Nurse Practice Act Flashcards
Who authored the NC-NPA
The North Carolina General Assembly
Who is the NC Board of Nursing
Elected and appointed individuals who are charged with enforcing the Nc nurse practice act
Who comprises the BON
14 members: 8 RN’s of which 3 are educators, 3 LPNs and 3 members at large
What is the charge from the NPA to the BON?
To interpret and enforce the NPA to keep the citizens of NC safe (regulatory).
What is the relationship of the NPA to the BON?
Interdependent or symbiotic. One depends on the other.
What is the NPA?
A law
Where in the NPA is RN practice defined?
Within the 10 points of RN practice…this is the SCOPE and boundaries of practice.
What is the first component of the definition of RN practice?
Assessment!Assess the patient’s physical and mental health including the patient’s reaction to illness and treatment regimens.
What does the NPA say about RN practice in regards to patient safety?
Providing for the maintenance of safe and effective nursing care, whether rendered directly or indirectly is one of the 10 components of the scope of RN practice.
What does the NPA say about RN practice in regards to delegation?
It is within the scope of the RN to delegate those activities that are appropriate for safe nursing care. The RN is ultimately responsible for the delegation and evaluation of the tasks delegated to another RN, LPN or nursing assistant.
* Search for the delegation tree on the BON website for the specifics of delegation.
What can be delegated to a nursing assistant?
Tasks that are:
- Routine
- Repetitive
- Have no impact on patient outcome
- Are stable patients as deemed by the RN assessment
- Requires no critical judgement
What is the primary purpose of the NPA?
To regulate the practice of nursing keep the citizens of NC safe from incompetent nurses
What was the first state to ever regulate nursing?
North Carolina in 1903.
Many states have modeled their practice act after NC.
What is the organization that is responsible for guiding the standards for nursing regulation and setting and authoring the content of the NCLEX exam?
The National Council of State Boards of Nursing
Is nursing practice regulated at the federal or the state level?
State.
Each state has their own practice act.
What is the style of language used to write the NPA
Legal or “ legalese”
Why is legalese style of language used?
To allow interpretation and debate in a court of law
What are 2 critical ways the RN practice differs from the LPN practice
- RN is responsible for the patient assessment while the LPN can only PARTICIPATE in a component if the assessment.
- RN creates the nursing plan of care and LPN participates in carrying out PART of that plan.
- RN creates the patient teaching plan, LPN can only teach PARTS of the plan delegated to LPN by the RN.
- In a delegated situation RN is responsible for the care and evaluation of what is delegated to the LPN. LPN is responsible for the care they complete.
What does the NPA say about medication administration by the RN?
It is one of the 10 points on RN practice if the medication has been prescribed by a licensed person i. The state (MD,DO, NP, CRNA, CNM, dentist).
How much does it cost the first tine you apply for license in NC?
$75
In NC how often must RN’s renew their license?
Every 2 years by the last day of their birth month.
How much does it cost to renew an RN license?
$100 if mailed in
What requirements must be met for a new graduate to obtain an RN license the first tine in NC?
- Graduate from a BON approved school.
- Pay all fees.
- Pass the background check
- Pass NCLEX, cost $200 to sit the exam through PearsonVUE
- Submit all BON documents + $75
- Be certified as mentally and physically competent
What does the NPA say about mental and physical fitness?
The Act states that a nurse must be certified as mentally and physically competent (done by program director and faculty at DUKE) and able to safely render care to patients or populations.
What is the responsibility of a licensed RN who believes a colleague is impaired?
The RN is legally bound to take steps to report the colleague to the board of nursing. The first step in this process is to take the alleged complaint to the supervisor. That said, the RN must not stop till corrective action and an investigation into the alleged complaint has been completed.
Failure to report can be just cause to revoke the reporting RN’s license.
What could happen to an RN who is CONVICTED of a DUI?
Must report the CONVICTION within 30 days to the BON.
May lose or have their license suspended.
May be required by BON to submit to a BON treatment plan and complete that treatment and provide proof of successful completion before reinstatement of the license can occur.
Why can a student at DUSON practice without a license?
Because they are enrolled in a NC BON approved school.
Does the student practice “on” the license of another RN?
Absolutely not! Only one person who holds that license can practice on that license. The student practices as an unlicensed provider enrolled in a program of study from a BON approved school.
What is the responsibility of the student when providing patient care?
To uphold the same standard of care as a licensed RN.
What is the legal definition of a standard of care?
“What any reasonably prudent nurse would do in similar circumstances.”
What is the responsibility of the CI in regards to student practice?
To ensure the student meets the same standard of care as the licensed RN.
Can an employer restrict a nurses scope of practice to less points than is outlined in the NPA?
Yes if that nurse is an employee or a contractual employee accepting compensation for services.
Example: a hospital has an IV team do RN’s on the unit are not allowed to start IV’s even though venipunctures are within the scope of an RN as outlined in the 10 points of the scope of practice of an RN.
Can an employer expand an RN’s scope if practice?
No. Not beyond what is outlined in the NPA.
Example: hospital wants OR nurses to learn to suture all surgical closings in the OR so surgeons can move on to another case. This is beyond the skills and knowledge of an RN. So the nurse must refuse this task on the grounds of “beyond my scope of practice.”
