Nurse Practice Acts Research Articles

Getting Ready for Foot Care Certification: Implementing Off-loading Interventions to Prevent or Manage Injury.

Getting Ready for Foot Care Certification: Implementing Off-loading Interventions to Prevent or Manage Injury.

State Nurse Practice Acts: The Law Governing Your Nursing Practice

State Nurse Practice Acts: The Law Governing Your Nursing Practice

State Nurse Practice Acts: The Law Governing Your Nursing Practice

State Nurse Practice Acts: The Law Governing Your Nursing Practice

Clinical Issues—March 2022

Nursing scope of practice Key words: state nurse practice act (NPA), state board of nursing, decision-making framework, standards, guidance. Practice of unlicensed perioperative personnel Key words: job description, task delegation, unlicensed personnel, allied health care provider, scope of practice. Definition of a cavity for counting procedures Key words: anatomical hollow space, counting, cavity, retained surgical item (RSI), retained foreign object (RFO). Identifying retained suture needles on radiographic images Key words: suture needle size, suture needle length, radiographic imaging, counting procedures, count discrepancy.

Critical Care Clinical Nurse Specialist Role in Developmental Care for Infants With Heart Disease.

Critical Care Clinical Nurse Specialist Role in Developmental Care for Infants With Heart Disease.

Licensed Practical Nurse Workforce in New Jersey as Described by LPNs and Employers

<h3>Background</h3> Licensed practical nurses (LPNs) are essential members of the nursing workforce in the United States. The growing aging population has led to an increased need for healthcare in settings where LPNs work. In many states, including New Jersey (NJ), the LPN roles and job functions in today's healthcare organizations have not been examined. <h3>Purpose</h3> The purpose of this study is to gain an understanding of the current practice of LPNs in NJ by describing and comparing the perceptions of LPNs and LPN employers about their roles and job functions across settings. <h3>Methods</h3> For this qualitative descriptive study, 10 LPN focus groups were held and 17 employers who hire LPNs were interviewed regarding their perspectives of the LPN role. <h3>Results</h3> Two common themes emerged from the focus groups with LPNs and the interviews with LPN employers: (a) uncertainty exists regarding the future of LPNs and (b) LPNs need more hands-on experience. Additional themes from LPN focus groups were that (a) LPNs question what they should do, can do, and will do; (b) LPNs are stuck in their role; and (c) LPNs pray they make it through their shift. Themes that emerged from employer interviews were that (a) RNs and LPNs are pretty much interchangeable and (b) LPNs make economic "cents." <h3>Conclusion</h3> Our findings reveal that LPNs in NJ have expanded their role, contributing to role confusion. Although state nurse practice acts and regulations should drive LPN practice, organizational policies often dictate how scope of practice is applied. To ensure a clear understanding of the LPN role and scope of practice, discussions regarding the nurse practice act should be conducted at the state level with the board of nursing and in practice settings.

The Authority for Certain Clinical Tasks Performed by Unlicensed Patient Care Technicians and LPNs/LVNs in the Hemodialysis Setting: An Update and Invitation to Take Action

As the demand on time and resources of licensed health care professionals increases and cost-containment measures challenge organizations, the use of unlicensed assistive personnel for patient care activities increases. Emphasis on safe and effective care delivery remains crucial when registered nurses (RNs) delegate certain tasks and aspects of patient care. The principles of delegation from the American Nurses Association and the National Council of State Boards of Nursing include the responsibility and accountability of the RN for patient care outcomes. Authority for delegation of clinical tasks in the chronic hemodialysis setting varies significantly by state. The responsibility remains with the RN to oversee complex tasks despite the staff skill mix. Knowing individual state Nurse Practice Acts remains the responsibility of the individual. This article discusses the results of a review of the available information on state positions on delegation of clinical tasks in hemodialysis.

The Pursuit of Nurse Practitioner Practice Legislation: A Case Study.

