reglab/statecodes huggingface dataset:
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-5 - ADVANCED PRACTICE NURSING - COLLABORATIVE PRACTICE › Section 610-X-5-.15 - Qualifications For Physicians In Collaborative Practice With Certified Nurse Midwives

Current through Register Vol. 42, No. 9, June 28, 2024
(1)
			 The physician in collaborative practice with a certified nurse midwife shall:
(a) Possess a current unrestricted license to
			 practice medicine in the State of Alabama.
(b) Practiced medicine, including the active
			 practice of obstetrics and/or gynecology, for at least one year, if the
			 physician is certified by or eligible for board certification by a specialty
			 board approved by the American Medical Association or by the American
			 Osteopathic Association; or have practiced medicine, including the active
			 practice of obstetrics and/or gynecology, for at least three years.
(c) Paid all collaborative practice fees due
			 to the Board of Medical Examiners and submitted to the Board of Medical
			 Examiners the appropriate form.
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-5 - ADVANCED PRACTICE NURSING - COLLABORATIVE PRACTICE › Section 610-X-5-.16 - Limitations Upon Utilization Of Certified Nurse Midwives

Current through Register Vol. 42, No. 9, June 28, 2024
(1) A physician may enter into a
			 collaborative agreement with certified nurse midwives not exceeding a
			 cumulative three hundred and sixty (360) hours (nine FTEs) per week.
The physician shall not collaborate with or supervise any
				combination of certified registered nurse practitioners, certified nurse
				midwives and/or assistants to physicians Physician Assistants exceeding three
				hundred and sixty (360) hours per week (nine full-time equivalent positions).
				"One fulltime equivalent" (FTE) is herein described as a person/persons
				collectively working forty hours a week, excluding time on call.
(a) A physician collaborating with more than
			 four FTEs per week shall engage in documented quality assurance review with
			 each CRNP every month for six (6) months following the commencement of a
			 collaborative practice with a new CNM.
(b) A physician shall disclose to the Board
			 of Medical Examiners the existence of all collaborative and supervisory
			 agreements to which the physician is a party, including collaborative and
			 supervisory agreements in other states, and shall not be eligible to
			 collaborate with or supervise any combination of certified registered nurse
			 practitioners, certified nurse midwives and/or assistants to physicians
			 Physician Assistants exceeding three hundred and sixty (360) hours per week
			 (nine full-time equivalent positions), inclusive of collaborative and
			 supervisory agreements existing in other states. Agreements with an individual
			 certified registered nurse practitioner, certified nurse midwife, and/or
			 Physician Assistants in multiple states shall only be counted once for purposes
			 of calculating the total number of full-time equivalent positions.
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-5 - ADVANCED PRACTICE NURSING - COLLABORATIVE PRACTICE › Section 610-X-5-.17 - Application For Approval To Practice As A Certified Nurse Midwife

Current through Register Vol. 42, No. 9, June 28, 2024
(1) The applicant for
			 approval to practice as a certified nurse midwife shall submit to the Board:
(a) The required fee(s) and a completed
			 application including the standard protocol to be followed by the certified
			 nurse midwife and each collaborating physician, unless application is made for
			 an exemption from a collaborative practice agreement as provided in Rule
			 610-X-5-.18.
(b) An official transcript of education for
			 advanced practice nursing as a nurse midwife that indicates the date of
			 completion of the program and the date the degree or certificate was conferred
			 if the dates are not the same.
(c)
			 Official evidence of current certification as a certified nurse midwife by the
			 American College of Nurse Midwives Certification Council.
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-5 - ADVANCED PRACTICE NURSING - COLLABORATIVE PRACTICE › Section 610-X-5-.18 - Authorization For Practice As A Certified Nurse Midwife

Current through Register Vol. 42, No. 9, June 28, 2024
(1) The Board of Nursing may grant a
			 certificate of qualification for advanced practice nursing as a nurse midwife
			 to applicants who meet all requirements of
			 610-X-5-.14.
(2) Use of the designation "CNM" or of any
			 titles that imply that they are certified nurse midwives shall be restricted to
			 those registered nurses who have been issued certificates of qualification by
			 the Board of Nursing and either:
(a) Have
			 current approval for collaborative practice in the state of Alabama.
(b) Are employed by the United States
			 government and working in federal facilities.
(c) Hold teaching positions in nurse midwife
			 education programs recognized by the Alabama Board of Nursing.
Prior to approval as a CNM, the registered nurse may use only
				the designation or title granted by the national certifying agency.
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-5 - ADVANCED PRACTICE NURSING - COLLABORATIVE PRACTICE › Section 610-X-5-.19 - Temporary Approval As A Certified Nurse Midwife

Current through Register Vol. 42, No. 9, June 28, 2024
(1) The applicant for approval to practice as
			 a certified nurse midwife may be granted temporary approval for practice under
			 the following stipulations until such time as the application is approved or
			 denied by the Board of Nursing and the Board of Medical Examiners.
(a) The applicant shall meet the requirements
			 of Rules
			 610-X-5-.14 and
			 610-X-5-.17.
(b) The collaborating physician shall meet
			 the qualifications established in Rule
			 610-X-5-.15.
(c) Temporary approval is limited to the
			 standard protocol and formulary, including oxytocics, approved by the Joint
			 Committee of the Alabama Board of Nursing and the Alabama State Board of
			 Medical Examiners and does not include the authority to:
(i) Perform additional skills as provided in
			 Rule
			 610-X-5-.22.
(ii) Prescribe drugs other than oxytocics
			 that are defined in the standard formulary with "Restrictions."
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-5 - ADVANCED PRACTICE NURSING - COLLABORATIVE PRACTICE › Section 610-X-5-.20 - Requirements For Collaborative Practice By Physicians And Certified Nurse Midwives

