reglab/statecodes huggingface dataset:
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › Section 246-840-095 - Temporary practice permits

Current through Register Vol. 24-14, July 15, 2024
The Washington state board of nursing (board) conducts
				  background checks on applicants to assure safe patient care. Completion of a
				  fingerprint-based national background check may cause a delay in
				  licensing.
(1) The board may issue a
				temporary practice permit to an applicant who holds an unrestricted, active
				license in another state which has substantially equivalent licensing standards
				to those in Washington. The applicant must not be subject to denial of a
				license or issuance of a conditional or restricted license.
(2) A temporary practice permit serves as a
				license to practice nursing during the time period specified on the
				permit.
(3) A temporary practice
				permit expires when:
(a) A license is
				granted;
(b) A notice of decision
				on application is mailed to the applicant, unless the notice of decision on
				application specifically extends the duration of the temporary practice permit;
				or
(c) Sixty days after the
				temporary practice permit is issued, or 180 days for military spouse
				applicants.
If, at the expiration of the original temporary practice
				  permit, the department of health (department) has not received information from
				  the fingerprint-based national background check, the board may renew the
				  temporary practice permit for an additional 30 days.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › Section 246-840-105 - Brief adjudicative proceedings - Denials based on failure to meet education, experience, or examination prerequisites for licensure

Current through Register Vol. 24-14, July 15, 2024
The commission adopts
				  RCW
				  34.05.482 and
				  34.05.485 through
				  34.05.494 for adjudicative
				  proceedings requested by applicants, who are denied a license under chapter
				  18.79 RCW or chapter 246-840 WAC for failure to meet the education, experience,
				  or examination prerequisites for licensure. The sole issue at the adjudicative
				  proceeding shall be whether the applicant meets the education, experience, and
				  examination prerequisites for the issuance of a license.
Statutory Authority: Chapter 18.79 RCW. 97-13-100, §
					 246-840-105, filed 6/18/97, effective
					 7/19/97.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › Section 246-840-111 - Expired license

Current through Register Vol. 24-14, July 15, 2024
(1) If the license
				has expired for three years or less, the practitioner must meet the
				requirements in WAC
				246-12-020
				through
				246-12-051.
(2) If the license has expired for more than
				three years and the practitioner has been in active practice in another United
				States jurisdiction, the practitioner must:
(a) Submit verification of active practice
				from any other United States jurisdiction;
(b) Meet the requirements in WAC 246-12020
				through 246-12-051.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › Section 246-840-120 - Inactive credential

Current through Register Vol. 24-14, July 15, 2024
(1) A
				practitioner may obtain an inactive credential. Refer to the requirements in
				WAC 246-12090 through 246-12-110.
(2) Practitioners with an inactive credential
				for three years or less who wish to return to active status must meet the
				requirements in WAC
				246-12-090
				through
				246-12-110.
(3) Practitioners with an inactive credential
				for more than three years, who have been in active practice in another United
				States jurisdiction, and wish to return to active status must:
(a) Submit verification of active practice
				from any other United States jurisdiction;
(b) Meet the requirements in WAC
				246-12-090
				through
				246-12-110.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › Section 246-840-125 - Retired active credential

Current through Register Vol. 24-14, July 15, 2024
(1) A
				registered or licensed practical nurse may place their credential in "retired
				active" status by meeting the requirements of this section.
(2) A registered or licensed practical nurse
				who holds a retired active credential may only practice in intermittent or
				emergent circumstances.
(a) Intermittent means
				the registered or licensed practical nurse will practice no more than ninety
				days a year.
(b) Emergent means the
				registered or licensed practical nurse will practice only in emergency
				circumstances such as earthquakes, floods, times of declared war, or other
				states of emergency.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › Section 246-840-130 - Criteria for approved refresher course (Repealed)

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority: Chapter 18.79 RCW. 97-13-100, §
					 246-840-130, filed 6/18/97, effective
					 7/19/97.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › DOCUMENTING CONTINUING COMPETENCY › Section 246-840-200 - Continuing competency purpose statement

Current through Register Vol. 24-14, July 15, 2024
Patients, families, and communities expect safe,
					 competent, and compassionate nursing care. WAC 246-840-200 through 246-840-260
					 establish a self-directed continuing competency program which includes
					 participation in active practice and continuing nursing education for
					 registered nurses and licensed practical nurses as a mechanism to help keep
					 patients safe and improve nursing practice.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › DOCUMENTING CONTINUING COMPETENCY › Section 246-840-201

