reglab/statecodes huggingface dataset:
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE - PAIN MANAGEMENT › Section 246-840-4667 - Treatment plan-Subacute pain

Current through Register Vol. 24-14, July 15, 2024
(1)
				  The advanced registered nurse practitioner shall recognize the progression of a
				  patient from the acute nonoperative or acute perioperative phase to the
				  subacute phase and take into consideration the risks and benefits of continued
				  opioid prescribing for the patient.
(2) If tapering has not begun prior to the
				  six- to twelve-week subacute phase, 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. The advanced registered nurse practitioner shall make
				  reasonable attempts to discontinue the use of opioids prescribed for the acute
				  pain event by no later than the twelve-week conclusion of the subacute
				  phase.
(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. The advanced registered
				  nurse practitioner shall not prescribe beyond a fourteen-day supply of opioids
				  without clinical documentation to justify the need for such a quantity during
				  the subacute phase.
(4) If the
				  advanced registered nurse practitioner elects to prescribe a combination of
				  opioids with a medication listed in WAC 246-840-4960 or prescribes opioids to a
				  patient known to be receiving a medication listed in WAC 246-840-4960 from
				  another practitioner, such prescribing must be in accordance with WAC
				  246-840-4960.
(5) If the advanced
				  registered nurse practitioner elects to treat a patient with opioids beyond the
				  six- to twelve-week subacute phase, the advanced registered nurse practitioner
				  shall document in the patient record that the patient is transitioning from
				  subacute pain to chronic pain. Rules governing the treatment of chronic pain,
				  WAC
				  246-840-467
				  through 246-840-4940, shall apply.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE - PAIN MANAGEMENT › Section 246-840-467 - Patient evaluation and patient record

Current through Register Vol. 24-14, July 15, 2024
The advanced registered nurse practitioner shall evaluate
					 and document the patient's health history and physical examination in the
					 patient's health record prior to treating for chronic pain.
(1) The patient's health history shall
				  include:
(a) The nature and intensity of the
				  pain;
(b) The effect of pain on
				  physical and psychosocial function;
(c) Current and past treatments for pain,
				  including medications and their efficacy;
(d) Review of any significant
				  comorbidities;
(e) Any current or
				  historical substance use disorder;
(f) Current medications and, as related to
				  treatment of the pain, the efficacy of medications tried; and
(g) Medication allergies.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE - PAIN MANAGEMENT › Section 246-840-470 - Treatment plan

Current through Register Vol. 24-14, July 15, 2024
(1) When the
				  patient enters the chronic pain phase, the advanced registered nurse shall
				  reevaluate the patient by treating the situation as a new disease.
(2) The chronic pain treatment plan must
				  state the objectives that will be used to determine treatment success and must
				  include, at a minimum:
(a) Any change in pain
				  relief;
(b) Any change in physical
				  and psychosocial function; and
(c)
				  Additional diagnostic evaluations or other planned 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 246-840-473

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
						RCW
						18.79.400. 11-10-064, § 246-840-473,
						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 246-840-475 - Written agreement for treatment

Current through Register Vol. 24-14, July 15, 2024
The advanced registered nurse practitioner shall use a
					 written agreement for treatment with the patient who requires long-term opioid
					 therapy for chronic pain that outlines the patient's responsibilities. This
					 written agreement for treatment must include:
(1) The patient's agreement to provide
				  biological samples for biological specimen testing when requested by the
				  advanced registered nurse practitioner;
(2) The patient's agreement to take
				  medications at the dose and frequency prescribed, with a specific protocol for
				  lost prescriptions and early refills or renewals;
(3) Reasons for which opioid therapy may be
				  discontinued ;
(4) The requirement
				  that all chronic opioid prescriptions are provided by a single prescriber, a
				  single clinic, or a multidisciplinary pain clinic ;
(5) The requirement that all chronic opioid
				  prescriptions are to be dispensed by a single pharmacy or pharmacy system
				  whenever possible;
(6) The
				  patient's agreement to not abuse substances that can put the patient at risk
				  for adverse outcomes;
(7) A written
				  authorization for:
(a) The advanced
				  registered nurse practitioner to release the agreement for treatment to:
(i) Local emergency departments;
(ii) Urgent care facilities;
(iii) Other practitioners caring for the
				  patient who might prescribe pain medications; and
(iv) Pharmacies.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE - PAIN MANAGEMENT › Section 246-840-477 - Periodic review