Current through Register Vol. 42, No. 9, June 28, 2024
(1)
			 The collaborating physician shall:
(a)
			 Provide professional medical oversight and direction to the certified nurse
			 midwife.
(b) Be readily available
			 for direct communication or by radio, telephone or
			 telecommunications.
(c) Be readily
			 available for consultation or referrals of patients from the certified nurse
			 midwife.
(d) Be readily available
			 during labor management to provide direct medical intervention and to attend
			 deliveries if needed.
(e) Be
			 readily available at each remote practice site.
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-5 - ADVANCED PRACTICE NURSING - COLLABORATIVE PRACTICE › Section 610-X-5-.21 - Standards Of Practice For Certified Nurse Midwives

Current through Register Vol. 42, No. 9, June 28, 2024
The certified nurse midwife shall practice in accordance with
				the standards and functions developed by the American College of Nurse Midwives
				as recognized by the Board of Nursing and as congruent with Alabama
				law.
Rule .20 was renumbered to .21 as per certification filed
				  July 2, 2015; effective August 6, 2015
Author:
Alabama Board of Nursing.
Statutory Authority:
Code of Ala.
				  1975
, §§
										34-21-85,
				  34-21-87.
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-5 - ADVANCED PRACTICE NURSING - COLLABORATIVE PRACTICE › Section 610-X-5-.22 - Functions And Activities Of Certified Nurse Midwives

Current through Register Vol. 42, No. 9, June 28, 2024
(1) The certified nurse midwife is
			 responsible and accountable for the continuous and comprehensive management of
			 women's health care focusing on pregnancy, childbirth, the post-partum period,
			 care of the newborn, family planning and gynecological needs for which the
			 certified nurse midwife is educationally prepared and for which competency is
			 maintained, with physician collaboration as described in these rules. These
			 services include but are not restricted to the following:
(a) Evaluate current health status and risk
			 factors of individuals based on comprehensive health history and comprehensive
			 physical examinations and assessments.
(b) Formulate a working diagnosis, develop
			 and implement a treatment plan, evaluate and modify therapeutic regimens to
			 promote positive patient outcomes.
(c) Prescribe, administer and provide
			 therapeutic measures, tests, procedures, and drugs.
(d) Counsel, teach and assist
			 individuals/families to assume responsibility for self-care in prevention of
			 illness, health maintenance, and health restoration.
(e) Consult with and refer to other health
			 care providers as appropriate.
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-5 - ADVANCED PRACTICE NURSING - COLLABORATIVE PRACTICE › Section 610-X-5-.23 - Prescriptions And Medication Orders By Certified Nurse Midwives

Current through Register Vol. 42, No. 9, June 28, 2024
(1) Certified nurse
			 midwives engaged in collaborative practice with physicians may be granted
			 prescriptive authority upon submission of evidence of completion of an academic
			 course in pharmacology or evidence of integration of pharmacology theory and
			 clinical application in the certified nurse midwifery curriculum.
(2) Certified nurse midwives practicing under
			 protocols approved in the manner prescribed by
Code of Ala.
			 1975
, section
			 34-21-80 et seq. may prescribe legend drugs to their patients, subject to the following
			 conditions:
(a) The drug shall be included in
			 the formulary recommended by the Joint Committee and adopted by the Board of
			 Nursing and the State Board of Medical Examiners.
(b) The drug type, dosage, quantity
			 prescribed, and number of refills shall be authorized in an approved protocol
			 signed by the collaborating physician and the certified nurse midwife. This
			 requirement may be met if written prescriptions adhere to the standard
			 recommended doses of legend drugs, as identified in the Physician's Desk
			 Reference or ProductInformation Insert, and do not:
(i) Exceed the recommended treatment regimen
			 periods.
(ii) Include United States
			 Food and Drug Administration (FDA) non-approved supplements, drug products,
			 medication, and off label medications.
(c) Drugs and Medications that do not have
			 FDA approval may be prescribed through protocol registration in a United States
			 Institutional Review Board or Expanded Access authorized clinical
			 trial.
(d) "Off Label" use or
			 prescription of FDA-approved medications for uses other than that indicated by
			 the FDA, is permitted when such practices are:
(i) Within the current standard of care for
			 treatment of disease or condition.
(ii) Supported by evidence-based
			 research.
(iii) Approved by the
			 collaborating physician and entered into the patient record.
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-5 - ADVANCED PRACTICE NURSING - COLLABORATIVE PRACTICE › Section 610-X-5-.24 - Reinstatement Of Lapsed Approval For Practice As A Certified Nurse Midwife

