RULE 067.00.94-007 - Chapter 4 - Registered Nurse Practitioner Regulations

RULE 067.00.94-007. Chapter 4 - Registered Nurse Practitioner Regulations

SECTION I GLOSSARY OF TERMS

A. REGISTERED NURSE PRACTITIONER

A registered nurse practitioner is an individual with current licensure as a registered nurse in Arkansas who has acquired added knowledge, skills and attitudes through a specifically organized program of study and clinical experience designed for advanced nursing practice and approved by the Arkansas State Board of Nursing.

B. CLINICAL EXPERIENCE

Practice under the supervision of a qualified preceptor in the actual care of a consumer of health services.

C. DOCUMENTATION

Written proof or evidence to substantiate factual claims or statements of a nature satisfactory to the Board.

D. QUALIFIED PRECEPTOR

A currently licensed registered nurse practitioner with either three years nurse practitioner experience or a master's degree in nursing, or a currently licensed physician who supports the concept of the expanded role of the nurse. The functions of the preceptor include supervision, teaching, and evaluation of student performance in the appropriate health care setting.

SECTION II SCOPE OF PRACTICE

A. REGISTERED NURSE PRACTITIONER

A registered nurse practitioner is a licensed professional nurse prepared in the manner stated herein who provides direct care to individuals, families and other groups in a variety of settings including, homes, hospitals, offices, industry, schools and other institutions and health care settings. The service provided by the nurse practitioner is directed toward the delivery of primary, secondary and tertiary care which focuses on the achievement and maintenance of optimal functions in the population. The nurse practitioner engages in independent decision making about the nursing care needs of clients and collaborates with health professionals and others in making decisions about other health care needs. The practitioner plans and institutes health care programs as a member of the health care team. The nurse practitioner is directly accountable and responsible to the recipient for the quality of care rendered.

B. ACTS PROPER TO BE PERFORMED BY A REGISTERED NURSE PRACTITIONER

The Arkansas State Board of Nursing authorized the registered nurse practitioner, in collaboration with a licensed physician and under direction of the physician, to perform particular acts at the advanced and specialized levels recognized by the nursing profession and which are in conformity with the Nurse Practice Act.

1. Secures, records and evaluates the health, psychosocial and developmental history of patients.

2. Performs physical examinations using techniques of observation, inspection, auscultation, palpation and percussion, and uses appropriate diagnostic tests.

3. Discriminates between normal and abnormal findings on the history and physical examination and refers the individuals who need further evaluation or supervision.

4. Documents the processes of nursing care delivery.

5. Contributes to the comprehensive care of the ill in collaboration with the health care team.

6. Coordinates health care plans to enhance the quality of health care and diminish both fragmentation and duplication of service.

7. Contributes to the health education of individuals and groups and applied methods designed to increase each person's motivation to assume responsibility for his own health care.

8. Facilitates entry into and through the health care system by appropriate route.

9. Assumes responsibility for ongoing health maintenance and clinical management of stable chronically ill patients.

10. Provides effective initial care of emergencies and initiates arrangements for continuing definitive care.

11. Identifies, manages and initiates treatment for common medical problems by "Guidelines" as described in Section II.C.

12. Evaluates progress and manages prenatal and postpartum care in normal pregnancies.

13. Counsels with families and/or individuals regarding family planning, pregnancy, child care, emotional stresses, long term illness and general health problems.

14. Performs periodic health evaluations and plans for health maintenance of clients.

15. Conducts community clinics for case findings and screening for health problems.

C. GUIDELINES

Every nurse practicing as a registered nurse practitioner shall practice in accordance with written guidelines developed in collaboration with a licensed physician or with the appropriate staff of the agency employing the nurse practitioner, and in compliance with statutes of the State of Arkansas. These guidelines shall include established procedures for the management of common medical problems in the practice setting and specialty area of the nurse practitioner. They shall specifically address the degree to which collaboration, independent action, and supervision are required for actions of the nurse practitioner when such actions involve medical determination to administer a particular treatment to a patient. Guidelines shall provide for the performance by the nurse practitioner of acts including, but not limited to, evaluation, diagnosis and treatment. These guidelines shall be reviewed jointly at least annually, and revised when necessary.

D. SERVICES AND RESPONSIBILITIES

The extent of services, responsibilities and required supervision of nurse practitioners, and the accompanying responsibilities of attending physicians must be defined by each agency or clinic in a policy statement, job description, protocol or other appropriate document.

E. DELEGATED DUTIES

The supervising authority may delegate acts to be performed to a registered nurse practitioner who has demonstrated competence in such procedures.

F. REVIEW OF GUIDELINES

The Board may, upon request, review the guidelines governing the practice of any nurse practicing as a registered nurse practitioner.

