Or. Admin. Code § 851-045-0060 - [Effective until 6/30/2025] Standards Related to RN Scope in the Practice of Nursing
(1) The RN's practice of registered nursing
is independent and can occur in a variety of roles. Such roles commonly include
but are not limited to:
(a) Nursing
administration;
(b) Nursing
education;
(c) Health care policy
development, implementation and evaluation;
(d) Consultation in the practice of
nursing;
(e) Provision of direct
care;
(f) Clinical direction and
clinical supervision of others;
(g)
Health promotion and wellness;
(h)
Case management;
(i) Nursing
research;
(j) Teaching health care
providers and prospective health care providers;
(k) Nursing Informatics; and
(l) With additional education, professional
certification, and licensure, engagement in an advanced practice registered
nurse practice role.
(2)
The RN's engagement in the practice of registered nursing occurs through the
following actions:
(a) Assessment of client to
identify their overall response to their current state of health that brought
them into contact with the RN;
(b)
Identification of reasoned conclusions based on validation, analysis and
synthesis of assessment data.
(c)
Identification of expected outcomes for reasoned conclusions.
(d) Development of a plan of care to:
(A) Prioritize reasoned
conclusions;
(B) Identify
interventions to attain expected outcomes;
(C) Identify implementation responsibilities,
timelines and documentation requirements; and
(D) Utilization of language appropriate to
the context of care.
(e)
Implementation of plan of care. RN may include utilization of practice team
members to carry out planned interventions per the context of care.
(f) Evaluation of client progress toward
expected outcomes through:
(A) Ongoing
collection and analysis of assessment data; and
(B) Revision of reasoned conclusions,
expected outcomes, planned interventions, implementation responsibilities and
timelines as indicated by clinical judgment.
(3) The RN may assign to a practice team
member work the team member is authorized by license or certification and
organizational position description to perform in the practice setting.
(a) This includes assigning to:
(A) Another RN;
(B) LPN;
(C) CNA or CMA; and
(D) UAP.
(b) Prior to assigning work, the RN must know
the duties, functions, activities or interventions the recipient is authorized
to perform.
(c) The RN who assigns
work must:
(A) Assign according to the health,
safety and welfare of their client;
(B) Provide supervision and evaluation of
assigned work consistent with:
(i) The context
of care; and
(ii) The RN's nursing
practice relationship with the team member who accepts the
assignment.
(C) Revise
how work is distributed as indicated by client outcome data, availability of
qualified practice team members and other appropriate resources.
(d) The RN who agrees to act as a
nurse intern (NI) supervisor must:
(A) Assign
to the nurse intern only those functions authorized for performance by a NI per
OAR Chapter 851, Division 41;
(B)
Maintain a physical presence in the NI's practice setting; and
(C) Be readily available to the NI either in
person or by other means.
(4) The RN must employ strategies that
promote health and safety.
(a) Such strategies
may include providing opportunity for the client to identify needed health
promotion, disease prevention and self-management topics.
(b) The RN who engages in teaching to promote
health and safety must apply evidence-based teaching and learning principles in
the development, implementation and evaluation of teaching plans and the
evaluation of learner outcomes.
(c)
Based on the RN's context of care, teaching content may include but is not
limited to:
(A) Teaching a client's family
member how to execute a medical order;
(B) Teaching a designated caregiver how to
execute a medical order per OAR Chapter 851, Division 48;
(C) Teaching a UAP how to perform a client's
nursing procedure per OAR Chapter 851, Division 47;
(D) Teaching a practice team member how to
administer a regularly scheduled or pro re nata (PRN) noninjectable medication
to a client;
(E) Teaching a
practice team member how to administer PRN injectable or noninjectable
lifesaving medication to a specific client;
(F) Teaching a group of people how to
administer noninjectable medications to other persons; and
(G) Teaching a group of people how to
administer a lifesaving medication to another person per ORS
433.800 to
433.830, ORS
689.681, or ORS
339.869.
(d) Effective February 21, 2025, through June
30, 2025, the RN may teach and validate a CNA to perform one or more additional
authorized duties as listed in OAR
851-063-0030(10).
(A) The RN must represent or be employed by
the CNA's employment site.
(B) Once
the RN validates the CNA is competent to perform the additional duty, the duty
may then be assigned to the CNA by nurses in the employing
organization.
Notes
Statutory/Other Authority: ORS 678.150 & HB 4003 2022
Statutes/Other Implemented: ORS 678.150, 678.010 & ORS 339.869
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