CO Code § 12-255-104 (2021)
2021 Colorado Code|Title 12 - Professions and Occupations|Article 255 - Nurses and Nurse Aides|Part 1 - Nurses and Nurse Aides|§ 12-255-104. Definitions

 As used in this article 255, unless the context otherwise requires:    “Advanced practice registered nurse” means a registered professional nurse who is licensed to practice pursuant to this part 1, who obtains specialized education or training as provided in section 12-255-111, and who applies to and is accepted by the board for inclusion in the advanced practice registry established pursuant to section 12-255-111.    “Approved education program” means a course of education conducted by an educational or health-care institution that implements the basic practical or professional nursing curriculum or the basic nurse aide curriculum, as applicable, prescribed and approved by the board.    “Board” means the state board of nursing created in section 12-255-105.  (3.3) “Certified nurse aide” means a person who meets the qualifications specified in part 2 of this article 255 and who is currently certified by the board. Only a person who holds a certificate to practice as a nurse aide in this state pursuant to part 2 of this article 255 has the right to use the title “certified nurse aide” and its abbreviation, “C.N.A.”  (3.5) “Collaboration” means the act of licensed health care providers working cooperatively within each licensed health care provider's scope of practice to formulate and carry out the plan of patient care.    “Delegated medical function” means an aspect of care that implements and is consistent with the medical plan as prescribed by a licensed or otherwise legally authorized physician, podiatrist, or dentist and is delegated to a registered professional nurse or a practical nurse by a physician, podiatrist, dentist, or physician assistant. For purposes of this subsection (4), “medical plan” means a written plan, verbal order, standing order, or protocol, whether patient specific or not, that authorizes specific or discretionary medical action, which may include but is not limited to the selection of medication. Nothing in this subsection (4) shall limit the practice of nursing as defined in this part 1. (4.5)   “Delegation of patient care” means aspects of patient care that are consistent with a plan of patient care prescribed by a licensed health care provider within the scope of the provider's practice and that may be delegated to a registered nurse or licensed practical nurse within the scope of the nurse's practice. “Delegation of patient care” includes aspects of patient care that may be delegated by a licensed health care provider within the scope of the provider's practice and within the provider's professional judgment to a licensed or an unlicensed health care provider within the scope of that provider's practice. Nothing in this subsection (4.5) limits or expands the scope of practice of any nurse licensed pursuant to this article 255.    For purposes of this subsection (4.5), “plan of patient care” means a written plan, verbal order, standing order, or protocol, whether patient specific or not, that authorizes specific or discretionary nursing action and that may include the administration of medication.       “Diagnosing” means the use of professional nursing knowledge and skills in the identification of, and discrimination between, physical and psychological signs or symptoms to arrive at a conclusion that a condition exists for which nursing care is indicated or for which referral to appropriate medical or community resources is required. “Diagnosis” has a corresponding meaning. (5.3) “Home health agency” means a provider of home health services, as defined in section 25.5-4-103 (7) , that is certified by the department of public health and environment.  (5.5) “Licensed health care provider” means an individual who is licensed or otherwise authorized by the state pursuant to this title 12 or article 3.5 of title 25 to provide health care services.  (5.6) “Medical facility” means a nursing facility licensed by the department of public health and environment or home health agencies certified to receive medicare or medicaid funds, pursuant to the federal “Social Security Act”, as amended, distinct part nursing facilities, or home health agencies or entities engaged in nurse aide practice. “Medical facility” does not include hospitals and other facilities licensed or certified pursuant to section 25-1.5-103 (1)(a) . (5.7) “Nursing facility” has the same meaning as set forth in section 25.5-4-103 (14) .    “Panel” means either panel of the board created in section 12-255-119 (1).    “Practical nurse”, “trained practical nurse”, “licensed vocational nurse”, or “licensed practical nurse” means a person who holds a license to practice pursuant to this part 1 as a licensed practical nurse in this state or is licensed in another state and is practicing in this state pursuant to section 24-60-3802, with the right to use the title “licensed practical nurse” and its abbreviation “L.P.N.” or “licensed vocational nurse” and its abbreviation “L.V.N.”      “Practice of advanced practice registered nursing” means an expanded scope of professional nursing in a scope, role, and population focus approved by the board, with or without compensation or personal profit, and includes the practice of professional nursing.    “Practice of advanced practice registered nursing” includes prescribing medications as may be authorized pursuant to section 12-255-112.    Nothing in this subsection (8) shall alter the definition of the practice of professional nursing. (8.5) “Practice of a nurse aide” or “nursing aide practice” means the performance of services requiring the education, training, and skills specified in part 2 of this article 255 for certification as a nurse aide. These services are performed under the supervision of a dentist, physician, podiatrist, professional nurse, licensed practical nurse, or other licensed or certified health-care professional acting within the scope of the professional's license or certificate.         “Practice of practical nursing” means the performance, under the supervision of a licensed health care provider authorized to practice in this state, of those services requiring the education, training, and experience, as evidenced by knowledge, abilities, and skills required in this part 1 for licensing as a practical nurse pursuant to section 12-255-114, in:   Caring for the ill, injured, or infirm;    Teaching and promoting preventive health measures;    Acting to safeguard life and health;    Administering treatments and medications prescribed by a licensed health care provider; or    Participating in the assessment, planning, implementation, and evaluation of the delivery of patient care services that is commensurate with the practical nurse's education.       “Practice of practical nursing” includes:   The performance of delegated medical functions and delegated patient care functions;    The assumption of responsibilities and accountabilities for the performance of acts within the practical nurse's educational background and using procedures leading to predictable outcomes; and    The administration and management of nursing, including directing and assigning nursing interventions that may be performed by other licensed or unlicensed health care personnel.       Nothing in this part 1 limits or denies a practical nurse from supervising other practical nurses or other licensed or unlicensed health-care personnel.         “Practice of professional nursing” means the delivery of independent and collaborative nursing care to individuals of all ages, families, groups, and communities, whether sick or well, in all settings. The functions include the initiation and performance of nursing care through health promotion, supportive or restorative care, disease prevention, diagnosis and treatment of human disease, ailment, pain, injury, deformity, and physical or mental condition using specialized knowledge, judgment, and skill involving the application of biological, physical, social, and behavioral science principles required for licensure as a professional nurse pursuant to section 12-255-110.    The “practice of professional nursing” includes the performance of such services as:   Evaluating health status through the collection and assessment of health data;    Health teaching and health counseling;    Providing therapy and treatment that is supportive and restorative to life and well-being either directly to the patient or indirectly through consultation with, delegation to, supervision of, or teaching of others;    Executing delegated medical functions and delegated patient care functions;    Referring to medical or community agencies those patients who need further evaluation or treatment;    Reviewing and monitoring therapy and treatment plans.          “Registered nurse” or “registered professional nurse” means a professional nurse, and only a person who holds a license to practice professional nursing in this state pursuant to this part 1 or who holds a license in another state and is practicing in this state pursuant to section 24-60-3802 may use the title “registered nurse” and its abbreviation, “R.N.”    “Treating” means the selection, recommendation, execution, and monitoring of those nursing measures essential to the effective determination and management of actual or potential human health problems and to the execution of the delegated medical functions and delegated patient care functions. The delegated medical functions and delegated patient care functions shall be performed under the responsible direction and supervision of a licensed health care provider. “Treatment” has a corresponding meaning.    “Unauthorized practice”, for purposes of this part 1, means the practice of practical nursing or the practice of professional nursing by any person:   Who has not been issued a license under this part 1;    Who is not practicing in this state pursuant to section 24-60-3802; or    Whose license has been suspended or revoked or has expired.        History. Source: L. 2019: Entire title R&RE with relocations,(HB 19-1172), ch. 136, p. 1318, § 1, effective October 1. L. 2020: (1), (2), (4), (7), IP(9)(a), (9)(c), (11), and (13) amended and (3.3), (5.3), (5.6), (5.7), and (8.5) added with relocations,(HB 20-1183), ch. 157, p. 674, § 5, effective July 1; (1), (2), (7), (8)(a), (8)(b), (9), (10)(a), IP(10)(b), (10)(b)(IV), and (12) amended and (3.5), (4.5), and (5.5) added,(HB 20-1216), ch. 190, p. 868, § 10, effective July 1.    Editor's note:    This section is similar to former § 12-38-103 as it existed prior to 2019.    Subsection (3.3) is similar to former § 12-260-103 (3); subsection (5.3) is similar to former § 12-260-103 (4); subsection (5.6) is similar to former § 12-260-103 (5); subsection (5.7) is similar to former § 12-260-103 (6); and subsection (8.5) is similar to former § 12-260-103 (7), as they existed prior to 2020.    Amendments to subsections (1), (2), (7), and (9) by HB 20-1183 and HB 20-1216 were harmonized.     Cross references:   For the legislative declaration in HB 20-1216, see section 1 of chapter 190, Session Laws of Colorado 2020.   ANNOTATION   Annotator's note. The following annotations include cases decided under former provisions similar to this section.   The definition of the practice of professional nursing in subsection (10) includes the handling of patient records. Thus, petitioner could be disciplined for failing to properly handle patient records. Weber v. Colo. State Bd. of Nursing, 830 P.2d 1128 (Colo. App. 1992).   Failure to furnish medical records in a timely fashion to patients violates generally accepted standards of nursing practice, warranting disciplinary action. Weber v. Colo. State Bd. of Nursing, 830 P.2d 1125 (Colo. App. 1992).   Subsection (10)(b)(III) appears to contemplate the actual performance of patient services or the supervision of such services. Further, respondent's conduct as vice-president of nursing care services did not constitute the practice of professional nursing as the board's own interpretation of the statutory term “supervision” required. Tryon v. Colo. State Bd. of Nursing, 989 P.2d 216 (Colo. App. 1998).   In interpreting a statute, a reviewing court must accord deference to the interpretation adopted by the agency charged with enforcement of the statute unless the agency's interpretation is inconsistent with its own rules. Tryon v. Colo. State Bd. of Nursing, 989 P.2d 216 (Colo. App. 1998).   The governor's attestation under federal law that allows states to opt out of the requirement that certified nurse anesthetists receive physician supervision while administering anesthesia in order to receive Medicare reimbursement is not a binding interpretation of the supervision provisions of the state Nurse Practice Act. The attestation has the single effect of exempting certified nurse anesthetists from the federal supervision requirement without jeopardizing their Medicare reimbursements. Colo. Med. Soc'y v. Hickenlooper, 2015 CO 41, 349 P.3d 1133 .