AN ACT relating to nurses.

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AN ACT relating to nurses. 1
Be it enacted by the General Assembly of the Commonwealth of Kentucky: 2
Section 1. KRS 314.011 is amended to read as follows: 3
As used in this chapter, unless the context thereof requires otherwise: 4
(1) "Board" means Kentucky Board of Nursing; 5
(2) "Delegation" means directing a competent person to perform a selected nursing 6
activity or task in a selected situation under the nurse's supervision and pursuant to 7
administrative regulations promulgated by the board in accordance with the 8
provisions of KRS Chapter 13A; 9
(3) "Nurse" means a person who is licensed or holds the privilege to practice under the 10
provisions of this chapter as a registered nurse or as a licensed practical nurse; 11
(4) "Nursing process" means the investigative approach to nursing practice utilizing a 12
method of problem-solving by means of: 13
(a) Nursing diagnosis, a systematic investigation of a health concern, and an 14
analysis of the data collected in order to arrive at an identifiable problem; and 15
(b) Planning, implementation, and evaluation based on natio nally accepted 16
standards of nursing practice; 17
(5) "Registered nurse" means one who is licensed or holds the privilege under the 18
provisions of this chapter to engage in registered nursing practice; 19
(6) "Registered nursing practice" means the performance of acts requiring substantial 20
specialized knowledge, judgment, and nursing skill based upon the principles of 21
psychological, biological, physical, and social sciences in the application of the 22
nursing process in: 23
(a) The care, counsel, and health teaching of the ill, injured, or infirm; 24
(b) The maintenance of health or prevention of illness of others; 25
(c) The administration of medication and treatment as prescribed by a physician, 26
physician assistant, dentist, or advanced practice registered nurse and as 27
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further authorized or limited by the board, and which are consistent either 1
with American Nurses' Association Scope and Standards of Practice or with 2
standards of practice established by nationally accepted organizations of 3
registered nurses. Components of medi cation administration include but are 4
not limited to: 5
1. Preparing and giving medications in the prescribed dosage, route, and 6
frequency, including dispensing medications only as defined in 7
subsection (17)(a)[(b)] of this section; 8
2. Observing, recording, and reporting desired effects, untoward reactions, 9
and side effects of drug therapy; 10
3. Intervening when emergency care is required as a result of drug therapy; 11
4. Recognizing accepted prescribing limits and reporting deviations to the 12
prescribing individual; 13
5. Recognizing drug incompatibilities and reporting interactions or 14
potential interactions to the prescribing individual; and 15
6. Instructing an individual regarding medications; 16
(d) The supervision, teaching of, and delegation to other personnel in the 17
performance of activities relating to nursing care; and 18
(e) The performance of other nursing acts which are authorized or limited by the 19
board, and which are consistent either with American Nurses' Association 20
Standards of Practice or with Standards of Pr actice established by nationally 21
accepted organizations of registered nurses; 22
(7) "Advanced practice registered nurse" or "APRN" means a certified nurse 23
practitioner, certified registered nurse anesthetist, certified nurse midwife, or 24
clinical nurse specia list, who is licensed to engage in advance practice registered 25
nursing pursuant to KRS 314.042 and certified in at least one (1) population focus; 26
(8) "Advanced practice registered nursing" means the performance of additional acts by 27
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registered nurses who have gained advanced clinical knowledge and skills through 1
an accredited education program that prepares the registered nurse for one (1) of the 2
four (4) APRN roles; who are certified by the American Nurses' Association or 3
other nationally established orga nizations or agencies recognized by the board to 4
certify registered nurses for advanced practice registered nursing as a certified nurse 5
practitioner, certified registered nurse anesthetist, certified nurse midwife, or 6
clinical nurse specialist; and who ce rtified in at least one (1) population focus. The 7
additional acts shall, subject to approval of the board, include but not be limited to 8
prescribing treatment, drugs, devices, and ordering diagnostic tests. Advanced 9
practice registered nurses who engage in these additional acts shall be authorized to 10
issue prescriptions for and dispense , as defined in KRS 315.010, nonscheduled 11
legend drugs, as defined in KRS 217.905 , and to issue prescriptions for but not to 12
dispense Schedules II through V controlled substa nces described in or as classified 13
pursuant to KRS 218A.020, 218A.060, 218A.080, 218A.100, and 218A.120 under 14
the conditions set forth in KRS 314.042 and regulations promulgated by the 15
Kentucky Board of Nursing on or before August 15, 2006. 16
(a) 1. Prescriptions issued by advanced practice registered nurses for Schedule 17
II controlled substances classified under KRS 218A.060, except 18
hydrocodone combination products as defined in KRS 218A.010, shall 19
be limited to a seventy-two (72) hour supply without any refill. 20
2. Prescriptions issued by advanced practice registered nurses for 21
hydrocodone combination products as defined in KRS 218A.010 shall 22
be limited to a thirty (30) day supply without any refill. 23
3. Prescriptions issued under this subsection for psychostim ulants may be 24
written for a thirty (30) day supply only by an advanced practice 25
registered nurse certified in psychiatric -mental health nursing who is 26
providing services in a health facility as defined in KRS Chapter 216B 27