Current through Register Vol. 42, No. 9, June 28, 2024
(1) Lapsed approval as
			 a certified nurse midwife may be reinstated upon submission of a completed
			 application and compliance with the following:
(a) An active Alabama registered nurse
			 license, or a multistate registered nurse license issued by a party state, as
			 defined in Chapter 4 of these rules.
(b) Payment of current renewal and
			 reinstatement fees, as well as outstanding fees and fines, if
			 applicable.
(c) Official evidence
			 of current national certification as a certified nurse midwife by a national
			 certifying agency recognized by the Board.
(d) Documented evidence of completion of six
			 contact hours of pharmacology content specific to prescriptive practice in the
			 approved area for collaborative practice earned within the 24 months
			 immediately preceding application.
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-5 - ADVANCED PRACTICE NURSING - COLLABORATIVE PRACTICE › Section 610-X-5-.25 - Grounds For Termination Of Approval Of A Collaborative Practice

Current through Register Vol. 42, No. 9, June 28, 2024
(1) The following acts
			 may constitute grounds for the termination of the advanced practice approval
			 for the collaborating practice of a physician and a certified registered nurse
			 practitioner or certified nurse midwife:
(a)
			 Prescribing by a certified registered nurse practitioner or certified nurse
			 midwife in violation of §§
									20-2-54,
			 20-2-254,
			 20-2-260, and
			 34-21-80 through
			 34-21-93 of the
Code of Ala. 1975
, as amended, or the rules of
			 the State Board of Medical Examiners.
(b) For a certified registered nurse
			 practitioner or certified nurse midwife to knowingly engage in any act or
			 render any services not authorized in his or her protocol.
(c) Failure of a certified registered nurse
			 practitioner or certified nurse midwife to maintain current licensure and
			 advanced practice approval with the Board of Nursing.
(d) Failure of a certified registered nurse
			 practitioner or certified nurse midwife to comply with any statute or rule
			 governing collaborative practice.
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-6 - STANDARDS OF NURSING PRACTICE › Section 610-X-6-.02 - Standards Of Practice

Current through Register Vol. 42, No. 9, June 28, 2024
The Board of Nursing may adopt standards of nursing practice
				and continuing competency.
(1) The RN,
			 LPN, or APRN shall comply with the standards of practice within these rules,
			 national standards of practice according to the nursing role including, but not
			 limited to, the following:
(a) Practicing
			 within their legal scope of practice as defined in the Alabama Nurse Practice
			 Act and the Alabama Board of Nursing Administrative Code.
(b) Accepting responsibility for individual
			 nursing actions, competence, decisions, standards or practice, and behavior in
			 the course of nursing practice and the exercise of appropriate nursing
			 judgment.
(c) Maintaining
			 competence through on-going learning and application of knowledge in nursing
			 practice and skills in the area of practice to maintain ability to manage risks
			 and potential complications.
(d)
			 Executing medical regimens according to approved medical protocols,
			 standardized procedures, and standing orders, including administering
			 medications and treatments prescribed by a legally authorized
			 prescriber.
(e) Identifying changes
			 in patient health status and taking appropriate action, to include preventive
			 measures to protect patient, self, and others.
(f) Documenting nursing interventions and
			 responses to care in an accurate, timely, thorough, and clear manner.
(g) Providing patient surveillance and
			 monitoring.
(h) Maintaining
			 professional boundaries.
(i)
			 Providing care supportive to or restorative of life and well- being and end of
			 life care.
(j) Conducting and
			 documenting comprehensive and/or focused assessments, to include evaluations of
			 patient care.
(k) Consulting with
			 or referring patients to other healthcare providers to resolve situations
			 beyond the expertise of the licensed nurse.
(l) Collaborating on planning and care of
			 patients to include health maintenance, patient teaching, counseling,
			 collaborative planning, prevention of illness, rehabilitation, and discharge
			 planning.
(m) Delegating to another
			 only those nursing measures for which that person has the necessary skills and
			 competence to accomplish safely.
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-6 - STANDARDS OF NURSING PRACTICE › Section 610-X-6-.03 - Standards For Conduct And Accountability

Current through Register Vol. 42, No. 9, June 28, 2024
The registered nurse or licensed practical nurse shall:
(1) Have knowledge and understanding of the
			 laws and rules regulating nursing.
(2) Function within the legal scope of
			 nursing practice.
(3) Obtain
			 instruction and supervision as necessary, when implementing new or unfamiliar
			 nursing techniques or practices.
(4) Be responsible and accountable for the
			 quality of nursing care delivered to patients, based on and limited to scope of
			 education, demonstrated competence, and nursing experience.
(5) Be responsible for monitoring and
			 evaluating the quality of patient care delivered by personnel under the
			 individual nurse's supervision.
(6)
			 Be responsible and accountable for the delegation of selected nursing
			 activities in selected situations to unlicensed individuals.
(7) Accept individual responsibility and
			 accountability for judgments, actions, and nursing competency, remaining
			 current with technology and practicing consistent with facility policies and
			 procedures.
(8) Accept individual
			 responsibility and accountability for recognition and appropriate nursing
			 action following a change in the patient's mental or physical status.
(9) Practice in compliance with current CDC
			 Standard Precautions and Infection Control, including aseptic
			 technique.
(10) Practice without
			 discrimination on the basis of age, race, religion, gender, national origin,
			 sexual orientation, patient diagnosis, or disability.
(11) Respect the dignity and rights of
			 patients and their significant others, including, but not limited to:
(a) Privacy.
(b) Safety.
(c) Protection of confidential information,
			 unless disclosure is required by law.
(d) Freedom from exploitation of physical,
			 mental, sexual, or financial boundaries.
(e) Protection of real and personal
			 property.
(f) Behavior that is
			 therapeutic and places the patient's interests before the nurse's
			 interests.
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-6 - STANDARDS OF NURSING PRACTICE › Section 610-X-6-.04 - Practice Of Professional Nursing (Registered Nurse Practice)