Current through Register Vol. 24-14, July 15, 2024
(1) The advanced
				  registered nurse practitioner shall periodically review the course of treatment
				  for chronic pain. The frequency of visits, biological testing, and prescription
				  monitoring program (PMP) queries are determined based on the patient's risk
				  category:
(a) For a high-risk patient, at
				  least quarterly;
(b) For a
				  moderate-risk patient, at least semiannually;
(c) For a low-risk patient, at least
				  annually;
(d) Immediately upon
				  indication of concerning aberrant behavior; and
(e) More frequently at the advanced
				  registered nurse practitioner's discretion.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE - PAIN MANAGEMENT › Section 246-840-480

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
						RCW
						18.79.400. 11-10-064, § 246-840-480,
						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 246-840-483

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
						RCW
						18.79.400. 11-10-064, § 246-840-483,
						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 246-840-485 - Consultation-Recommendations and requirements

Current through Register Vol. 24-14, July 15, 2024
(1) The
				  advanced registered nurse practitioner shall consider and document referring
				  the patient for additional evaluation and treatment as needed to achieve
				  treatment objectives. Special attention should be given to those chronic pain
				  patients who are under eighteen years of age or who are potential high-risk
				  patients. The management of pain in patients with a history of substance use or
				  with comorbid psychiatric disorders may require extra care, monitoring,
				  documentation, and consultation with, or referral to, an expert in the
				  management of such patients.
(2)
				  The mandatory consultation threshold is one hundred twenty milligrams morphine
				  equivalent dose (MED). If an advanced registered nurse practitioner prescribes
				  a dosage amount that meets or exceeds the mandatory consultation threshold of
				  one hundred twenty milligrams MED per day, a consultation with a pain
				  management specialist as described in WAC
				  246-840-493,
				  246-853-750, 246-854-330,
				  246-817-965,
				  246-918-880, 246-919-940, or 246-922-750 is required, unless the consultation
				  is exempted under WAC
				  246-840-487
				  or
				  246-840-490.
				  The mandatory consultation shall consist of at least one of the following:
(a) An office visit with the patient and the
				  pain management specialist;
(b) A
				  consultation between the pain management specialist and the advanced registered
				  nurse practitioner;
(c) An
				  audio-visual evaluation conducted by the pain management specialist remotely,
				  where the patient is present with either the advanced registered nurse
				  practitioner or with a licensed health care practitioner designated by the
				  advanced registered nurse practitioner or the pain management specialist;
				  or
(d) Other chronic pain
				  evaluation services as approved by the commission.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE - PAIN MANAGEMENT › Section 246-840-487 - Consultation-Exemptions for exigent and special circumstances

Current through Register Vol. 24-14, July 15, 2024
An advanced registered nurse practitioner is not required
					 to consult with a pain management specialist as defined in WAC
					 246-840-493
					 when the advanced registered nurse practitioner has documented adherence to all
					 standards of practice as defined in WAC
					 246-840-460
					 through
					 246-840-493,
					 and when any one or more of the following conditions apply:
(1) The patient is following a tapering
				  schedule;
(2) The patient requires
				  treatment for acute pain, which may or may not include hospitalization,
				  requiring a temporary escalation in opioid dosage with expected return to their
				  baseline dosage level or below;
(3)
				  The advanced registered nurse practitioner documents reasonable attempts to
				  obtain a consultation with a pain management specialist and the circumstances
				  justifying prescribing above one hundred twenty milligrams morphine equivalency
				  dosage (MED) per day without first obtaining a consultation; or
(4) The advanced registered nurse
				  practitioner documents the patient's pain and function is stable, and the
				  patient is on a nonescalating dosage of opioids.
Statutory Authority:
						RCW
						18.79.400. 11-10-064, § 246-840-487,
						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 246-840-490 - Consultation-Exemptions for the advanced registered nurse practitioner

