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Rule 1000-1-.11, Definitions is amended by adding the following language as new paragraph (6) and renumbering the remaining paragraphs accordingly:
(6) Continued Competence: Means the application
of integrated nursing knowledge and the
interpersonal, decision-making, psychomotor,
communication, and leadership skills expected for
the nursing practice role pursuant to T.C.A.
§ 63-7-103, within the context of the public
health, safety, and welfare.
Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-7-101, 63-7-103, and 63-7-207.
Rule 1000-1-.14, Standards of Nursing Competence, is amended by adding the following introductory sentences and is further amended by deleting paragraphs (1) and (2) in their entirety and substituting instead the following language, so that as amended, the new introductory sentences and the new paragraphs (1), (2), and (3) shall read:
1000-1-.14 Standards of Nursing Competence. The Board requires all nurses to document evidence of competence in their current practice role. The Board believes that the individual nurse is responsible for maintaining and demonstrating competence in the practice role whether the recipient of the nursing intervention is the individual, family, community, nursing staff, nursing student body, or other.
(1) Standards of Nursing Practice for the Registered
Nurse
(a) Standards Related to the Registered
Nurse’s Responsibility to Implement the
Nursing Process – The Registered Nurse
shall:
1. Conduct and document nursing assessments
of individuals and groups by:
(i)collecting objective and subjective
data in an accurate and timely manner.
(ii)accurately sorting, selecting, reporting
and recording the data.
(iii)validating, refining and modifying the
data by utilizing available resources
including interactions with the client,
family, significant others, and health
team members.
2.Establish critical paths and teaching plans
based on individual patient’s plans of care
after prioritizing need upon completion of a
comprehensive assessment.
3.Develop the plan of care/action based on a
comprehensive assessment, desired
outcomes, and current knowledge.
4.Safely implement the plan of care/action
either directly or by delegation.
5.Establish and maintain a therapeutic
nurse/client relationship.
6.Seek resources for patients/clients with
cultural, physical or language barriers.
7.Use appropriate teaching skill for individual or
group teaching.
8.Evaluate the responses of individuals or
groups to nursing interventions and revise
the plan of care where appropriate.
Evaluation shall involvethe client, family,
significant others and health team members.
9.Communicate accurately in writing and orally
with recipients of nursing care and other
professionals.
(b) Standards Related to the Registered Nurse’s
Responsibilities as a Member of the Nursing
Profession – The Registered Nurse shall:
1.Integrate knowledge of the statutes and
regulations governing nursing and function
within the legal and ethical boundaries of
nursing practice.
2.Demonstrate personal responsibility for
currency of practice and individual nursing
actions.
3.Identify practice abilities and limitations and
obtain instruction and supervision as
necessary when implementing essential
functions of the practice role.
4.Consult with nurses and other health team
members and make referrals as necessary.
5.Report unsafe practice and unsafe practice
conditions to recognized legal authorities
and to the Board where appropriate.
6.Delegate to another only those nursing
measures which that person is prepared or
qualified to perform.
7.Supervise others to whom nursing activities
are delegated.
8.Retain professional accountability for nursing
care when delegating nursing interventions.
9.Conduct practice without discrimination on
the basis of age, race, religion, sex, sexual
preference, national origin, language,
handicap or disease.
10.Demonstrate a respect for the dignity and
rights of clients regardless of social or
economic status, personal attributes or
nature of health problems.
11.Protect confidential information unless
obligated by law to disclose such
information.
12.Demonstrate respect for the property of
clients, family, significant others and the
employer.
13.Participate in activities designed to improve
health care delivery in any setting.
14.Exhibit ethical behavior.
(2) Requirement Standards for Nurses Inactive in
Nursing for More Than Five (5) Years – Prior to
January 1, 2004, a licensee or an applicant for
licensure by endorsement who has not been
engaged in the practice of nursing for five (5)
years shall submit an application and evidence of
nursing competence with documentation in one (1)
of the following areas:
(a) Completion of a two (2) week Board-approved
nursing refresher program.
(b) Completion of a two (2) week Board-approved
comprehensive orientation program offered by
a prospective nursing
employer.
(c) Enrollment in a program leading to licensure as
a Registered Nurse or to an advanced degree
in nursing.