Current through Register Vol. 42, No. 9, June 28, 2024
(1) The practice of
			 professional nursing includes the performance, for compensation, of any act in
			 the care and counselling of persons or in the promotion and maintenance of
			 health and prevention of illness and injury based upon the nursing process
			 which includes systematic data gathering, assessment, appropriate nursing
			 judgment and evaluation of human responses to actual or potential health
			 problems through such services as case finding, health teaching, and health
			 counselling; and provision of care supportive to or restorative of life and
			 well-being, and executing medical regimens including administering medications
			 and treatments prescribed by a licensed or otherwise legally authorized
			 physician or dentist. A nursing regimen shall be consistent with and shall not
			 vary any existing medical regimen. Additional acts requiring appropriate
			 education and training designed to maintain access to a level of health care
			 for the consumer may be performed under emergency or other conditions which are
			 recognized by the nursing and medical professions as proper to be performed by
			 a registered nurse.
(2) The scope
			 of an individual registered nurse's level of practice includes, but is not
			 limited to:
(a) License status, including
			 Board approval for advanced practice as detailed in Chapters 610-X-5 and
			 610-X-9 of these rules.
(b)
			 Educational preparation, initial and continued.
(c) State and federal statutes and
			 regulations.
(d) State and national
			 standards appropriate to the scope and the type of practice.
(e) Nursing experience.
(f) Demonstrated competence.
(g) Facility policy and procedures, Board
			 approved standardized procedures and approved medical protocols.
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-6 - STANDARDS OF NURSING PRACTICE › Section 610-X-6-.05 - Practice Of Practical Nursing (Licensed Practical Nurse Practice)

Current through Register Vol. 42, No. 9, June 28, 2024
(1) The practice of
			 practical nursing includes the performance, for compensation, of acts designed
			 to promote and maintain health, prevent illness and injury, and provide care
			 utilizing standardized procedures and the nursing process, including
			 administering medications and treatments, under the direction of a licensed
			 professional nurse or a licensed or otherwise legally authorized physician or
			 dentist. Such practice requires basic knowledge of the biological, physical,
			 and behavioral sciences and of nursing skills but does not require the
			 substantial specialized skill, independent judgment, and knowledge required in
			 the practice of professional nursing. Additional acts requiring appropriate
			 education and training may be performed under emergency or other conditions
			 which are recognized by the nursing and medical professions as proper to be
			 performed by a licensed practical nurse.
(2) The scope of an individual licensed
			 practical nurse's level of practice includes, but is not limited to:
(a) License status.
(b) Educational preparation, initial and
			 continued.
(c) State and federal
			 statutes and regulations.
(d) State
			 and national standards appropriate to the scope and the type of
			 practice.
(e) Nursing experience.
			 Assumption of responsibility for recognizing personal limits of knowledge and
			 experience.
(f) Demonstrated
			 competence.
(g) Facility policy and
			 procedures, Board approved standardized procedures, and approved medical
			 protocols.
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-6 - STANDARDS OF NURSING PRACTICE › Section 610-X-6-.06 - Standards For Documentation

Current through Register Vol. 42, No. 9, June 28, 2024
(1) The standards for documentation of
			 nursing care provided to patients by licensed nurses are based on principles of
			 documentation, regardless of the documentation format.
(2) Documentation of nursing care shall be:
(a) Legible.
(b) Accurate.
(c) Complete. Complete documentation includes
			 reporting and documenting on appropriate records a patient's status, including
			 signs and symptoms, responses, treatments, medications, other nursing care
			 rendered, communication of pertinent information to other health team members,
			 and unusual occurrences involving the patient. A signature of the writer,
			 whether electronic or written, is required in order for the documentation to be
			 considered complete.
(d) Timely.
1. Charted at the time or after the care, to
			 include medications. Charting prior to care being provided, including
			 medications, violates principles of documentation.
2. Documentation of patient care that is not
			 in the sequence of the time the care was provided shall be recorded as a "late
			 entry," including a date and time the late entry was made, as well as the date
			 and time the care was provided.
(e) A mistaken entry in the record by a
			 licensed nurse shall be corrected by a method that does not obliterate,
			 white-out, or destroy the entry.
(f) Corrections to a record by a licensed
			 nurse shall include the name or initials of the individual making the
			 correction.
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-6 - STANDARDS OF NURSING PRACTICE › Section 610-X-6-.07 - Standards For Medication Administration And Safety