Across the United States, nursing practice acts (NPAs) have been revised to include provisions that promote full practice authority (FPA) for nurse practitioners (NPs). Such revisions provide a mechanism to better utilize the full scope of NP services to address growing demands for access to health care. Modernized NPAs that facilitate FPA for NPs are imperative, especially now with the unprecedented health care crisis that the world now faces: Coronavirus Disease 2019. This is the first known study to use an embedded single-case study design, guided by the Kingdon policy stream model, to provide a detailed account of how stakeholders for NP FPA determine the appropriate time to pursue legislative changes to NP scope of practice regulations. Qualitative data analysis revealed four themes which comprised the components considered by stakeholders during their decision-making processes related to NP FPA: participants, problem, policy development, and politics. Themes were further collapsed within concepts from the Kingdon model to form the case description. Study findings can be used to increase the competency among NP FPA stakeholders in determining the timing of legislative pursuits for regulatory change.

Beyond the Nurse Practice Act: Making a Difference through Advocacy

Policy frames nursing practice in the most fundamental way: through state nurse practice acts (NPA) which date back over one hundred years in many states. NPAs frame nursing practice by defining a professional scope and educational requirements for practice. NPAs have not remained stagnant over the past century, rather they have evolved – but only with the active involvement of nurses in legislative efforts to change statute and update policies related to nursing practice. However, changing practice through policy does not stop with the NPA. This article will begin by briefly addressing the role of nurses in advocacy to advance professional practice, and offer background information about the changing healthcare industry that has influenced the example of advocacy we discuss. We offer exemplars that illustrate policies that regulate the environment of practice, such as nurse staffing, musculoskeletal injury prevention, and failure to advocate, and discuss needed protections, including whistleblower protections in our state. We conclude by considering implications for nursing organizations and nurses among these exemplars.

Exploring Reported Practice Habits of Registered Nurses and Licensed Practical Nurses at Illinois Nursing Homes

Introduction Nurses are expected to understand their states’ Nurse Practice Act (NPA) and practice within its scope. Role confusion can occur when nurses who practice with different scopes, such as registered nurses (RNs) and licensed practical nurses (LPNs), work closely together. Aim The purpose of this study is to examine the types of nursing activities performed by licensed nurses, and the extent to which RNs and LPNs in Illinois nursing homes are engaged in these activities. Methods A questionnaire was used to explore the types of nursing activities 140 nurses performed in 13 Illinois nursing homes and extent of their engagement in nursing activities within their scope of practice. Results Activities most frequently performed by all nurses included supervision of unlicensed assistive personnel, advocacy for residents, and collection of data to contribute to resident assessment. Both LPNs and RNs did not engage in the full extent of activities that their Illinois scope allowed, and LPNs completed activities that were not included in their scope. Conclusion Poor understanding exists about the differences between RN and LPN scope. Confusion about licensed nurses’ scopes of practice suggests that education about NPAs is needed. RNs indicated that they practice beyond their scope; however, it is not known in what way they practice beyond their scope.

Nurse Practice Acts Guide and Govern: Update 2017

The state's duty to protect those who receive nursing care is the basis for a nursing license. That license is an authorization or permission from state government to practice nursing. The guidelines within the state nurse practice act and the state nursing regulations provide the framework for safe, competent nursing practice. All nurses have a duty to understand their nurse practice act and regulations, and to keep up with ongoing changes as this dynamic document evolves and the scope of practice expands.

Historic Leadership.

School nursing practice establishes itself in the midst of both education and nursing philosophies, ethics, standards, laws, and regulations. Treading these two worlds is difficult at times and requires that a school nurse possess a strong foundational knowledge base, seek professional collaboration, and navigate conflicting professional demands in order to promote student and public safety. This article is Part 2 of a four-part series that recounts the inspiring story of a school nurse, Ellen Johnsen, who did just that back in the 1980s in Broken Arrow, Oklahoma. Part 2 describes how Ellen's actions led the Broken Arrow Public Schools to revise its unsafe and illegal medication administration policy, which brought the policy into partial compliance with the nurse practice act but culminated in Ellen losing her job. The purpose of this series is to enhance understanding of the legal parameters governing school nurse practice, provide examples of ethical decision making, and review the challenges associated with serving as a leader.

Historic Leadership.

