Chapter 093
2013 -- S 0614 SUBSTITUTE A
Enacted 06/17/13
A N A C T
RELATING TO
BUSINESSES AND PROFESSIONS -- NURSES
Introduced By: Senators Miller, Doyle, Goldin, Pichardo, and Walaska
Date Introduced: March 06, 2013
It is enacted by the
General Assembly as follows:
SECTION 1. Sections 5-34-3, 5-34-4, 5-34-7, 5-34-40 and
5-34-43 of the General Laws
in Chapter 5-34 entitled "Nurses" are hereby
amended to read as follows:
5-34-3.
Definitions. -- As used in this chapter:
(1) "Advanced
practice registered nurse" means the status of qualified
individuals who
hold an active license as a registered nurse and an active
license as a nurse in an advanced role as
defined under the provisions of this chapter or chapter
5-34.2.
(APRN) is the title
given to an individual licensed to practice advanced practice
registered nursing within one of the following roles: certified
nurse practitioner (CNP), certified
registered nurse anesthetist (CRNA) as defined in chapter
5-34.2, or certified clinical nurse
specialist (CNS), and who functions in a population focus. An
APRN may serve as a primary or
acute care provider of record.
(2) "Advanced
practice registered nursing" means an independent and expanded scope of
nursing in a role and population focus approved by the Board
of Nurse Registration and Nursing
Education that includes the registered nurse scope of
practice and may include, but is not limited
to, performing acts of advanced assessment, diagnosing,
prescribing and ordering. Each APRN is
accountable to patients, the nursing profession and the Board of
Nursing for complying with the
requirements of this chapter and the quality of advanced nursing care
rendered; recognizing limits
of knowledge and experience; planning for the management
of situations beyond the APRN’s
expertise; and for consulting with or referring patients to
other health care providers as
appropriate.
(2)(3)
"Approval" means the process where the board of nursing evaluates and
grants
official recognition to basic nursing education programs
meeting established criteria and
standards.
(3)(4)
"Certified registered nurse practitioner" is an advanced
practice nurse utilizing
independent knowledge of physical assessment, diagnosis,
and management of health care and
illnesses. The practice includes prescriptive privileges. The
practice includes collaboration with
other licensed health care professionals including, but not
limited to, physicians, pharmacists,
podiatrists, dentists and nurses. Certified nurse practitioners are members of the
health care
delivery system practicing in areas including, but not limited
to: family practice, pediatrics, adult
health care, geriatrics and women’s health care in primary,
acute, long-term and critical care
settings in health care facilities and the community.
Certified nurse practitioners may be
recognized as the primary care provider or acute care provider
of record.
(5) "Certified
Clinical Nurse Specialist" is an advanced practice registered nurse that
independently provides care to clients, facilitates attainment of
health goals, and provides
innovation in nursing practice, based on clinical expertise,
evidence-based decision-making, and
leadership skills. The clinical nurse specialist practices with
individual clients and populations;
nurses and other multidisciplinary team members; and
organizations to effect system-wide
changes to improve programs of care. The practice may include
prescriptive privileges.
(6) Certified
registered nurse anesthetist is as defined in chapter 5-34.2 ("Nurse
Anesthetist").
(4)(7)
"Department" means the department of health.
(5)(8)
"Health" means optimum well-being.
(6)(9)
"Healthcare" means those services provided to promote the optimum
well-being of
individuals.
(7)(10)
"Licensed" means the status of qualified individuals who have
completed a
designated process by which the board of nursing grants
permission to individuals accountable
and/or responsible for the practice of nursing and to engage
in that practice, prohibiting all others
from legally doing so.
(8)(11)
"Nursing" means the provision of services that are essential to the
promotion,
maintenance, and restoration of health throughout the continuum
of life. It provides care and
support of individuals and families during periods of
wellness, illness, and injury, and
incorporates the appropriate medical health care
plan of care prescribed by a licensed advanced
practice registered nurse, certified nurse midwife, licensed physician, dentist, or podiatrist. It is a
distinct component of health services. Nursing practice is
based on specialized knowledge,
judgment, and nursing skills acquired through educational
preparation in nursing and in the
biological, physical, social, and behavioral sciences.