1.The individual must have satisfactorily
completed two (2) hours of nursing credits
or equivalent during the past five (5) years.
2.An official transcript verifying the completion
of nursing courses shall be submitted with
the renewal, reactivation, or endorsement
application.
(d) Current certification in an appropriate nursing
specialty area.
(3) Notwithstanding paragraph (2) of this rule, and
because of the biennial renewal of licenses required
by T.C.A. § 63-7-114, on January 1, 2002 the
Board shall begin to notify applicants for renewal of
continued competence requirements as provided in
T.C.A. § 63-7-207 (16). Beginning January 1, 2004
all applicants for licensure, renewal of license,
reactivation of license, or reinstatement of license
must demonstrate competency.
(a) For new licensees, successfully completing the
requirements of Rule .01 or .02, as applicable,
shall be considered proof of sufficient
competence to constitute compliance with this
rule.
(b) Registered Nurses who are practicing full or
part-time, attesting to having practiced
nursing during the past five (5) years and
attesting to maintaining a personal file
documenting professional competence shall be
considered proof of sufficient competence to
constitute compliance with this rule. Such
personal file shall include evidence of
continued competency in the work setting
which shall consist of at least two (2) of the
following parts:
1.Having had a satisfactory employer
evaluation.
2.Having had a satisfactory peer evaluation
3.Having a satisfactory patient/client
relationship.
4.Having a contract renewal, re-appointment,
or continuing contract.
5.Having completed a written self-evaluation
based on the standards in paragraph (1).
6.Having earned, during the most recent
biennial renewal period, initial or continuing
certification from a nationally recognized
certification body appropriate to practice.
7.Having identified two (2) or more areas of
interest or goals and subsequently having
developed, implemented and evaluated,
during the most recent biennial renewal
period, a plan to demonstrate competency
for these areas of interest or goals based on
the standards in paragraph (1).
8.Having performed activities including, but
not limited to:
(i)Satisfactory volunteer work in a
position using nursing knowledge, skills,
and abilities. Examples are:
(I)The Red Cross.
(II)Homeless clinics.
(III)Parish nursing.
(ii)Service relevant to nursing on local,
state, or national boards, commissions,
foundations, or agencies.
9.Having participated in the education of
students in a program leading to licensure as
a Registered Nurse or to an advanced
degree in nursing.
10.Having successfully completed five
(5)contact hours of continuing education.
11.Having had an article published relevant to
nursing.
12.Having successfully completed a two (2)
week nursing refresher program.
13.Having successfully completed a two (2)
week comprehensive orientation program
offered by a prospective nursing
employer.
14.Having enrolled in an approved/accredited
nursing program leading to licensure as a
Registered Nurse or to an advanced degree
in nursing.
(i)The individual must have satisfactorily
completed two (2) hours of nursing
credits or equivalent during the past
five (5) years.
(ii)An official transcript verifying the
completion of nursing courses shall be
maintained.
15.Having retaken and successfully completed
the examination required in Rule .01 of this
chapter.
(c) Registered Nurses who wish to maintain an
active license who are not practicing full-time,
part-time, or self employed, attesting to any
of the following activities which require the
expertise of the Registered Nurse shall be
considered proof of sufficient competence to
constitute compliance with this rule.
1.Having performed Board-approved activities
including, but not limited to:
(i)Satisfactory volunteer work in a
position using nursing knowledge, skills,
and abilities. Examples are:
(I)The Red Cross.
(II)Homeless clinics.
(III)Parish nursing.
(ii)Service relevant to nursing on local,
state, or national boards, commissions,
foundations, or agencies.
2.Having participated in the education of
students in a program leading to licensure as
a Registered Nurse or to an advanced
degree in nursing.
3.Having successfully completed five (5)
contact hours of continuing education for
each year of inactivity.
4.Having had an article published during the
period of inactivity in a professional journal
acceptable to the Board.
5.Having successfully completed a two (2)
week Board-approved nursing refresher
program.
6.Having successfully completed a two (2)
week Board-approved comprehensive
orientation program offered by a prospective
nursing employer.
7.Having enrolled in an approved/accredited
nursing program leading to licensure as a
Registered Nurse or to an advanced degree
in nursing.
