Chapter
138
2003 -- H 6111 SUBSTITUTE A AS AMENDED
Enacted 07/10/03
A N A C T
RELATING TO BUSINESSES AND
PROFESSIONS -- NURSES
Introduced By:
Representatives Costantino, Ginaitt, Slater, Mumford, and Giannini
Date
Introduced: February 13, 2003
It is enacted by the General
Assembly as follows:
SECTION
1. Chapter 5-34 of the General Laws entitled "Nurses" is hereby
amended by
adding thereto the following
section:
5-34-1.1.
Title of act. – This act shall be known and may be cited as
"The Rhode Island
Nurse Practice Act."
SECTION
2. Sections 5-34-3, 5-34-4, 5-34-5, 5-34-6, 5-34-7, 5-34-9, 5-34-14, 5-34-18,
5-34-19, 5-34-20, 5-34-24.1,
5-34-25, 5-34-26, 5-34-31, 5-34-35, 5-34-39, 5-34-40 and 5-34-41
of the General Laws in Chapter
5-34 entitled "Nurses" are hereby amended to read as follows:
5-34-3.
Definitions. -- (a) "Approval" means the process where the
board of nursing
evaluates and grants official
recognition to basic nursing education programs meeting established
criteria and standards.
(b)
"Certified registered nurse practitioner" is an advanced role practice
nurse utilizing
independent knowledge of physical
assessment 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.
(c)
"Health" means optimum well-being.
(d)
"Healthcare" means those services provided to promote the optimum
well-being of
individuals.
(e)
"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.
(f)
"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 plan of care prescribed by a 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.
(g)
"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 professional registered
nurse. In situations where professional registered nurses are not
employed, the licensed practical
nurse functions under the direction of a licensed physician,
dentist, or podiatrist or
other licensed health care providers authorized by law to prescribe. Each
L.P.N. is responsible for the
nursing care rendered.
(h)
"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.
(i) "Psychiatric
and mental health nurse clinical specialist" is an advanced role practice
nurse utilizing independent knowledge and management of
mental health and illnesses. The
practice including may
include prescription privileges 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 include
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 has a masters degree
in nursing, has an active
license as a registered nurse and is certified by a national body as
approved by the Rhode Island
board of nurse registration and nursing education. holds the
qualifications defined in
section 5-34-40.1.
(j)
"Advanced practice 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.
(k)
"Department" means the department of health.
5-34-4.
Board of nursing -- Establishment -- Composition -- Appointment, terms,
and removal of members --
Director of nursing education 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.
The board is composed of eleven
(11) fifteen (15) members. The term of office is for three (3)
years. No member serves more than
two (2) consecutive terms. The member serves until a
qualified successor is appointed to
serve. In making those appointments, the director of health
considers 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 as
amended, entitled
"Nurses", serve as members of the board until the expiration of their
terms or
until qualified successors are
appointed. The eleven (11) fifteen (15) member board includes:
seven (7) 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 are from different basic education programs preparing
students to become professional
nurses; one professional nurse is from a basic education program
preparing students to become
practical nurses; one (1)
professional nurse is from a nursing
service administration; and two
(2) four (4) professional nonadministrative, clinical nurses not
licensed as advanced practice
nurses, and three (3) professional advanced practice nurses, one (1)
who holds a license as a
certified registered nurse anesthetist, one (1) who holds a license as a
certified registered nurse
practitioner, and one (1) who holds a license as a psychiatric and mental
health nurse clinical specialist. No educational program or cooperating agency has
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 is disqualified from
board business until the charge is
adjudicated. There is also 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. , who
serves as executive secretary of the board.
5-34-5.
Board of nursing -- Qualifications of members. -- (a) Each member of
the
board of nurse registration and
nursing education shall:
(1)
Be a citizen of the United States;
(2)
Be a resident of the state for at least one year immediately preceding
appointment;
(3)
File the statutory oath of office with the secretary of state before beginning
the term
of office; and
(4)
Sign a conflict-of-interest statement.
