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Licensure & Scope of Practice: The Nurse Practice Act

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Polsinelli PC. In California, Polsinelli LLP

Nursing Care Delivery: Current

Challenges, Future Opportunities

Leading Age

2015 Senior Living Conference September 29, 2015 – 9:00 am

Licensure & Scope of Practice:

The Nurse Practice Act

225 ILCS 65 / et seq.

 The Illinois Nurse Practice Act of 2007

establishes the licensure requirements for

nurses in Illinois

 Also establishes grounds for disciplinary action

against nurses and against persons engaging in

unauthorized practice of nursing

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real challenges. real answers.SM

Licensure & Scope of Practice: LPN

 Licensed Practical Nurse (LPN)

– An LPN is a person who is specifically prepared in the

techniques of nursing, who is a graduate of an

accredited school of practical nursing and whose

qualifications have been examined by a state board of

nursing, and who has been legally authorized to

practice as a licensed practical nurse must have the

basic nursing knowledge, judgment, and skill acquired

by means of completion of an approved practical

nursing education program.

real challenges. real answers.SM

Licensure & Scope of Practice: LPN

 Licensed Practical Nurse (LPN)

– Practical nursing includes assisting in the

nursing process as delegated by and under

the direction of a registered professional

nurse (“RN”).

– The practical nurse may also work under the direction

of a licensed physician, dentist, podiatrist, or other

health care professional

.

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real challenges. real answers.SM

Licensure & Scope of Practice: LPN

68 Ill. Admin Code 1300.250

1. Collecting data and collaborating in the assessment of the health status of a patient.

2. Collaborating in the development and modification of the registered professional nurse's or advanced practice nurse's comprehensive nursing plan of care for all types of patients.

3. Implementing aspects of the plan of care as delegated.

4. Participating in health teaching and counseling to promote, attain, and maintain the optimum health level of patients, as delegated.

5. Serving as an advocate for the patient by communicating and collaborating with other health service personnel, as delegated.

6. Participating in the evaluation of patient responses to interventions.

7. Communicating and collaborating with other health care professionals, as delegated.

Licensure & Scope of Practice: RN

– A RN is specifically prepared and promotes health

and the prevention of disease, and helps patients

cope with illness.

– When providing direct patient care they observe,

assess and record symptoms, reactions and

progress, assist physicians during surgery,

treatments, and examinations, administer

medications and help in the convalescence and

rehabilitation of patients.

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real challenges. real answers.SM

Licensure & Scope of Practice: RN

 RN Scope of Practice 68 Ill. Admin Code 1300.360

All aspects of LPN scope of practice, plus:

1. The comprehensive nursing assessment of the health status of patients that addresses changes to patient conditions.

2. The development of a plan of nursing care to be integrated within the patient-centered health care plan that establishes nursing diagnoses, and setting goals to meet identified health care needs, determining nursing interventions, and implementation of nursing care through the execution of nursing strategies and regimens ordered or prescribed by authorized healthcare professionals.

3. The administration of medication or delegation of medication administration to licensed practical nurses.

4. Delegation of nursing interventions to implement the plan of care.

5. The provision for the maintenance of safe and effective nursing care rendered directly or through delegation.

real challenges. real answers.SM

Licensure & Scope of Practice: RN

6. Providing input into the development of policies and procedures to support patient safety.

7. Advocating for patients.

8. The evaluation of responses to interventions and the effectiveness of the plan of care.

9. Communicating and collaborating with other health care professionals.

10.The procurement and application of new knowledge and technologies.

11.The provision of health education and counseling.

12.Participating in development of policies, procedures and systems to support patient safety.

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real challenges. real answers.SM

Comparing the duties of LPN v. RN

Common LPN Duties

 Monitoring patients' vitals

 Administering basic patient care, like changing bandages

 Helping patients bathe and dress

 Maintaining patients' health records

 Reporting patients' status to RNs and doctors

Common RN Duties

All of the LPN tasks, plus the following:

 Administering medications and treatments

 Establishing and maintaining patients' care plans

 Performing diagnostic tests and analyzing results

 Operating and monitoring medical equipment

 Teaching patients and their families how to manage illnesses and injuries

Licensure & Scope of Practice: APN

 Advanced Practice Nurse(APN)

– An APN is licensed as a registered professional nurse and meets the requirements for licensure as an advanced practice nurse.

– An APN cares for patients by using advanced diagnostic skills, the results of diagnostic tests and procedures ordered by the advanced practice nurse, a physician assistant, a dentist, a podiatrist, or a physician, and professional judgment to initiate and coordinate the care of patient.

– An APN can also order diagnostic tests, prescribe medications and drugs, and administer medications and drugs.

– Categories include certified nurse midwife (CNM), certified nurse practitioner (CNP), certified registered nurse anesthetist (CRNA), and certified clinical nurse specialist (CNS).

– Must have a Written Collaborative Agreement to describe working relationship with collaborating physician

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real challenges. real answers.SM

Licensure & Scope of Practice: APN

APN Scope of Practice (68 Ill. Admin Code 1300.440)

 Includes all aspects of LPN and RN scope of practice, plus:

1. Advanced nursing patient assessment and diagnosis.

2. Ordering diagnostic and therapeutic tests and procedures, performing those tests and procedures when using health care equipment, and interpreting and using the results of diagnostic and therapeutic tests and procedures ordered by the advanced practice nurse or another health care professional.

3. Ordering treatments, ordering or applying appropriate medical devices, and using nursing, medical, therapeutic, and corrective measures to treat illness and improve health status.

real challenges. real answers.SM

Licensure & Scope of Practice: APN

4. Providing palliative and end-of-life care.

5. Providing advanced counseling, patient education, health education, and patient advocacy.

6. Prescriptive authority as defined in Section 65-40 of the Act.

7. Delegating selected nursing activities or tasks to a licensed practical nurse, a registered professional nurse, or other personnel.

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real challenges. real answers.SM

Discussion Points

 Handling medications

 Staffing

 MMAI/ICP – Managed Care expectations

and care coordination

 Resident acuity

 Data tracking

 Medical vs. Social model

QUESTIONS?

Meredith A. Duncan

Polsinelli, P.C.

161 N. Clark St., Ste. 4200

Chicago, Illinois 60601

312-873-3602

mduncan@polsinelli.com

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real challenges. real answers.SM

Polsinelli provides this material for informational purposes only. The material provided herein is general and is not intended to be legal advice. Nothing herein should be relied upon or used without consulting a lawyer to consider your specific circumstances, possible changes to applicable laws, rules and regulations and other legal issues. Receipt of this material does not establish an attorney-client relationship.

Polsinelli is very proud of the results we obtain for our clients, but you should know that past results do not guarantee future results; that every case is different and must be judged on its own merits; and that the choice of a lawyer is an important decision and should not be based solely upon advertisements.

© 2015 Polsinelli PC. In California, Polsinelli LLP.

Polsinelli is a registered mark of Polsinelli PC

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