Current through Register Vol. 24-14, July 15, 2024
The advanced registered nurse practitioner is exempt from
					 the consultation requirement in WAC
					 246-840-485
					 if one or more of the following qualifications are met:
(1) The advanced registered nurse
				  practitioner is a pain management specialist under WAC
				  246-840-493;
(2) The advanced registered nurse
				  practitioner has successfully completed, within the last two years, a minimum
				  of twelve continuing education hours on chronic pain management approved by a
				  continuing education accrediting organization. At least two of these hours must
				  be dedicated to substance use disorder;
(3) The advanced registered nurse
				  practitioner is a pain management practitioner working in a multidisciplinary
				  chronic pain clinic or a multidisciplinary academic research facility;
				  or
(4) The advanced registered
				  nurse practitioner has a minimum three years of clinical experience in a
				  chronic pain management clinic, and at least thirty percent of the advanced
				  registered nurse practitioners' current practice is the direct provision of
				  pain management care.
Statutory Authority:
						RCW
						18.79.400. 11-10-064, § 246-840-490,
						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 246-840-493 - Pain management specialist

Current through Register Vol. 24-14, July 15, 2024
An advanced registered nurse practitioner pain management
					 specialist, functioning as a consultant for the prescribing of chronic opioid
					 therapy, shall meet the following qualifications:
(1) Credentialed in pain management by a
				  Washington state nursing care quality assurance commission-approved certifying
				  or credentialing entity; or
(2)
				  Meet all of the following:
(a) A minimum of
				  three years of clinical experience in a chronic pain management care
				  setting;
(b) Successful completion
				  of a minimum of at least eighteen continuing education hours in pain management
				  during the past two years; and
(c)
				  At least thirty percent of the advanced registered nurse practitioner's current
				  practice is the direct provision of pain management care or is in a
				  multi-disciplinary pain clinic.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE - PAIN MANAGEMENT › Section 246-840-4935 - Assessment of treatment plan

Current through Register Vol. 24-14, July 15, 2024
The advanced registered nurse practitioner shall assess and
					 document the appropriateness of continued use of the current treatment plan if
					 the patient's response to, or compliance with, the current treatment plan is
					 unsatisfactory. The advanced registered nurse practitioner shall consider
					 tapering, changing, discontinuing treatment, or referral for a substance use
					 disorder evaluation when:
(1) The
				  patient requests;
(2) The patient
				  experiences a deterioration in function or pain;
(3) The patient is noncompliant with the
				  written agreement;
(4) Other
				  treatment modalities are indicated;
(5) There is evidence of misuse, abuse,
				  substance use disorder, or diversion;
(6) The patient experiences a severe adverse
				  event or overdose;
(7) There is
				  unauthorized escalation of doses; or
(8) There is continued dose escalation with
				  no improvement in pain, function, or quality of life.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE - PAIN MANAGEMENT › Section 246-840-4940 - Patients with chronic pain, including those on high doses, establishing a relationship with a new practitioner

Current through Register Vol. 24-14, July 15, 2024
(1)
				  When a patient receiving chronic opioid pain medication(s) changes to a new
				  advanced registered nurse practitioner, the advanced registered nurse
				  practitioner shall query the prescription monitoring program (PMP). It is
				  normally appropriate for the new advanced registered nurse practitioner to
				  initially maintain the patient's current opioid doses. Over time, the advanced
				  registered nurse practitioner may evaluate if any tapering or other adjustments
				  in the treatment plan can or should be done.
(2) An advanced registered nurse
				  practitioner's treatment of a new high dose chronic pain patient is exempt from
				  the mandatory consultation requirements of WAC
				  246-840-485
				  and the tapering requirements of WAC 246-840-4935 if:
(a) The patient was previously being treated
				  with a dosage of opioids in excess of one hundred twenty milligram MED for
				  chronic pain under an established written agreement for treatment of the same
				  chronic condition or conditions;
(b) The patient's dose is stable and
				  nonescalating;
(c) The patient has
				  a demonstrated history in their record of compliance with treatment plans and
				  written agreements as documented by medical records and PMP queries;
				  and
(d) The patient has documented
				  functional stability, pain control, or improvements in function or pain
				  control, at the dose in excess to one hundred twenty milligram MED.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE - PAIN MANAGEMENT › Section 246-840-4950 - Special populations-Patients twenty-five years of age or under, pregnant patients, and aging populations