(b)
Each professional nurse member of the board is:
(1)
Currently licensed as a registered nurse in the state; and
(2)
Has at least five (5) years' experience in nursing practice or administration,
nursing
service, or teaching or
administration in a nursing education program and is currently employed
in nursing at the time of
appointment and employed in nursing for at least three (3) years
immediately preceding appointment.
(c)
Each practical nurse member of the board is:
(1)
Currently licensed as a practical nurse in the state; and
(2)
Has at least five (5) years' experience in practical nursing and is currently
employed
in nursing for at least three (3)
years immediately preceding appointment.
(d)
Each advanced practice nurse member of the board:
(1)
Is currently licensed as an advanced practice nurse in the state; and
(2)
Has at least five (5) years experience in nursing practice and is currently
employed as
an advanced practice nurse for
at least three (3) years immediately preceding appointment.
(e)
Neither member from the general public is a nurse or is enrolled in a nursing
education program.
5-34-6.
Board of nursing -- Organization -- Meetings. -- The board of nurse
registration and nursing education
elects annually from its membership a president and vice-
president. A secretary is also
elected. The state director of nurse registration and nursing
education serves as executive
secretary to the board but is not a member of the board. Meetings
may be called by the president,
vice-president, executive secretary director of nurse registration
and nursing education, director of health, or upon written request of five
(5) members of the
board. A majority constitutes a
quorum at any meeting.
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 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;
(2)
Prescribe standards for nursing education programs preparing persons for
licensure
under this chapter;
(3) Provide for evaluation of nursing education programs and related clinical
facilities at
those times it may deem
necessary;
(4) Approve nursing education programs that meet the requirements of the
chapter;
(5) Deny or withdraw approval from nursing education programs for failure to
meet or
maintain prescribed standards;
provided, that withdrawal of approval is effected only after a
hearing in accordance with the
board's rules and regulations;
(6)
(3) Require standards for nursing practice within organized nursing
services and the
individual practice of licensees;
(7)
(4) Approve and administer the examinations for licensure;
(8)
(5) Establish requirements to validate competence for reinstatement to
the active list;
(9)
(6) Conduct hearings upon charges calling for discipline of a licensee
or revocation
of a license;
(10)
(7) Issue subpoenas to, compel the attendance of witnesses at, and
administer oaths
to persons giving testimony at
hearings;
(11)
(8) Cause the prosecution or enjoinder of all persons violating this
chapter;
(12)
(9) Maintain a record of all its proceedings;
(13)
(10) Submit an annual report to the director of health;
(14)
(11) Utilize other persons that may be necessary to carry on the work of
the board;
(15)
(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, allowing the
nursing profession to provide safe, effective nursing services to the
public;
(16)
(13) Determine qualifications necessary for prescriptive privileges for
certified
registered nurse practitioners; and
(17)
(14) Grant certified registered nurse practitioners prescriptive
privileges and
transmit this information to the
board of pharmacy. ;
(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.
5-34-9.
Register of nurses -- Records -- Issuance of licenses. -- The administrator
of
professional regulation department licenses and renews licenses upon
the recommendation of the
board of nurse registration and
nursing education and maintains a roster of all applicants for
licensure and all nurses licensed
under this chapter, which is open at all reasonable times to
public inspection; and is custodian
of all records pertaining to the roster and licensing of all
nurses; and has the custody of the
official seal. He or she The department issues all licenses to
practice nursing only upon
recommendation of the board of nurse registration and nursing
education.
5-34-14.