(9)(12)
"Practical nursing" is practiced by licensed practical nurses (L.P.N.s). It is an
integral part of nursing based on a knowledge and skill level
commensurate with education. It
includes promotion, maintenance, and restoration of health and
utilizes standardized procedures
leading to predictable outcomes, which are in accord with the
professional nurse regimen under
the direction of a registered nurse. In situations where
registered nurses are not employed, the
licensed practical nurse functions under the direction of a
licensed physician, dentist, podiatrist or
other licensed health care providers authorized by law to
prescribe. Each L.P.N. is responsible for
the nursing care rendered.
(13) "Population
foci" means focus of the patient population. Population focus shall
include:
(i)
Family/Individual across the lifespan ;
(ii)
Adult-gerontology;
(iii)
Neonatal;
(iv)
Pediatrics;
(v) Women’s
health/gender-related; and
(vi)
Psychiatric/mental health.
(10)(14)
"Professional nursing" is practiced by registered nurses (R.N.s). The practice of
professional nursing is a dynamic process of assessment of an
individual's health status,
identification of health care needs, determination of health care
goals with the individual and/or
family participation and the development of a plan of
nursing care to achieve these goals. Nursing
actions, including teaching and counseling, are directed
toward the promotion, maintenance, and
restoration of health and evaluation of the individual's response
to nursing actions and the
medical regimen of care. The professional nurse provides care
and support of individuals and
families during periods of wellness and injury, and
incorporates where appropriate, the medical
plan of care as prescribed by a licensed physician,
dentist or podiatrist or other licensed health
care providers authorized by law to prescribe. Each R.N.
is directly accountable and responsible
to the consumer for the nursing care rendered.
(11)(15)
"Psychiatric and mental health nurse clinical specialist" is a
certified clinical
nurse specialist working in the population foci of
psychiatric/mental health as an
advanced
practice nurse utilizing independent knowledge in
psychiatric mental health assessment,
diagnosis, health promotion, psychotherapeutic modalities and management of mental health and
illnesses. The practice may include prescription privileges within
their scope of practice of certain
legend medications, controlled substances from Schedule II
classified as stimulants, and
controlled substances from Schedule IV within the scope of their
practice. The practice may also
include consultation and education. collaboration
with other licensed health care professionals,
including, but not limited to, psychiatrists, psychologists,
physicians, pharmacists, and
nurses.
The psychiatric and mental health clinical specialist
holds the qualifications defined in section 5-
34-40.1.
5-34-4. Board of
nursing -- Establishment -- Composition -- Appointment, terms,
and removal of members -- Director of nurse registration
and nursing education. -- (a)
Within the division of professional regulation,
pursuant to chapter 26 of this title, there is a board
of nurse registration and nursing education,
sometimes referred to herein as the "board of
nursing". The
board shall be composed of fifteen (15) members. The term of office shall be
for
three (3) years. No member shall serve more than two (2)
consecutive terms. The member shall
serve until a qualified successor is appointed to serve. In
making those appointments, the director
of the department of health shall consider persons
suggested by professional nurse organizations
and the practical nurse's association.
(b) Present members of
the board holding office under the provisions of this chapter
shall serve as members of the board until the expiration of
their terms or until qualified successors
are appointed. The fifteen (15) member board shall
include: eleven (11) professional nurses, two
(2) practical nurses
appointed by the director of health and approved by the governor and two (2)
members of the general public appointed by the governor.
Three (3) professional nurses shall be
from different basic education programs preparing students
to become nurses; one professional
nurse shall be from a nursing service administration; four
(4) professional non-administrative,
clinical nurses not licensed as advanced practice nurses, and
three (3) professional advanced
practice nurses, one who holds a license as a certified
registered nurse anesthetist, one who holds
a license as a certified registered nurse practitioner,
and one who holds a license as a psychiatric
and mental health
certified clinical nurse clinical specialist. No educational
program or
cooperating agency shall have more than one representative on the
board.
(c) The director of
health may remove any member from the board for cause including,
but not limited to, neglect of any duty required by law,
or incompetence, or unprofessional
conduct, or willful misconduct. A member subject to
disciplinary proceedings shall be
disqualified from board business until the charge is adjudicated.