School nursing practice establishes itself in the midst of both education and nursing philosophies, ethics, standards, laws, and regulations. Treading these two worlds is difficult at times and requires that a school nurse possess a strong foundational knowledge base, seek professional collaboration, and navigate conflicting professional demands in order to promote student and public safety. This article is Part 1 of a four-part series that recounts the inspiring story of a school nurse, Ellen Johnsen, who did just that back in the 1980s in Broken Arrow, Oklahoma. Part 1 describes the upbringing and early career experiences that molded Ellen into a courageous and tenacious child advocate who rose to the challenge when she found herself in a school setting where tradition and policy were at odds with the nurse practice act and professional standards regarding medication administration. The purpose of this series is to enhance understanding of the legal parameters governing school nurse practice, provide examples of ethical decision making, and review the challenges associated with serving as a leader.

Care of the Student With Special Healthcare Needs: The Development of the WISHeS Unlicensed Assistive Personnel Training.

Care of the Student With Special Healthcare Needs is a free resource that can assist school nurses in ensuring they are providing the most up-to-date, evidence-based care to children. Although the training module was developed to improve the care provided to Wisconsin children, the module can be accessed by school nurses and unlicensed assistive personnel (UAP) across the United States and internationally. School nurses in other states would need to review their state's nurse practice act and school district policies to evaluate which procedures they are allowed to delegate.

The ANA Code of Ethics for Nurses With Interpretive Statements: Resource for Nursing Regulation

The American Nurses Association (ANA) Code of Ethics for Nurses With Interpretive Statements informs decision making about ethical violations by nurses and nursing education programs. The Code is the nursing profession's ethical standard of practice and nursing's contract with society. Nurse practice acts (NPAs) and the standards of practice are the profession's legal standard. This article describes the nine provisions of the Code and provides cases of ethical violations and the disciplinary actions that were taken. The intent of this article is to serve as an educational resource on how the Code can be used with NPAs to support nurse regulators in their decision making.

Substance Abuse Policy Among Nursing Students: A Scoping Review.

Nursing students practicing in healthcare settings may increase risks to consumers, if impaired by drugs and/or alcohol, and are incapable of practicing safely. Several agencies implemented educational/professional policies, designed to protect healthcare consumers from risks. Policies addressing impaired nursing students vary among these agencies, and no nationally implemented policy exists for the treatment of impaired nursing student practice in the United States. This scoping study synthesizes substance abuse policy among nursing students, guided by the research question: What professional and state policies exist to address substance abuse among U.S. nursing students? The broader term, substance abuse, was used because alcohol-specific policies were not identified. Evidence was drawn from several policy documents identified through electronic sources that include national nursing organizations (NNOs) and nurse practice acts (NPAs) and rules. A comparative analysis was conducted on the identified policies to determine similarities and differences at the national and state levels and between national and state levels. Four NNO policies, 50 U.S. states, District of Columbia, and two U.S. territories' NPAs were selected for review based on selection criteria. Six areas were identified in NNO policies, and four were identified in NPAs that addressed chemically impaired nursing students. This review of current policy provided evidence that identifies and describes areas of concern. Impaired nursing practice, which includes nursing students, remains a major issue, complicated by the inconsistencies noted particularly within the reviewed NPAs. Knowledge gained from this review will be used to guide future research and subsequent state policy development.

Reuse of single-use critical medical devices.