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
						RCW
						18.79.010 and
						18.79.110. 10-24-047, §
						246-840-201, filed 11/24/10, effective
						1/1/11.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › DOCUMENTING CONTINUING COMPETENCY › Section 246-840-202

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
						RCW
						18.79.010 and
						18.79.110. 10-24-047, §
						246-840-202, filed 11/24/10, effective
						1/1/11.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › DOCUMENTING CONTINUING COMPETENCY › Section 246-840-203

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
						RCW
						18.79.010 and
						18.79.110. 10-24-047, §
						246-840-203, filed 11/24/10, effective
						1/1/11.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › DOCUMENTING CONTINUING COMPETENCY › Section 246-840-204

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
						RCW
						18.79.010 and
						18.79.110. 10-24-047, §
						246-840-204, filed 11/24/10, effective
						1/1/11.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › DOCUMENTING CONTINUING COMPETENCY › Section 246-840-205

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
						RCW
						18.79.010 and
						18.79.110. 10-24-047, §
						246-840-205, filed 11/24/10, effective
						1/1/11.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › DOCUMENTING CONTINUING COMPETENCY › Section 246-840-206

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
						RCW
						18.79.010 and
						18.79.110. 10-24-047, §
						246-840-206, filed 11/24/10, effective
						1/1/11.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › DOCUMENTING CONTINUING COMPETENCY › Section 246-840-207

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
						RCW
						18.79.010 and
						18.79.110. 10-24-047, §
						246-840-207, filed 11/24/10, effective
						1/1/11.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › DOCUMENTING CONTINUING COMPETENCY › Section 246-840-210 - Continuing competency definitions

Current through Register Vol. 24-14, July 15, 2024
The definitions in this section apply throughout WAC
					 246-840-200
					 through
					 246-840-260
					 unless the context clearly requires otherwise.
(1)
"Active nursing practice"
means engagement in paid, unpaid, or volunteer activity performing acts
				  requiring substantial nursing knowledge, judgment, and skills described under
				  RCW
				  18.79.040,
				  18.79.050,
				  and
				  18.79.060.
				  Active nursing practice may include, but is not limited to, working as an
				  administrator, quality manager, policy officer, public health nurse, parish
				  nurse, home health nurse, educator, consultant, regulator, and investigator or
				  case manager.
(2)
"Advanced
				  nursing degree"
means education preparation beyond one's initial
				  education for nurse licensure.
(3)
"Attestation"
means the affirmation by signature of the nurse
				  indicating compliance with the standards and terms of the continuing competency
				  requirements.
(4)
"Compliance
				  audit"
means a review of documents to determine whether the nurse has
				  fulfilled the requirements in WAC
				  246-840-220
				  through
				  246-840-260.
(5)
"Continuing competency"
is
				  the ongoing ability of a nurse to maintain, update and demonstrate sufficient
				  knowledge, skills, judgment, and qualifications necessary to practice safely
				  and ethically in a designated role and setting in accordance with the scope of
				  nursing practice. A nurse achieves continuing competency through active
				  practice and continuing nursing education.
(6)
"Continuing nursing
				  education"
refers to systematic professional learning experiences
				  obtained after initial licensure and designed to augment the knowledge, skills,
				  and judgment of nurses and enrich nurses' contributions to quality health care
				  and the pursuit of professional career goals, related to a nurse's area of
				  professional practice, growth and development.
(7)
"Nurse"
means a registered
				  nurse and licensed practical nurse.
(8)
"Review period"
is one full
				  licensing renewal cycle. For purposes of a compliance audit, the review period
				  will be the one year preceding the audit due date.
(9)
"Technical assistance"
means
				  guidance provided by commission staff to help the nurse comply with laws and
				  rules.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › DOCUMENTING CONTINUING COMPETENCY › Section 246-840-220 - Continuing competency requirements-Active status

Current through Register Vol. 24-14, July 15, 2024
(1) Upon license renewal a nurse must attest
				  on a form provided by the department of health declaring completion of the
				  required active nursing practice hours and continuing nursing education
				  hours.
(2) A nurse must complete
				  within a 12-month period prior to the renewal of licensure:
(a) A minimum of 96 hours of active nursing
				  practice; and
(b) A minimum of
				  eight hours of continuing nursing education of which at least two hours must be
				  on health equity training, as specified in WAC
				  246-840-222.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › DOCUMENTING CONTINUING COMPETENCY › Section 246-840-222 - Continuing competency requirements-Health equity continuing education