Current through Register Vol. 24-14, July 15, 2024
(1)
				  Patients twenty-five years of age or under. In the treatment of pain for
				  patients twenty-five years of age or under, the advanced registered nurse
				  practitioner shall treat pain in a manner equal to that of an adult but must
				  account for the weight of the patient and adjust the dosage prescribed
				  accordingly.
(2) Pregnant patients.
				  Use of medication assisted treatment (MAT) opioids, such as methadone or
				  buprenorphine, by a pregnant patient shall not be discontinued without
				  oversight by the MAT prescribing practitioner. The advanced registered nurse
				  practitioner shall weigh carefully the risks and benefits of opioid
				  detoxification during pregnancy.
(3) Aging populations. As people age, their
				  tolerance and metabolizing of opioids may change. The advanced registered nurse
				  practitioner shall consider the distinctive needs of patients who are
				  sixty-five years of age or older and who have been on chronic opioid therapy or
				  who are initiating opioid treatment.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE - PAIN MANAGEMENT › Section 246-840-4955 - Episodic care of chronic opioid patients

Current through Register Vol. 24-14, July 15, 2024
(1) When providing episodic care for a
				  patient who the advanced registered nurse practitioner knows is being treated
				  with opioids for chronic pain, such as for emergency or urgent care, the
				  advanced registered nurse practitioner shall review the prescription monitoring
				  program (PMP) to identify any Schedule II-V or drugs of concern received by the
				  patient and document in the patient record their review and any
				  concerns.
(2) An advanced
				  registered nurse practitioner providing episodic care to a patient who the
				  advanced registered nurse practitioner knows is being treated with opioids for
				  chronic pain should provide additional opioids to be equal to the severity of
				  the acute pain. If opioids are provided, the advanced registered nurse
				  practitioner shall limit the use of opioids to the minimum amount necessary to
				  control the acute nonoperative pain, acute perioperative pain, or similar acute
				  exacerbation of pain until the patient can receive care from the practitioner
				  who is managing the patient's chronic pain treatment.
(3) The episodic care advanced registered
				  nurse practitioner shall report known violations of the patient's written
				  agreement to the patient's treatment practitioner who provided the agreement
				  for treatment.
(4) The episodic
				  care advanced registered nurse practitioner shall coordinate care with the
				  patient's chronic pain treatment practitioner if that person is known to the
				  episodic care advanced registered nurse practitioner, when
				  practicable.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE - PAIN MANAGEMENT › Section 246-840-4960 - Coprescribing with certain medications

Current through Register Vol. 24-14, July 15, 2024
(1) The advanced registered nurse
				  practitioner shall not knowingly prescribe opioids in combination with the
				  following Schedule II-IV medications without documentation in the patient
				  record of clinical judgment and discussion of risks with the patient:
(a) Benzodiazepines;
(b) Barbiturates;
(c) Sedatives;
(d) Carisoprodol; or
(e) Nonbenzodiazepine hypnotics also known as
				  Z drugs.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE - PAIN MANAGEMENT › Section 246-840-4970 - Coprescribing of opioids for patients receiving medication assisted treatment (MAT)

Current through Register Vol. 24-14, July 15, 2024
(1) Where
				  practicable, the advanced registered nurse practitioner providing acute
				  nonoperative pain or acute perioperative pain treatment to a patient known to
				  be receiving medication assisted treatment (MAT) shall prescribe opioids for
				  pain relief either in consultation with the MAT prescribing practitioner or a
				  pain specialist.
(2) The advanced
				  registered nurse practitioner shall not discontinue MAT medications when
				  treating acute nonoperative pain or acute perioperative pain without
				  documentation of the reason for doing so, nor shall use of these medications be
				  used to deny necessary operative intervention.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE - PAIN MANAGEMENT › Section 246-840-4980 - Coprescribing of naloxone

Current through Register Vol. 24-14, July 15, 2024
(1) The
				  advanced registered nurse practitioner shall confirm or provide a current
				  prescription for naloxone when fifty milligrams MED or above, or when
				  prescribed to a high-risk patient.
(2) The advanced registered nurse
				  practitioner should counsel and provide an option for a current prescription
				  for naloxone to patients being prescribed opioids as clinically
				  indicated.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › ADVANCED PRACTICE - PAIN MANAGEMENT › Section 246-840-4990 - Prescription monitoring program-Required registration, queries, and documentation