There shall also be a director of
nurse registration and nursing education appointed by the
director of health in accordance with
the provisions of chapter 4 of title 36.
5-34-7.
Board of nursing -- General powers. -- The board
of nurse registration and
nursing education is authorized, subject to the approval of
the director of the department of
health, to:
(1) Adopt, review, or
revise rules, and regulations consistent with the law that may be
necessary to effect provisions of the chapter;
(2) Approve nursing
education programs according to the rules established by the board;
(3) Require standards
for nursing practice within organized nursing services and the
individual practice of licensees;
(4) Approve
the examinations for licensure;
(5) Establish
requirements to validate competence for reinstatement to the active list;
(6) Conduct hearings
upon charges calling for discipline of a licensee or revocation of a
license;
(7) Issue subpoenas to,
compel the attendance of witnesses at, and administer oaths to
persons giving testimony at hearings;
(8) Cause the prosecution
or enjoinder of all persons violating this chapter;
(9) Maintain
a record of all its proceedings;
(10) Submit
an annual report to the director of the department of health;
(11) Utilize
other persons that may be necessary to carry on the work of the board;
(12) Conduct public
hearings, investigations, and studies of nursing practice, nursing
education, and related matters and prepare and issue
publications that, in the judgment of the
board, allow the nursing profession to provide safe,
effective nursing services to the public;
(13) Determine
qualifications necessary for prescriptive privileges for certified
registered
nurse practitioners
advanced practice registered nurses;
(14) Grant certified
registered nurse practitioners prescriptive privileges to advanced
practice registered nurses; and
(15) Determine
qualification necessary for the prescriptive privileges for psychiatric and
mental health clinical nurse specialists; and
(16) Grant certified
psychiatric and mental health clinical nurse specialists prescriptive
privileges.
(17) Adopt criteria
for recognizing national certifying bodies for APRN roles and
population foci.
5-34-40. Advanced practice nurse advisory committee. -- (a) The nine (9) seven (7)
member committee consists of two (2) certified registered
nurse practitioners, two (2) certified
registered nurse anesthetists, two (2) psychiatric and mental
health certified clinical nurse
specialists, one physician and two (2) consumers and
one consumer. The director of health shall
appoint the committee. In making appointments to the
committee, the director shall consider
persons recommended by professional nurse organizations and
professional medical associations.
The professional members of the committee shall be
currently engaged in practice. The consumer
members shall be: (1) knowledgeable in consumer health
concerns; (2) a resident of the state; (3)
not licensed as a health care practitioner; (4) not a
parent, spouse, sibling, or child of a person
licensed as a health care practitioner, and not a student in a
professional program; (5) not having a
direct financial interest in health care services; (6) not a
member or an employee of any board of
control of any public or private health care service.
(b) Each member
appointment shall be for three (3) years, with no member serving more
than two (2) consecutive three (3) year terms except that
in making the initial appointments the
director designates: four (4) members for a term of two (2)
years; three (3) members for a term of
three (3) years; and the consumer members for three (3)
year terms.
(c) This committee must
meet not fewer than two (2) times per year. The committee has
the following functions:
(1) To assess advanced
nursing practice for the purpose of improving patient care.
(2) (i) To review all complaints
regarding advanced practice nurses, and recommend any
and all disciplinary or corrective action that they deem
appropriate, including revocation and
suspension of license, upon proof that an advanced practice
nurse has:
(A) Aided or abetted an
uncertified person to practice as an advanced practice nurse;
(B) Become
addicted to the use of liquor or controlled substances;
(C) Negligently,
willfully, or intentionally acted in a manner inconsistent with the health
and safety of persons entrusted to his or her care;
(D) Had his or her
authorization to practice as an advanced practice nurse denied,
revoked or suspended in another state;
(E) Engaged in the
performance of medical functions beyond the scope of practice
authorized by the provisions of this chapter;
(F) Willfully failed to
file or record medical records and reports;
(G) Mental
incompetence; or
(H) Willfully failed to
maintain standards established by the nursing profession.