Qualifications of practical nurse applicants. -- An applicant for a
license to
practice as a licensed practical
nurse submits to the board of nurse registration and nursing
education written evidence on forms
furnished by the division of professional regulation
department, verified by oath, that the applicant:
(1)
Has completed the preliminary educational requirements prescribed by the board;
(2)
Has furnished satisfactory proof that he or she successfully completed
the prescribed
curriculum in a an state-approved
program of practical nursing and holds a diploma or certificate
from the program or is a
graduate of an approved school of professional nursing or was a student
in good standing at an approved
school of professional nursing before completing the program of
studies and, at the time of
withdrawal, had completed a program of study, theory and clinical
practice equivalent to that
required for graduation from an approved school of practical nursing if
the applicant has not been
previously licensed; and
(3)
Is of good moral character.
5-34-18.
Signature on licenses for nursing. -- All original licenses to practice
nursing
either as a professional or
practical nurse under this chapter is are signed by the president
and
executive secretary of the board the director of nurse registration and nursing
education, the
administrator of professional
regulation, and the director of
health.
5-34-19.
Expiration and renewal of licenses. -- (a) The license of every person
licensed
under this chapter expires on the
first day of March of every other year following the date of
license. This will be determined
on an odd-even basis. On or before the first day of January of
every year, the administrator of
professional regulation the director mails an application for
renewal of license to people scheduled
to be licensed that year on an odd-even basis with respect
to the license number. Every person who wishes to renew his or her license
files with the
administrator of professional
regulation department a
renewal application duly executed together
with the renewal fee of sixty-two
dollars and fifty cents ($62.50).
(b)
Upon receipt of an application accompanied by payment of fees, the administrator
of
professional regulation department grants a renewal license effective
March second and expiring
two (2) years later on March first,
and that renewal license renders the holder a legal practitioner
of nursing for the period stated on
the certificate of renewal. ; provided that every person seeking
renewal of a license hereunder
shall provide satisfactory evidence to the department that in the
preceding two (2) years the
practitioner has completed the ten (10) required continuing education
hours as established by the
department through rules and regulations. The department may
extend for only one (1) six (6)
month period these educational requirements if the department is
satisfied that the applicant has
suffered hardship which prevented meeting the educational
requirement.
(c)
Any person practicing nursing during the time his or her license has lapsed is
considered an illegal practitioner
and is subject to the penalties provided for violation of this
chapter.
(d)
A licensee whose license has expired by failure to renew may apply for
reinstatement
according to the rules
established by the board. Upon satisfaction of the requirements for
reinstatement, the board shall
issue a renewal of license.
5-34-20.
Transfer to inactive list -- Reinstatement. -- A nurse who does not
intend to
practice nursing during the two (2)
year period, upon written request to the administrator of
professional regulation department, may have his or her name
transferred to an inactive list and is
not required to pay the renewal fee
for as long as the inactive status is maintained. Should that
nurse resume practice at some
future time, he or she notifies the administrator of professional
regulation and remits the
renewal fee, and the license is reinstated. A licensee whose license has
been transferred to the inactive
list may apply for reactivation according to the rules established
by the board. Upon satisfaction
of the requirements for reinstatement, the department shall issue
a renewal of license.
5-34-24.1.
Nondisciplinary alternative. -- The board of nurse registration and
nursing
education may provide for a nondisciplinary alternative in
situations involving alcohol and drug
abuse; or any mental illness as
listed in the most recent revised publication or the most updated
volume of either the Diagnostic and
Statistical Manual of Mental Disorders (DSM) published by
the American Psychiatric
Association or the International Classification of Disease Manual (ICO)
published by the World Health
Organization and that substantially limits the life activities of the
person with the illness; provided, that the nurse agrees to voluntarily
participate in a program of
treatment and rehabilitation. All
records pertaining to a nurse's participation in the
nondisciplinary program are
confidential and not subject to discovery, subpoena or public
disclosure. Provided, that
information related to the nondisciplinary program is provided to the
nurse's employer to ensure adequate
worksite monitoring and compliance.
5-34-25.
Procedure for discipline of licensees. -- (a) Upon filing a timely
sworn
complaint within a time period the
board considers reasonable with the board charging a person
with having been guilty of any of
the actions specified in section 5-34-24, two (2) or more
members of the board of nurse registration
and nursing education immediately investigate those
charges, or the board, after
investigation, may institute charges.