Current through Register Vol. 24-14, July 15, 2024
(1) The
				  advanced registered nurse practitioner shall register to access the
				  prescription monitoring program (PMP) or demonstrate proof of having registered
				  to access the PMP if they prescribe opioids in Washington state.
(2) The advanced registered nurse
				  practitioner is permitted to delegate performance of a required PMP query to an
				  authorized designee, as defined in WAC
				  246-470-050.
(3) At a minimum, the advanced registered
				  nurse practitioner shall ensure a PMP query is performed prior to the
				  prescription of an opioid at the following times:
(a) First opioid prescription for acute pain
				  unless clinical exception is documented; such exceptions should be rare,
				  occurring in less than ten percent of the first prescriptions;
(b) First refill for acute pain if not
				  checked with initial prescription due to documented clinical
				  exception;
(c) Time of transition
				  from acute to subacute pain;
(d)
				  Time of transition from subacute to chronic pain; and
(e) Time of preoperative assessment for any
				  elective surgery or prior to discharge for nonelective surgery.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › NURSING EDUCATION PROGRAMS › Section 246-840-500 - Philosophy governing approval of nursing education programs

Current through Register Vol. 24-14, July 15, 2024
The commission believes that quality nursing education
					 provides the foundation for safe and effective nursing practice. Nursing
					 education shall be accessible and promote student and faculty diversity. While
					 the commission has established minimum standards for approved nursing education
					 programs, it believes that each nursing education program should have
					 flexibility in developing and implementing its philosophy, purposes, and
					 objectives. Such development and implementation should be based not only upon
					 the minimum standards for approved nursing education programs, but also upon
					 sound educational and professional principles for the preparation of registered
					 nurses, practical nurses, advanced registered nurse practitioners, and other
					 nurses who pursue graduate nursing degrees and postgraduate degrees and
					 certifications to meet current and future nursing needs of the public. The
					 commission believes that there must be congruence between the total program
					 activities of the nursing education program and its stated philosophy, purpose
					 and objectives.
The commission further believes that the standards for
					 approved nursing education programs are useful for promoting self-evaluation
					 and peer evaluation, which may lead to further program development and ongoing
					 continuous quality improvement.
Statutory Authority:
						RCW
						18.79.110. 95-21-072, § 246-840-500,
						filed 10/16/95, effective 11/16/95.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › NURSING EDUCATION PROGRAMS › Section 246-840-505 - Purposes of commission approval of nursing education programs

Current through Register Vol. 24-14, July 15, 2024
The commission approves nursing education programs
					 to:
(1) Assure preparation for the
				  safe and effective practice of nursing by setting minimum standards for nursing
				  education programs preparing persons for licensure as registered nurses ,
				  practical nurses, advanced registered nurse practitioners, or for preparing
				  nurses for additional graduate education or higher levels of nursing
				  practice.
(2) Provide criteria for
				  the approval, development, evaluation, and improvement of new and established
				  nursing education programs.
(3)
				  Assure graduates of nursing education programs are educationally prepared for
				  licensure at the appropriate level of nursing practice.
(4) Facilitate interstate endorsement of
				  graduates of commission approved nursing education programs .
(5) Assure nursing education standards for
				  out-of-state distance learning nursing education programs placing students in
				  Washington state for clinical or other practice experiences are equivalent to
				  in-state nursing education programs.
(6) Assure internationally educated nurses'
				  educational preparation is equivalent to that of in-state nursing education
				  programs.
Statutory Authority:
						RCW
						18.79.110 and
						18.79.150. 05-12-058, §
						246-840-505, filed 5/26/05, effective 6/26/05. Statutory Authority:
						RCW
						18.79.110. 95-21-072, § 246-840-505,
						filed 10/16/95, effective 11/16/95.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › NURSING EDUCATION PROGRAMS › Section 246-840-510 - Approval of initial (new) in-state nursing education programs

Current through Register Vol. 24-14, July 15, 2024
(1) New nursing
				  education programs must submit a commission approved application for approval
				  to operate a new undergraduate, post-licensure, or graduate nursing education
				  program in Washington state.
(2)
				  Graduate programs changing from a master's degree in nursing to a doctoral of
				  nursing practice degree must submit a substantive change request identified in
				  WAC 246-840-554(3).
(3) The
				  commission shall consider the need, size, type, and geographic location when
				  approving a program.
Phase I: Submission of application and feasibility
					 study
(4) A postsecondary
				  educational institution wishing to establish a nursing education program or
				  additional program in nursing shall submit an application and feasibility study
				  as follows:
(a) Submit to the commission a
				  statement of intent to establish a nursing education program or additional
				  program on a form provided by the commission and a completed feasibility study
				  that includes the following information:
(i)
				  Studies documenting the current and future supply and demand needs for nurses
				  in the area of the proposed nursing education program;
(ii) Purposes and classification of the
				  proposed nursing education program;
(iii) Availability of qualified candidates
				  for the nurse administrator and faculty positions;
(iv) Budgeted nurse administrator and faculty
				  positions over the course of five years;
(v) Source and description of adequate and
				  acceptable clinical or practice facilities for the nursing education
				  program;
(vi) Description of
				  adequate and acceptable academic facilities for the nursing education
				  program;
(vii) Potential effect on
				  other nursing programs within a sixty mile radius of the proposed nursing
				  education program location;
(viii)
				  Evidence of financial resources adequate and acceptable for the planning,
				  implementation, and continuation of the nursing education program for the next
				  five years;
(ix) Anticipated
				  student population;
(x) Tentative
				  time schedule for planning and initiating the nursing education program;
				  and
(xi) Accreditation status of
				  the parent institution.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › NURSING EDUCATION PROGRAMS › Section 246-840-511 - Accreditation requirements for all nursing education programs located in Washington state

Current through Register Vol. 24-14, July 15, 2024
(1)
(a) A nursing education program must be
				  located in a postsecondary educational institution with approval from either
				  the Washington state student achievement council or state board of technical
				  and community colleges to grant the appropriate degree or certificate;
				  and
(b) A nursing education program
				  must be located in an institution accredited by a United States Department of
				  Education approved regional accrediting body or national institutional
				  accrediting body.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › NURSING EDUCATION PROGRAMS › Section 246-840-512 - Standards and evaluation of nursing education programs

Current through Register Vol. 24-14, July 15, 2024
(1) The nursing education program shall meet
				  minimum standards established by the commission as detailed in WAC 246-840-511
				  through 246-840-556.
(2) The
				  nursing education program shall implement a written, comprehensive, systematic
				  plan for ongoing evaluation that is based on program outcomes data and input
				  from faculty, students, health care partners and consumers, and that
				  incorporates continuing improvement goals and measures.
(a) The plan must include evaluative
				  criteria, methods used to evaluate, frequency of evaluation, assignment of
				  responsibility, and measurable indicators or benchmarks of effectiveness for
				  the nursing education program and instruction.
(b) The nursing education program shall
				  document analysis of the data collected and actions taken as a result of use of
				  the systematic program evaluation plan.
(c) Major changes in the professional nursing
				  education program must be evidence-based.
(d) The nursing education program shall
				  review and analyze the evaluative methods and instruments used to measure
				  program outcomes for appropriateness according to the timeline specified in the
				  plan.
(e) The nursing education
				  program shall evaluate didactic and clinical course effectiveness each time a
				  course is taught.
(f)
				  Implementation of the plan for systematic program evaluation and ongoing
				  quality improvements must be documented in faculty or faculty-related
				  minutes.
(g) The following items
				  must be included in the systematic program evaluation: Faculty, student and
				  graduate satisfaction surveys, facility, resource and services surveys of
				  faculty and students, faculty workload surveys and evaluations, national
				  council licensing examination (NCLEX) pass rates, post licensure certification
				  examination pass rates, student attrition and completion rates, employment
				  rates after graduation, employer satisfaction, and program and student learning
				  outcomes.
(h) Faculty and students
				  shall participate in program planning, implementation, evaluation, and
				  continuous quality improvement.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › NURSING EDUCATION PROGRAMS › Section 246-840-513 - Reporting and recordkeeping requirements for nursing education programs

Current through Register Vol. 24-14, July 15, 2024
(1) Within two
				  business days, nursing education programs shall report to the commission, on
				  forms provided by the commission, events involving a student or faculty member
				  that the program has reason to believe resulted in patient harm, an
				  unreasonable risk of patient harm, or diversion of legend drugs or controlled
				  substances.
(2) The nursing
				  education program shall keep a log of all events reported by a patient, family
				  member, student, faculty or a health care provider resulting in patient harm,
				  an unreasonable risk of patient harm, or allegations of diversion, and
				  medication errors. The log must include:
(a)
				  The date and nature of the event;
(b) The name of the student or faculty member
				  involved;
(c) The name of the
				  clinical faculty member responsible for the student's clinical
				  experience;
(d) Assessment of
				  findings and suspected causes related to the incident or root cause
				  analysis;
(e) Nursing education
				  program corrective action; and
(f)
				  Remediation plan, if applicable.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › NURSING EDUCATION PROGRAMS › Section 246-840-514 - Purpose and outcomes for approved nursing education programs

Current through Register Vol. 24-14, July 15, 2024
(1) The purpose and
				  expected outcomes of the nursing education program shall be stated clearly and
				  must be available to the public in written form.
(2) The purpose and expected outcomes shall
				  be consistent with nursing practice as outlined in chapters 18.79 RCW and
				  246-840 WAC.
(3) The nursing
				  education program shall have a purpose statement and expected outcomes
				  consistent with the parent institution and with generally accepted standards of
				  nursing practice appropriate for graduates of the type of nursing program
				  offered.
(4) The input of
				  stakeholders including, but not limited to, health care partners and community
				  members shall be considered in developing and evaluating the purpose and
				  expected outcomes of the program.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › NURSING EDUCATION PROGRAMS › Section 246-840-515 - Branch campus and distance learning nursing education programs (Repealed)

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
						RCW
						18.79.110 and
						18.79.150. 05-12-058, §
						246-840-515, filed 5/26/05, effective
						6/26/05.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › NURSING EDUCATION PROGRAMS › Section 246-840-516 - Organization and administration for all nursing education programs

Current through Register Vol. 24-14, July 15, 2024
(1) The nursing
				  education program must be an integral part of the accredited parent
				  institution.
(2) The relationship
				  of the nursing education program to the parent institution and other units
				  within the parent institution must be clearly delineated and included in an
				  organizational chart, which indicates lines of responsibility and
				  authority.
(3) The parent
				  institution shall provide financial support and resources needed to operate a
				  professional nursing education program, which meets the requirements of this
				  chapter and fosters achievement of program goals and expected outcomes.
The financial resources must support adequate educational
					 facilities, equipment, technology, and qualified administrative and
					 instructional personnel sufficient to achieve program goals and
					 outcomes.
(4) The nursing
				  education program shall involve nursing faculty in determining academic
				  policies and procedures.
(5) The
				  nursing education program shall provide opportunity for student participation
				  in the development and evaluation of program policies and procedures,
				  curriculum planning and evaluation.
(6) The nursing education program shall
				  provide accurate information to students and the public.
(7) The governing entity shall employ a
				  qualified nurse administrator with clear institutional authority and
				  administrative responsibility for the nursing program.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › NURSING EDUCATION PROGRAMS › Section 246-840-517 - Nurse administrator qualification requirements in nursing education programs located in Washington state

Current through Register Vol. 24-14, July 15, 2024
(1)
				  The nursing education program administrator must be a professionally and
				  academically qualified registered nurse with an active, unencumbered Washington
				  nursing license.
Practical or Associate Degree Nursing Education
					 Programs
(2) In a nursing
				  education program offering practical or associate degree nursing education, the
				  nurse administrator must have a minimum of:
(a) A bachelor of science in nursing (BSN)
				  from a nursing education program accredited by a national nursing education
				  accrediting body recognized by the United States Department of Education and a
				  graduate degree; or
(b) A graduate
				  degree from a nursing education program accredited by a national nursing
				  education accrediting body recognized by the United States Department of
				  Education; and
(c) Preparation in
				  education that includes teaching adults, adult learning theory, teaching
				  methods, curriculum development, and curriculum evaluation, or two years of
				  teaching experience in nursing education that demonstrates this type of
				  preparation;
(d) Curriculum
				  development and administration experience;
(e) Five years of experience as a registered
				  nurse including two years of experience in nursing education; and
(f) Current knowledge of nursing practice at
				  the practical nurse or associate degree program level as appropriate.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › NURSING EDUCATION PROGRAMS › Section 246-840-518 - Resources, facilities and services for approved nursing education programs

Current through Register Vol. 24-14, July 15, 2024
(1) A nursing
				  education program shall have the fiscal, human, physical, technological,
				  clinical and learning resources adequate to support program processes and
				  outcomes.
(2) Classrooms,
				  laboratories, and conference rooms must be available and adequate in size,
				  number, and type according to the number of students and the educational
				  purposes for, which the rooms are to be used.
(3) Offices must be available and adequate in
				  size, number, and type to provide faculty with opportunity for uninterrupted
				  work and privacy for conferences with students. Adequate space must be provided
				  for clerical staff, records, files, and other equipment.
(4) An office allowing for private
				  consultation with students and faculty, and support for administrative
				  responsibilities must be available to the nurse administrator.
(5) Library facilities and computer access
				  must be provided for use by the faculty and students. Physical facilities,
				  hours, and scope and currency of learning resources must be appropriate for the
				  purpose of the program and for the number of faculty and students.
(6) The nursing education program shall
				  conduct annual evaluations of resources, facilities, and services based on
				  input from faculty and students. The schedule and results of these evaluations
				  must be available to the commission upon request.
(7) The nursing education program shall
				  demonstrate adequate financial support for faculty, support personnel,
				  equipment, technology, supplies, and services.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › NURSING EDUCATION PROGRAMS › Section 246-840-519 - Student requirements in all approved nursing education programs

Current through Register Vol. 24-14, July 15, 2024
(1) The nursing
				  education program shall hold students accountable for professional behavior as
				  identified in chapters 18.79,
				  18.130 RCW, and 246-840 WAC,
				  including, academic honesty and integrity.
(2) Written policies and procedures for
				  students must be available and communicated in a fair, accurate, inclusive, and
				  consistent manner.
(3) The approved
				  nursing education program shall:
(a) Develop
				  and implement written policies and procedures specific to nursing students
				  including, but not limited to, the following:
(i) Student selection, admission,
				  progression, remediation, graduation, withdrawal, and dismissal of
				  students;
(ii) Student
				  recordkeeping and systems;
(iii)
				  ADA accommodations for students;
(iv) Student rights and
				  responsibilities;
(v) Grievances
				  and complaint processes;
(vi)
				  Incident reports and tracking of reports;
(vii) Medication administration or selection
				  by students and faculty role in supervising students during medication
				  administration or selection processes;
(viii) Reporting and logging of events
				  involving a student and faculty member that the nursing education program has
				  reason to believe resulted in patient harm, unreasonable risk of patient harm,
				  or diversion of legend drugs;
(ix)
				  Documenting student near miss errors incidents;
(x) Student professional dress;
(xi) Professional behavior;
(xii) Background check
				  requirements;
(xiii) Immunization
				  requirements;
(xiv) Clinical
				  practice expectations;
(xv) Student
				  performance evaluations; and
(xvi)
				  Other expectations of nursing students, including providing direction to
				  students on how to apply for national council licensing examination (NCLEX)
				  testing and licensure.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › NURSING EDUCATION PROGRAMS › Section 246-840-520 - Ongoing evaluation and approval of nursing education programs (Repealed)

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
						RCW
						18.79.110 and
						18.79.150. 05-12-058, §
						246-840-520, filed 5/26/05, effective 6/26/05. Statutory Authority:
						RCW
						18.79.110. 95-21-072, § 246-840-520,
						filed 10/16/95, effective 11/16/95.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › NURSING EDUCATION PROGRAMS › Section 246-840-521 - Additional student requirements for prelicensure registered nurse nursing education programs located in the state of Washington

Current through Register Vol. 24-14, July 15, 2024
The nursing education program shall provide the student in
					 a prelicensure registered nursing program with written information on the legal
					 role of the nursing technician as defined in WAC
					 246-840-010 and
					 246-840-840. The information must
					 be provided prior to the time of completion of the first clinical course and
					 shall clearly advise the student of his or her responsibilities, if he or she
					 chooses to be employed as a nursing technician.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › NURSING EDUCATION PROGRAMS › Section 246-840-522 - Additional student requirements for RN to BSN and graduate nursing education programs

Current through Register Vol. 24-14, July 15, 2024
(1) The nursing
				  education program shall ensure nursing students in RN to BSN and graduate
				  nursing education programs are licensed as a registered nurse in each state or
				  United States territory where practice or clinical experiences occur.
(2) The nursing education program shall
				  provide the student in a graduate nursing program with written or electronic
				  information on the requirements for national certification as appropriate to
				  the level of educational degree and specialty.