(ii) The recommendation
shall be submitted to the board of nursing for implementation.
(3) To advise
periodically to the board of nurse registration and nursing education
regarding advanced nurse practice.
5-34-43. Criminal
records review. -- (a) Notwithstanding any
provision of law to the
contrary contained in any general or public law, rule or
regulation, any person seeking a license to
practice under this chapter, or who is previously licensed and
authorized to practice under this
chapter and is seeking employment, shall undergo a federal
and statewide criminal background
check (BCI), which shall be processed prior to receiving a
license to practice or to enter into
employment.
(b) The applicant shall
apply to the bureau of criminal identification for a national
criminal records check that shall include fingerprints
submitted to the federal bureau of
investigation. Upon the discovery of any disqualifying information,
the bureau of criminal
identification will inform the applicant in writing of the nature of
the disqualifying information;
and, without disclosing the nature of the disqualifying
information, will notify the licensing
agency or the potential employer in writing that
disqualifying information has been discovered.
(c) The applicant
against whom disqualifying information has been found, may request
that a copy of the criminal background report be sent to
the licensing agency or the potential
employer. The licensing agency or the potential employer shall
make a judgment regarding the
issuing of a license.
(d) In those situations
in which no disqualifying information has been found, the bureau
of criminal identification shall inform the applicant
and the licensing agency or the potential
employer in writing of this fact.
(e) It shall be the
responsibility of the applicant to pay for the criminal records check.
SECTION 2. Chapter 5-34 of the General Laws entitled
“Nurses” is hereby amended by
adding thereto the following sections:
5-34-44. Advanced practical registered nurses as independent
practitioners. --
APRNs are licensed independent practitioners within
standards established or recognized by the
board of nursing. Each APRN is accountable to patients, the
nursing profession and the board of
nursing for:
(1) Complying with
the requirements of this chapter and the quality of advanced nursing
care rendered ;
(2) Recognizing
limits of knowledge and experience;
(3) Planning for the
management of situations beyond the APRN’s expertise;
(4) Consulting with
or referring patients to other licensed health care providers as
appropriate.
(5) In the case of CRNAs, comply with the requirements of chapter 5-34.2 of
the Rhode
Island general laws, including subsection 5-34.2-5(b)
regarding scope of practice. In the case of
any conflict between this chapter and chapter 5-34.2 with
regard to the licensure and practice of
CRNAs, chapter 5-34.2 shall control.
5-34-45.
Licensure of APRNs. -- (a)
An applicant for initial licensure to practice as an
APRN shall:
(1) Submit a
completed written application and appropriate fees as established by the
board of nursing;
(2) Hold a current RN
license or privilege to practice and shall not hold an encumbered
license or privilege to practice as an RN in any state or
territory;
(3) Have completed an
accredited graduate or post-graduate level APRN program in one
of the three roles (RNP, CRNA, or CNS) and at least one
population focus;
(4) Be currently
certified by a national certifying body recognized by the board of nursing
in the APRN role and population foci appropriate to
educational preparation;
(5) Report any
criminal conviction, nolo contendere
plea, Alford plea or other plea
arrangement in lieu of conviction;
(6) Have committed no
acts or omissions that are grounds for disciplinary action as set
forth in this chapter; and
(7) Provide other
evidence as required by regulation.
(b) The board of
nursing may issue an initial APRN license to clinical nurse specialists
without a certification exam when:
(1) A national
certification exam does not exist for the current population foci; and
(2) The applicant has
submitted a portfolio to the board of nursing that includes proof of
graduation, course descriptions, official transcript that
includes courses in pharmacology,
pathophysiology and physical assessment, letters of recommendation
from his/her employer
attesting to the CNS’s practice at the advanced practice level.
(c) After January 1,
2015, all clinical nurse specialists seeking initial licensure as an APRN
must meet all the criteria as stated in this chapter
including national certification in a role and
population foci recognized by the board of nursing.
