Bill Text: MS HB114 | 2018 | Regular Session | Introduced
Bill Title: Nursing; delete requirement that advanced practice registered nurses have collaborative relationship with physician.
Spectrum: Partisan Bill (Democrat 2-0)
Status: (Failed) 2018-01-30 - Died In Committee [HB114 Detail]
Download: Mississippi-2018-HB114-Introduced.html
MISSISSIPPI LEGISLATURE
2018 Regular Session
To: Public Health and Human Services
By: Representative Dortch
House Bill 114
AN ACT TO AMEND SECTIONS 73-15-5 AND 73-15-20, MISSISSIPPI CODE OF 1972, TO DELETE THE REQUIREMENT THAT ADVANCED PRACTICE REGISTERED NURSES MUST PRACTICE WITHIN A COLLABORATIVE OR CONSULTATIVE RELATIONSHIP WITH A PHYSICIAN OR DENTIST; AND FOR RELATED PURPOSES.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:
SECTION 1. Section 73-15-5, Mississippi Code of 1972, is amended as follows:
73-15-5. (1) "Board" means the Mississippi Board of Nursing.
(2) The "practice of nursing" by a registered nurse means the performance for compensation of services which requires substantial knowledge of the biological, physical, behavioral, psychological and sociological sciences and of nursing theory as the basis for assessment, diagnosis, planning, intervention and evaluation in the promotion and maintenance of health; management of individuals' responses to illness, injury or infirmity; the restoration of optimum function; or the achievement of a dignified death. "Nursing practice" includes, but is not limited to, administration, teaching, counseling, delegation and supervision of nursing, and execution of the medical regimen, including the administration of medications and treatments prescribed by any licensed or legally authorized physician or dentist. The foregoing shall not be deemed to include acts of medical diagnosis or prescriptions of medical, therapeutic or corrective measures, except as may be set forth by rules and regulations promulgated and implemented by the Mississippi Board of Nursing.
(3) "Clinical nurse specialist practice" by a certified clinical nurse specialist means the delivery of advanced practice nursing care to individuals or groups using advanced diagnostic and assessment skills to manage and improve the health status of individuals and families; diagnose human responses to actual or potential health problems; plan for health promotion, disease prevention, and therapeutic intervention in collaboration with the patient or client; implement therapeutic interventions based on the nurse specialist's area of expertise and within the scope of advanced nursing practice, including, but not limited to, direct patient care, counseling, teaching, collaboration with other licensed health care providers; and, coordination of health care as necessary and appropriate and evaluation of the effectiveness of care.
(4) "Advanced nursing
practice" means, in addition to the practice of professional nursing, the
performance of advanced-level nursing approved by the board which, by virtue of
graduate education and experience are appropriately performed by an advanced
practice registered nurse. The advanced practice registered nurse may
diagnose, treat and manage medical conditions. This may include prescriptive
authority as identified by the board. * * *
(5) The "practice of nursing" by a licensed practical nurse means the performance for compensation of services requiring basic knowledge of the biological, physical, behavioral, psychological and sociological sciences and of nursing procedures which do not require the substantial skill, judgment and knowledge required of a registered nurse. These services are performed under the direction of a registered nurse or a licensed physician or licensed dentist and utilize standardized procedures in the observation and care of the ill, injured and infirm; in the maintenance of health; in action to safeguard life and health; and in the administration of medications and treatments prescribed by any licensed physician or licensed dentist authorized by state law to prescribe. On a selected basis, and within safe limits, the role of the licensed practical nurse shall be expanded by the board under its rule-making authority to more complex procedures and settings commensurate with additional preparation and experience.
(6) A "license" means an authorization to practice nursing as a registered nurse or a licensed practical nurse designated herein.
(7) A "registered nurse" is a person who is licensed or holds the privilege to practice under the provisions of this article and who practices nursing as defined herein. "RN" is the abbreviation for the title of Registered Nurse.
(8) A "licensed practical nurse" is a person who is licensed or holds the privilege to practice under this article and who practices practical nursing as defined herein. "LPN" is the abbreviation for the title of Licensed Practical Nurse.
(9) A "registered nurse in clinical practice" is one who functions in any health care delivery system which provides nursing services.
(10) A "clinical nurse specialist" is a person who is licensed or holds the privilege to practice under this article in this state to practice professional nursing and who in this state practices advanced nursing as defined herein. "CNS" is the abbreviation for the title of Clinical Nurse Specialist.
(11) An "advanced practice registered nurse" is a person who is licensed or holds the privilege to practice under this article and who is certified in advanced practice registered nurse or specialized nursing practice and includes certified registered nurse midwives, certified registered nurse anesthetists and certified nurse practitioners. "CNM" is the abbreviation for the title of Certified Nurse Midwife, "CRNA" is the abbreviation for the title of Certified Registered Nurse Anesthetist. "CNP" is the abbreviation for the title of Certified Nurse Practitioner.
(12) A "nurse educator" is a registered nurse who meets the criteria for faculty as set forth in a state-accredited program of nursing for registered nurses, or a state-approved program of nursing for licensed practical nurses, and who functions as a faculty member.
