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Board of Registration in Nursing. Module: Legal Scope of RN, LPN, and APRN Practice . 244 CMR 3.00: Registered Nurse and Licensed Practical Nurse. 3.01: Registered Nurse Graduate of a Board approved school Holds ultimate responsibility for care

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244 cmr 3 00 registered nurse and licensed practical nurse
244 CMR 3.00: Registered Nurse and Licensed Practical Nurse

3.01: Registered Nurse

  • Graduate of a Board approved school
  • Holds ultimate responsibility for care
  • Scope includes: nursing care, health maintenance, teaching, counseling, plans and restoration for optimal functioning & comfort
244 cmr 3 00
244 CMR 3.00

3.02: Responsibilities & Functions (RN)

  • Systematically assess health status of individuals or groups
  • Analyze & interpret data; and make informed judgements
  • Plan & implement care - prescribed medical or therapeutic regimes, scientific principles, recent advances & current research
slide5
3.02 - continued
  • Provide & coordinate health teaching
  • Evaluate outcomes
  • Collaborate, communicate and cooperates to ensure quality and continuity of care
  • Serves as a patient advocate within the limits of the law
  • MAY DELEGATE . . .
244 cmr 3 001
244 CMR 3.00

3.03: Practical Nurse

  • Graduate of a Board approved school
  • Bears full responsibility for the quality of health care she/he provides
  • Scope includes: participation in nursing care, health maintenance, teaching, counseling, collaborative planning and rehabilitation, to the extent of his/her education
244 cmr 3 002
244 CMR 3.00

3.04: Responsibilities & Function (PN)

  • Assess individuals basic health status
  • Participates in analyzing data & making informed judgements
  • Participates in planning & implementing interventions including recent advances & current knowledge in the field
  • Incorporates medical regimes
slide8
3.04 – continued
  • Participates in health teaching
  • When appropriate, evaluates outcomes, initiates or encourages change in the plan
  • Collaborates, cooperates, communicates to ensure quality and continuity of care
  • MAY DELEGATE . . .
244 cmr 4 00 the practice of nursing in the expanded role
244 CMR 4.00: The Practice of Nursing in the Expanded Role
  • Establishes the conditions under which RNs may practice in the advanced role.
  • Governs education & practice requirements.
  • Criteria for authorization to practice.
  • Criteria for prescriptive authority.
  • Requirements for guidelines
  • Details “Scope of Practice”
advisory rulings on nursing practice
Advisory Rulings On Nursing Practice

Advisory Rulings on Nursing Practice are declarative statements of the Board which:

  • carry with them the full weight of law
  • represent the Board’s interpretation of the legal scope of nursing practice
determining scope of practice
Determining Scope of Practice
  • Describe nursing practice or activity.
  • Is it supported by statute or regulation?
  • Does entry into practice education provide the necessary knowledge/ skill/ability? Or Continuing Education?
  • Is this a practice that is consistent with the nursing literature and/or research?
  • Does the nurse have a documented competence?
scope of practice continued
Scope of Practice - continued
  • Is this within a standard of care that another reasonable & prudent would do?
  • Is the patient’s safety assured?
  • Is the nurse prepared to accept accountability for performing the activity?
scope of practice continued1
Scope of Practice - continued
  • Apply the Board’s Decisionmaking Guidelines to a clinical situation to determine if the selected activity is within the nurse’s scope of practice.