Utah Admin. Code R156-31b-703b - Scope of Nursing Practice Implementation
(1) Under Subsection
58-31b-102(13),
an LPN shall:
(a) conduct a focused nursing
assessment;
(b) plan for and
implement nursing care within limits of competency;
(c) conduct patient surveillance and
monitoring;
(d) assist in
identifying patient needs;
(e)
assist in evaluating nursing care;
(f) participate in nursing management by:
(i) assigning appropriate nursing activities
to other LPNs;
(ii) delegating care
for stable patients to unlicensed assistive personnel under this rule and
applicable statutes;
(iii) observing
nursing measures and providing feedback to nursing managers; and
(iv) observing and communicating outcomes of
delegated and assigned tasks; and
(g) serve as faculty in areas of
competence.
(2) Under
Subsection
58-31b-102(14),
an RN shall:
(a) interpret patient data,
whether obtained through a focused nursing assessment or otherwise, to:
(i) complete a comprehensive nursing
assessment; and
(ii) determine
whether, and according to what timeframe, another medical professional, a
patient's family member, or any other person should be apprised of a patient's
nursing needs;
(b)
detect faulty or missing patient information;
(c) apply nursing knowledge effectively in
the synthesis of the biological, psychological, spiritual, and social aspects
of the patient's condition;
(d)
utilize broad and complete analyses to plan strategies of nursing care and
nursing interventions that are integrated within each patient's overall health
care plan or IHP;
(e) demonstrate
appropriate decision-making, critical thinking, and clinical judgment to make
independent nursing decisions and to identify health care needs;
(f) correctly identify changes in each
patient's health status;
(g)
comprehend clinical implications of patient signs, symptoms, and changes as
part of ongoing or emergent situations;
(h) critically evaluate the impact of nursing
care, the patient's response to therapy, and the need for alternative
interventions;
(i) intervene on
behalf of a patient when problems are identified so as to revise a care plan as
needed;
(j) appropriately advocate
for patients by:
(i) respecting patients'
rights, concerns, decisions, and dignity;
(ii) identifying patient needs;
(iii) attending to patient concerns or
requests; and
(iv) promoting a safe
and therapeutic environment by:
(A) providing
appropriate monitoring and surveillance of the care environment;
(B) identifying unsafe care situations;
and
(C) correcting problems or
referring problems to appropriate management level when needed;
(k) communicate with
other health team members regarding patient choices, concerns, and special
needs, including:
(i) patient status and
progress;
(ii) patient response or
lack of response to therapies; and
(iii) significant changes in patient
condition;
(l)
demonstrate the ability to responsibly organize, manage, and supervise the
practice of nursing by:
(i) delegating tasks
under this rule and applicable statutes; and
(ii) matching patient needs with personnel
qualifications, available resources, and appropriate supervision;
(m) teach and counsel patient
families regarding an applicable health care regimen, including general
information about health and medical conditions, specific procedures, wellness,
and prevention;
(n) if acting as a
chief administrative nurse:
(i) ensure that
organizational policies, procedures, and standards of nursing practice are
developed, kept current, and implemented to promote safe and effective nursing
care;
(ii)
(A) assess the knowledge, skills, and
abilities of nursing staff and assistive personnel; and
(B) ensure personnel are assigned to nursing
positions appropriate to their determined competence and licensure,
certification, or registration level; and
(iii) ensure that thorough and accurate
documentation of personnel records, staff development, quality assurance, and
other aspects of the nursing organization are maintained;
(o) if employed by a department of health:
(i) implement standing orders and protocols;
and
(ii) complete and provide to
any patient prescription prepared and signed by a physician under Section
58-17b-620;
(p) serve as faculty in areas of competence;
and
(q) perform any task within the
scope of practice of an LPN.
(3) Under Subsection
58-31b-102(11),
the following scope and standards shall apply to the practice of advanced
practice registered nursing:
(a) an APRN who
chooses to change or expand from a primary focus of practice shall, at the
request of the Division, document competency within that expanded practice
based on education, clinical practice experiences, and certification with the
burden to demonstrate competency upon the APRN;
(b) an APRN may practice within the scope of
practice of an RN and an LPN in Utah; and
(c) an APRN who wishes to practice as an RN
in a Party state, as defined in Section
58-31e-102 of the Nurse Licensure
Compact, shall reinstate, qualify for, and obtain an RN Compact license in
Utah.
(4) Under
Subsections
58-1-510(3) and
(4) and
58-31b-102(11)(d),
a certified registered nurse anesthetist (APRN-CRNA) licensed under Subsection
58-31b-301(2) who
provides general anesthesia, deep sedation, or moderate sedation, shall possess
the knowledge, skills, and education and training required by the following
standards, and shall comply with the following standards, which are
incorporated by reference:
(a)
(i) American Association of Nurse
Anesthesiology (AANA) Standards for Nurse Anesthesia Practice, 2019 edition;
or
(ii) the following American
Society of Anesthesiologists (ASA) standards:
(A) Basic Standards for Preanesthesia Care,
2020 edition;
(B) Standards for
Basic Anesthetic Monitoring, 2020 edition; and
(C) Standards for Postanesthesia Care, 2019
edition;
(b)
the following American Dental Association (ADA) standards:
(i) Guidelines for the Use of Sedation and
General Anesthesia by Dentists, 2016 edition;
(ii) Guidelines for Teaching Pain Control and
Sedation to Dentists and Dental Students, 2016 edition;
(iii) Guidelines for Teaching Pediatric Pain
Control and Sedation to Dentists and Dental Students, 2021 edition;
and
(iv) ADA Policy Statement: The
Use of Sedation and General Anesthesia by Dentists, 2007 edition;
or
(c) the following
American Association of Oral and Maxillofacial Surgeons (AAOMS) standards:
(i) Office Anesthesia Evaluation Manual, 2018
9th edition; and
(ii) Parameters of
Care, 2023 7th edition.
Notes
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