Louisiana Administrative Code › Title 46 - PROFESSIONAL AND OCCUPATIONAL STANDARDS › Part XLVII - Nurses: Practical Nurses and Registered Nurses › Subpart 2 - Registered Nurses › Chapter 45 - Advanced Practice Registered Nurses › Section XLVII-4505 - Definitions

Current through Register Vol. 50, No. 6, June 20, 2024
Accrediting Agency
- an organization which
					 establishes and maintains standards for professional nursing or nursing related
					 programs and recognizes those programs that meet these standards.
Advanced Practice
					 Certification
-certification by a nationally recognized certifying body
					 approved by the board.
Advanced Practice Nursing Education
					 Program
- a program whose purpose is to prepare advanced practitioners
					 of nursing with a graduate degree or post-graduate certification/award by an
					 academic institution accredited or awarded pre-approval, pre-accreditation
					 status by a nursing or nursing-related accrediting organization recognized by
					 the U.S. Department of Education (USDE) and/or the Council for Higher Education
					 Accreditation (CHEA) and whose graduates are eligible for certification as an
					 advanced practice registered nurse.
Advanced Practice Registered Nurse
					 (APRN)
-a registered nurse:
1. who has completed an accredited graduate-level education
					 program preparing him/her for one of the four recognized
APRN
roles in addition to a population focus;
2. who has passed a national certification examination that
					 measures
APRN
role and population-focused competencies and who
					 maintains continued competence as evidenced by recertification in the role and
					 population through the national certification program;
3. who has acquired advanced clinical knowledge and skills
					 preparing him/her to provide direct care to patients;
4. whose practice builds on the competencies of registered
					 nurses (RNs) by demonstrating a greater depth and breadth of knowledge, a
					 greater synthesis of data, increased complexity of skills and interventions,
					 and greater role autonomy;
5. who is educationally prepared to assume responsibility
					 and accountability for health promotion and/or maintenance as well as the
					 assessment, diagnosis, and management of patient problems, which includes the
					 use and prescription of pharmacologic and non-pharmacologic
					 interventions;
6. who has clinical experience of sufficient depth and
					 breadth to reflect the intended license;
7. who has obtained a license to practice as an
APRN
;
8. who is expected to practice within established standards
					 and is accountable for the quality of advanced nursing care rendered, for
					 recognizing limits of knowledge and experience, planning for the management of
					 situations beyond one's expertise; and for consulting with or referring
					 patients to other health care providers as appropriate.
Advanced Practice Registered Nurse
					 Student
- Repealed.
Advanced Practice Registered Nursing
-
					 nursing by a certified registered nurse anesthetist, certified nurse midwife,
					 clinical nurse specialist, or nurse practitioner which is based on knowledge
					 and skills acquired in a basic nursing education program, licensure as a
					 registered nurse, and a minimum of a graduate degree with a concentration in
					 one or more respective advanced practice nursing role and population focus
					 which includes both didactic and clinical components, advanced knowledge in
					 nursing theory, physical and psychosocial assessment, nursing interventions,
					 and management of health care.
Advanced Practice Registered Nursing Role
-
					 a designated area of advanced practice in which the registered nurse holds a
					 graduate degree with a concentration in the respective area of practice that
					 includes both the didactic and clinical components, advanced knowledge in
					 nursing theory, physical and psychosocial assessment, nursing interventions,
					 pharmacotherapeutics, and management of health care and also prepares the APRN
					 for national certification. For the purpose of this part, the
area of
					 practice
is defined within the context of the role and population
					 focus of advanced practice nursing. The four APRN roles include: certified
					 registered nurse anesthetist, certified nurse midwife, clinical nurse
					 specialist, and nurse practitioner.
Alternate Collaborating Physician (ACP)
- a
					 physician designated by a collaborating physician (CP) with whom an APRN has
					 been previously approved to collaborate by the board, who agrees to serve in
					 this capacity, and is available to the APRN for consultation and collaboration
					 as delineated in the collaborative practice agreement signed by the CP The ACP
					 shall be a physician actively engaged in clinical practice and the provision of
					 direct patient care in Louisiana who holds a current and valid medical license
					 issued by the Louisiana State Board of Medical Examiners. The ACP shall be
					 engaged in clinical practice in the same or a practice comparable in scope,
					 specialty or expertise to that of the APRN. Physicians otherwise authorized to
					 practice in the state of Louisiana under provisions of federal law may be
					 considered to serve as an ACP Retired physicians are not eligible to serve as
					 an ACP The ACP shall collaborate with the APRN at a practice site(s) previously
					 submitted to the board that is affiliated with the CP who formally designates
					 the ACP The ACP is not approved directly through processes of the board.
Approval
- Repealed.
Approved Program
- Repealed.