(d) The board of
nursing may issue a license by endorsement to an APRN licensed under
the laws of another state if, in the opinion of the board
of nursing, the applicant meets the
qualifications for licensure in this jurisdiction. An applicant for
APRN licensure by endorsement
shall:
(1) Submit a
completed written application and appropriate fees as established by the
board of nursing;
(2) Hold a current
license or privilege to practice as an RN and APRN in a state or
territory;
(3) Not have an
encumbered license or privilege to practice in any state or territory;
(4) Have completed an
accredited graduate or post-graduate level APRN program in one
of the three roles (CNP, CRNA or CNS) and at least one
population focus or meets the standards
for grandfathering as described in this chapter;
(5) Be currently
certified by a national certifying body recognized by the board of nursing
in the APRN role and at least one population focus
appropriate to educational preparation;
(6) Meet continued
competency requirements as set forth in board of nursing regulations;
(7) Report any
conviction, nolo contendere
plea, Alford plea or other plea arrangement in
lieu of conviction;
(8) Have committed no
acts or omissions, which are grounds for disciplinary action in
another jurisdiction; and
(9) Provide other
evidence as required by the board of nursing in its regulations.
(e) APRN licenses
issued under this chapter shall be renewed every two (2) years
according to a schedule established by the BON. An applicant
for APRN license renewal shall:
(1) Submit a renewal
application as directed by the board of nursing and remit the
required fee as set forth in regulation;
(2) Maintain national
certification in the appropriate APRN role and at least one
population focus, authorized by licensure, through an ongoing
recertification maintenance
program of a nationally recognized certifying body recognized
by the board of nursing; and
(3) Meet other
requirements set forth in regulations.
(f) The board of
nursing may reactivate or reinstate an APRN license as set forth in BON
regulation.
5-34-46.
Status of current licensees. -- (a) Any person holding a license to practice
nursing as a certified nurse practitioner ,psychiatric
clinical nurse specialists, certified registered
nurse anesthetist, as defined in this chapter and chapter
5-34.2, in this state that is valid upon
passage of this chapter shall be deemed to be licensed as an
APRN, with his or her current
privileges and shall be eligible for renewal of such license as
defined under the provisions of this
chapter and chapter 5-34-2.
(b) Any person
holding a valid license to practice nursing having graduated from an
accredited course of study, actively practicing in an advanced
role, and holding a national
certification related to his or her current practice setting as of
(effective date of this act), as
defined in chapters 5-35 or 5-34.2, shall be deemed to be
eligible for to license as an APRN.
(c) After August 1,
2013, all new applicants for APRN licensure must meet the stipulated
licensure requirements as stated in this chapter.
5-34-47.
Titles and abbreviations. -- (a) Only those persons who hold a license or
privilege to practice as advanced practice registered nurses in
this state shall have the right to use
the title "advanced practice registered nurse"
and the roles of "certified registered nurse
anesthetist," "clinical nurse specialist" and
"certified nurse practitioner;" and the abbreviations
"APRN,"
"CRNA," "CNS" and "CNP" respectively.
(b) The abbreviation
for the APRN designation of a certified registered nurse anesthetist,
a clinical nurse specialist and for a certified nurse
practitioner will be APRN, plus the role title,
i.e., CRNA, CNS, and CNP.
5-34-48.
APRN education programs. -- (a) The standards for the establishment and
outcomes of APRN education programs, including clinical
learning experiences, shall be set
by APRN national accrediting agencies recognized by the
Council for Higher Education
Accreditation.
(b) Compliance with
the standards for the APRN program will be evidenced by official
certification of accreditation by the appropriate national
accrediting agency, a copy of such shall
be submitted to the Board of Nursing. The Board of
Nursing will act as the sole custodian of
record for any and all documentation used to demonstrate
such certification by the appropriate
national accrediting agency.
5-34-49.
Prescriptive authority. -- (a) The board of nursing shall grant prescribing,
ordering, dispensing and furnishing authority .
(b) An APRN licensed
by the board of nursing may prescribe, order, procure, administer,
dispense and furnish over the counter, legend and controlled
substances pursuant to applicable
state and federal laws, when the APRN has completed an
educational program as described in this
chapter that includes courses in pathophysiology,
pharmacology and physical assessment and is
within the APRN’s role and
population focus.