Current through Register Vol. 42, No. 9, June 28, 2024
(1) The registered nurse or licensed
			 practical nurse shall have applied knowledge of medication administration and
			 safety, including but not limited to:
(a) Drug
			 action.
(b)
			 Classifications.
(c) Expected
			 therapeutic benefit of medication.
(d) Expected monitoring.
(e) Indications based on existing patient
			 illness or injury processes.
(f)
			 Contraindications based on presence of additional known patient illnesses,
			 disease processes, or pre-existing conditions.
(g) Possible side effects and interventions
			 for same.
(h) Adverse reactions and
			 interventions for same.
(i)
			 Emergency interventions for anaphylactic reactions.
(j) Safety precautions, including but not
			 limited to:
1. Right patient.
2. Right medication.
3. Right time.
4. Right dose.
5. Right route.
6. Right reason.
7. Right documentation.
(k) Interactions with other drugs, foods, or
			 complementary therapies.
(l)
			 Calculation of drug dosages.
(m)
			 Federal and state legal requirements related to storage of controlled
			 substances.
(n) Healthcare facility
			 policy and procedure on secure storage of all medications.
(o) Patient education specific to
			 medication.
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-6 - STANDARDS OF NURSING PRACTICE › Section 610-X-6-.08 - Standards For Moderate Sedation

Current through Register Vol. 42, No. 9, June 28, 2024
(1) After a patient assessment and
			 verification of the physical presence of a physician, dentist, or certified
			 registered nurse anesthetist and licensed or unlicensed assistive personnel in
			 the procedural area, the registered nurse may administer ordered medications
			 for the purpose of inducing moderate sedation that allows the patient to be
			 aroused and to retain reflexes for short-term therapeutic or diagnostic
			 procedures, pursuant to facility policies and procedures.
(2) The minimum requirements for a registered
			 nurse to perform moderate sedation and associated monitoring includes;
			 successful completion of an organized program of study, supervised clinical
			 practice, and demonstrated clinical competence.
(3) The minimum training for the registered
			 nurse managing the care of patients receiving moderate sedation shall include:
(a) Anatomy, physiology, pharmacology,
			 cardiac arrhythmia recognition, and complications related to sedation and
			 medications.
(b) Total patient care
			 requirements to be assessed during moderate sedation and recovery, including
			 but not limited to the following physiologic measurements:
(i) Respiratory rate.
(ii) Oxygen saturation.
(iii) Blood pressure.
(iv) Cardiac rate and rhythm.
(v) Level of consciousness.
(c) Principles of oxygen delivery,
			 respiratory physiology, transport, uptake and demonstration of the ability to
			 use oxygen delivery devices.
(d)
			 Anticipation and recognition of potential complications of sedation in relation
			 to the type of medication being administered.
(e) Requisite knowledge and skills to assess
			 and intervene in the event of complications or undesired outcomes and to
			 institute nursing interventions, in compliance with orders or institutional
			 protocols or guidelines.
(f)
			 Demonstration of skill in airway management resuscitation.
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-6 - STANDARDS OF NURSING PRACTICE › Section 610-X-6-.09 - Standards For Patient Assessment

Current through Register Vol. 42, No. 9, June 28, 2024
(1) Patient assessment shall be provided in
			 accordance with the definitions of professional nursing and practical nursing,
			 as defined in the Alabama Nurse Practice Act, Section
			 34-21-1.
(2) The registered nurse shall conduct and
			 document comprehensive and focused nursing assessments of the health status of
			 patients by:
(a) Collecting objective and
			 subjective data from observations, physical examinations, interviews, and
			 written records in an accurate and timely manner, as appropriate to the
			 patient's health care needs.
(b)
			 Analysis and reporting of data collected.
(c) Developing a plan of care based upon the
			 patient assessment.
(d) Modifying
			 the plan of care based upon the evaluation of patient responses to the plan of
			 care, including:
1. Anticipating and
			 recognizing changes or potential changes in patient status.
2. Identifying signs and symptoms of
			 deviation from current health status.
3. Implementing changes in
			 interventions.
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-6 - STANDARDS OF NURSING PRACTICE › Section 610-X-6-.10 - Patient Care Orders

Current through Register Vol. 42, No. 9, June 28, 2024
(1)
			 The licensed nurse may receive handwritten, verbal, or electronic medical
			 orders from the legally authorized prescriber relayed by another licensed or
			 registered health care professional, or registered or certified medical
			 assistant.
(2) The licensed nurse
			 may implement approved medical protocols and standing orders at the direction
			 of a legally authorized prescriber.
(3) The licensed nurse shall follow the
			 facility policy and procedures on verifying and implementing electronic
			 orders.
Author:
Alabama Board of Nursing
Statutory Authority:
Code of Ala.
				  1975
, §§
										34-21-1(3),
				  34-21-2(c)
				  (21).
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-6 - STANDARDS OF NURSING PRACTICE › Section 610-X-6-.11 - Assignment, Delegation And Supervision

Current through Register Vol. 42, No. 9, June 28, 2024
(1) The registered nurse shall be accountable
			 and responsible for the assignment of nursing activities and tasks to other
			 health care workers based on, but not limited to:
(a) Knowledge, skills, and
			 experience.
(b) Complexity of
			 assigned tasks.
(c) Health status
			 of the patient.
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-6 - STANDARDS OF NURSING PRACTICE › Section 610-X-6-.12 - Practice Beyond Basic Nursing Education: Standardized Procedures