(i)The individual must have satisfactorily
completed two (2) hours of nursing
credits or equivalent during the past
five (5) years.
(ii)An official transcript verifying the
completion of nursing courses shall be
submitted with the renewal,
reactivation, or endorsement
application.
8.Having retaken and successfully completed
the examination required in Rule .01 of this
chapter.
(d) Registered Nurses who have not practiced for
more than five (5) years shall submit the
appropriate application and one (1) of the
following as evidence of continued nursing
competence:
1.Proof of successful completion of five (5)
contact hours of continuing education for
each year of inactivity.
2.Proof of having had an article published
during the period of inactivity in a
professional journal acceptable to the Board.
3.Proof of successful completion of a two (2)
week Board-approved nursing refresher
program.
4.Proof of successful completion of a two (2)
week Board-approved comprehensive
orientation program offered by a prospective
nursing employer.
5.Proof of enrollment in an
approved/accredited nursing program leading
to licensure as a Registered Nurse or to an
advanced degree in nursing.
(i)The individual must have satisfactorily
completed two (2) hours of nursing
credits or equivalent during the past
five (5) years.
(ii)An official transcript verifying the
completion of nursing courses shall be
submitted with the renewal,
reactivation, or endorsement
application.
6.Proof of current certification in an
appropriate nursing specialty area.
7.Proof of retaking and successfully completing
the examination required in Rule .01 of this
chapter.
(e) Documentation of compliance
1.Each licensee must retain documentation of
completion of all continued competence
requirements of this rule for a period of four
(4) years from when the requirements were
completed. This documentation must be
produced for inspection and verification, if
requested in writing by the Board during its
verification process.
2.The licensee must, within thirty (30) days of
a request from the Board, provide evidence
of continued competence activities.
3.Any licensee who fails to complete the
continued competence activities or who
falsely certifies completion of continued
competence activities may be subject to
disciplinary action pursuant to T.C.A. §§
63—7—115, 63—7—116, 63—7—120, and
63—7—207.
Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-7-101, 63-7-114, 63-7-115, 63-7-116, 63-7-120, and 63-7-207.
Rule 1000-2-.11, Definitions is amended by adding the following language as new paragraph (6) and renumbering the remaining paragraphs accordingly:
(6) Continued Competence: Means the application of
selected nursing knowledge and the interpersonal,
psychomotor, and communication skills expected
for the nursing practice role pursuant to T.C.A. §
63-7-108, within the context of the public health,
safety, and welfare.
Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-7-101, 63-7-108, and 63-7-207.
Rule 1000-2-.14, Standards of Nursing Competence, is amended by adding the following introductory sentences and is further amended by deleting paragraphs (1) and (2) in their entirety and substituting instead the following language, so that as amended, the new introductory sentences and the new paragraphs (1), (2), and (3) shall read:
1000-2-.14 Standards of Nursing Competence. The Board requires all nurses to document evidence of competence in their current practice role. The Board believes that the individual nurse is responsible for maintaining and demonstrating competence in the practice role whether the recipient of the nursing intervention is the individual, family, community, nursing staff, nursing student body, or other.
(1) Standards of Nursing Practice for the Licensed
Practical Nurse.
(a) Standards Related to the Licensed Practical
Nurse’s Contribution to and Responsibility for
the Nursing Process – The Licensed Practical
Nurse shall:
1.Contribute to the nursing assessment by
collecting, reporting and recording objective
and subjective data in an accurate and
timely manner.
2.Participate in the development of the plan of
care/action in consultation with a Registered
Nurse.
3.Participate in the assisting and giving of safe
direct care.
4.Participate in establishing and maintaining a
therapeutic nurse/client relationship.
5.Seek resources for patients/clients with
cultural, physical or language barriers.
6.Contribute to the evaluation of the
responses of individuals or groups to nursing
interventions and participate in revising the
plan of care where appropriate.
7.Communicate accurately in writing and orally
with recipients of nursing and other
professionals.
(b) Standards Relating to the Licensed Practical
Nurse’s Responsibilities as a Member of the
Health Team – The Licensed Practical Nurse
shall:
1.Integrate knowledge of the statutes and
regulations governing nursing and function
within the legal and ethical boundaries of
practical nursing practice.