SECTION III LICENSURE

A. REQUIREMENTS FOR LICENSURE

Requirements for licensure as a registered nurse practitioner in the State of Arkansas shall consist of the following:

1. Active licensure as a registered nurse in Arkansas.

2. Documentation acceptable to the Board of at least one of the following:

a. Satisfactory completion of a nurse practitioner educational program. Such program of study shall conform to the program guidelines outlined herein or certification guidelines for educational preparation established by national organizations that offer certification and are approved by the Board.

b. Certification of practitioner behaviors by the appropriate specialty association or equivalent, which must be approved by the Board (Section III.C).

c. Graduation from a program leading to a master's degree in nursing with preparation in a clinical specialty.

3. Documentation to the Board of satisfactory advanced practice under a qualified preceptor.

B. USE OF NOMENCLATURE

Any person who meets the requirements of Section III.A., "Requirements for Licensure," shall have the right to use the title "Registered Nurse Practitioner" and the abbreviation "R.N.P." No other person shall practice or advertise, as or assume the title of "Registered Nurse Practitioner" or use the abbreviation "R.N.P." or any words, letters, signs, or figures to indicate that the person using same is a registered nurse practitioner.

C. CERTIFICATION APPROVED BY THE ARKANSAS STATE BOARD OF NURSING

1. The Board shall annually review the approved certification programs and reserves the right to discontinue approval in the event that a certification program does not, in the judgment of the Board, provide an adequate evaluation of an individual's ability to practice as a certified registered nurse practitioner.

2. Upon request, the Board shall consider the approval of specific certification programs offered by national associations.

D. SUSPENSION OR REFUSAL TO LICENSE

1. The Arkansas State Board of Nursing may suspend, or refuse to renew the license of any registered nurse practitioner or may refuse to license any applicant if the Board finds evidence that the person fails to meet requirements for registered nurse practitioners as stated herein, provided, however, that prior to any such action by the Board, the nurse shall be given notice and opportunity for a hearing.

2. The Board may refuse to issue a license, certificate or registration to any applicant if the license, certificate or registration of such person has been revoked or suspended or placed on probation and not reinstated by the jurisdiction which took such action.

3. In the event that a registered nurse practitioner is brought before the Arkansas State Board of Nursing for a hearing directly related to the practice of nursing, the Council of Nurse Practitioners of the Arkansas State Nurses' Association shall be notified and a representative from that group encouraged to attend.

SECTION IV PROGRAMS OF STUDY

The program of study preparing a registered nurse practitioner shall meet the following requirements:

A. PHILOSOPHY, PURPOSE, OBJECTIVES

1. The program shall have in its purpose the preparation of nurse practitioners.

2. The philosophy, purpose and objectives of the program shall be clearly defined and available in written form.

3. The objectives reflecting the philosophy shall be stated in behavioral terms and describe the competencies of the graduate.

B. ADMINISTRATION

1. The program shall be conducted by an approved school of nursing which offers a baccalaureate or higher degree in nursing.

2. Admission criteria shall be clearly stated and available in written form.

3. Admission requirements, philosophy, objectives and criteria shall be available to the student.

4. The student shall receive official evidence that indicates successful completion of the course.

C. FACULTY

1. There must be an adequate number of qualified faculty to develop and implement the program and achieve the stated objectives.

2. Faculty must include registered nurse practitioners with a master's degree in nursing with preparation in a clinical specialty.

3. Nursing faculty must hold a current license to practice nursing.

4. Medical faculty must hold a current license to practice medicine.

D. PRECEPTORS Preceptors must:

1. Meet the qualifications as stated in Section I.D.

2. Participate in teaching, supervising and evaluating students.

E. CURRICULUM

1. The course content, methods of instruction and learning experiences shall be consistent with the philosophy and objectives of the program.

2. Outlines and descriptions of all learning experiences shall be available in writing.

3. The program shall be at least one (1) academic year in length {nine months full-time} and shall include theory in the biological, behavioral, nursing and medical sciences relevant to the area of advanced practice, in addition to clinical experience with a qualified preceptor.

(a) The program shall include, but not be limited to, theory and directed clinical experience in comprehensive physical and biopsychosocial assessment; interviewing and communication skills; eliciting, recording and maintaining a health history; interpretation of laboratory findings; assessment of community resources; making referrals to appropriate professionals or agencies.

(b) The program shall include content relating to role realignment, legal implications of advanced nursing practice, and the health care delivery system.

(c) The program shall provide theory and supervised clinical experiences in the "Acts Proper to be Performed by an R.N.P." as stated in Section II.B.

F. RECORDS

Records of the program, philosophy, objectives, administration, faculty, curriculum, students and graduates shall be maintained systematically and be retrievable.

G. EVALUATION

Provision shall be made for periodic program evaluation by the faculty and students.

(2/28/1994)

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