Assessment Studies
- diagnostic studies
					 including, but not limited to laboratory testing, radiologic studies,
					 electrocardiograms, pulmonary function tests, and pharmaceutical diagnostic
					 testing.
Attestation of APRN Collaborative
					 Practice
-
a
form provided by the board and required to
					 be submitted to the board for review and approval as indicated in rules and
					 procedures to validate that an APRN possesses and retains a collaborative
					 practice agreement with a specified CP or dentist and signed by the APRN and
					 the specified CP or dentist that is associated with a practice site submitted
					 to the board.
Board
- the Louisiana State Board of
					 Nursing.
Clinical Practice Guidelines
- refers to
					 written or electronic documents, jointly agreed upon by the collaborating
					 professionals that describe a specific plan, arrangement, or sequence of
					 orders, steps, or procedures to be followed or carried out in providing patient
					 care in various clinical situations. These may include textbooks, reference
					 manuals, electronic communications, and internet sources.
Clinical
					 practice guidelines
must be commensurate with the APRN's knowledge,
					 skills and abilities; in accordance with current standards of care and
					 evidence-based practice for the APRN role and population focus; address types
					 or categories or schedules of drugs for prescription; be specific to the
					 practice setting; and be maintained on site.
Collaborating Physician
- Repealed.
Collaborating Physician
					 (CP)
-
a
physician with whom an APRN has been approved
					 to collaborate by the board, who is actively engaged in clinical practice and
					 the provision of direct patient care in Louisiana, with whom the APRN has
					 developed and signed a collaborative practice agreement for prescriptive and
					 distributing authority, who holds a current and valid medical license issued by
					 the Louisiana State Board of Medical Examiners (LSBME), and practices in
					 accordance with rules of the LSBME. The CP shall be engaged in clinical
					 practice in the same or a practice comparable in scope, specialty or expertise
					 to that of the APRN. Physicians otherwise authorized to practice in the state
					 of Louisiana under provisions of federal law may be considered to serve as a CP
					 Retired physicians are not eligible to serve as a CP
Collaboration
- a cooperative working
					 relationship with licensed physicians, dentists, or other health care providers
					 to jointly contribute to providing patient care and may include but not be
					 limited to discussion of a patient's diagnosis and cooperation in the
					 management and delivery of health care with each provider performing those
					 activities that he is legally authorized to perform.
Collaborative Practice
- the joint
					 management of the health care of a patient by an advanced practice registered
					 nurse performing advanced practice registered nursing and one or more
					 consulting physicians or dentists. Except as otherwise provided in
					 R.S.
					 37:930, acts of medical diagnosis and
					 prescription by an advanced practice registered nurse shall be in accordance
					 with a collaborative practice agreement.
Collaborative Practice Agreement
-
1. a formal written statement/document addressing the
					 parameters of the collaborative practice which are mutually agreed upon by the
					 advanced practice registered nurse and one or more collaborating physicians or
					 dentists. Dentists shall be given consideration to serve as a collaborating
					 professional within a collaborative practice agreement only with CRNAs for
					 services relative to anesthesia care. The collaborative practice agreement
					 shall include but not be limited to the following provisions:
a. availability of the CP or dentist for consultation or
					 referral, or both;
b. methods of management of the collaborative practice
					 which shall include clinical practice guidelines;
c. coverage of the health care needs of a patient during
					 any absence of the advanced practice registered nurse, physician, or
					 dentist;
2. the APRN retains the collaborative practice agreement on
					 site and attests to possessing and retaining such document by submitting an
					 attestation to the board as required in rules and procedures.
3. coverage of the health care needs of a patient during
					 any absence of the advanced practice registered nurse, physician, or
					 dentist.
Contact Hour
- a unit of measurement that
					 describes 60 minutes of participation in an educational activity, which meets
					 the board's continuing education criteria. Ten
contact hours
equal one continuing education unit (CEU).
Controlled Substance
- any substance
					 defined, enumerated, or included in federal or state statute or regulations  21
					 CFR §1308 . 11-15 or
					 R.S.
					 40:964, or any substance which may hereafter
					 be designed as a controlled substance by amendment of supplementation or such
					 regulations and statute.
Cooperating Agency
-Repealed.
Course-
Repealed.
Curriculum
-Repealed.
Distance Education
-Repealed.
Distance Education
					 Technology
-Repealed.
Distribute
,
Distribution
or
Distributed
-the issuing of free samples and other
					 gratuitous medications supplied by drug manufacturers, as defined by clinical
					 practice guidelines contained in a collaborative practice agreement for
					 prescriptive authority.
Electronic Transmission
-transmission of
					 information in electronic form or the transmission of the exact visual image of
					 a document by way of electronic equipment.
Faculty
-Repealed.
Functional Role
-the advanced practice role
					 for which a master's in nursing program prepares its graduates. The categories
					 of functional roles for advanced practice licensure include nurse midwives,
					 nurse anesthetists, clinical nurse specialists, and nurse practitioners.
