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THE SENATE |
S.B. NO. |
2103 |
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TWENTY-SIXTH LEGISLATURE, 2012 |
S.D. 2 |
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STATE OF HAWAII |
H.D. 2 |
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A BILL FOR AN ACT
RELATING TO HEALTH.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. The legislature finds that physician assistants, licensed practical nurses, and registered nurses provide valuable medical care to patients under the orders of licensed physicians. Licensed practical nurses and registered nurses currently must use reasonable judgment in carrying out the prescribed medical orders of a licensed dentist, medical doctor, osteopathic physician, or podiatrist, or the orders of an advanced practice registered nurse. The legislature also finds that the relevant statutory language fails to explain whether licensed practical nurses and registered nurses are required to administer orders given by physician assistants. That lack of clarity has led to confusion between hospital administrators and nurses when physician assistants write or give verbal orders in a hospital setting.
The purpose of this Act is to clarify that licensed practical nurses and registered nurses are required to carry out the orders of a licensed physician assistant practicing with physician supervision and acting as an agent of the supervising physician.
SECTION 2. Section 457-2, Hawaii Revised Statutes, is amended by amending the definitions of "the practice of nursing as a licensed practical nurse" and "the practice of nursing as a registered nurse" to read as follows:
""The
practice of nursing as a licensed practical nurse" means the performance
of those acts commensurate with the required educational preparation and
demonstrated competency of the individual, whereby the individual shall be
accountable and responsible to the consumer for the quality of nursing care
rendered. The foregoing may include, but shall not be limited to:
implementation of basic nursing procedures in the plan of care; observing and
caring for individuals at all levels of the health spectrum, giving counsel and
acting to safeguard life and health and functioning as a part of the health
care team, under the direction of a dentist, physician, osteopathic physician,
registered nurse, or podiatrist licensed in accordance with chapter 448, 453,
457, or 463E[;], or under the orders of a physician assistant
licensed pursuant to chapter 453, practicing with physician supervision as
required by chapter 453, and acting as the agent of the supervising physician;
administration of treatment and medication as prescribed; promotion of health
maintenance of individuals, families, or groups; or teaching and supervision of
auxiliary personnel.
"The
practice of nursing as a registered nurse" means the performance of
professional services commensurate with the educational preparation and
demonstrated competency of the individual having specialized knowledge,
judgment, and skill based on the principles of the biological, physical,
behavioral, and sociological sciences and nursing theory, whereby the
individual shall be accountable and responsible to the consumer for the quality
of nursing care rendered. The foregoing may include but shall not be limited
to observation, assessment, development, implementation, and evaluation of a
plan of care, health counseling, supervision and teaching of other personnel,
and teaching of individuals, families, and groups in any stage of health or
illness; administration, supervision, coordination, delegation, and evaluation
of nursing practice; provision of health care to the patient in collaboration
with other members of the health care team as autonomous health care
professionals providing the nursing component of health care; or use of
reasonable judgment in carrying out prescribed medical orders of a licensed
dentist, physician, osteopathic physician, or podiatrist licensed in accordance
with chapter 448, 453, or 463E [or the]; orders of an advanced
practice registered nurse recognized in accordance with this chapter[.];
or the orders of a physician assistant licensed pursuant to chapter 453,
practicing with physician supervision as required by chapter 453, and acting as
the agent of the supervising physician."
SECTION 3. Section 457-8.5, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:
"(a) Effective October 1, 2009, the board shall grant recognition as an advanced practice registered nurse to a nurse who has:
(1) A current, unencumbered license as a registered nurse in this State;
(2) An unencumbered license as a registered nurse in all other states in which the nurse has a current and active license;
(3) An unencumbered recognition as an advanced practice registered nurse or similar designation in all other states in which the nurse has a current and active recognition as an advanced practice registered nurse;
(4) Completed an accredited graduate-level education
program [leading to a master's degree as a certified registered nurse
anesthetist, a nurse midwife, a clinical nurse specialist, or a nurse
practitioner;] preparing the nurse for one of the four recognized advanced
practice registered nurse roles;
(5) A current, unencumbered certification of having passed a national certification examination that measures role and population-focused competencies and is recognized by the board;
(6) Maintained continued competencies through recertification in role and population-focused competencies through a national certification program recognized by the board;
(7) Acquired advanced clinical knowledge and skills preparing the nurse to provide direct care to patients through a significant educational and practical concentration on the direct care of patients;
(8) Demonstrated a greater breadth of knowledge, a greater synthesis of data, greater complexity of skills and interventions, and greater role autonomy than demonstrated by a registered nurse;
(9) Been educationally prepared to assume responsibility and accountability for health promotion and maintenance and to assess, diagnose, and manage patient problems through the use and prescription of pharmacologic and non-pharmacologic interventions;
(10) Acquired clinical experience of sufficient depth and breadth to reflect the intended license; and
(11) Paid the appropriate fees."
SECTION 4. This Act does not affect rights and duties that matured, penalties that were incurred, and proceedings that were begun before its effective date.
SECTION 5. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 6. This Act shall take effect on July 1, 2050.
Report Title:
Licensed Practical Nurse; Registered Nurse; Physician Assistant
Description:
Amends the definitions of "the practice of nursing as a licensed practical nurse" and "the practice of nursing as a registered nurse" to include carrying out the orders of a licensed physician assistant practicing with physician supervision, and acting as an agent of the supervising physician. Modifies the formal educational qualifications of an advanced practice registered nurse. Effective July 1, 2050. (SB2103 HD2)
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.