(b)
In the event that investigation, in the opinion of the board, reveals
reasonable grounds
for believing the applicant or
licensee is guilty of the charges, the board fixes a time and place for
a hearing of the charges and
causes a copy of the charges, together with a notice of the time and
place fixed for the hearing, to
be personally served upon the accused
shall notify the licensee of
the charges and the time and
place for a hearing at least twenty
(20) days prior to the time fixed
for the hearing. When personal
service cannot be effected and that fact is certified by oath by any
person authorized to make
service, the board causes to be published once in each of two (2)
successive weeks a notice of the
hearing in a newspaper published in the county where the
defendant last resided according
to the records of the board and mails a copy of the charges and
the notice to the accused at his
or her last known address. When publication of notice is
necessary, the date of the
hearing is not less than twenty (20) days after the last date of
publication of the notice. At the hearing, the accused has the right to appear
personally, or by
counsel, or both, to produce
witnesses and to have subpoenas issued by the board. The attendance
of witnesses and the production of
books, documents, and papers at the hearing may be
compelled by subpoenas issued by
the board, which is served in accordance with the law. At the
hearing, the board administers
oaths that may be necessary for the proper conduct of the hearing.
The board is not bound by the
strict rules of procedure or by the laws of evidence in the conduct
of its proceedings, but the
determination is based upon sufficient legal evidence to sustain it. The
board shall complete the
investigation of each complaint and issue a decision within six (6)
months of the receipt of the
complaint; provided, however, that the board may extend the time for
issuing its decision beyond the
initial six (6) month period in documented cases in which delays
in the process are the direct
result of requests or actions by the accused and/or his or her
representative(s) or other good cause.
The board, on a case by case basis, for good cause shown in
writing, may extend the time for
issuing its decision. If the accused is found guilty of the charges,
the board may revoke, suspend, or
otherwise discipline a licensee. If the accused is found guilty
of the charges, the board may
revoke, suspend, or discipline a licensee.
(b)
Upon revocation or suspension of a license, the holder surrenders the license
to the
administrator of professional
regulation, who strikes the name of the holder from the current
roster of licensed nurses. The
date and action taken is recorded. The case of a licensee with a
revoked or suspended license is
reviewed at the discretion of the board. The case of a licensee
who was reprimanded or
disciplined by the board should be recorded as to the date and the action
taken and may be reviewed at the
discretion of the board.
(c)
All hearings held under this section shall be conducted in accordance with the
provisions of chapter 42-35
entitled "Administrative Procedures Act."
5-34-26.
Grounds for discipline without a hearing. -- In the event a person
is
hospitalized for mental illness,
or for substance abuse, the board may, without the necessity of the
proceedings provided for in
section 5-34-25, suspend or refuse to renew the license of that person
for the duration of that
confinement or until that person is medically discharged from that
hospitalization. The director may temporarily suspend the license
of a nurse without a hearing if
the director finds that evidence
in his or her possession indicates that a nurse's continuation in
practice would constitute an
immediate danger to the public. In the event that the director
temporarily suspends the license
of a nurse without a hearing, a hearing by the board must be held
within ten (10) days after the
suspension has occurred.
5-34-31.