(c) Prescribing,
ordering, dispensing and furnishing shall include the authority to:
(1) Diagnose,
prescribe and institute therapy or referrals of patients to health care
agencies, health care providers and community resources;
(2) Prescribe,
procure, administer, dispense and furnish pharmacological agents,
including over the counter, legend and controlled substances;
and
(3) Plan and initiate
a therapeutic regimen that includes ordering and prescribing non-
pharmacological interventions, including, but not limited to, durable
medical equipment, medical
devices, nutrition, blood and blood products, and diagnostic
and supportive services including,
but not limited to, home health care, hospice, and
physical and occupational therapy.
(d) Prescriptive
privileges for the certified nurse practitioner shall include all the
authority under the APRN license including:
(1) Prescription of
legend medications and prescription of controlled substances from
schedules II,
(2) May be certified
to prescribe controlled substances from Schedule I.
(e) Prescriptive
privileges for APRNs with the population focus of
psychiatric/mental
health:
(1) Shall include
prescription of certain psychotropic and certain legend medications,
controlled substances from Schedule II classified as stimulants,
and controlled substances from
Schedule III and IV that are prescribed in
regulations;
(2) Shall not include
controlled substances from Schedules I, II, and V and those certain
legend medications not included in subdivision (1) of this
subsection.
(f) CRNAs may be granted prescriptive privileges in accordance
with the provisions of
chapter 5-34.2.
(g) Prescriptive
privileges for certified clinical nurse specialist shall include:
(1) Diagnosing,
prescribing and instituting therapy or referrals of patients to health care
agencies, health care providers and community resources; and
(2) Planning and
initiating a therapeutic regimen that includes ordering and prescribing
non-pharmacological interventions, including, but not limited to, durable
medical equipment,
medical devices, nutrition, blood and blood products, and
diagnostic and supportive services
including, but not limited to, home health care, hospice, and
physical and occupational therapy;
and
(3) Prescription of
over the counter medications within their population foci.
SECTION 3. Sections 5-34-35, 5-34-36, 5-34-39, 5-34-40.1,
5-34-40.2, 5-34-40.3, 5-34-
40.4 and
5-34-41 of the General Laws in Chapter 5-34 entitled "Nurses" are
hereby repealed.
5-34-35.
Qualifications of a certified registered nurse practitioner applicant.
-- (a)
An applicant for licensure to practice as a certified
registered nurse practitioner shall submit to
the board of nurse registration and nursing education
written evidence on forms furnished by the
division of professional regulation, verified by oath, that:
(1) The applicant is
a registered nurse who has completed an accredited educational
program resulting in a master's degree in nursing and/or an
approved nurse practitioner course of
study. This curriculum must include both a didactic
component and supervised clinical
experience. Effective January 1, 2004, all applicants for
initial licensure must complete an
accredited educational program resulting in a master's degree
with a major in nursing.
(2) The applicant
passed a national qualifying examination recognized by the board of
nurse registration and nursing education.
(b) A license to
practice as a certified registered nurse practitioner may be issued to an
applicant who is licensed by examination or endorsement as a
certified registered nurse
practitioner under the laws of another state or territory if, in
the opinion of the board, the
applicant meets the qualifications required of certified
registered nurse practitioners in this state.
5-34-36. Licensing of certified registered nurse practitioners. --
A license to practice
as a certified nurse practitioner shall be issued if the
applicant meets the qualifications for the
certified registered nurse practitioner (R.N.P.). Persons who
meet the qualifications of a certified
registered nurse practitioner, as stated in section 5-34-35, and
are currently licensed as certified
registered nurse practitioners by examination or endorsement
under the laws of another state of
the
registered nurse practitioners in this state for a period not to
exceed ninety (90) days from the date
of clearance by the board of nurse registration and
nursing education of the department of health,
provided that they are licensed in this state within ninety
(90) days. The original privilege to work
ninety (90) days from the date of clearance shall not be
extended or renewed.
5-34-39.
Process for prescriptive privileges of certified registered nurse practitioner.
--
(a) Prescriptive privileges for the certified registered nurse practitioner:
(1) Shall be granted
under the governance and supervision of the department, board of
nurse registration and nurse education; and
(2) Shall include
prescription of legend medications and prescription of controlled
substances from schedules II, III, IV and V that are established
in regulation; and
(3) Must not include
controlled substances from Schedule I.