Current through Register Vol. 42, No. 9, June 28, 2024
(1) For practice beyond
			 basic education that has not been previously approved by the Board, a
			 standardized procedure is required for the licensed nurse in any practice
			 setting.
(a) Approval is not required for an
			 acute care hospital prior to implementation, except for standardized procedures
			 related to rapid sequence intubation (RSI), provided that the facility submits
			 a standardized procedure application for each standardized procedure within
			 sixty (60) days of implementation.
(b) Practice beyond basic education in home
			 health, hospice, physician offices, and other locations outside a licensed
			 hospital requires approval by the Board prior to implementation.
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-6 - STANDARDS OF NURSING PRACTICE › Section 610-X-6-.13 - Standards For Wound Assessment And Care

Current through Register Vol. 42, No. 9, June 28, 2024
(1) It is within the scope of a licensed
			 nurse practice to perform wound assessments, including but not limited to
			 staging of a wound and making determinations as to whether wounds are present
			 on admission to a healthcare facility, pursuant to an approved standardized
			 procedure, outlined in Rule
			 610-X-6-.12,
			 Standardized Procedures, including supervised clinical practice and
			 demonstrated clinical competence, initially and at periodic
			 intervals.
(2) The minimum training
			 for the licensed nurse who performs selected tasks associated with wound
			 assessment and care shall include:
(a)
			 Anatomy, physiology, and pathophysiology.
(b) Fluid and electrolyte balance.
(c) Equipment and procedures used in wound
			 assessment and care.
(d) Chronic
			 wound differentiation.
(e) Risk
			 identification.
(f) Measurement of
			 wound.
(g) Stage of
			 wound.
(h) Condition of the wound
			 bed, including:
(i) Tissues.
(ii) Exudate.
(iii) Edges.
(iv) Infection.
(i) Skin surrounding the wound.
(j) Pain.
(k) Complications, prevention, and nursing
			 intervention.
(l) Identification
			 of any contributing factors, including but not limited to:
1. Perfusion/oxygenation.
2. Nutritional status.
3. Infection.
4. Medications.
5.  Diabetes.
(m) Photographing wounds.
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-6 - STANDARDS OF NURSING PRACTICE › Section 610-X-6-.14 - Intravenous (IV) Therapy By Licensed Practical Nurses

Current through Register Vol. 42, No. 9, June 28, 2024
(1) A licensed facility may develop a
			 standardized procedure, as defined in Rule
			 610-X-6-.12, for intravenous (IV)
			 therapy by a licensed practical nurse.
(2) The minimum requirements for a licensed
			 practical nurse to perform IV therapy includes successful completion of an
			 organized program of study, supervised clinical practice, and demonstrated
			 clinical competence, initially and at periodic intervals, according to the
			 requirements of Rule
			 610-X-6-.12.
(3) The minimum training for the licensed
			 practical nurse who performs selected tasks associated with IV therapy shall
			 include:
(a) Anatomy and physiology.
(b) Fluid and electrolyte balance.
(c) Equipment and procedures utilized in
			 intravenous therapy.
(d)
			 Complications, prevention, and nursing intervention.
(e) Introducing a peripheral intravenous
			 device on an adult patient.
(f)
			 Set-up, replacement, and removal of intravenous tubing for gravity flow and/or
			 pump infusion.
(g) Intravenous
			 fluid infusion calculations and adjustment of flow rates on intravenous fluids
			 and administration of intravenous medications by piggyback.
(h) Procedures for reconstituting and
			 administering intravenous medications via piggyback, including but not limited
			 to pharmacology, compatibilities, and flow rates.
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-6 - STANDARDS OF NURSING PRACTICE › Section 610-X-6-.15 - Telecommunication For Pronouncement Of Patient Death

Current through Register Vol. 42, No. 9, June 28, 2024
(1) The licensed nurse may receive
			 pronouncement of a patient's death from a physician via telecommunication
			 without a physical examination of the patient by that physician.
(2) The facility policy shall specify the
			 permissible patient conditions for which the licensed nurse in a specific
			 health care facility or agency may receive the pronouncement of a patient's
			 death by telecommunication.
Rule .10 was renumbered .15 as per certification filed
				  November 23, 2009; effective December 28,
				  2009.
Author:
Alabama Board of Nursing
Statutory Authority:
Code of Ala.
				  1975
, §§
										22-31-2,
				  34-21-2(c)
				  (21).
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-6 - STANDARDS OF NURSING PRACTICE › Section 610-X-6-.16 - Telehealth Nursing

Current through Register Vol. 42, No. 9, June 28, 2024
(1)
			 The licensed nurse must hold an active Alabama license or multistate license
			 issued by a party state other than Alabama, as defined in Chapter 4 of these
			 rules, in order to practice telenursing in the State of Alabama. The licensed
			 nurse shall adhere to the existing Alabama Nurse Practice Act and Alabama
			 Administrative Code.
(2)
			 Telenursing practice can take place in varied practice settings. The individual
			 nurse is responsible for:
(a) Having
			 knowledge and understanding of the laws and rules regulating
			 telenursing.
(b) Functioning within
			 the legal scope of nursing practice for Alabama licensed nurses.
(c) Maintaining competency in the area of
			 practice.
1. Competency should include how to
			 use telehealth technologies and medical devices in the practice of nursing at a
			 distance.
(d) The
			 licensed nurse shall follow the facility specific policy of the permissible
			 activities of telenursing.
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-7 - STANDARDS OF NURSING PRACTICE; SPECIFIC SETTINGS › Section 610-X-7-.01 - Definitions