Practices and persons exempt. -- No provisions of this chapter are
construed
as prohibiting: (1) gratuitous
nursing by friends or members of the family or as prohibiting the
care of the sick by domestic
servants, housekeepers, nursemaids, companions, or household aides
of any type, whether employed
regularly or because of an emergency of illness, provided that
person is employed primarily in a
domestic capacity and does not hold himself or herself out or
accept employment as a person
licensed to practice nursing for hire under the provisions of this
chapter or as prohibiting nursing
assistants in the case of any emergency; (2) the practice of
nursing by students enrolled in
approved educational programs of professional nursing or
practical nursing educational
programs nor by graduates of those schools or courses pending the
results of the licensing
examinations following that graduation, provided that they are licensed in
this state within ninety (90)
days from the date on the application fee receipt, in accordance with
regulations prescribed by the
board; (3) the practice of nursing in this state by any legally
qualified nurse of another state
whose engagement requires him or her to accompany and care for
a patient temporarily residing in
this state during the period of this engagement not to exceed six
(6) months in length, provided that
person does not represent or hold himself or herself out as a
nurse licensed to practice in this
state; (4) the practice of any legally qualified nurse of another
state who is employed by the United
States government or any bureau, division, or agency of the
government while in the discharge
of his or her official duties; (5) persons employed in state and
licensed hospitals and sanatoria,
licensed homes for the aged and/or convalescent persons, and
recognized public health agencies
from assisting in the nursing care of patients if adequate
medical or nursing supervision is
provided; (6) nursing care of the sick with or without
compensation or personal profit
when done in connection with the practice of the religious tenets
of any recognized or established
church by adherents as long as they do not engage in the practice
of nursing as defined in this
chapter; (7) persons who provide acceptable evidence of being
currently licensed by examination
or endorsement under the laws of other states of the United
States and the District of Columbia
from practicing nursing in this state for a period of ninety (90)
days from the date on the
application fee receipt, provided that they are licensed in this state
within ninety (90) days from the
date on the application fee receipt. The original privilege to
work ninety (90) days from the date
on the application fee receipt is not extended or renewed.
5-34-35.
Qualifications of a certified registered nurse practitioner applicant. –
(a)
An applicant for licensure to practice
as a certified registered nurse practitioner submits to the
board of nurse registration and
nursing education written evidence on forms furnished by the
division of professional
regulation, verified by oath, that the applicant:
(1) Is
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) Passed
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.
5-34-39.
Process for prescriptive privileges of certified registered nurse
practitioner
-- Formulary committee Process for prescriptive privileges of certified
registered nurse
practitioner. -- (a) Prescriptive privileges for the certified
registered nurse practitioner:
(1)
Are granted under the governance and supervision of the division of
professional
regulation department, board of nurse registration and
nurse education; and
(2)
Include prescription of legend medications and prescription of controlled substances
from schedules II, III, IV and V
that are established in regulation by the director with the advice
of the formulary committee
established by this section; and
(3)
Must not include controlled substances from Schedule I.
(b)
The director of the department of health establishes a formulary committee to
develop a formulary to carry out
the provisions of this section. The formulary is updated annually
by the formulary committee. Each
setting where these privileges are allowed, may further restrict
the formulary according to their
own protocols. The committee consists of two (2) physicians,
from a list submitted by the
Rhode Island medical society, one pharmacist, from a list submitted
by the Rhode Island
pharmaceutical association, two (2) certified registered nurse practitioners,
from a list submitted by the
Rhode Island state nurses association and one who is the department
of health's drug control
administrator or designee. The committee submits a completed formulary
to the director of the
department of health of the state by September 1, 1996.
(c)
Each committee member is initially appointed for a one year term by the
director of
the department of health. At the
expiration of the one year term, one certified registered nurse
practitioner is appointed for a
three (3) year term, one certified registered nurse practitioner is
appointed for a two (2) year
term; one physician is appointed for a three (3) year term, one
physician is appointed for a two
(2) year term; one pharmacist is appointed for a three (3) year
term. Subsequently, each
appointment is for three (3) years with no member serving more than
two (2) consecutive three (3)
year terms.
(d)
(b) A certified registered nurse practitioner (R.N.P.) as stated in
section 5-34-3 is
permitted to prescribe from the
formulary established by the formulary committee in accordance
with annually updated guidelines,
written in collaboration with the medical director or physician
consultant of their individual
establishments.
(e)
(c) 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.
