The registered nurse is evaluating the student nurse for the Teach-Back technique

[Rev. 9/10/2019 10:49:21 AM]

[NAC-632 Revised Date: 8-19]

CHAPTER 632 - NURSING

GENERAL PROVISIONS

632.010������������� Definitions.

632.015������������� �Academic study� defined.

632.020������������� �Advanced practice registered nurse� defined.

632.024������������� �Approved program� defined.

632.0245����������� �Approved program for medication aides - certified� defined.

632.026������������� �Assessment� defined.

632.028������������� �Basic� defined.

632.030������������� �Board� defined.

632.033������������� �Charge nurse� defined.

632.037������������� �Clinical nurse specialist� defined.

632.0385����������� �Competence� defined.

632.039������������� �Competency evaluation test� defined.

632.040������������� �Contact hour� defined.

632.045������������� �Continuing education� defined.

632.046������������� �Delegable nursing duty� defined.

632.047������������� �Delegation� defined.

632.0475����������� �Designated facility� defined.

632.048������������� �Direct supervision� defined.

632.049������������� �Direction� defined.

632.053������������� �Focused nursing assessment� defined.

632.057������������� �Graduate nurse� defined.

632.058������������� �Home study� defined.

632.059������������� �Immediate supervision� defined.

632.060������������� �Intravenous therapy� defined.

632.0605����������� �Nurse midwife� defined.

632.061������������� �Nurse practitioner� defined.

632.063������������� �Nursing student� defined.

632.070������������� �Physician� defined.

632.0705����������� �Physician assistant� defined.

632.071������������� �Prescription� defined.

632.076������������� �Qualified� defined.

632.083������������� �Social media� defined.

632.085������������� �Superimpose� defined.

632.087������������� �Supervision� defined.

632.091������������� �To piggyback� defined.

632.096������������� �Trainee� defined.

632.101������������� �Write� and �written� defined.

632.105������������� �In the process of obtaining accreditation� defined for chapter 632 of NRS.

632.110������������� Adoption by reference of Cumulative Index to Nursing and Allied Health Literature; review of revisions.

LICENSING AND CERTIFICATION

632.150������������� Qualifications for license.

632.155������������� Application and examination.

632.160������������� Interim permit.

632.165������������� Procedure for writing examination after initial attempt.

632.166������������� Limitation on taking competency evaluation test.

632.167������������� Application for certification: Submission to Board.

632.168������������� Competency evaluation test: Notification; application.

632.169������������� Competency evaluation test: Failure of one or both components.

632.170������������� Qualifications for license or certificate without examination.

632.173������������� Additional requirements for obtaining license by endorsement.

632.175������������� Temporary license or certificate.

632.180������������� Graduation from program outside United States.

632.185������������� Lapse of application for license or certificate.

632.188������������� Issuance, renewal or denial of license or certificate; notice; hearing.

632.190������������� Fees.

632.192������������� Expiration and renewal of license or certificate.

632.193������������� Renewal of certificate: Requirements; training programs; audits by Board to ensure compliance with certain requirements.

632.200������������� Change of name.

632.205������������� Notification of address for mailing notices.

GENERAL STANDARDS FOR PRACTICE OF NURSING

Advisory Committees

632.211������������� Committees to advise Board on certain matters regarding practice of nursing.

Registered Nurses

632.212������������� Duties included; competency required.

632.214������������� Observation of patients; communication with other providers of health care; allowance for patients� choices.

632.216������������� Care of patients; additional authorized duties.

632.218������������� Maintenance of patients� health.

632.220������������� Medication and treatment of patients; response to orders; adjustment of dosage or frequency of medication.

632.222������������� Delegation and supervision of nursing care.

632.224������������� Supervision of others; duties of chief nurse; determination of authorized scope of practice; verification of competency.

632.225������������� Additional duties in area of specialization.

632.226������������� Employment as school nurse: Duties; delegation of nursing services; requirements for administering medication to pupils.

Practical Nurses

632.228������������� Duties included.

632.230������������� Limitations on performance of tasks; supervision of others.

632.232������������� Focused nursing assessment.

632.234������������� Performance of therapeutic procedures; duties of scrub nurse.

632.236������������� Understanding and verifying orders.

632.238������������� Preparing and administering medication.

632.240������������� Knowledge of community resources; participation concerning policies and procedures of practice.

632.242������������� Additional duties in area of specialization.

