Utah Admin. Code 156-31b-703b

Current through Bulletin No. 2024-21, November 1, 2024

Section R156-31b-703b - Scope of Nursing Practice Implementation

(1) Under Subsection 58-31b-102(13), an LPN shall be expected to:

(a) conduct a focused nursing assessment;

(b) plan for and implement nursing care within limits of competency;

(c) conduct patient surveillance and monitoring;

(d) assist in identifying patient needs;

(e) assist in evaluating nursing care;

(f) participate in nursing management by:

(i) assigning appropriate nursing activities to other LPNs;

(ii) delegating care for stable patients to unlicensed assistive personnel in accordance with this rule and applicable statutes;

(iii) observing nursing measures and providing feedback to nursing managers; and

(iv) observing and communicating outcomes of delegated and assigned tasks; and

(g) serve as faculty in areas of competence.

(2) Under Subsection 58-31b-102(14), an RN shall be expected to:

(a) interpret patient data, whether obtained through a focused nursing assessment or otherwise, to:

(i) complete a comprehensive nursing assessment; and

(ii) determine whether, and according to what timeframe, another medical professional, a patient's family member, or any other person should be apprised of a patient's nursing needs;

(b) detect faulty or missing patient information;

(c) apply nursing knowledge effectively in the synthesis of the biological, psychological, spiritual, and social aspects of the patient's condition;

(d) utilize broad and complete analyses to plan strategies of nursing care and nursing interventions that are integrated within each patient's overall health care plan or IHP;

(e) demonstrate appropriate decision-making, critical thinking, and clinical judgment to make independent nursing decisions and to identify health care needs;

(f) correctly identify changes in each patient's health status;

(g) comprehend clinical implications of patient signs, symptoms, and changes as part of ongoing or emergent situations;

(h) critically evaluate the impact of nursing care, the patient's response to therapy, and the need for alternative interventions;

(i) intervene on behalf of a patient when problems are identified so as to revise a care plan as needed;

(j) appropriately advocate for patients by:

(i) respecting patients' rights, concerns, decisions, and dignity;

(ii) identifying patient needs;

(iii) attending to patient concerns or requests; and

(iv) promoting a safe and therapeutic environment by:

(A) providing appropriate monitoring and surveillance of the care environment;

(B) identifying unsafe care situations; and

(C) correcting problems or referring problems to appropriate management level when needed;

(k) communicate with other health team members regarding patient choices, concerns, and special needs, including:

(i) patient status and progress;

(ii) patient response or lack of response to therapies; and

(iii) significant changes in patient condition;

(l) demonstrate the ability to responsibly organize, manage, and supervise the practice of nursing by:

(i) delegating tasks in accordance with this rule and applicable statutes; and

(ii) matching patient needs with personnel qualifications, available resources, and appropriate supervision;

(m) teach and counsel patient families regarding an applicable health care regimen, including general information about health and medical conditions, specific procedures, wellness, and prevention;

(n) if acting as a chief administrative nurse:

(i) ensure that organizational policies, procedures, and standards of nursing practice are developed, kept current, and implemented to promote safe and effective nursing care;

(ii)

(A) assess the knowledge, skills, and abilities of nursing staff and assistive personnel; and

(B) ensure personnel are assigned to nursing positions appropriate to their determined competence and licensure, certification, or registration level; and

(iii) ensure that thorough and accurate documentation of personnel records, staff development, quality assurance, and other aspects of the nursing organization are maintained;

(o) if employed by a department of health:

(i) implement standing orders and protocols; and

(ii) complete and provide to a patient prescriptions that have been prepared and signed by a physician in accordance with Section 58-17b-620;

(p) serve as faculty in areas of competence; and

(q) perform any task within the scope of practice of an LPN.

(3) Under Subsection 58-31b-102(11), the following scope and standards shall apply to the practice of advanced practice registered nursing:

(a) an APRN who chooses to change or expand from a primary focus of practice shall, at the request of the Division, document competency within that expanded practice based on education, Clinical Practice Experiences, and certification with the burden to demonstrate competency upon the APRN.

(b) an APRN may practice within the scope of practice of an RN and an LPN in Utah;

(c) an APRN who wishes to practice as an RN in a Party state, as defined in Section 58-31e-102 of the Nurse Licensure Compact, shall reinstate, qualify for, and obtain an RN Compact license in Utah.

(4) Under Subsections 58-1-510(3) and (4) and 58-31b-102(11)(d), a certified registered nurse anesthetist (APRN-CRNA) licensed under Subsection 58-31b-301(2) who provides general anesthesia, deep sedation, or moderate sedation, shall possess the knowledge, skills, and education and training required by the following standards, and shall comply with the following standards, which are incorporated by reference:

(a)

(i) American Association of Nurse Anesthesiology (AANA) Standards for Nurse Anesthesia Practice, 2019 edition; or

(ii) the following American Society of Anesthesiologists (ASA) standards:

(A) Basic Standards for Preanesthesia Care, 2020 edition;

(B) Standards for Basic Anesthetic Monitoring, 2020 edition; and

(C) Standards for Postanesthesia Care, 2019 edition; or

(b) the following American Dental Association (ADA) standards:

(i) Guidelines for the Use of Sedation and General Anesthesia by Dentists, 2016 edition;

(ii) Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students, 2016 edition;

(iii) Guidelines for Teaching Pediatric Pain Control and Sedation to Dentists and Dental Students, 2021 edition; and

(iv) ADA Policy Statement: The Use of Sedation and General Anesthesia by Dentists, 2007 edition; or

(c) the following American Association of Oral and Maxillofacial Surgeons (AAOMS) standards:

(i) Office Anesthesia Evaluation Manual, 2018 9th edition; and

(ii) Parameters of Care, 2017 6th edition.

Utah Admin. Code R156-31b-703b

Amended by Utah State Bulletin Number 2017-2, effective 12/22/2016

Amended by Utah State Bulletin Number 2018-1, effective 12/11/2017

Amended by Utah State Bulletin Number 2021-02, effective 1/8/2021

Amended by Utah State Bulletin Number 2022-01, effective 12/27/2021

Amended by Utah State Bulletin Number 2023-03, effective 1/24/2023