HEAL Conference 2015

Presented by:LaDonna Patton, MSN, RN, CEN

Objectives

• Identify new or problematic issues for the ABN as applicable to Health Care Educators.

• Review existing ABN Rules for specific situations.

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.

ALABAMA BOARD OF NURSINGWHAT DOES THE ABN DO? AND 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

THE NURSE PRACTICE ACT&

THE ABN ADMINISTRATIVE CODE

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”

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

Scope of PracticeThe 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.

APNs• STANDARDS of Practice are specific to

1) RN2) 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

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

Disciplinary Process

• Complaint• NOI/LOA• Investigation• Nurse Consultant• Attorney

Disciplinary Process• Types: –Public

Reprimand–Probation–Suspension–Revocation

• Occurs in 1 of 3 ways: –VS–Consent Order–Administrative

Hearing

Pre-Conference Survey

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)

CE Audit• Completely Random– Computer-generated

• Notice of Audit: – Certified Mail

CE AuditCertified 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

CE AuditABN 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!

CE ProvidersIf 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?

CE QuestionsIs 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

CE UpdateNew/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

DelegationSpecifically 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

Delegation

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?

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???

LaDonna Patton, MSN, RN, CEN334-293-5223ladonna.patton@abn.alabama.gov