2.Demonstrate personal responsibility for
individual nursing actions and currency of
competence.
3.Consult with Registered Nurses and/or other
health team members and seek guidance as
necessary.
4.Identify practice abilities and limitations and
obtain instruction and supervision as
necessary when implementing essential
functions of the practice role.
5.Report unsafe practice and unsafe practice
conditions to recognized legal authorities
and to the Board where appropriate.
6.Conduct practice without discrimination on
the basis of age, race, religion, sex, sexual
preference, national origin, language,
handicap, or disease.
7.Demonstrate respect for the dignity and
rights of clients regardless of social or
economic status, personal attributes or
nature of health problems.
8.Protect confidential information, unless
obligated by law to disclose such
information.
9.Demonstrate respect for the property of
clients, family, significant others, and the
employer.
10.Participate in activities designed to improve
health care delivery in any setting.
11.Exhibit ethical behavior.
(2) Requirement Standards for Nurses Inactive in Nursing for More Than Five (5) Years – Prior to January 1, 2004, a licensee or an applicant for licensure by endorsement who has not been engaged in the practice of nursing for five (5) years shall submit an application and evidence of nursing competence with documentation in one (1) of the following areas:
(a) Completion of a two (2) week Board-approved
nursing refresher program.
(b) Completion of a two (2) week Board-approved
comprehensive orientation program offered by
a prospective nursing employer.
(c) Enrollment in a program leading to licensure as
a Registered or Practical Nurse or to an
advanced degree in nursing.
1.The individual must have satisfactorily
completed two (2) hours of nursing credits
or equivalent during the past five (5 years.
2.An official transcript verifying the completion
of nursing courses shall be submitted with
the renewal, reactivation, or endorsement
application.
(d) Current certification in an appropriate nursing
specialty area.
(3) Notwithstanding paragraph (2) of this rule, and because of the biennial renewal of licenses required by T.C.A. § 63-7-114, on January 1, 2002 the Board shall begin to notify applicants for renewal of continued competence requirements as provided in T.C.A. § 63-7-207 (16). Beginning January 1, 2004 all applicants for licensure, renewal of license, reactivation of license, or reinstatement of license must demonstrate competency.
(a) For new licensees, successfully completing
the requirements of Rule .01 or .02, as
applicable, shall be considered proof of
sufficient competence to constitute
compliance with this rule.
(b) Practical Nurses who are practicing full or part
time, attesting to having practiced nursing
during the past five (5) years and attesting to
maintaining a personal file documenting
professional competence shall be considered
proof of sufficient competence to constitute
compliance with this rule. Such personal file
shall include evidence of continued
competency in the work setting which shall
consist of at least two (2) of the following
parts:
1.Having had a satisfactory employer
evaluation.
2.Having had a satisfactory peer evaluation
3.Having a satisfactory patient/client
relationship.
4.Having a contract renewal, re-appointment,
or continuing contract.
5.Having completed a written self-evaluation
based on the standards in paragraph (1).
6.Having earned, during the most recent
biennial renewal period, initial or continuing
certification from a nationally recognized
certification body appropriate to practice.
7.Having identified two (2) or more areas of
interest or goals and subsequently having
developed, implemented and evaluated,
during the most recent biennial renewal
period, a plan to demonstrate competency
for these areas of interest or goals based on
the standards in paragraph (1).
8.Having performed activities including, but
not limited to:
(i)Satisfactory volunteer work in a
position using nursing knowledge, skills,
and abilities. Examples are:
(I)The Red Cross.
(II)Homeless clinics.
(III)Parish nursing.
(ii)Service relevant to nursing on local,
state, or national boards, commissions,
foundations.
9.Having successfully completed five (5)
contact hours of continuing education.
10.Having had an article published relevant to
nursing.
11.Having successfully completed a two (2)
week nursing refresher program.
12.Having successful completed a two (2)
week comprehensive orientation program
offered by a prospective nursing
employer.
13.Having enrolled in an approved/accredited
program leading to licensure as a Registered
or Practical Nurse or to an advanced degree
in nursing.
(i)The individual must have satisfactorily
completed two (2) hours of nursing
credits or equivalent during the past
five (5) years.
