1. HEAL Conference 2015 Presented by: LaDonna Patton, MSN, RN, CEN

2. Objectives Identify new or problematic issues for the ABN as applicable to Health Care Educators. Review existing ABN Rules for specific situations.

3. ABN Mission The mission of the Alabama Board of Nursing is to safeguard and promote the health, safety and welfare of the public through licensing and approval of qualified individuals and adopting and enforcing legal standards for nursing education and nursing practice.

4. A LABAMA B OARD OF NURSING W HAT DOES THE ABN DO ? A ND WHY ? The Board consists of thirteen members – Eight (8) RNs Two (2) Advanced Practice Three (3) Nursing Practice Three (3) Nursing Education – Four (4) LPNs Two (2) AFLPN members Two (2) LPNAA members – One (1) consumer ALL are appointed by the Governor

5. THE NURSE PRACTICE ACT & THE ABN ADMINISTRATIVE CODE

6. NPA The Act (Law) which allows for the existence and functioning of the ABN Contains 5 articles: – General Provisions – Licenses – Continuing Education – Post-Baccalaureate Scholarships – Advanced Practice Nursing ABN Admin Code Contains the rules and regulations adopted by the Alabama Board of Nursing and provides for the implementation of the Alabama Nurse Practice Act. It contains the detail to enforce the NPA. – A.K.A. “The Rules”

7. NPA Code of Alabama 1975, § 34-21- 2(j)(1) The board may adopt and, from time to time revise such rules and regulations, not inconsistent with law, as may be necessary to carry out this chapter. Code of Alabama 1975, § 34-21- 2(j)(21) Adopt standards for registered and practical nursing practice and for continued competency of licensees. ABN Admin Code

8. Scope of Practice The scope of an individual _________ nurse’s level of practice includes but is not limited to: (a) Educational preparation, initial and continued. (b) License status, including Board approval for advanced practice nursing as detailed in Chapters 610-X-5 and 610-X-9 of these rules. (c) State and federal statutes, and regulations. (d) State and national standards appropriate to the type of practice. (e) Nursing experience. (f) Limitations on scope as determined by facility policy and procedure. (g) Demonstrated competence. (h) Knowledge, skills, and ability to manage risks and potential complications.

9. APNs STANDARDS of Practice are specific to 1)RN 2)Role (CRNP, CRNA, CNS, CNM) 3)Specialty Certification Joint Committee – Meets Every Other Month – Makes RECOMMENDATIONS to ABN/BME Collaborative Practice Rules/Regs Practice Protocols Formulary

10. School Nurses ABN Administrative Code § 610-X-7-.02 – Delegation by School Nurses – Med admin by unlic personnel ABN Administrative Code § 610-X-7-.10 – Delegation of Insulin & Glucagon Administration in the School Setting

11. Disciplinary Process Complaint NOI/LOA Investigation Nurse Consultant Attorney

12. Disciplinary Process Types: – Public Reprimand – Probation – Suspension – Revocation Occurs in 1 of 3 ways: – VS – Consent Order – Administrative Hearing

13. Pre-Conference Survey

14. CHEST TUBES Chest Tube Mgmt is NOT a part of basic (RN) NSG Education Unit/Facility specific In order to pull Chest Tubes, an RN must complete a Standardized Procedure PRECEPTING CE NO Alabama Board of Nursing Administrative Code – Section 610-X-10-.03(2)(e)

15. CE Audit Completely Random – Computer-generated Notice of Audit: – Certified Mail

16. CE Audit Certified Mail Returned Email Phone call If unable to reach? Audit failure letter via regular mail LEGAL CASE Certified Mail NOT Returned If no response has been received – Letter for non-response If licensee responds at that time: – $150 Late CE Fee Applies regardless if pass/fail If fails to respond OR fails Audit: – LEGAL CASE

17. CE Audit ABN Provider If nurse has ALL ABN Provider CE electronically submitted, nurse would only receive letter notifying of CE Audit passage – But, if a single portion of CE was NOT electronically submitted, nurse must comply with Audit as requested Past 2 yrs, some have also been notified by Cert Mail of CE Audit due to computer glitch where ABNP was coded incorrectly!

18. CE Providers If a nurse needs help with documentation for an Audit, what should the provider provide to the nurse? My question would be, what was the way that CE was credited/awarded in the first place??? – Electronically submitted? – Certificate? – Worst case: sign in sheet?

19. CE Questions Is there a feedback loop to confirm communication that transpired? Licensees & Providers are maintained in ABN Database PHONE CALLS: Summary entered into Journal CHAT: Transcript available at end of chat

20. CE Update New/Revised Forms & CE Process? CE Chapter is due for review this year – Changes will occur! New information will be given once the rules are updated CHEAT SHEET: Currently being created for uploading CE data to ABN Follow the current application & provide only what is needed

21. Delegation Specifically regarding Nurse Extenders Tasks delegated to UAP may not include tasks that require… the assistance with medications except as provided in Chapter 610- X-7. ABN Administrative Code 610-X-6-.11 Assignment, Delegation, & Supervision

22. Delegation

23. Tuberculin Skin Tests (TST) Current LPN education includes instruction on Intradermal administration & interpretation LTC Deficiency concerns??? – ADPH Health Care Facilities Rule: 420-5-10-.17 – CMS Provider Certification: Tag F441 – BOTH reference facility’s establishment of Infection Control Program What does the facility’s POLICY say?

24. COMMENTS I want to know your issues with CE!!! – As a LICENSEE – As a CE Provider If you could change ONE thing about CE, what would it be? – WHY???

25. LaDonna Patton, MSN, RN, CEN 334-293-5223 ladonna.patton@abn.alabama.gov