Nurse practitioner joint practice advisory committee Certified
registered
nurse practitioner joint practice
advisory committee. -- (a) The
seven (7) member committee
consists of three (3) physicians,
three (3) certified registered nurse practitioners, and one
consumer. The governor appoints
three (3) physicians to the committee from the following
specialties -- adult medicine,
pediatric medicine, and obstetrical-gynecological medicine. The
governor appoints three (3)
certified registered nurse practitioners from the following specialties -
- adult nurse practitioner,
pediatric nurse practitioner, and obstetrical-gynecological nurse
practitioner. The professional
members of the committee are currently engaged in a collaborative
certified registered nurse
practitioner-physician care practice. The consumer member is appointed
by the director of the department
of health of the state. The consumer member is (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
professional committee member and the consumer member are initially
appointed for a one year term.
At the expiration of the one year term, one certified registered
nurse practitioner and one
physician shall be appointed for a three (3) year term, one certified
registered nurse practitioner
and one physician are appointed for a two (2) year term, and one
certified registered nurse
practitioner, one physician and the consumer member are appointed for
a one year term. Subsequently,
each Each member appointment
is for three (3) years, with no
member serving more than two (2)
consecutive 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 nurse practitioner joint primary care practice for the purpose of
improving
patient care.
(2)
Review complaints regarding certified registered nurse practitioners, and
recommend
any disciplinary or corrective
action that they deem appropriate, including revocation and
suspension of certification, upon
proof that a nurse practitioner has:
(i)
Aided or abetted an uncertified person to practice as a nurse practitioner;
(ii)
Become addicted to the use of liquor or controlled substances;
(iii)
Negligently, willfully, or intentionally acted in a manner inconsistent with
the health
and safety of persons entrusted to
his or her care;
(iv)
Had his or her authorization to practice as a nurse practitioner denied,
revoked or
suspended in another state;
(v)
Engaged in the performance of medical functions beyond the scope of practice
authorized by the provisions of
this chapter;
(vi)
Willfully failed to file or record medical records and reports; or
(vii) Mental incompetence.
(3)
The recommendation is submitted to the board of nursing for
implementation,.
subject to the approval of the
director of health. Provided, that the board of nursing may, if they
have clear and convincing
evidence that actions of the nurse practitioner that led to the
recommendation is more
appropriately the responsibility of their board, request that the director
of health review the case and
make a determination as to which entity has responsibility for the
case.
(4)
Report periodically to the board of nurse registration and nursing education
regarding
certified registered nurse
practitioner practice.
5-34-41.
Process for prescriptive privileges of psychiatric and mental health nurse
clinical specialist --
Formulary committee
Process for prescriptive privileges of psychiatric
and mental health clinical
nurse specialist. -- (a)
Prescriptive privileges for the psychiatric and
mental health clinical nurse
clinical specialist:
(1)
Are granted under the governance and supervision of the division of
professional
regulations, board of nurse
registration and nurse education; and
(2)
Include prescription of certain psychotropic and certain legend medications;,
controlled substances from
Schedule II classified as stimulants, and
prescription of controlled
substances from Schedule IV, that
are prescribed in regulations by the director with the advice
and consent of the formulary
committee established by this section;
and
(3)
Do not include controlled substances from Schedules I, II, III and V and those
certain
legend medications not included in
subdivision (2).
(4)
Are granted for psychiatric and mental health clinical nurse specialists who
have a
master's degree in nursing.
(b) The director of the department of health establishes a formulary committee
to
develop a formulary to carry out
the provisions of this section. The formulary is updated annually
by the formulary committee. Each
setting may further restrict the formulary according to their
own protocols. The committee
consists of two (2) psychiatrists from a list submitted by the R.I.
Medical Society, two (2)
psychiatric and mental health nurse clinical specialists, from a list
submitted by the R.I. State
Nurses Association, one pharmacist, from a list submitted by the R.I.
Pharmacists Association, and one
who is the department of health's chairperson of the board of
pharmacy or designee. The
committee must submit a completed formulary to the director of the
department of health of the
state of R.I. by September 1, 1997.
