9/14/2015 2015 OSBN UPDATE OVERVIEW • Identify structure and role of Oregon State Board of Nursing • Describe and discuss recent changes in the Nurse Practice Act affecting Nurse Practitioners. • Discuss the intent of the Board regarding Advanced Practice Titles • Identify trends in discipline cases and practice risks Structure and Role of Oregon State Board of Nursing • Mission • Formation • Composition • Mandate 1
9/14/2015 MISSION • The Oregon State Board of Nursing safeguards the public’s health and well ‐ being by providing guidance for, and regulation of, entry into the profession, nursing education, and continuing safe practice. Values FORMATION • OSBN is an agency within Oregon state government. 2
9/14/2015 FORMATION COMPOSITION • Appointed Board • Board Staff Both individually and collectively THE BOARD APPOINTED BOARD • Two public members, four Registered Nurses, one Licensed Practical Nurse, one Certified Nursing Assistant, and one Nurse Practitioner. The four RN members represent various areas of nursing practice; one nurse educator, one nurse administrator, and two direct ‐ care non ‐ supervisory nurses. They also represent a variety of geographic locations. Board members serve three ‐ year terms. Limit is two. • Functionally only exists when called together in duly noticed and conducted meeting 3
9/14/2015 Board Staff Personnel Changes • New Executive Director 2013 • New Advanced Practice Consultant 2014 • Interim Advanced Practice Consultant 2015 • Interim Advanced Practice Consultant takes APC position when New APC takes another position • Significant turnover in General Staff • Public member to appoint • Staff nurse position to fill • Dec 2015 to Feb 2016: New Nurse Practitioner Board Member to appoint Changes Update October 2015 4
9/14/2015 MANDATE • PUBLIC PROTECTION THROUGH REGULATION NOT ADVOCACY That said • Within the board, appointed and staff, there is underlying intent to enhance the profession and support nurses Recent changes in the Nurse Practice Act affecting Nurse Practitioners Effective January 1, 2015 • Updates to Division 56 • CRNA Prescriptive Authority • The renewal of licensure CE requirements for APRNS with Prescriptive Authority changed • Rule advisory committee created • APRN language 5
9/14/2015 Division 56 Updates • Uniformity in rule language • CRNA practice CE Requirements a) Proof of active, unencumbered national • certification for specialty role as required by applicable licensure, attesting to completion of continuing education required for maintaining national certification; or b) 45 structured contact hours of continuing • education completed in the two years prior to renewal of their license. At least 15 of the • completed CE hours must be in pharmacotherapeutic content at the NP level congruent with their specialty role. Rule Advisory Committee • Rule Advisory Committee information with link on the main page of the OSBN website: http://www.oregon.gov/OSBN/Pages/APRN ‐ Rule ‐ Advisory ‐ Committee.aspx • Charter ‐ Details how to becomes an appointed member: http://www.oregon.gov/OSBN/pdfs/APRN%20Rule%20Advi sory%20Committee%20Charter%202015_Final.pdf • Committee meeting dates & minutes: http://www.oregon.gov/OSBN/Pages/meetings.aspx • Committee members: http://www.oregon.gov/OSBN/pdfs/APRN ‐ RACnames.pdf 6
9/14/2015 Rule Advisory Committee • The entire RAC group will be meeting 1 October to write their report of proposals which will be delivered to the board at the November meeting. • Additionally the group will plan meeting dates and times at this meeting for the next calendar year. • Dates outside of business hours are up for discussion. • The committee was unable to meet outside of business hours this year because of dates being published on the website and members scheduling time off from work. TITLING ADVANCED PRACTICE • IS THIS AN ISSUE? Let’s Find Out • https://www.polleverywhere.com/multiple_c hoice_polls/yd6zRxO1fbiZMFU 7
9/14/2015 APRN • National level: NCSBN consensus model doc 2008 white paper to guide certification/education/licensure/accreditation • Consistency state to state: encourage: portability between states: followed guidance of IOM report encouraging minimizing barriers to practice. • Proposed one title: limit confusion encourage groups working together. • Responsible for raising level of practice in a number of states since. Issues • To enact change requires regulatory teeth: law change. • States like Oregon with long history the change may impact previous designations. • With representation where do we fit: compact administration. Transparent or hidden process? Nurse Practitioner • Ancient history? Differentiating the role from that of physician and other nurses. • Public recognition • Dollar value: branding 8
9/14/2015 Oregon 2015 • Board supported use of APRN as a place ‐ holder without the intent to require it as a title or to replace existing titles. Rule • Statutory protection Future Directions • How do we want to be known? Personal thoughts: the opinions presented here may not reflect those of OSBN or National Council of State Boards of Nursing • Advanced Practice • KISS • Pride in the Profession Identify trends in discipline cases and practice risks • anatomy of a case • case trends • safe practice strategies 9
9/14/2015 Anatomy of a Case Foxit Reader PDF Document Just Culture • Seeks to create environments that incentivize rather than punish error reporting • Individuals are not held accountable for system problems over which they have no control • Recognizes that patient care safety and quality is based on teamwork, communication, and a collaborative work environment (ANA, 2010) Disciplinary Grid • Informal tool used to assess mitigating and aggravating factors. • Used to help set appropriate sanction. • Takes into account system problems, duration of practice, intention, past history of practice issues, participation with investigation, licensee attitude. • Ongoing evaluation and refinement 10
9/14/2015 Trends in Disclipine Safe Practice Strategies • Know your scope of practice and your comfort and stay within both • Stay up to date with current practice • Have an established patient/provider relationship • Know your patient and communicate well • Get help when you need it • Document Thanks for your Attention • It has been a privilege to hold this position • Questions 11
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