Current through Register Vol. 42, No. 9, June 28, 2024
(1) Delegation: The act
			 of authorizing a competent individual to perform selected nursing activities
			 supportive to licensed nurses in selected situations while retaining the
			 accountability for the outcome if the delegation is to an unlicensed
			 individual.
(2) Medication
			 Assistant, Certified (MAC): Mental health worker or unlicensed assistive
			 personnel who has successfully completed a Board-approved curriculum for
			 assistance with medications, or a comparable program in another state, and
			 holds a valid medication assistant certification (MACE).
(3) Medication Assistant Supervisor (MAS): A
			 licensed nurse who supervises Medication Assistant, Certified (MAC).
(4) Registered Nurse First Assistant (RNFA):
			 A registered nurse who, through additional education and supervised clinical
			 practice, has acquired knowledge, skills, and judgment specific to providing
			 assistance during a surgical procedure, as directed by the attending surgeon
			 and as defined in standardized procedures.
(5) Sexual Assault Nurse Examiner (SANE): A
			 registered nurse who, through additional education and supervised clinical
			 practice, has acquired knowledge, skills, and judgment specific to providing
			 health services to sexual assault or rape victims, including a forensics
			 examination.
Author:
Alabama Board of Nursing
Statutory Authority:
Code of Ala.
				  1975
, §
										34-21-2(c)(21).
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-7 - STANDARDS OF NURSING PRACTICE; SPECIFIC SETTINGS › Section 610-X-7-.02 - Delegation By School Nurses

Current through Register Vol. 42, No. 9, June 28, 2024
(1)
			 The school nurse is accountable and responsible for the nursing care delivered
			 to students under the nurse's jurisdiction.
(2) Over-the-counter (OTC) medications may be
			 administered to school children by the school nurse with a parent's written
			 authorization and without a physician's authorization, unless the school system
			 policy requires a physician authorization. Parental authorization requirements
			 require the following documentation:
(a) The
			 purpose of the OTC medication.
(b)
			 The circumstances under which the over-the-counter medication can be
			 administered.
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-7 - STANDARDS OF NURSING PRACTICE; SPECIFIC SETTINGS › Section 610-X-7-.03 - State Of Alabama Independent Living (SAIL) Program

Current through Register Vol. 42, No. 9, June 28, 2024
(1) Registered nurses employed by the State
			 of Alabama Independent Living (SAIL) Program administered by the Department of
			 Rehabilitation Services may delegate tasks to a patient's designated caregiver
			 if each of the following conditions is met:
(a) The Department of Rehabilitation
			 Services, in conjunction with the registered nurse, approves the patient's
			 designated caregiver to receive delegation.
(b) The registered nurse is accountable for
			 determining the tasks that may be safely performed by the patient's designated
			 caregiver.
(c) The registered nurse
			 identifies the training needs of the patient's designated caregiver and assures
			 that the training is appropriate for the task to be delegated.
(d) The patient's designated caregiver
			 demonstrates competency to perform the delegated task.
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-7 - STANDARDS OF NURSING PRACTICE; SPECIFIC SETTINGS › Section 610-X-7-.04 - Registered Nurse As Surgical First Assistant (RNFA)

Current through Register Vol. 42, No. 9, June 28, 2024
(1) The registered nurse may function as a
			 surgical first assistant according to standardized procedures, as defined in
			 Rule
			 610-X-6-.12.
			 The RNFA has the duty to verify that standardized procedures are in effect
			 before performing the functions of a surgical first assistant.
(2) Performing intra-operative functions as a
			 RNFA is limited to the direct supervision of the attending surgeon physically
			 present in the surgical suite where the case is being performed.
(3) When directed by the attending surgeon,
			 the RNFA intra-operative functions include, but are not limited to:
(a) Positioning the patient, preparing and
			 draping the surgical site.
(b)
			 Providing exposure, retraction, and hemostasis.
(c) Use and handling of surgical
			 instrumentation.
(d) Tissue
			 handling, dissection, suturing, and stapling.
(e) Making the skin nick or stab wound for
			 laparoscopic surgery or drains, excluding placement of primary trocar for
			 laparoscopic and robotic access. Secondary placement of trocars for
			 laparoscopic and robotic surgery if the RNFA is deemed competent to perform by
			 the attending surgeon who is within proximity of the sterile field.
(f) Securing drains.
(g) Closing of wounds external to the
			 fascia.
(h) Harvesting extremity
			 veins and closure of the resulting wounds.
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-7 - STANDARDS OF NURSING PRACTICE; SPECIFIC SETTINGS › Section 610-X-7-.05 - Sexual Assault Nurse Examiner (SANE)

