1. Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.

2. Chapter 4 Nursing Licensure and Certification

3. 3 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc. The History of Nursing Licensure   Recognition: pins and registries   Nursing pins Symbolize the school’s philosophy, beliefs, and aspirations Evidence of achievement, learning, and skills   Registry Nightingale started the tradition of maintaining a registry of all graduates in 1860 Provided institutions and clients with the means to ascertain the skills and knowledge of graduates

4. 4 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.   Purpose of licensure   As nursing programs proliferated, the need to demonstrate a certain level of nursing skill and knowledge evolved   Primary purpose was, and still is, the protection of the public The History of Nursing Licensure (Cont’d)

5. 5 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.   Mandatory licensure   1930s: New York first state to require mandatory licensure   1950: NLN administered first State Board Test Pool Examination, a standardized exam for licensure   1982: first NCLEX examination   1994: paper-and-pencil test replaced by computerized adaptive testing The History of Nursing Licensure (Cont’d)

6. 6 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.   Current licensing activities   Efforts to provide common definitions of nursing practice, standards of education, and testing for entry into practice for all states have been successful   “Mutual recognition model” of nursing practice Resolution adopted in 1997 by the delegate assembly of the National Council of State Boards of Nursing (NCSBN) National Council of State Boards of Nursing (NCSBN) Provides for individual state boards to adopt an interstate compact, allowing nurses licensed in one state to practice in all other states and territories The History of Nursing Licensure (Cont’d)

7. 7 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc. Components of Nurse Practice Acts   Components   Statements that refer to protecting the health and safety of the populace   Statements to protect the title of registered nurse   Definition of professional nursing   Definition of advanced practice, which may be expressed in a single definition or may be separately defined   Description of requirements for licensure

8. 8 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.   Description of requirements and procedures necessary for entry into practice   Description of requirements for renewal of licensure   Designation of a regulatory board to administer the nurse practice act   Guidelines for delegation Components of Nurse Practice Acts (Cont’d)

9. 9 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.   Role of regulatory boards to ensure safe practice   Membership of the board of nursing usually appointed by the governor’s office   Duties of the board of nursing Administering the state’s nurse practice act Granting and renewing licenses and taking disciplinary action when provisions of the act are violated   Arkansas State Board of Nursing Arkansas State Board of Nursing Components of Nurse Practice Acts (Cont’d)

10. 10 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc. Continued Competency   Mandatory continuing education   Arkansas requires 15 contact hours every 2 years   Kansas, California, Delaware, Alaska, requires 30 hours every 2 years   Missouri, Tennessee, Arizona, Colorado do not require any

11. 11 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.   Special cases of licensure   As a U.S. government employee, nurses have to be licensed in only one state to practice across the country Military and government nurses Foreign nurse graduates: Nurses who receive education in another country must take a special examination administered by the Commission on Graduates of Foreign Nursing Schools before applying for a license to practice in this country International practice Components of Nurse Practice Acts

12. 12 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.   Revision of nurse practice acts   Nurse practice acts are written and passed by legislators   Governmental agencies, administrators, and special interest groups seek to influence the legislation and accompanying rules and regulations Nurses and nursing associations Physicians, pharmacists, and other health-related specialties Representatives of hospitals, long-term care groups, and managed care groups Components of Nurse Practice Acts (Cont’d)

13. 13 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.   Because of varied interests, it is essential for nurses to understand the nurse practice act and additional legislation that will alter the act and influence nursing practice   Sunset legislation Laws found in many states to ensure legislation are current and reflect the needs of the public Through sunset activities, nurse practice acts are updated and revised Components of Nurse Practice Acts (Cont’d)

14. 14 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.   Delegation of authority to others: regulations for delegating to unlicensed personnel and LPN/LVNs are found in the nurse practice act and may vary from state to state   Current licensure activities   Mutual recognition model   Continued competency Components of Nurse Practice Acts (Cont’d)

15. Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc. Delegation of Authority to Others   Nurse practice acts establish legal definitions of delegation   Guidelines for delegation developed by nursing organizations   Scope of Practice Decision Making Model Scope of Practice Decision Making Model 15

16. 16 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.   ANCC   Offers certification in 25 areas of specialty nursing   Certified more than 200,000 nurses as of 2009   Purpose   Recognizes excellence in nursing practice   Nongovernmental agencies, usually professional nursing organizations, grant certification   Requirements and practice opportunities vary markedly   Most states require certification for advanced practice Certification

17. 17 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.   Steps to certification   Become informed about specific requirements in the chosen specialty   Contact the ANCC or specialty nursing organization offering certification to determine the educational experience and examination requirements   Contact the state board of nursing for information about legal requirements for practice in a specific specialty area Certification (Cont’d)

18. 18 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.   Current Issues in certification   Legal issues of scope of practice for advanced practice nurses   Reimbursement for nursing services Certification (Cont’d)

19. Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc. Mutual Recognition Model  Nurse licensure compact (NLC): formed by individual states to allow nurses to practice in more than one state without applying for multiple licenses  Nurse Licensure Compact Nurse Licensure Compact Nurse Licensure Compact 19