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or in a regional services program for mental health or individuals with 1
an intellectual disability as defined in KRS Chapter 210. 2
(b) Prescriptions issued by advanced practice registered nurses for Schedule III 3
controlled substances classified under KRS 218A.080 shall be limited to a 4
thirty (30) day supply without any refill. Prescriptions issued by advanced 5
practice registered nurses for Schedules IV and V controlled substances 6
classified under KRS 218A.100 and 218A.120 shall be limited to the original 7
prescription and refills not to exceed a six (6) month supply. 8
Nothing in this chapter shall be construed as requiring an advanced practice 9
registered nurse designated by the board as a certified registered nurse anesthetist to 10
obtain prescriptive authority pursuant to this chapter or any ot her provision of law 11
in order to deliver anesthesia care. The performance of these additional acts shall be 12
consistent with the certifying organization or agencies' scopes and standards of 13
practice recognized by the board by administrative regulation; 14
(9) "Licensed practical nurse" means one who is licensed or holds the privilege under 15
the provisions of this chapter to engage in licensed practical nursing practice; 16
(10) "Licensed practical nursing practice" means the performance of acts requiring 17
knowledge and skill such as are taught or acquired in approved schools for practical 18
nursing in: 19
(a) The observing and caring for the ill, injured, or infirm under the direction of a 20
registered nurse, advanced practice registered nurse, physician assistant, 21
licensed physician, or dentist; 22
(b) The giving of counsel and applying procedures to safeguard life and health, as 23
defined and authorized by the board; 24
(c) The administration of medication or treatment as authorized by a physician, 25
physician assistant, dentist, or advanced practice registered nurse and as 26
further authorized or limited by the board which is consistent with the 27
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National Federation of Licensed Practical Nurses or with Standards of 1
Practice established by nationally accepted organizations of licensed practical 2
nurses; 3
(d) Teaching, supervising, and delegating except as limited by the board; and 4
(e) The performance of other nursing acts which are authorized or limited by the 5
board and which are consistent with the National Federation of Practical 6
Nurses' Standards of Practice or with Standards of Practice established by 7
nationally accepted organizations of licensed practical nurses; 8
(11) "School of nursing" means a nursing education program preparing persons for 9
licensure as a registered nurse or a practical nurse; 10
(12) "Continuing education" means offerings beyond the basic nursing program tha t 11
present specific content planned and evaluated to meet competency based 12
behavioral objectives which develop new skills and upgrade knowledge; 13
(13) "Nursing assistance" means the performance of delegated nursing acts by 14
unlicensed nursing personnel for compensation under supervision of a nurse; 15
(14) "Sexual assault nurse examiner" means a registered nurse who has completed the 16
required education and clinical experience and maintains a current credential from 17
the board as provided under KRS 314.142 to condu ct forensic examinations of 18
victims of sexual offenses under the medical protocol issued by the Justice and 19
Public Safety Cabinet in consultation with the Sexual Assault Response Team 20
Advisory Committee pursuant to KRS 216B.400(5); 21
(15) "Competency" means the application of knowledge and skills in the utilization of 22
critical thinking, effective communication, interventions, and caring behaviors 23
consistent with the nurse's practice role within the context of the public's health, 24
safety, and welfare; 25
(16) "Credential" means a current license, registration, certificate, or other similar 26
authorization that is issued by the board; 27
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(17) "Dispense" or "dispensing" means: 1
(a) If appropriately prescribed by a physician, physician assistant, dentist, or 2
advanced practice registered nurse: 3
1. To receive and distribute nonscheduled legend drug samples from 4
pharmaceutical manufacturers to patients at no charge to the patient or 5
any other party; or 6
2.[(b)] To distribute nonscheduled legend drugs from a local, district, and 7
independent health department, subject to the direction of the 8
appropriate governing board of the individual health department; and 9
(b) For an advanced practice registered nurse who is authorized to dispense 10
nonscheduled legend drugs, the same as in KRS 315.010. 11
(18) "Dialysis care" means a process by which dissolved substances are removed from a 12
patient's body by diffusion, osmosis, and convection from one (1) fluid 13
compartment to another across a semipermeable membrane; 14
(19) "Dialysis technician" means a person who is not a nurse, a physician assistant, or a 15
physician and who provides dialysis care in a licensed renal dialysis facility under 16
the direct, on-site supervision of a registered nurse or a physician; 17
(20) "Population focus" means the section of the population within which the advanced 18
practice registered nurse has targeted to practice. The categories of population foci 19
are: 20
(a) Family and individual across the lifespan; 21
(b) Adult gerontology; 22
(c) Neonatal; 23
(d) Pediatrics; 24
(e) Women's health and gender-related health; and 25
(f) Psychiatric mental health; and 26
(21) "Conviction" means but is not limited to: 27
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(a) An unvacated adjudication of guilt; 1
(b) Pleading no contest or nolo contendere or entering an Alford plea; or 2
(c) Entering a guilty plea pursuant to a pretrial diversion order; 3
Regardless of whether the penalty is rebated, suspended, or probated. 4