(b) To qualify for
prescriptive privileges an applicant must submit on forms provided by
the board of nurse registration and nursing education,
verified by oath, that the applicant has
evidence of completion of thirty (30) hours of education in
pharmacology within the three (3)
year period immediately prior to date of application. To
maintain prescriptive privileges the
certified registered nurse practitioner (R.N.P.) must submit
upon request of the board of nurse
registration and nursing education evidence of thirty (30) hours
continuing education in
pharmacology every six (6) years.
5-34-40.1.
Qualifications of a psychiatric and mental health clinical nurse specialist
applicant. --
(a) An applicant for licensure as a psychiatric and
mental health clinical nurse
specialist shall submit to the board written evidence on forms
furnished by the department of
health, verified by oath, that the applicant:
(1) Is a registered
nurse who has completed an accredited educational program resulting
in a master's degree in psychiatric and mental health
nursing; and/or
(2) Passed a
national qualifying examination recognized by the board.
(b) All persons who
are engaged in the practice of a psychiatric and mental health
clinical nurse specialist on July 1, 2003, who meet the
definition in section 5-34-3(i) may be
considered to have met the qualifications for licensure
providing they have three (3) years
experience acceptable to the board between January 1, 1997, and
January 1, 2003. After January
1, 2004, all applicants for initial licensure must
complete an accredited educational program
resulting in a master's degree in nursing and must pass a
national qualifying examination
recognized by the board.
5-34-40.2. Licensing of psychiatric and mental health clinical nurse
specialists. -- A
license to practice as a psychiatric clinical nurse
specialist shall be issued if the applicant meets
the qualifications for the psychiatric and mental health
clinical nurse specialist. Persons who meet
the qualifications of a psychiatric and mental health
clinical nurse specialist, as stated in section
5-34-40.1, and are currently licensed as psychiatric
and mental health clinical nurse specialists by
examination or endorsement under the laws of another state or
territory of the
and/or the
clinical nurse specialists in this state for a period not to
exceed ninety (90) days from the date of
clearance by the board of nurse registration and nursing education
of the
of health, provided that they are licensed in this state
within ninety (90) days. The original
privilege to work ninety (90) days from the date of clearance
shall not be extended or renewed.
5-34-40.3.
Application fee for psychiatric and mental health clinical nurse
specialists. --
The initial application fee for licensure as a psychiatric and mental health
clinical
nurse specialist, the renewal fee for a psychiatric and
mental health clinical nurse specialist, and
the application fee for prescriptive privileges shall be
as set forth in section 23-1-54.
5-34-40.4.
Right to use psychiatric and mental health clinical nurse specialist title.
--
Any person who holds a license to practice as a
psychiatric and mental health clinical nurse
specialist in this state has the right to use the title
psychiatric and mental health clinical nurse
specialist and use the abbreviation "P.C.N.S." No
other person may assume that title or use that
abbreviation or any other words or letters, signs, figures, or
devices to indicate that the person
using it is a psychiatric and mental health clinical nurse
specialist.
5-34-41.
Process for prescriptive privileges of psychiatric and mental health clinical
nurse specialist. -- (a) Prescriptive privileges for the psychiatric and
mental health clinical nurse
specialist:
(1) Shall be granted
under the governance and supervision of the division of professional
regulations, board of nurse registration and nurse education; and
(2) Shall include
prescription of certain psychotropic and certain legend medications,
controlled substances from Schedule II classified as stimulants,
and controlled substances from
Schedule IV, that are
prescribed in regulations;
(3) Shall not
include controlled substances from Schedules I, II, III and V and those
certain legend medications not included in subdivision (2) of
this subsection; and
(4) Shall be granted
for psychiatric and mental health clinical nurse specialists who have
a master's degree in nursing.
(b) A psychiatric
and mental health clinical nurse specialist as stated in section 5-34-3
shall be permitted to prescribe in accordance with annually
updated guidelines, written in
collaboration with the medical director or physician consultant of
their individual establishments.