(13) A "consumer representative" is a person representing the interests of the general public, who may use services of a health agency or health professional organization or its members but who is neither a provider of health services, nor employed in the health services field, nor holds a vested interest in the provision of health services at any level, nor has an immediate family member who holds vested interests in the provision of health services at any level.
(14) "Privilege to practice" means the multistate licensure privilege to practice nursing in the state as described in the Nurse Licensure Compact provided for in Section 73-15-201.
(15) "Licensee" is a person who has been issued a license to practice nursing in the state or who holds the privilege to practice nursing in the state.
SECTION 2. Section 73-15-20, Mississippi Code of 1972, is amended as follows:
73-15-20. (1) Advanced practice registered nurses. Any nurse desiring to be certified as an advanced practice registered nurse shall apply to the board and submit proof that he or she holds a current license to practice professional nursing and that he or she meets one or more of the following requirements:
(a) Satisfactory completion of a formal post-basic educational program of at least one (1) academic year, the primary purpose of which is to prepare nurses for advanced or specialized practice.
(b) Certification by a board-approved certifying body. Such certification shall be required for initial state certification and any recertification as a registered nurse anesthetist, nurse practitioner or nurse midwife. The board may by rule provide for provisional or temporary state certification of graduate nurse practitioners for a period of time determined to be appropriate for preparing and passing the National Certification Examination. Those with provisional or temporary certifications must practice under the direct supervision of a licensed physician or a certified nurse practitioner or certified nurse midwife with at least five (5) years of experience.
(c) Graduation from a program leading to a master's or post-master's degree in a nursing clinical specialty area with preparation in specialized practitioner skills.
(2) Rulemaking. The
board shall provide by rule the appropriate requirements for advanced practice
registered nurses in the categories of certified registered nurse anesthetist,
certified nurse midwife and * * * advanced practice registered
nurse.
* * *. An advanced practice registered nurse shall perform those functions
authorized in this section within a collaborative/consultative relationship
with a dentist or physician with an unrestricted license to practice dentistry
or medicine in this state and within an established protocol or practice
guidelines, as appropriate, that is filed with the board upon license
application, license renewal, after entering into a new
collaborative/consultative relationship or making changes to the protocol or
practice guidelines or practice site. The board shall review and approve the
protocol to ensure compliance with applicable regulatory standards. The
advanced practice registered nurse may not practice as an APRN if there is no
collaborative/consultative relationship with a physician or dentist and a board-approved
protocol or practice guidelines.
( * * *3) Renewal. The board shall renew
a license for an advanced practice registered nurse upon receipt of the renewal
application, fees and protocol or practice guidelines. The board shall adopt
rules establishing procedures for license renewals. The board shall by rule
prescribe continuing education requirements for advanced practice registered
nurses not to exceed forty (40) hours biennially as a condition for renewal of
a license or certificate.
( * * *4) Reinstatement. Advanced
practice registered nurses may reinstate a lapsed privilege to practice upon
submitting documentation of a current active license to practice professional
nursing, a reinstatement application and fee, * * *
documentation of current certification as an advanced practice nurse in a
designated area of practice by a national certification organization recognized
by the board and documentation of at least forty (40) hours of continuing
education related to the advanced clinical practice of the nurse practitioner
within the previous two-year period. The board shall adopt rules establishing
the procedure for reinstatement.
* * *
( * * *5) Practice requirements. The
advanced practice registered nurse shall practice:
(a) According to standards and guidelines of the National Certification Organization.
* * *
( * * *b) According to a board-approved
protocol or practice guidelines.
( * * *c) Advanced practice registered nurses
practicing as nurse anesthetists must practice according to board-approved
practice guidelines that address pre-anesthesia preparation and evaluation;
anesthesia induction, maintenance, and emergence; post-anesthesia care; peri-anesthetic
and clinical support functions.
* * *
( * * *d) Each * * * advanced
practice registered nurse shall * * * implement a formal quality
assurance/quality improvement program, which shall be maintained on site
and shall be available for inspection by representatives of the board. This
quality assurance/quality improvement program must be sufficient to provide a
valid evaluation of the practice and be a valid basis for change, if any.
( * * *e) Nurse practitioners may not write
prescriptions for, dispense or order the use of or administration of any
schedule of controlled substances except as contained in this * * * article.
( * * *6) Prescribing controlled
substances and medications. Certified nurse midwives and certified nurse
practitioners may apply for controlled substance prescriptive authority after
completing a board-approved educational program. Certified nurse midwives and
certified nurse practitioners who have completed the program and received
prescription authority from the board may prescribe Schedules II-V. The words
"administer," "controlled substances" and "ultimate
user," shall have the same meaning as set forth in Section 41-29-105,
unless the context otherwise requires. The board shall promulgate rules
governing prescribing of controlled substances, including distribution, record
keeping, drug maintenance, labeling and distribution requirements and
prescription guidelines for controlled substances and all medications.
Prescribing any controlled substance in violation of the rules promulgated by
the board shall constitute a violation of Section 73-15-29(1)(f), (k) and (l)
and shall be grounds for disciplinary action. The prescribing, administering
or distributing of any legend drug or other medication in violation of the
rules promulgated by the board shall constitute a violation of Section 73-15-29(1)(f),
(k) and (l) and shall be grounds for disciplinary action.
SECTION 3. This act shall take effect and be in force from and after July 1, 2018.
