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Legislative efforts in both the Federal and State domains serve as guidelines for all levels of health policy
Legislative efforts in both the Federal and State domains serve as guidelines for all levels of health policy; from Federal regulations that impact all people in the United States, all the way down to the bedside. Bedside nursing practice is regulated by each State via their State Nurse Practice Act (NPA) which often includes a separate Rules and Regulations document.
In this discussion, you will explore your State's Nurse Practice act.
Find your state’s NPA using this site: NCSBN’s Find Your Nurse Practice Act webpageLinks to an external site.
In your initial discussion response, please address the following:
Your state Professions included in your State's NPA. Compare scope of LPN vs. RN vs. APRN. What are the limitations of each? Rules for the Board of Nursing Delegation as described in the NPA Continuing Education Requirements. Reflect: What is something you learned while exploring your State's NPA? Is the scope, as stated in the NPA, for an RN adequately integrated in your nursing model of care at your institution? If yes, how? If no, what are the steps for aligning the NPA and the nursing structure at your facility? https://www.ncsbn.org/npa
Full Answer Section
Comparison of Scope of Practice:
LVN (LPN):
Scope is focused on basic nursing care under the supervision of an RN or physician.
Limitations: Limited ability to perform complex assessments, administer certain medications (e.g., IV push), or develop care plans. They work within a more dependent role.
RN:
Scope encompasses a broader range of nursing activities, including complex assessments, care planning, medication administration, and patient education.
Limitations: While RNs have a wider scope than LVNs, they still operate within the boundaries of their education, training, and state regulations. They may have limitations on independent practice, especially concerning prescribing medications or performing advanced procedures without specific certifications.
APRN:
Scope includes advanced assessment, diagnosis, treatment, and management of patient conditions. They may have prescriptive authority and perform advanced procedures.
Limitations: The scope of APRN practice varies depending on their specific certification and state regulations. In California, NPs have a high degree of autonomy, especially with standardized procedures, but still operate within a collaborative framework with physicians. Full practice authority is a current topic of debate.
Rules for the Board of Nursing (California Board of Registered Nursing - BRN):
The BRN is responsible for:
Licensing RNs and APRNs.
Establishing and enforcing standards of nursing practice.
Approving nursing education programs.
Investigating complaints and disciplining nurses who violate the NPA.
Creating rules and regulations to implement the NPA.
Protecting the public.
Delegation as Described in the NPA:
The NPA outlines the principles of delegation, emphasizing that RNs are accountable for the delegation of nursing tasks.
Delegation must be based on:
The patient's condition.
The delegatee's competence.
The complexity of the task.
The level of supervision required.
The RN must ensure that the delegatee understands the task and is competent to perform it safely.
The RN retains ultimate responsibility for the patient's care.
Continuing Education Requirements:
In California, Registered nurses are required by law (California Code of Regulations, Section 1451, Article 5) to complete 30 contact hours of continuing education every two years, in addition to paying the renewal fee, to maintain an active license.
Also, within those hours one hour must contain information regarding implicit bias.
This ensures that nurses stay up-to-date with current best practices and maintain competency throughout their careers.
By understanding the NPA, nurses can ensure that they are practicing within the legal and ethical boundaries of their profession, ultimately safeguarding patient safety and upholding the standards of nursing practice.
Sample Answer
California Nurse Practice Act Analysis:
State: California
Professions Included: The California Nurse Practice Act (found within the California Business and Professions Code, Division 2.5) covers:
Registered Nurses (RNs)
Licensed Vocational Nurses (LVNs), which are functionally equivalent to Licensed Practical Nurses (LPNs) in other states.
Advanced Practice Registered Nurses (APRNs), including: