Jurisprudence

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As a nurse in TX what 2 set of rules should you follow?

Nursing Practice Act- NPA
BON Rules & Regulations

Where can you download rules from the BON & NPA?

from the BON's website at www.bon.texas.gov

Where do the BON's rule changes appear?

In the newsletter

How often is the newsletter mailed?

quarterly or every 3 months

Where can proposed rules open for public comment be viewed?

- Secretary of states website www.sos.state.tx.us
- in the BON's offices
- in the Texas Register's Office room 245 James Rudder building 1019 Brazos st in Austin

Recite the TX BON mission

The mission of the TXBON is to protect and promote the welfare of the people of TX by ensuring that each person holding a license as a nurse is competent to practice safely.

How many board members are on the BON?

13

Who are the tx BON members appointed by?

governor

How does the board fufill its mission?

- regulates practice of nursing
-approves nsg education programs

What kind of rules can the board adopt and enforce. (4)

1. rules to perform its duties and conduct proceedings in front of the board
2. rules to regulate the practice of RN's & LVN's
3. rules to establish standards for professional conduct of license holders
4. determine if an act constitutes professional nursing or vocational nursing.

What defines the LVN's scope?

- Nursing Practice Act
- BON's Rules & Regulation

What is the LVN responsible for?

providing safe compassionate and focused nursing care to assigned patients with PREDICTABLE health care

Where are the TX nursing program competencies located?

In the Board's Differentiated Essential Competencies (DECs) of Graduates of the Texas Nursing Programs

Who is required to make sure nursing graduates are up to par with the DEC's?

The Nursing programs

What do the DEC's serve as?

guidelines for employers to assist LVN's as they transition from an educational environment into nursing practice.

Who is the LVN an advocate for?

the patient & patient's family

Who can LVN's practice under?

1. RN
2. APRN
3. Physician
4. Physician Assistant
5. Podiatrists
6. Dentist

Define Supervision

the active process of directing, guiding, and influencing the outcome of an individual's performance of an activity

Can the LVN practice in a completely independent matter?

No

Things the LVN scope does not include

- medical diagnosis
-prescription of therapeutic or corrective measures

Lvn settings should have...

well defined policies, procedures, & guidelines

How long should an LVN work in a structured setting?

12-18 months

Examples of structured settings

NSg homes
hospitals, rehab facilities
skilled nsg; clinics or private dr's offices

What kind of approach should the LVN use when caring for multiple patients?

a systematic problem solving approach

What kind of nsg care should the LVN provide?

individualized, goal directed nursing care

How many steps are in the nursing process for LVN's?

4 APIE

RN tasks prohibited from delegation

1. assessment
2. formulation of a nursing care plan
3. implementation of parts of the nursing care plan
4. responsibility and accountability of health education
5. dose calculation
6. injectable meds except insulin
7. meds via a non permanent tube
8. verbal & telephone orders
9. Initial dose

What are the 5 rights of delegation?

Right Task
Right Circumstance
Right Person
Right Direction/ Communication
Right Supervision/ Evaluation

Define CNE

programs beyond the basic nursing preparation that are designed to promote and enrich knowledge, improve skills, and develop attitudes for the enhancement of nursing practice, thus improving healthcare to the public.

How often should you renew CNE?

Every 2 years

How many CNE hours are required each renewal

20 contact hours; extra CNE hours do not roll over

When is the CNE period in relation to renewal?

first day after the renewal month to the last day of the subsequent renewal. ie I renew Dec 2012. Cne period is from Jan 1 2011 to Dec 30 2012

What are the 2 primary certification accreditation agencies

Accreditation Board for Nsg Certification ABSNC
Nat'l Commission for Certifying Agencies NCCA

all programs must be approved by 1 of these agencies to count as CNE

Academic CNE how luch is 1 semester hour?

15 contact hours

Academic CNE- how much is one quarter?

10 contact hours

Types of things that dont qualify as CNE

liberal arts courses, Basic CPR, in service programs, on the job training, orientation programs, self improvement type courses, economic persons, courses for lay people.

Who must receive Forensic Evidence CNE's?

Nurses practicing in the ED setting as their home unit, floating, contracted, or other duties that involve functioning in an ED setting or role. 1 time requirement.

Temporary Permit

grants graduate of a nursing program to practice under an RN or LVN

Inactive Status

For person who is not actively engaged , person must submit request in writing.

When does the inactive date begins? Can you moonlight?

Inactive status begins on expiry date on persons license. You may not practice any nursing service or work.

How much is it to renew your license?

$55 unexpired
$115 expired 90 days or less

What kind of issues doesn't the BON regulate

employment issues: salaries, staffing ratios, workplace concerns, practice settings, environment. It regulates nurses and protects the public.

How many questions and how long is the jurisprudence exam?

50 questions; 2 hours long

How long do you have to wait to retake the test if you do not pass with 75%?

7 days.

How long does it take the BON to recieve the NClex results?

5-7 days

How long do you have to take the NCLEX after you graduate?

4 years within graduation or receiving the ATT; then you must repeat the nursing program

Acts of misconduct include...

- sexual misconduct
- fraud, theft, and deception
- substance abuse, dependency, disorder
- lying and falsification

where can I find the nurse practice act

bon website; begins with 300's

where can i find the BON rules & regulations

bon website; begins with 200's

what are 3 types of BON CE offerings

webinars
hosted workshops
interactive online CNE opportunity

What is Incident Based Peer Review? Who initiates IBPR?

peer review initiated by faculty, association, school, agency, or any other setting that utilizes services of nurses

What is Safe Harbor? Who initiates it?

initiated by an RN, LVN, or APN PRIOR to accepting an assignment or engaging in conduct the nurse believes would place patients at risk for harm, causing the nurse to violate duty to the patient. This protects the nurse from employer retaliation and action from the BON.

What is Peer Review?

evaluation of nursing services, qualifications, quality of care, meritsd of a complaint, and determination or recommendation regarding a complaint.

Scope LVN

supervise & assign

Scope RN

delegate

6 Step decision making progress

1. is the act consistent w/ the NPA & BON rules, positions, statements & guidelines?
2. is the activity appropriately authorized by valid order/ protocol and in accordance w/ established policies & procedures?
3. is the act supported by research reported in nsg & health related literature or in scope of practice statements by national nursing organizations?
4. do u possess the req knowledge and have you demonstrated the competency required to carry out this actively safely?
5. would a reasonable and prudent nurse perform the activity in this setting?
6. are you prepared to assume accountability for the provision of safe care and the outcome of the care rendered?

minor incident is defined as

conduct that does not indicate that the continuing practice of nursing by an affected nurse poses a risk of harm to the client or other person

circumstances that are never considered minor incidents

- an error that contributed to death
- criminal conduct defined in the NPA 301.4535
- serious violation of the board's Unprofessional Conduct rule 217.12 involving intentional or unethical conduct such as fraud, theft, patient abuse or patient exploitation

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