(c) Each committee member is initially appointed for a one year term by the
director of
the department of health. At the
expiration of the one year term, one psychiatrist is appointed for
a three (3) year term and one
psychiatrist is appointed for a two (2) year term; one psychiatric and
mental health nurse clinical
specialists is appointed for a three (3) year term and one psychiatric
and mental health nurse clinical
specialists is appointed for a two (2) year term; the pharmacist is
appointed to a three (3) year
term. Subsequently, each appointment is for three (3) years with no
member serving more than two (2)
consecutive three (3) year terms.
(d)
(b) A psychiatric and mental health clinical nurse clinical
specialist as stated in
section 5-34-3, is permitted to
prescribe from the formulary established by the formulary
committee in accordance with annually updated guidelines,
written in collaboration with the
medical director or physician
consultant of their individual establishments.
(e)
(c) Provided, that a psychiatric and mental health clinical nurse
clinical specialist in
independent practice does not have
prescriptive privileges.
(f)
(d) To qualify for prescriptive privileges a psychiatric and mental
health clinical nurse
clinical specialist, as stated in section 5-34-3, submits 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 clinical 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
3. Chapter 5-34 of the General Laws entitled "Nurses" is hereby
amended by
adding thereto the following
sections:
5-34-24.2.
Immunity. – (a) The director of health, director of nursing
registration and
education, board members, and
their agents and employees are immune from suit in any action,
civil or criminal, based on any
disciplinary proceeding or other official act performed in good
faith in the course of their
duties under this chapter. There is no civil liability on the part of, or
cause of action of any nature
against, the board, director, their agents or their employees or
against any organization or its
members, peer review board or its members, or other witnesses
and parties to board
proceedings for any statements made in good faith by them in any reports,
communications, or testimony
concerning an investigation by the board of the conduct or
regarding the competence of a
licensed nurse.
(b)
No licensed health care provider, physician, or limited registrant may
discharge,
threaten or discriminate
against an employee, staff member or any other person for making a
report to, giving testimony to,
or providing any other communication to the board, a peer review
organization, or any
appropriate supervisory personnel concerning the unprofessional conduct or
incompetence or negligence of a
nurse; provided, that the report, testimony or other
communication was made in good
faith.
5-34-40.1.
Qualifications of a psychiatric and mental health clinical nurse specialist
applicant. – (a) An applicant for licensure as a psychiatric
and metal health clinical nurse
specialist submits 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 is 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 United States
and/or the District of Columbia
are allowed to practice as psychiatric and mental health 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 Rhode Island 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 in not 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 is ninety-three dollars and seventy-five cents
($93.75). The renewal fee for a
psychiatric and mental health clinical nurse specialist is eighty-seven
dollars and fifty cents
($87.50) biennially, sixty-two dollars and fifty cents ($62.50) for the
registered nurse fee plus
twenty-five dollars ($25.00) for the psychiatric and mental health
clinical nurse specialist. The
fee for application for prescriptive privileges is thirty-one dollars
and twenty-five cents ($31.25).
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.
SECTION
4. Sections 5-34-22, 5-34-23, 5-34-24.2, 5-34-24.3 and 5-34-24.4 of the
General Laws in Chapter 5-34
entitled "Nurses" are hereby repealed.
5-34-22.
Application for evaluation and approval of basic nursing education
programs. -- An institution desiring to conduct an educational
program of professional or
practical nursing applies to the
board of nurse registration and nursing education and submits
evidence that:
(1) It is prepared to carry out the program in accordance with the
board-prescribed
curriculum standards for
professional or practical nursing education; and
(2) It is prepared to meet other standards and criteria established in
accordance with this
chapter by the board.
5-34-23.