Current through Register Vol. 24-14, July 15, 2024
(1) Licensed
				  practical nurses and registered nurses must complete a minimum of two hours of
				  health equity continuing education every year upon license renewal as described
				  in WAC 246-12-800 through
				  246-12-830.
(2) This training must be completed by the
				  end of the second full continuing education reporting period after January 1,
				  2024, or the second full continuing education reporting period after initial
				  licensure, whichever is later.
(3)
				  After the first required reporting period, this training must be completed
				  within a 12-month period prior to license renewal. Additional hours cannot be
				  rolled over to the following year.
(4) The hours spent completing health equity
				  continuing education under this section count toward meeting applicable
				  continuing education requirements for nurse license renewal as described in WAC
				  246-840-220.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › DOCUMENTING CONTINUING COMPETENCY › Section 246-840-230 - Continuing competency audit process and compliance

Current through Register Vol. 24-14, July 15, 2024
(1) The commission may conduct a compliance
				  audit:
(a) Through random selection; and
(b) At the discretion of the
				  commission, on nurses under the disciplinary process.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › DOCUMENTING CONTINUING COMPETENCY › Section 246-840-250 - Continuing competency requirements-Reactivation from expired status

Current through Register Vol. 24-14, July 15, 2024
(1) All nurses
				  applying for reactivation must meet the requirements of WAC
				  246-12-020
				  through
				  246-12-051
				  and
				  246-840-111.
(2) If a license is expired for more than one
				  year, and the nurse has not held an active nursing license in any United States
				  jurisdiction, the nurse must complete ninety-six hours of active nursing
				  practice and eight hours of continuing nursing education within one year of
				  reactivation.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › DOCUMENTING CONTINUING COMPETENCY › Section 246-840-260 - Continuing competency requirements-Reactivation from inactive status

Current through Register Vol. 24-14, July 15, 2024
(1) All nurses
				  applying for reactivation must meet the requirements of WAC
				  246-12-090
				  through
				  246-12-110
				  and
				  246-840-120.
(2) If a license is inactive for more than
				  one year, and the nurse has not held an active nursing license in any United
				  States jurisdiction, the nurse must complete ninety-six hours of active nursing
				  practice and eight hours of continuing nursing education within one year of
				  reactivation.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE › Section 246-840-300 - ARNP scope of practice

Current through Register Vol. 24-14, July 15, 2024
The scope of practice of a licensed ARNP is as provided in
					 RCW
					 18.79.250 and this section.
(1) The ARNP is prepared and qualified to
				  assume primary responsibility and accountability for the care of patients
				  within their roles of ARNP licensure: Certified nurse practitioner (CNP),
				  certified registered nurse anesthetist (CRNA), certified nurse midwife (CNM),
				  and clinical nurse specialist (CNS).
(2) As a licensed independent practitioner,
				  an ARNP provides a wide range of health care services including the diagnosis
				  and management of acute, chronic, and complex health conditions, health
				  promotion, disease prevention, health education, and counseling to individuals,
				  families, groups, and communities. Performing within the scope of the ARNP's
				  education, training, and experience, the licensed ARNP may perform the
				  following:
(a) Examine patients and establish
				  diagnoses by patient history, physical examination, and other methods of
				  assessment;
(b) Admit, manage, and
				  discharge patients to and from health care facilities;
(c) Order, collect, perform, and interpret
				  diagnostic tests;
(d) Manage health
				  care by identifying, developing, implementing, and evaluating a plan of care
				  and treatment for patients;
(e)
				  Prescribe therapies and medical equipment;
(f) Prescribe medications when granted
				  prescriptive authority under this chapter;
(g) Refer patients to other health care
				  practitioners, services, or facilities; and
(h) Perform procedures or provide care
				  services that are within the ARNP's scope of practice according to a commission
				  approved certifying body as defined in WAC
				  246-840-302.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE › Section 246-840-302 - ARNP designations, certification, and approved certification examinations

Current through Register Vol. 24-14, July 15, 2024
(1) ARNP
				  designations recognized by the commission include:
(a)Nurse practitioner (NP);
(b)Certified nurse-midwife (CNM);
(c)Certified registered nurse anesthetist
				  (CRNA); and
(d) Clinical nurse
				  specialist (CNS).
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE › Section 246-840-304

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
						RCW
						18.79.010, [18.79.]050,[18.79.]110 , and
						[18.79.]210. 09-01-060, § 246-840-304, filed 12/11/08, effective
						1/11/09.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE › Section 246-840-310 - Use and protection of professional titles

Current through Register Vol. 24-14, July 15, 2024
A person who holds a license to practice as an ARNP shall
					 have the right to use the title "advanced registered nurse practitioner" and
					 the abbreviation following the nurse's name shall read "ARNP" or "NP."
An ARNP may also use the applicable title or abbreviation,
					 or designation as defined in WAC
					 246-840-302.
No other person shall assume such titles or use such
					 abbreviations.
Statutory Authority:
						RCW
						18.79.010, [18.79.]050,[18.79.]110 , and
						[18.79.]210. 09-01-060, § 246-840-310, filed 12/11/08, effective 1/11/09.
						Statutory Authority:
						RCW
						18.79.110 and
						18.79.050. 00-21-119, §
						246-840-310, filed 10/18/00, effective 11/18/00. Statutory Authority: Chapter
						18.79 RCW. 97-13-100, § 246-840-310, filed 6/18/97, effective
						7/19/97.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE › Section 246-840-311 - ARNP previously adopted specialties

Current through Register Vol. 24-14, July 15, 2024
(1) An ARNP holding an active license,
				  without sanctions or restrictions, under one or more of the following
				  previously existing advanced practice certification designations, may continue
				  to renew his or her license as an ARNP:
(a)
				  Community health;
(b)
				  Maternal-gynecological-neonatal;
(c) Medical-surgical;
(d) Occupational health;
(e) Neurosurgical; or
(f) Enterostomal therapy.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE › Section 246-840-340 - Initial ARNP requirements

Current through Register Vol. 24-14, July 15, 2024
(1) An
				  applicant for licensure as an ARNP shall have the following qualifications:
(a) An active Washington state RN license,
				  without sanctions or restrictions;
(b) A graduate degree from an advanced
				  nursing education program accredited by a national nursing accreditation body
				  recognized by the United States Department of Education;
(c) Certification from a certifying body as
				  identified in WAC
				  246-840-302;
(d) Completion of advanced clinical practice
				  hours, as defined in WAC
				  246-840-010(1)
				  and in the role of an advanced practice nurse as defined in WAC
				  246-840-010(2),
				  when applicable, in situations under subsection (3) of this section.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE › Section 246-840-342 - Licensure for ARNP applicants by interstate endorsement

Current through Register Vol. 24-14, July 15, 2024
(1) An applicant for interstate endorsement
				  for Washington state licensure as an ARNP shall meet the following
				  requirements:
(a) Have an active RN and ARNP
				  license, or recognition in another state or jurisdiction, as practicing in an
				  advanced practice role, without sanctions or restrictions;
(b) Have a graduate degree from an advanced
				  nursing education program as identified in WAC
				  246-840-340(1)(b);
				  and
(c) Hold certification from a
				  certifying body as identified in WAC
				  246-840-302(3).
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE › Section 246-840-344 - Licensure for ARNP applicants educated and licensed outside the United States

Current through Register Vol. 24-14, July 15, 2024
(1) An applicant
				  for ARNP licensure in Washington state, educated and licensed outside the
				  United States, shall:
(a) Apply for and be
				  granted an active RN license, or recognition in another state or jurisdiction,
				  without sanctions or restrictions, issued by a regulatory entity outside the
				  United States, and have been practicing at an advanced practice
				  level;
(b) Submit a
				  course-by-course evaluation of education from a commission approved credential
				  evaluating service verifying the advanced nursing educational program completed
				  by the applicant is equivalent to the ARNP education identified in WAC
				  246-840-455;
(c) Hold certification from a certifying body
				  as identified in WAC
				  246-840-302(3);
				  and
(d) Have been performing
				  advanced clinical practice in his or her country for at least two hundred fifty
				  hours within the two years prior to the date of application for ARNP
				  licen-sure.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE › Section 246-840-350

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
						RCW
						18.79.010, [18.79.]050,[18.79.]110 , and
						[18.79.]210. 09-01-060, § 246-840-350, filed 12/11/08, effective 1/11/09.
						Statutory Authority:
						RCW
						43.70.280. 98-05-060, § 246-840-350,
						filed 2/13/98, effective 3/16/98. Statutory Authority: Chapter 18.79 RCW.
						97-13-100, § 246-840-350, filed 6/18/97, effective
						7/19/97.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE › Section 246-840-360 - Renewal of ARNP licensure

Current through Register Vol. 24-14, July 15, 2024
(1) An
				  applicant applying for ARNP license renewal, shall have:
(a) An active Washington state RN license,
				  without sanctions or restrictions;
(b) Current certification from a certifying
				  body as identified in WAC
				  246-840-302;
				  and
(c) Thirty contact hours of
				  continuing education obtained during the renewal period in each ARNP
				  designation. An ARNP who has certification in more than one area of practice
				  may count the continuing education hours for more than one certification when
				  applicable to each area of practice.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE › Section 246-840-361 - Continuing education for ARNP license renewal

Current through Register Vol. 24-14, July 15, 2024
The thirty contact hours of continuing education required
					 for the two-year renewal of ARNP licensure must:
(1) Be acceptable to the certifying body
				  identified in WAC
				  246-840-302(3);
(2) Be obtained from courses in
				  which the contact hour is at least fifty minutes;
(3) Not include the fifteen hours of
				  continuing education required for an ARNP with prescriptive authority as
				  identified in WAC
				  246-840-450(1)(b);
				  and
(4) Not include the same course
				  taken more than once during the renewal cycle.
Statutory Authority:
						RCW
						18.79.010, [18.79.]050,[18.79.]110 , and
						[18.79.]210. 09-01-060, § 246-840-361, filed 12/11/08, effective
						1/11/09.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE › Section 246-840-365 - Inactive and reactivating an ARNP license

Current through Register Vol. 24-14, July 15, 2024
To apply for an inactive ARNP license, an ARNP shall comply
					 with WAC 246-12-090 or
					 246-12-540, if military
					 related.
(1) An ARNP may apply for an
				  inactive license if he or she holds an active Washington state ARNP license
				  without sanctions or restrictions.
(2) To return to active status the ARNP:
(a) Shall meet the requirements for an
				  inactive credential for nonmilitary practitioners identified under WAC
				  246-12-090 through
				  246-12-110;
(b) Must hold an active RN license under
				  chapter 18.79 RCW without sanctions or restrictions;
(c) Shall submit the fee as identified under
				  WAC 246-840-990;
(d) Shall submit evidence of current
				  certification by the commission approved certifying body identified in WAC
				  246-840-302(1);
				  and
(e) Shall submit evidence of 30
				  contact hours of continuing education for each designation within the past two
				  years.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE › Section 246-840-367 - Expired license

Current through Register Vol. 24-14, July 15, 2024
When an ARNP license is not renewed, it is placed in
					 expired status and the nurse must not practice as an ARNP.
(1) To return to active status when the
				  license has been expired for less than two years, the nurse shall:
(a) Meet the requirements for initial and
				  renewal credentialing of practitioners as identified under WAC
				  246-12-020 through
				  246-12-051;
(b) Meet ARNP renewal requirements identified
				  in WAC 246-840-360; and
(c) Meet the prescriptive authority
				  requirements identified in WAC
				  246-840-450, if renewing
				  prescriptive authority.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE › Section 246-840-400 - ARNP prescriptive authority

Current through Register Vol. 24-14, July 15, 2024
(1)
				  An ARNP licensed under chapter 18.79 RCW when authorized by the nursing
				  commission may prescribe drugs and medical devices pursuant to applicable state
				  and federal laws.
(2) The ARNP when
				  exercising prescriptive authority is accountable for competency in:
(a) Problem identification through
				  appropriate assessment;
(b)
				  Medication and device selection;
(c) Patient education for use of
				  therapeutics;
(d) Knowledge of
				  interactions of therapeutics;
(e)
				  Evaluation of outcome; and
(f)
				  Recognition and management of side effects, adverse reactions, and
				  complications.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE › Section 246-840-410 - Application requirements for ARNP prescriptive authority

Current through Register Vol. 24-14, July 15, 2024
(1) An ARNP who applies for prescriptive
				  authority must:
(a) Hold an active Washington
				  state ARNP license, without sanctions or restrictions, issued by the
				  commission;
(b) Provide evidence
				  of thirty contact hours of education in pharmacology, including didactic and
				  clinical application, and consisting of pharmacodynamics, pharmacokinetics,
				  pharmacotherapeutics, and pharmacological management of individual patients
				  related to the applicant's scope of practice.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE › Section 246-840-420 - Authorized prescriptions by ARNP with prescriptive authority

Current through Register Vol. 24-14, July 15, 2024
Prescriptions for drugs and medical devices must comply
					 with all applicable state and federal laws and be within the ARNP's scope of
					 practice.
(1) An ARNP must sign
				  prescriptions and include the initials ARNP or NP.
(2) An ARNP may not, under
				  RCW
				  18.79.240(1)  and
				  chapter
				  69.50 RCW, prescribe
				  controlled substances in Schedule I.
(3) An ARNP with prescriptive authority who
				  prescribes controlled substances must be registered with the drug enforcement
				  administration.
Statutory Authority:
						RCW
						18.79.010, [18.79.]050,[18.79.]110 , and
						[18.79.]210. 09-01-060, § 246-840-420, filed 12/11/08, effective 1/11/09.
						Statutory Authority:
						RCW
						18.79.240 and 2005 c 28. 06-01-102, §
						246-840-420, filed 12/21/05, effective 1/21/06. Statutory Authority: Chapter
						18.79 RCW. 97-13-100, § 246-840-420, filed 6/18/97, effective
						7/19/97.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE › Section 246-840-450 - Renewal of ARNP prescriptive authority

Current through Register Vol. 24-14, July 15, 2024
(1) ARNP prescriptive authority must be
				  renewed at the time of renewal of the ARNP license. For renewal of ARNP
				  prescriptive authority, the licensee must:
(a) Meet the requirements of WAC
				  246-840-360; and
(b) Provide a written declaration on forms
				  provided by the commission of fifteen contact hours of continuing education
				  during the renewal period in pharmacotherapeutics related to the licensee's
				  scope of practice that are in addition to the thirty contact hours of
				  continuing education required for renewal of the ARNP license as identified in
				  WAC 246-840-360(1)(c) and
				  (2)(c) and
				  246-840-361; and
(c) Submit evidence of completion of
				  continuing education contact hours when requested by the commission.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE › Section 246-840-451 - Continuing education requirements for ARNP prescriptive authority

Current through Register Vol. 24-14, July 15, 2024
(1) The fifteen
				  hours of pharmacotherapeutic continuing education must:
(a) Relate to the ARNP's scope of
				  certification and scope of practice; and
(b) Be obtained from continuing education
				  courses in which the contact hour time is not less than fifty
				  minutes.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE › Section 246-840-455 - Requirements for advanced registered nurse practice educational programs in Washington state (Repealed)

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
						RCW
						18.79.010, [18.79.]050,[18.79.]110 , and
						[18.79.]210. 09-01-060, § 246-840-455, filed 12/11/08, effective
						1/11/09.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE - PAIN MANAGEMENT › Section 246-840-460 - Pain management-Intent

Current through Register Vol. 24-14, July 15, 2024
WAC 246-840-460 through 246-840-4990 govern the use of
					 opioids in the treatment of pain in the acute, perioperative, sub-acute, and
					 chronic phases. Treatment modalities including opioid use can serve to improve
					 the quality of life for those patients who suffer from pain, as well as reduce
					 the morbidity and costs associated with undertreatment or inappropriate
					 treatment of pain. For the purpose of these rules, the inappropriate treatment
					 of pain includes nontreatment, undertreatment, overtreatment, and the continued
					 use of ineffective treatments. In addition to these rules, the nursing
					 commission recommends practitioners adhere to applicable state agency medical
					 directors' group (AMDG) and federal Centers for Disease Control and Prevention
					 (CDC) guidelines for the treatment of pain in all phases.
Statutory Authority:
						RCW
						18.79.400. 11-10-064, § 246-840-460,
						filed 5/2/11, effective 7/1/11.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE - PAIN MANAGEMENT › Section 246-840-463 - Exclusions

Current through Register Vol. 24-14, July 15, 2024
WAC
					 246-840-460 through
					 246-840-4990 do not apply
					 to:
(1) The treatment of patients with
				  cancer-related pain;
(2) The
				  provision of palliative, hospice, or other end-of-life care;
(3) The treatment of inpatient hospital
				  patients; or
(4) Procedural
				  premedications.
(5) The treatment
				  of patients in nursing homes licensed under chapter 18.51 RCW or 388-97 WAC,
				  nursing homes and long-term acute care hospitals (LTACs).
Statutory Authority:
						RCW
						18.79.400. 11-10-064, § 246-840-463,
						filed 5/2/11, effective 7/1/11.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE - PAIN MANAGEMENT › Section 246-840-4651 - Patient notification, secure storage, and disposal

Current through Register Vol. 24-14, July 15, 2024
(1) The practitioner shall provide
				  information to the patient educating them of:
(a) Risks associated with the use of opioids
				  as appropriate to the medical condition, the type of patient, and the phase of
				  treatment;
(b) The safe and secure
				  storage of opioid prescriptions;
(c) The proper disposal of unused opioid
				  medications including, but not limited to, the availability of recognized drug
				  take-back programs; and
(d) The
				  patient's right to refuse an opioid prescription or order for any
				  reason.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE - PAIN MANAGEMENT › Section 246-840-4653 - Use of alternative modalities for pain treatment

Current through Register Vol. 24-14, July 15, 2024
The practitioner shall consider multimodal pharmacologic
					 and nonpharmacologic therapy for pain rather than defaulting to the use of
					 opioid therapy alone whenever reasonable as evidence-based, clinically
					 appropriate alternatives exist. A practitioner may combine opioids with other
					 medications and treatments including, but not limited to, acetaminophen,
					 acupuncture, chiropractic, cognitive behavior therapy, nonsteroidal
					 anti-inflammatory drugs (NSAIDs), osteopathic manipulative treatment, physical
					 therapy, massage, or sleep hygiene.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE - PAIN MANAGEMENT › Section 246-840-4655 - Continuing education requirements for opioid prescribing

Current through Register Vol. 24-14, July 15, 2024
(1) In order to prescribe an opioid in
				  Washington state, an advanced registered nurse practitioner licensed to
				  prescribe opioids shall complete a one-time continuing education requirement
				  regarding best practices in the prescribing of opioids. Additionally, a chronic
				  pain management specialist must meet the continuing education requirements in
				  WAC
				  246-840-493.
				  The continuing education must be at least four hours in length.
(2) The advanced registered nurse
				  practitioner shall complete the one-time continuing education requirement
				  described in subsection (1) of this section by the end of the advanced
				  registered nurse practitioner's first full continuing education reporting
				  period after January 1, 2019, or during the first full continuing education
				  reporting period after initial licensure, whichever is later. The four hour
				  course may count toward any NCQAC required continuing education.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE - PAIN MANAGEMENT › Section 246-840-4657 - Diagnosis identified on prescriptions

Current through Register Vol. 24-14, July 15, 2024
The advanced registered nurse practitioner shall include
					 the diagnosis or the International Classification of Diseases (ICD) code on all
					 opioid prescriptions.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE - PAIN MANAGEMENT › Section 246-840-4659 - Patient evaluation and patient record-Acute

Current through Register Vol. 24-14, July 15, 2024
Prior to prescribing an opioid for acute nonoperative pain
					 or acute perioperative pain, the advanced registered nurse practitioner
					 shall:
(1) Conduct and document an
				  appropriate history and physical examination including screening for risk
				  factors for overdose and severe postoperative pain; or
(2) Consider the discharge facility's history
				  and physical examination an appropriate history and physical examination to
				  allow timely prescribing of needed medications for acute nonoperative pain or
				  acute perioperative pain in nursing homes licensed under chapter 18.51 RCW or
				  388-97 WAC, nursing homes and long-term acute care hospitals (LTACs);
(3) Evaluate the nature and intensity of the
				  pain or anticipated pain following surgery; and
(4) Inquire about any other medications the
				  patient is prescribed or is taking including type, dosage, and quantity
				  prescribed.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE - PAIN MANAGEMENT › Section 246-840-4661 - Treatment plan-Acute nonoperative pain

Current through Register Vol. 24-14, July 15, 2024
The advanced registered nurse practitioner shall comply
					 with the requirements in this section when prescribing opioid analgesics for
					 acute nonoperative pain and shall document completion of these requirements in
					 the patient record.
(1) The advanced
				  registered nurse practitioner shall consider recommending or prescribing
				  nonopioid analgesics as the first line of pain control in patients under the
				  provisions of WAC 246-840-4653, unless not clinically appropriate.
(2) The advanced registered nurse
				  practitioner, or practitioner's authorized designee as defined in WAC
				  246-470-050,
				  shall conduct queries of the prescription monitoring program (PMP) in
				  accordance with the provisions of WAC 246-840-4990 to identify any Schedule
				  II-V medications or drugs of concern received by the patient, and document
				  their review and any concerns.
(3)
				  If the advanced registered nurse practitioner prescribes opioids for effective
				  pain control, such prescription must not be in greater quantity than needed for
				  the expected duration of pain severe enough to require opioids. A three-day
				  supply or less will often be sufficient; more than a seven-day supply will
				  rarely be needed. The advanced registered nurse practitioner shall not
				  prescribe beyond a seven-day supply without clinical documentation in the
				  patient record to justify the need for such a quantity.
(4) The advanced registered nurse
				  practitioner shall reevaluate the patient who does not follow the expected
				  course of recovery. If significant and documented improvement in function or
				  pain control has not occurred, the advanced registered nurse practitioner shall
				  reconsider the continued use of opioids, or whether tapering or discontinuing
				  opioids is clinically indicated.
(5) Follow-up visits for pain control must
				  include objectives or metrics to be used to determine treatment success if
				  opioids are to be continued. This includes, at a minimum:
(a) Change in pain level;
(b) Change in physical function;
(c) Change in psychosocial function;
				  and
(d) Additional planned
				  diagnostic evaluations to investigate causes of continued acute nonoperative
				  pain or other treatments.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE - PAIN MANAGEMENT › Section 246-840-4663 - Treatment plan-Acute perioperative pain