Reprints are available for purchase from SGNA Headquarters. To order, contact: Department of Membership Services, Society of Gastroenterology Nurses and Associates, Inc., 330 North Wabash, Chicago, IL 60611 (e-mail: [email protected]) THE OFFICIAL JOURNAL OF THE SOCIETY OF GASTROENTEROLOGY NURSES AND ASSOCIATES, INC. AND THE CANADIAN SOCIETY OF GASTROENTEROLOGY NURSES AND ASSOCIATES DEDICATED TO THE SAFE AND EFFECTIVE PRACTICE OF GASTROENTEROLOGY AND ENDOSCOPY NURSING DISCLAIMER The Society of Gastroenterology Nurses and Associates, Inc. (SGNA), presents this guideline for use in developing institutional policies, procedures, and/or protocols. Information contained in this guideline is based on current published data and current practice at the time of publication. The Society of Gastroenterology Nurses and Associates, Inc., assumes no responsibility for the practices or recommendations of any member or other practitioner, or for the policies and practices of any practice setting. Nurses and associates function within the limits of state licensure, state nurse practice act, and/or institutional policy. The members of the SGNA Practice Committee 2011-2012 are Michelle E. Day, MSN, BSN, RN, CGRN, Chair; Michelle Juan, MSN, RN, CGRN, Co-Chair; Kathy Buffington, BSN, RN, CGRN; Rhonda L. Casey, RN, BS, MHA, CGRN; Cynthia M. Friis, MEd, BSN, RN-BC; Ann Herrin, BSN, RN, CGRN; Colleen Kelley Keith, MSN, RN, CGRN; Judy Lindsay, MA, BSN, RN, CGRN; Marilee Schmelzer, PhD, RN; and Barbara Zuccala, MSN, RN, CGRN. The authors declare no conflicts of interest.

VA Professional Nursing Regulation and Practice

Just as boards of nursing (BONs) operationalize statutes specific to states' rules and regulations within their nurse practice act, Congress provides the U.S. Department of Veterans Affairs (VA) with the power and authority to regulate the professional activities of its health care practitioners under Title 38 of United States Code. Under this authority, the VA establishes qualifications for nurses and regulates their professional conduct. This article presents a demographic overview of VA registered nurses, nurse practitioners, and clinical nurse specialists; nursing practice standards and elements; the appointment, credentialing, and peer review of VA professional nurses; advanced practice registered nurse privileging; reporting and responding to BONs; and the related processes that ensure public safety.

Licensed Practical Nurse Scope of Practice and Quality of Nursing Home Care

Although higher levels of registered nurse (RN) staffing in nursing homes are related to better care quality, licensed practical nurses (LPNs) provide most licensed-nursing care; prior research is mixed regarding how this influences quality. The nature of LPN practice, and RN direction of that practice, follows in part from state nurse practice acts (NPAs). Among the 50 states and the District of Columbia, the aims of this study were to describe regulatory differences in how LPNs contribute to nursing assessment, care planning, delegation and supervision, and RN practice in these domains and to explore how these regulatory differences relate to quality of care in nursing homes. The study design was a sequential explanatory mixed-methods design of NPAs and Centers for Medicare and Medicaid quality measures of long-stay nursing home residents. In the qualitative strand, 51 NPAs and related administrative code were analyzed to classify guidance on RN and LPN practice; then, the coded data were transformed to quantitative indicators of specificity regarding LPN and RN scope of practice. In the quantitative strand, state NPA data were linked to facility-level Centers for Medicare and Medicaid staffing and quality measures (N = 12,698 facilities) for cross-sectional, quantitative analyses. States varied considerably in how NPAs guided LPN and RN scope of practice. NPA differences were related to quality indicators of resident pain, catheter use, weight loss, and restraints, even when accounting for nursing home staff mix. Care quality was better in states where the NPA clearly described LPN scope, but only when there was also greater RN availability (p < .05). Classifying scope of nursing practice regulations moves beyond traditional staffing measures to inform understanding of the effects of the RN-to-LPN staffing ratio on quality of care in nursing homes.

Reprocessing of Endoscopic Accessories and Valves

DISCLAIMER The Society of Gastroenterology Nurses and Associates, Inc. (SGNA), assumes no responsibility for the practices or recommendations of any member or other practitioner or for the policies and procedures of any practice setting. Nurses and associates function within the limitations of licensure, state nurse practice act, and/or institutional policy. THE OFFICIAL JOURNAL OF THE SOCIETY OF GASTROENTEROLOGY NURSES AND ASSOCIATES, INC. AND THE CANADIAN SOCIETY OF GASTROENTEROLOGY NURSES AND ASSOCIATES DEDICATED TO THE SAFE AND EFFECTIVE PRACTICE OF GASTROENTEROLOGY AND ENDOSCOPY NURSING