Assignment of Duties

632.244������������� Assignment of unauthorized acts prohibited.

632.246������������� Assignment to unauthorized person of duty to administer certain substances prohibited.

632.248������������� Assignment to unlicensed personnel of certain nursing duties prohibited; exception.

Identification

632.249������������� Identification by appropriate title required; identification requirements for telenursing.

632.251������������� Identification of graduate nurses.

Nursing Students

632.252������������� Performance of tasks.

632.253������������� Prohibited acts.

ADVANCED PRACTICE REGISTERED NURSES

632.254������������� Definitions.

632.2543����������� �Population of focus� defined.

632.2547����������� �Role� defined.

632.255������������� Scope of practice.

632.2556����������� Authorization to make certain evaluations, certifications and examinations and to execute a certain petition related to emergency and involuntary admissions of persons to mental health facilities.

632.256������������� Records; system of quality assurance.

632.2563����������� Portfolio: Duty to maintain; required contents.

632.2567����������� Professional liability insurance.

632.257������������� Authorization to issue written prescriptions for controlled substances, poisons, dangerous drugs and devices.

632.258������������� Review of application for authority to prescribe controlled substances, poisons, dangerous drugs or devices.

632.259������������� Controlled substances, poisons, dangerous drugs or devices that may be prescribed.

632.2595����������� License to dispense controlled substances, poisons, dangerous drugs and devices.

632.2597����������� License: Authorization to practice in certain roles; specification of role and population of focus.

632.260������������� License: Qualifications; practice by student.

632.265������������� License: Submission of application and other documents.

632.285������������� Change in role, population of focus or location of practice.

632.290������������� Expiration and renewal of license.

632.291������������� Requirements for renewal of license; continuing education; issuance of temporary license; audits by Board to ensure compliance with certain requirements.

632.292������������� License: Placement on inactive status.

632.293������������� Application to renew practice after period of inactivity or infrequent activity.

632.295������������� Denial, suspension or revocation of license; unprofessional conduct.

CLINICAL NURSE SPECIALISTS

632.300������������� General requirements; recognition as advanced practice registered nurse.

632.305������������� Duties; scope of practice.

632.310������������� Unauthorized use of title.

MEDICATION AIDES - CERTIFIED

632.320������������� Submission of application to employ medication aides - certified; required policies and procedures.

632.325������������� Review and approval of application; resubmission of application; withdrawal of approval.

632.330������������� Authorized duties; prohibited acts; reporting of errors.

CONTINUING EDUCATION

632.340������������� Attestation of compliance; audits of nurses; proof of completion.

632.355������������� Courses: Approval; employment of coordinator; review; audits.

632.400������������� Reinstatement of inactive or delinquent license.

632.415������������� Unprofessional conduct.

VENIPUNCTURE AND INTRAVENOUS THERAPY

632.450������������� Procedures delegable to licensed practical nurses.

632.455������������� Procedures not delegable to licensed practical nurses.

632.460������������� Labeling required on containers.

632.465������������� Course on intravenous therapy: Prerequisites to offering.

632.470������������� Course on intravenous therapy: Place of instruction; faculty.

632.475������������� Subjects and hours required for course on intravenous therapy; evidence of maintenance or improvement of knowledge and skills.

CERTIFIED REGISTERED NURSE ANESTHETISTS

632.500������������� Authorized functions.

632.510������������� Performance of duties in accordance with guidelines of facility.

632.515������������� Qualifications for initial approval.

632.520������������� Requirements if approved in another jurisdiction.

632.530������������� Certificate of recognition: Issuance; restrictions.

632.535������������� Temporary approval to practice.

632.540������������� Certificate of recognition: Expiration and renewal.

632.545������������� Certificate of recognition: Expiration due to lapse in national certification.

632.550������������� Certificate of recognition: Revocation, suspension or denial of issuance or renewal.

AMBULANCE ATTENDANTS

632.565������������� �Attendant� defined.

632.570������������� Certificate of completion of training: Application.

632.575������������� Certificate of completion of training: Renewal.

632.580������������� Submission of certificate of compliance to employer required.

632.590������������� Certificate of completion of training: Verification of issuance by employer required.

PROGRAMS FOR EDUCATION OF NURSES

632.600������������� Definitions.

632.605������������� Submission of application and statement of intent to establish program.

632.610������������� Review of application; inspection of facilities; notice of decision.