(ii)An official transcript verifying the
completion of nursing courses shall be
maintained.
14.Having retaken and successfully completed
the examination required in Rule .01 of this
chapter.
(c) Practical Nurses who wish to maintain an
active license who are not practicing full-time,
part-time, or self employed, attesting to any
of the following activities which require the
expertise of the Practical Nurse shall be
considered proof of sufficient competence to
constitute compliance with this rule.
1.Having performed Board-approved activities
including, but not limited to:
(i)Satisfactory volunteer work in a
position using nursing knowledge, skills,
and abilities. Examples are:
(I)The Red Cross.
(II)Homeless clinics.
(III)Parish nursing.
(ii)Service relevant to nursing on local,
state, or national boards, commissions,
foundations.
2.Having successfully completed five (5)
contact hours of continuing education for
each year of inactivity.
3.Having had an article published during the
period of inactivity in a professional journal
acceptable to the Board.
4.Having successfully completed a two (2)
week Board-approved nursing refresher
program.
5.Having successfully completed a two (2)
week Board-approved comprehensive
orientation program offered by a prospective
nursing employer.
6.Having enrolled in an approved/accredited
program leading to licensure as a Registered
or Practical Nurse or to an advanced degree
in nursing.
(i)The individual must have satisfactorily
completed two (2) hours of nursing
credits or equivalent during the past
five (5) years.
(ii)An official transcript verifying the
completion of nursing courses shall be
submitted with the renewal,
reactivation, or endorsement
application.
7.Having retaken and successfully completed
the examination required in Rule .01 of this
chapter.
(d) Practical Nurses who have not practiced for
more than five (5) years shall submit the
appropriate application and one (1) of the
following as evidence of continued nursing
competence:
1.Proof of successful completion of five (5)
contact hours of continuing education for
each year of inactivity.
2.Proof of having had an article published
during the period of inactivity in a
professional journal acceptable to the Board.
3.Proof of successful completion of a two (2)
week Board-approved nursing refresher
program.
4.Proof of successful completion of a two (2)
week Board-approved comprehensive
orientation program offered by a prospective
nursing employer.
5.Proof of enrollment in an
approved/accredited program leading to
licensure as a Registered or Practical Nurse
or to an advanced degree in nursing.
(i)The individual must have satisfactorily
completed two (2) hours of nursing
credits or equivalent during the past
five (5) years.
(ii)An official transcript verifying the
completion of nursing courses shall be
submitted with the renewal,
reactivation, or endorsement
application.
6.Proof of current certification in an
appropriate nursing specialty area.
7.Proof of retaking and successfully completing
the examination required in Rule .01 of this
chapter.
(e) Documentation of compliance
1.Each licensee must retain documentation of
completion of all continued competence
requirements of this rule for a period of four
(4) years from when the requirements were
completed. This documentation must be
produced for inspection and verification, if
requested in writing by the Board during its
verification process.
2.The licensee must, within thirty (30) days of
a request from the Board, provide evidence
of continued competence activities.
3.Any licensee who fails to complete the
continued competence activities or who
falsely certifies completion of continued
competence activities may be subject to
disciplinary action pursuant to T.C.A. §§
63—7—115, 63—7—116, 63—7—120, and
63—7—207.
Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-7-101, 63-7-108, 63-7-114, 63-7-115, 63-7-116, 63-7-120, and 63-7-207.
Legal Contact: John Fitzgerald, Special Counsel, Office of General Counsel, 26th Floor, William R. Snodgrass Tennessee Tower, 312 Eighth Avenue North, Nashville, TN 37247-0120 615-741-1611.
Contact for disk acquisition and/or party who will approve final copy for publication: Jerry Kosten, First Floor, Cordell Hull Building, 425 Fifth Avenue North, Nashville, TN 37247-1010 615-532-4397.
The roll call vote by the Board of Nursing on these rulemaking hearing rules was as follows:
Board Members
Colleen Conway-Welch, R.N. – Aye
Lynn Veirs, R.N. – Aye
Elizabeth Cole, R.N. – Aye
Donna Roddy, R.N. – Absent
Dava Shoffner, R.N. – Aye
Ava Morgan, L.P.N.- Aye
Barbara Wallace, L.P.N. – Aye