that nurses attain higher levels of education and training, practice to the full extent of that education and training, and assume more