(c) A psychiatric
and mental health clinical nurse specialist in independent practice does
not have prescriptive privileges.
(d) To qualify for
prescriptive privileges a psychiatric and mental health clinical nurse
specialist, as stated in section 5-34-3, shall submit on forms
provided by the board of nurse
registration and nursing education, verified by oath, that the
applicant has evidence of completion
of thirty (30) hours of education in pharmacology of
psychotropic drugs and certain legend
medications within the three (3) year period immediately prior to
date of application. To maintain
prescriptive privileges the psychiatric and mental health clinical
nurse specialist must submit
upon request of the board of nurse registration and
nursing education evidence of thirty (30)
hours continuing education in pharmacology of psychotropic
drugs every six (6) years.
SECTION 4. Sections 5-34.2-2 and 5-34.2-3 of the General
Laws in Chapter 5-34.2
entitled "Nurse Anesthetists" are hereby amended to
read as follows:
5-34.2-2.
Definitions. -- (a) "Board" means the
board of nurse registration and nurse
education established in section 5-34-4.
(b) "Certified
registered nurse anesthetist" (CRNA) means a registered nurse who has
successfully met the requirements stated in this chapter.
(c) "Practice of
certified registered nurse anesthesia" means providing certain health care
services under the supervision of in collaboration
with anesthesiologists, licensed physicians, or
licensed dentists in accordance with section 5-31.1-1(16)
which requires substantial specialized
knowledge, judgment and skill related to the administration of
anesthesia, including preoperative
and postoperative assessment of patients; administering
anesthetics; monitoring patients during
anesthesia; management of fluid in intravenous therapy and
management of respiratory care. It
also includes, in connection with the immediate perioperative care of a patient, the ability to issue
a medication order for drugs or medications to be
administered by a licensed, certified, or
registered health care provider; to order and evaluate
laboratory and diagnostic test results and
perform point of care testing that the CRNA is qualified to
perform; and order and evaluate
radiographic imaging studies that the CRNA is qualified to order
and interpret. For the purposes
of this section, the immediate perioperative
care of a patient shall be defined as the period
commencing on the day prior to surgery and ending upon discharge
of the patient from post-
anesthesia care. CRNAs shall comply
with the requirements set forth in this chapter, including
subsection 5-34.2-5(b) regarding scope of practice, and the
requirements set forth in chapter 5-34,
as applicable. In the case of any conflict between this
chapter and chapter 5-34 with regard to the
licensure and practice of CRNAs, this
chapter shall control.
5-34.2-3.
Requirements for licensure of the nurse anesthetist. --
Requirements for
licensure as a nurse anesthetist shall consist of the
following:
(1) Current licensure
as a professional registered nurse in the state; and
(2) Graduation from an
educational program accredited by the American Association of
Nurse Anesthetists council on accreditation of nurse anesthesia educational programs or
its
predecessors or successors, and which has as its objective
preparation of nurses to practice nurse
anesthesia; and
(3) Initial
certification by the American Association of Nurse Anesthetists council on
certification of nurse anesthetists and recertification, as
applicable by the American Association
of Nurse Anesthetists council on recertification of
nurse anesthetists or their predecessors or
successors.
(4) The requirements
stated in subdivision (3) of this section do not apply to a graduate
nurse anesthetist awaiting initial certification results,
providing that initial certification is
accomplished within ninety (90) days upon completion of an
accredited nurse anesthesia
educational program.
(5) The requirements
stated in subdivisions (2) and (3) of this section do not apply to a
professional registered nurse who practices nursing in accordance
with the provisions of the
Nurse Practice Act, chapter 34 of this title, and who
is enrolled as a bona fide student in an
accredited nurse anesthesia program providing nurse anesthesia
under the supervision of a
certified registered nurse anesthetist and anesthesiologist.
(6) Beginning July 21,
1992, all nurse anesthetists shall be afforded the same period of
time to become licensed. Notwithstanding the provisions of
this section, no person practicing as a
nurse anesthetist in
under this chapter. However, as required by subdivision (3)
of this section, persons who become
certified under this section shall become recertified as
applicable.
SECTION 5. This act shall take effect upon passage.
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LC01636/SUB A
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