2015 OSBN UPDATE OVERVIEW Identify structure and role of Oregon - - PDF document

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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

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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.

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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;

• ne 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

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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

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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

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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

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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

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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

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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

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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
• f practice, intention, past history of practice

issues, participation with investigation, licensee attitude.

• Ongoing evaluation and refinement

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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