Licensure & Scope of Practice: The Nurse Practice Act

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1 Nursing Care Delivery: Current Challenges, Future Opportunities Leading Age 2015 Senior Living Conference September 29, :00 am Polsinelli PC. In California, Polsinelli LLP Licensure & Scope of Practice: The Nurse Practice Act 225 ILCS 65 / et seq. The Illinois Nurse Practice Act of 2007 establishes the licensure requirements for nurses in Illinois Also establishes grounds for disciplinary action against nurses and against persons engaging in unauthorized practice of nursing 1

2 Licensure & Scope of Practice: LPN Licensed Practical Nurse (LPN) An LPN is a person who is specifically prepared in the techniques of nursing, who is a graduate of an accredited school of practical nursing and whose qualifications have been examined by a state board of nursing, and who has been legally authorized to practice as a licensed practical nurse must have the basic nursing knowledge, judgment, and skill acquired by means of completion of an approved practical nursing education program. Licensure & Scope of Practice: LPN Licensed Practical Nurse (LPN) Practical nursing includes assisting in the nursing process as delegated by and under the direction of a registered professional nurse ( RN ). The practical nurse may also work under the direction of a licensed physician, dentist, podiatrist, or other health care professional. 2

3 Licensure & Scope of Practice: LPN 68 Ill. Admin Code Collecting data and collaborating in the assessment of the health status of a patient. 2. Collaborating in the development and modification of the registered professional nurse's or advanced practice nurse's comprehensive nursing plan of care for all types of patients. 3. Implementing aspects of the plan of care as delegated. 4. Participating in health teaching and counseling to promote, attain, and maintain the optimum health level of patients, as delegated. 5. Serving as an advocate for the patient by communicating and collaborating with other health service personnel, as delegated. 6. Participating in the evaluation of patient responses to interventions. 7. Communicating and collaborating with other health care professionals, as delegated. Licensure & Scope of Practice: RN A RN is specifically prepared and promotes health and the prevention of disease, and helps patients cope with illness. When providing direct patient care they observe, assess and record symptoms, reactions and progress, assist physicians during surgery, treatments, and examinations, administer medications and help in the convalescence and rehabilitation of patients. 3

4 Licensure & Scope of Practice: RN RN Scope of Practice 68 Ill. Admin Code All aspects of LPN scope of practice, plus: 1. The comprehensive nursing assessment of the health status of patients that addresses changes to patient conditions. 2. The development of a plan of nursing care to be integrated within the patient-centered health care plan that establishes nursing diagnoses, and setting goals to meet identified health care needs, determining nursing interventions, and implementation of nursing care through the execution of nursing strategies and regimens ordered or prescribed by authorized healthcare professionals. 3. The administration of medication or delegation of medication administration to licensed practical nurses. 4. Delegation of nursing interventions to implement the plan of care. 5. The provision for the maintenance of safe and effective nursing care rendered directly or through delegation. Licensure & Scope of Practice: RN 6. Providing input into the development of policies and procedures to support patient safety. 7. Advocating for patients. 8. The evaluation of responses to interventions and the effectiveness of the plan of care. 9. Communicating and collaborating with other health care professionals. 10.The procurement and application of new knowledge and technologies. 11.The provision of health education and counseling. 12.Participating in development of policies, procedures and systems to support patient safety. 4

5 Comparing the duties of LPN v. RN Common LPN Duties Monitoring patients' vitals Administering basic patient care, like changing bandages Helping patients bathe and dress Maintaining patients' health records Reporting patients' status to RNs and doctors Common RN Duties All of the LPN tasks, plus the following: Administering medications and treatments Establishing and maintaining patients' care plans Performing diagnostic tests and analyzing results Operating and monitoring medical equipment Teaching patients and their families how to manage illnesses and injuries Licensure & Scope of Practice: APN Advanced Practice Nurse(APN) An APN is licensed as a registered professional nurse and meets the requirements for licensure as an advanced practice nurse. An APN cares for patients by using advanced diagnostic skills, the results of diagnostic tests and procedures ordered by the advanced practice nurse, a physician assistant, a dentist, a podiatrist, or a physician, and professional judgment to initiate and coordinate the care of patient. An APN can also order diagnostic tests, prescribe medications and drugs, and administer medications and drugs. Categories include certified nurse midwife (CNM), certified nurse practitioner (CNP), certified registered nurse anesthetist (CRNA), and certified clinical nurse specialist (CNS). Must have a Written Collaborative Agreement to describe working relationship with collaborating physician 5

6 Licensure & Scope of Practice: APN APN Scope of Practice (68 Ill. Admin Code ) Includes all aspects of LPN and RN scope of practice, plus: 1. Advanced nursing patient assessment and diagnosis. 2. Ordering diagnostic and therapeutic tests and procedures, performing those tests and procedures when using health care equipment, and interpreting and using the results of diagnostic and therapeutic tests and procedures ordered by the advanced practice nurse or another health care professional. 3. Ordering treatments, ordering or applying appropriate medical devices, and using nursing, medical, therapeutic, and corrective measures to treat illness and improve health status. Licensure & Scope of Practice: APN 4. Providing palliative and end-of-life care. 5. Providing advanced counseling, patient education, health education, and patient advocacy. 6. Prescriptive authority as defined in Section of the Act. 7. Delegating selected nursing activities or tasks to a licensed practical nurse, a registered professional nurse, or other personnel. 6

7 Discussion Points Handling medications Staffing MMAI/ICP Managed Care expectations and care coordination Resident acuity Data tracking Medical vs. Social model QUESTIONS? Meredith A. Duncan Polsinelli, P.C. 161 N. Clark St., Ste Chicago, Illinois

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