Board of Registration in Nursing

1. Board of Registration in Nursing

2. Module: Legal Scope of RN, LPN, and APRN Practice

3. 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

4. 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

5. 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 . . .

6. 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

7. 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

8. 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 . . .

9. 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”

10. 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

11. 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?

12. 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?

13. 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.