Goals-
Repealed.
Gratuitous Medications
-the medications
					 provided by the manufacturer to be distributed to indigent populations and/or
					 HIV and STD patients free of charge.
Lapsed APRN License
-inactive APRN
					 licensure status due to failure to renew or to request inactive licensure
					 status.
Major Change in
					 Curriculum
-Repealed.
Medical Therapeutic Device
-any instrument,
					 apparatus, implement, machine, contrivance, implant, or other similar or
					 related article, including any component part of accessory, which is required
					 under federal law to bear the label "Rx only". The medical device or appliance
					 shall be within the scope of practice of the Advanced Practice Registered
					 Nurse.
National Nursing Accrediting
					 Body
-Repealed.
National
Professional
Accrediting
-Repealed.
Nationally Recognized Certifying Body
-a
					 national certification organization which certifies qualified licensed
					 registered nurses as advanced practice registered nurses and which establishes
					 and requires certain eligibility criteria related to education and practice,
					 offers an examination in an advanced practice nursing role and population which
					 meets current psychometric guidelines and tests, and is approved by the
					 board.
Organization
-Repealed.
Objectives
-Repealed.
Parent Institution
-Repealed.
Philosophy
-Repealed.
Population Focus
-term referenced in the
					 National Council for State Boards of Nursings document entitled "Consensus
					 Model for APRN Regulation: Licensure Accreditation, Certification, and
					 Education" which refers to one of the areas of concentrated study and practice
					 provided to a collection of specified individuals who have characteristics in
					 common. A broad, population-based focus of study encompasses common problems
					 and aspects of that group of patients and the likely co-morbidities,
					 interventions, and responses to those problems. Examples include, but are not
					 limited to neonatal, pediatric, womens health, adult, family, mental health,
					 etc. A
population focus
is not defined as a specific
					 disease/health problem or specific intervention.
Practice Site
or
Site
-for
					 the purposes of clarifying prescriptive authority and collaborative practices,
					 including but not limited to the provisions for CPs and ACPs,
practice
					 site
or
site
refers to a location identified in
					 documentation submitted by the APRN to the board at which an APRN exercises
					 prescriptive authority or otherwise engages in advanced practice registered
					 nursing including but not limited to direct and indirect care of patients. A
					 hospital and its clinics, ambulatory surgery center, nursing home, any facility
					 or office licensed and regulated by the Department of Health, as well as a
					 group or solo practice, which have more than one physical location shall be
					 considered a
site
when the organizational policies and
					 provisions provided by the managing entity are applicable to all affected
					 locations including the policies delineated in §4513. D.1.f Business entities
					 that contract with facilities to provide services such as those provided by
					 APRNs, may be considered a practice site separate from the facility depending
					 upon the roles and responsibilities and agreements of the parties.
Preceptorship Experience-
Repealed.
Prescription Monitoring Program (PMP)
-a
					 system for the monitoring of controlled substances and other drugs of concern
					 dispensed in the state or dispensed to an address within the state as
					 established in R.S. 40:1001-1014.
Prescribe
-to direct, order, or designate
					 the preparation, use of or manner of using by spoken or written words or by
					 electronic means.
Prescription or Prescription Drug Order
-an
					 order from a practitioner authorized by law to prescribe for a drug or device
					 that is patient specific and is communicated by any means to a pharmacist in a
					 permitted pharmacy, and is preserved on file as required by law or regulation.
					 R.S. 37:14.1164 (44).
Program Head
(
Administrative
					 Director
)-Repealed.
Published Professional Standards
-level of
					 performance that advanced practice registered nurses, within their specific
					 role and population focus, are required to achieve and maintain in their
					 practice; represents the criteria against which the performance of all advanced
					 practice registered nurses within the role and population focus is considered
					 as published by the relevant professional nursing organizations.
Recommendations
- statements focusing on
					 areas where there are factors which may impinge on maintenance of
					 standards.
Requirements
-Repealed.
Role
-the advanced practice area for which
					 a graduate level nursing program prepares its graduates. The four
roles
for advanced practice registered nurse licensure include
					 certified nurse midwives, certified registered nurse anesthetists, clinical
					 nurse specialists, and certified nurse practitioners.
Samples
-a unit of prescription drug, which
					 is not intended to be sold and is intended to promote the sale of the
					 drug.
Shall-
a term used to denote a requirement
					 which must be met.
Should
- a term used to denote a suggested
					 method of meeting a requirement.
Standard
- a criterion by which performance
					 is measured.
Survey
-Repealed.
Under the Guidance of an Approved
					 Preceptor
-guidance by a licensed APRN, physician, dentist, or person
					 approved by the board within the same or related practice specialty or
					 functional role must be accessible but not physically
					 present.
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 37:918.