Current through Register Vol. 42, No. 9, June 28, 2024
(1) A registered nurse may practice as a SANE
			 with appropriate additional education, including supervised clinical practice
			 and demonstrated clinical competence.
(2) The educational program for a SANE shall
			 comply with the education standards of the International Association of
			 Forensic Nurses (IAFN). The educational program shall follow the content
			 outline contained in IAFN's Sexual Assault Nurse Examiner Education Guidelines
			 and shall be specific to the population examined by the SANE: adult/adolescent
			 or pediatric.
(a) An adult/adolescent sexual
			 assault nursing education program includes a minimum of forty (40) hours of
			 course work that provides nursing continuing education or academic credit from
			 an accredited educational institution.
(b) A pediatric SANE program includes:
1. A minimum of forty (40) hours of course
			 work that provides nursing continuing education or academic credit from an
			 accredited educational institution.
2. A combined adult/adolescent and pediatric
			 SANE program that includes a minimum of sixty-four (64) hours of course work
			 that provides nursing continuing education or academic credit from an
			 accredited educational institution.
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-7 - STANDARDS OF NURSING PRACTICE; SPECIFIC SETTINGS › Section 610-X-7-.06 - Alabama Department Of Mental Health Residential Community Programs

Current through Register Vol. 42, No. 9, June 28, 2024
(1) Alabama Department
			 of Mental Health shall train licensed nurses by the Alabama Department of
			 Mental Health approved nurse delegation programs: Program (NDP) and the
			 Medication Administration Supervisor (MAS). Licensed nurses who are MAS trained
			 are accountable and responsible for the outcome of the delegated nursing care
			 delivered by unlicensed mental health worker to residents in the residential
			 community mental health settings.
(2) Licensed nurses who provide nursing care
			 in the residential community mental health setting and the community
			 extensions, including day habilitation programs, may delegate specific limited
			 tasks to designated unlicensed assistive personnel.
(3) The MAS registered nurse is responsible
			 and accountable for the completion of a comprehensive assessment and evaluation
			 of patients' nursing care needs.
(a) The
			 licensed practical nurse may initiate and document data elements of the
			 comprehensive assessment.
(b) The
			 outcome of the comprehensive assessment shall determine the tasks that may
			 safely be performed by the unlicensed assistive personnel in residential
			 community mental health settings. The focused assessment after the completion
			 of comprehensive assessment may also identify tasks that may be
			 delegated.
(c) The nursing tasks
			 delegated by the MAS licensed nurse shall be based on the residents' needs, as
			 documented in the comprehensive and/or focused assessment. The comprehensive
			 assessment shall be reviewed annually, or in the event of a health status
			 change.
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-7 - STANDARDS OF NURSING PRACTICE; SPECIFIC SETTINGS › Section 610-X-7-.07 - Occupational Safety And Health Administration Respiratory Standard

Current through Register Vol. 42, No. 9, June 28, 2024
(1) Registered nurses
			 and certified registered nurse practitioners may administer the Occupational
			 Safety and Health Administration (OSHA) Respiratory Standard Medical
			 questionnaire.
(2) Registered
			 nurses and certified registered nurse practitioners may refer for further
			 evaluation based on the employee's response to the medical
			 questionnaire.
(3) Certified
			 registered nurse practitioners may perform the medical examination related to
			 the OSHA Respiratory Standard Medical questionnaire, if appropriate for their
			 area of practice.
Author:
Alabama Board of Nursing
Statutory Authority:
Code of Ala.
				  1975
, §
										34-21-2(c)(21).
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-7 - STANDARDS OF NURSING PRACTICE; SPECIFIC SETTINGS › Section 610-X-7-.08 - Behavioral Restraint And Seclusion

Current through Register Vol. 42, No. 9, June 28, 2024
Registered nurses are authorized to perform the one-hour,
				face-to-face evaluation for patients placed in behavioral restraint or
				seclusion, if the facility has a policy and procedure and organized program of
				study.
Author:
Alabama Board of Nursing
Statutory Authority:
Code of Ala.
				  1975
, §
										34-21-2(c)(21).
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-7 - STANDARDS OF NURSING PRACTICE; SPECIFIC SETTINGS › Section 610-X-7-.09 - Commercial Drivers License Examinations

Current through Register Vol. 42, No. 9, June 28, 2024
The assessment of applicants for commercial driver licenses is
				restricted to family, adult, acute care, gerontology, adult gerontology primary
				care, and adult gerontology acute care certified registered nurse
				practitioners.
Author:
Alabama Board of Nursing
Statutory Authority:
Code of Ala.
				  1975
, §
										34-21-2(c)
				  (21).
Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-7 - STANDARDS OF NURSING PRACTICE; SPECIFIC SETTINGS › Section 610-X-7-.10 - Delegation Of Insulin And Glucagon Administration In The School Setting

Current through Register Vol. 42, No. 9, June 28, 2024
(1) DEFINITIONS
(a) Glucagon: a hormone that raises the level
			 of glucose in the blood and is administered by injection to individuals to
			 treat severe hypoglycemia that is indicated by the inability to eat food or
			 drink, unconsciousness, unresponsiveness and/or seizures or
			 convulsions.
(b) Insulin: a hormone
			 made and released by the pancreas that allows glucose to enter the cells where
			 it is used for energy. Students with type 1 diabetes and some students with
			 type 2 diabetes need to administer insulin at regular times and take insulin to
			 cover carbohydrate intake to correct hyperglycemia.
(c) Medication Administration and Safety: See
			 Chapter
			 610-X-6-.07.
(d) School setting: preschool through
			 12th grade in a public or private school or school
			 activity sponsored by such a school, in which the student is a direct
			 participant.
(e) Trained,
			 Unlicensed Medication Assistant: a school employee who volunteers to receive
			 delegation of administration of insulin and glucagon in the school setting and
			 receives the approved training.