Current through Register Vol. 24-14, July 15, 2024
The advanced registered nurse practitioner shall comply
					 with the requirements in this section when prescribing opioid analgesics for
					 perioperative pain and shall document completion of these requirements in the
					 patient's record.
(1) The advanced
				  registered nurse practitioner shall consider prescribing nonopioid analgesics
				  as the first line of pain control in patients under the provisions of WAC
				  246-840-4653, unless not clinically appropriate.
(2) The advanced registered nurse
				  practitioner, or practitioner's authorized designee as defined in WAC
				  246-470-050,
				  shall conduct queries of the prescription monitoring program (PMP) in
				  accordance with the provisions of WAC 246-840-4990 to identify any Schedule
				  II-V medications or drugs of concern received by the patient, and document in
				  the patient record their review and any concerns.
(3) If the advanced registered nurse
				  practitioner prescribes opioids for effective pain control, such prescription
				  shall be in no greater quantity than needed for the expected duration of pain
				  severe enough to require opioids. A three-day supply or less will often be
				  sufficient; more than a fourteen-day supply will rarely be needed for
				  perioperative pain. The advanced registered nurse practitioner shall not
				  prescribe beyond a fourteen-day supply from the time of discharge without
				  clinical documentation in the patient record to justify the need for such a
				  quantity. For more specific best practices, the advanced registered nurse
				  practitioner may refer to clinical practice guidelines including, but not
				  limited to, those produced by the agency medical directors' group (AMDG), the
				  Centers for Disease Control and Prevention (CDC), or the Bree
				  Collaborative.
(4) The advanced
				  registered nurse practitioner shall reevaluate a patient who does not follow
				  the expected course of recovery. If significant and documented improvement in
				  function or pain control has not occurred, the advanced registered nurse
				  practitioner shall reconsider the continued use of opioids, or whether tapering
				  or discontinuing opioids is clinically indicated.
(5) Follow-up visits for pain control should
				  include objectives or metrics to be used to determine treatment success if
				  opioids are to be continued. This includes, at a minimum:
(a) Change in pain level;
(b) Change in physical function;
(c) Change in psychosocial function;
				  and
(d) Additional planned
				  diagnostic evaluations or other treatments.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE - PAIN MANAGEMENT › Section 246-840-4665 - Patient evaluation and patient record-Subacute pain

Current through Register Vol. 24-14, July 15, 2024
The advanced registered nurse practitioner shall comply
					 with the requirements in this section when prescribing opioid analgesics for
					 subacute pain and shall document completion of these requirements in the
					 patient record.
(1) Prior to
				  prescribing an opioid for subacute pain, the advanced registered nurse
				  practitioner shall:
(a) Conduct an
				  appropriate history and physical examination or review and update the patient's
				  existing history and examination taken during the acute nonoperative or acute
				  perioperative phase;
(b) Evaluate
				  the nature and intensity of the pain;
(c) Inquire about other medications the
				  patient is prescribed or taking including type, dosage, and quantity
				  prescribed;
(d) Conduct, or cause
				  the practitioner's authorized designee as defined in WAC
				  246-470-050
				  to conduct, a query of the prescription monitoring program (PMP) in accordance
				  with the provisions of WAC 246-840-4990, to identify any Schedule II-V
				  medications or drugs of concern received by the patient, and document their
				  review and any concerns;
(e) Screen
				  and document the patient's potential for high-risk behavior and adverse events
				  related to opioid therapy. If the advanced registered nurse practitioner
				  determines the patient is high-risk, consider lower dose therapy, shorter
				  intervals between prescriptions, more frequent visits, increased biological
				  specimen testing, and prescribing rescue naloxone;
(f) Obtain a biological specimen test if the
				  patient's function is deteriorating or if pain is escalating; and
(g) Screen or refer the patient for further
				  consultation for psychosocial factors that may be impairing recovery including,
				  but not limited to, depression or anxiety.