632.615������������� Provisional approval: Requirements for application; administrator required to meet with Board before approval.

632.620������������� Provisional approval: Reports to Board.

632.625������������� Full approval: Application; qualifications; bases for granting.

632.630������������� Conditional approval: Identification and correction of deficiencies; proof of compliance with Board�s plan; withdrawal of approval; removal from list of approved programs.

632.633������������� Application to implement innovative educational approaches; guidelines; approval by Board.

632.635������������� Denial, withdrawal and reinstatement of approval program authorized to conduct teach out under certain circumstances.

632.640������������� Requirements for operation; policies and procedures; accreditation required.

632.645������������� Resources and facilities; agreements regarding provision of experience.

632.650������������� Allocation of money for program.

632.655������������� Presence of qualified administrator required.

632.660������������� Administrator: Qualifications.

632.665������������� Administrator: Duties.

632.670������������� Faculty: Licensing required for teaching certain courses; other qualifications required.

632.675������������� Faculty: General requirements.

632.680������������� Students: Admission; policies.

632.685������������� Curriculum; awarding of credits; standardized examination for completion prohibited.

632.690������������� Requirements for instruction; records of evaluation of curriculum.

632.695������������� Substantial revision of curriculum.

632.701������������� Annual reports to Board.

632.703������������� Reports by program which conducts portion of its program in Nevada; visits to determine eligibility for approval; approval required for nontraditional courses of instruction; faculty required to be licensed in Nevada.

632.706������������� Periodic surveys; required reports; objections to report of Board.

632.708������������� Board may deem program as being surveyed in certain circumstances.

632.711������������� Termination of program.

TRAINING PROGRAMS FOR NURSING ASSISTANTS

632.721������������� Application for approval: Form; fee; renewal; evaluation.

632.726������������� Determinations required before approval.

632.731������������� Notice and effect of failure to approve program; limitation on authority of Board.

632.736������������� General requirements.

632.741������������� Required instruction.

632.746������������� Instruction in basic nursing skills.

632.751������������� Instruction in personal care skills.

632.756������������� Instruction in needs of patients concerning mental health and social services.

632.758������������� Instruction in care of cognitively impaired persons.

632.761������������� Instruction in basic restorative services.

632.765������������� Instruction in rights of patients.

632.770������������� Number of instructors required.

632.775������������� Instructors: Qualifications; certificate of approval.

632.780������������� Requirements for classrooms and clinical facilities.

632.785������������� Duties of coordinator of approved program.

632.790������������� Records and reports.

632.795������������� Revision of approved program.

632.800������������� Periodic review; inspection of facilities; bases for continued approval.

632.805������������� Withdrawal of approval.

TRAINING PROGRAMS FOR MEDICATION AIDES - CERTIFIED

632.810������������� Application for approval: Form; fee; renewal; evaluation.

632.815������������� Determinations required before approval.

632.820������������� Notice and effect of failure to approve program.

632.825������������� General requirements.

632.830������������� Required instruction.

632.835������������� Instructors: Number required.

632.840������������� Instructors: Qualifications; certificate of approval.

632.845������������� Requirements for classroom and clinical facilities.

632.850������������� Duties of coordinator of approved program.

632.855������������� Records and reports.

632.860������������� Revision of approved program.

632.865������������� Periodic review; inspection of facilities; bases for continued approval.

632.870������������� Withdrawal of approval.

DISCIPLINARY ACTION AND PRACTICE BEFORE THE BOARD

632.890������������� Unprofessional conduct.

632.895������������� Interpretations for purposes of disciplinary action.

632.901������������� Definitions.

632.910������������� Informal action for certain complaints and controversies; discovery of new evidence.

632.915������������� Executive Director�s response to report of investigation; disciplinary action determined unnecessary; discovery of new evidence.

632.916������������� Complaint and notice of hearing on disciplinary matter; waiver of claim of improper notice.

632.9165����������� Complaint: Amendment; continuance; withdrawal.

632.9175����������� Consolidation of cases.

632.918������������� Hearings: Board not bound by strict rules of procedure; stenographic notes of oral proceedings; record of charges and evidence.

632.9185����������� Hearings: Applicability; deviations from provisions.

632.919������������� Legal representation of respondent; rules of conduct; attorney�s fees.

632.9195����������� Withdrawal of attorney: Notice; denial of request.