Process for initial and continuing evaluation and approval of basic nursing
education programs. -- Utilizing the board-prescribed criteria and
curriculum standards for basic
professional practical nursing
education programs, a site visit and an initial evaluation of a new
basic nursing education program
is made by the state director of nursing education and/or another
authorized representative of the
board of nurse registration and nursing education, who submits a
written report of the findings
to the board. If, in the opinion of the board, the criteria are met by
the institution, the board
grants the program initial approval. Periodically, as deemed necessary
by the board, it is the duty of
the board, through the state director of nursing education or other
authorized representative of the
board, to re-evaluate all basic nursing education programs in this
state. Written reports of that
evaluation are submitted to the board. If the board determines that
any approved program of basic
nursing education is not maintaining the standards prescribed by
the board, notice, in writing,
of that deficit is immediately communicated, in writing, to the
program director by the board. A
program which fails to correct these conditions to the
satisfaction of the board within
a reasonable time and following a hearing on this may be
removed from the list of
state-approved programs of basic nursing education until the time the
program complies with the
standards required by the board. All approved programs must
maintain occurring or attempting
to procure a license to practice nursing;
(2) Guilty of a crime of gross immorality;
(3) Unfit or incompetent by reason of negligence or habits;
(4) Habitually intemperate or is addicted to the use of habit-forming drugs;
(5) Mentally incompetent;
(6) Guilty of unprofessional conduct which includes, but is not limited to, all
of the
above and also:
(i) Abandonment of a patient;
(ii) Willfully making and filing false reports or records in the practice of
nursing;
(iii) Willful omission to file or record nursing records and reports required
by law;
(iv) Failure to furnish appropriate details of a client's nursing needs to
succeeding nurses
legally qualified to provide
continuing nursing services to a client;
(v) Willful disregard of standards of nursing practice and failure to maintain
standards
established by the nursing
profession; or
(7) Guilty of and willfully or repeatedly violating any of the provisions of
this chapter
and/or rule or regulation
adopted thereunder.
5-34-24.2.
Criteria which disqualify a nurse from participating in a nondisciplinary
substance abuse program.
-- (1) Nurse previously
enrolled in the nondisciplinary program and
referred to the board of action.
(2) Nurse who has diverted drugs;
(3) Nurse convicted of the sale, distribution or manufacture of illegal substances;
(4) Severity of a chemical dependency problem that represents a clear and
present danger
to patient health and safety;
(5) Any other criteria established by the board of nursing by regulation.
5-34-24.3.
Criteria for admission to the program. -- (a) A nurse may be
considered for
a nondisciplinary program in the
following ways:
(1) By self referral;
(2) By employer referral;
(3) By identification of chemical dependency in conjunction with a sworn
complaint
filed against the nurse; or
(4) By referral from a family member, friend, nurse peer, another nurse or
professional
nurse association, or other
health care provider.
(b) If the nurse does not agree to voluntarily participate in a treatment program
protocol
approved by the board of
nursing, or fails to satisfactorily complete a treatment program, the
board of nursing is informed and
initiates disciplinary proceedings.
5-34-24.4.
Advisory panel. -- A nondisciplinary alternative advisory panel
is established
to assist the department of
health in developing rules and regulations pursuant to this chapter. The
panel, appointed by the director
of the department of health, consists of eight (8) members as
follows:
(1) One person who is a member of the nurse executive committee of the hospital
association of Rhode Island
designated by the president of the hospital association.
(2) One person who is a member of an employee assistance program in Rhode
Island
designated by the director of
the department of health.
(3) One person who is a member of the Rhode Island state nurses association
designated
by its president.
(4) One person who is a member of the American federation of
teachers/federation of
health professionals designated
by its president.
(5) One person who is a member of the Rhode Island health care association
designated
by its president.
(6) One person who is a member of the Rhode Island association of facilities
for the
aging designated by its president.
(7) One person who is a member of Rhode Island visiting nurse association
designated
by its president.
(8) One person who is a member of New England health care employees union,
district
1199 designated by its
president.
SECTION
5. This act shall take effect upon passage.
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LC02474/SUB A/2
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