632.9205����������� Hearing officer: Duties; authority.

632.921������������� Motions: Subject matter; service; written response.

632.922������������� Request for continuance of formal hearing.

632.923������������� Failure to appear.

632.924������������� Examination of witnesses.

632.925������������� Appearance by interested person.

632.9255����������� Procedure for hearing; transcript of proceedings; burden of proof.

632.926������������� Actions by Board; surrender of license.

632.927������������� Stay of order for revocation or suspension of license or certificate.

632.928������������� Request for reconsideration or rehearing.

632.929������������� Reissuance of license or certificate: Period during which licensee or certificate holder may not apply for reissuance; requirements for reissuance.

632.930������������� Reporting of disciplinary action or denial of application for license or certificate.

632.935������������� Advisory opinion, declaratory order or practice decision.

632.938������������� Issuance of citation for practicing or offering to practice nursing without license; administrative fine; appeal.

632.940������������� Violation of statutes or regulations.

GENERAL PROVISIONS

���� NAC 632.010Definitions. NRS 632.120)As used in this chapter, unless the context otherwise requires, the words and terms defined in NAC 632.015 to 632.101, inclusive, have the meanings ascribed to them in those sections.

���� (Supplied in codification; A by Bd. of Nursing, 3-28-86, eff. 4-3-86; 6-23-88; 8-18-88; 3-26-90; 1-24-92; 3-3-92; 3-4-92; 11-19-93; 11-19-93; 7-7-94; 5-9-96; R140-97, 4-17-98; R211-97, 9-25-98; R122-01, 12-17-2001; R081-06, 6-28-2006; R112-11, 2-15-2012)

���� NAC 632.015�Academic study� defined. (NRS 632.120)�Academic study� means a course provided by an accredited institution of higher learning for quarter or semester credits.

���� [Bd. of Nursing, � II subsec. D par. 14 subpar. a, eff. 12-20-79; A 12-11-81] — (NAC A 2-6-90)

���� NAC 632.020�Advanced practice registered nurse� defined. (NRS 632.120)�Advanced practice registered nurse� means a registered nurse who:

���� 1. Has specialized skill, knowledge and experience obtained from an organized formal program of training; and

���� 2. Is licensed by the Board and is authorized in special conditions as set forth in NAC 632.254 to 632.295, inclusive, to provide designated services in addition to those which a registered nurse is authorized to perform.

���� [Bd. of Nursing, � III subsec. C par. 1 subpar. d, eff. 5-16-79] — (NAC A 3-28-86, eff. 4-3-86; 3-26-90; 11-19-93; R141-97, 1-26-98; R081-06, 6-28-2006; R114-13, 2-26-2014)

���� NAC 632.024�Approved program� defined. (NRS 632.120)�Approved program� means a training program for nursing assistants which complies with the standards established by the Board.

���� (Added to NAC by Bd. of Nursing, eff. 3-26-90)

���� NAC 632.0245�Approved program for medication aides - certified� defined. (NRS 632.120, 632.292)�Approved program for medication aides - certified� means a training program for medication aides - certified that complies with the standards established by the Board.

���� (Added to NAC by Bd. of Nursing by R112-11, eff. 2-15-2012)

���� NAC 632.026�Assessment� defined. (NRS 632.120)�Assessment� means the systematic collection, analysis and interpretation of data that is relevant to the status of the health of a patient to determine the actual or potential needs of the patient regarding health care.

���� (Added to NAC by Bd. of Nursing by R211-97, eff. 9-25-98)

���� NAC 632.028�Basic� defined. (NRS 632.120)�Basic� means elementary processes or activities which are easy to perform.

���� (Added to NAC by Bd. of Nursing, eff. 6-23-88)

���� NAC 632.030�Board� defined. (NRS 632.120)�Board� means the State Board of Nursing.

���� [Bd. of Nursing, � III subsec. C par. 1 subpar. b, eff. 5-16-79; A 8-21-81]

���� NAC 632.033�Charge nurse� defined. (NRS 632.120)�Charge nurse� means a registered nurse who has basic skills in supervision and leadership and has the authority to function as a manager of other nurses.

���� (Added to NAC by Bd. of Nursing, eff. 6-23-88)

���� NAC 632.037�Clinical nurse specialist� defined. (NRS 632.120)�Clinical nurse specialist� means a registered nurse who has a graduate degree in a selected clinical area of nursing.

���� (Added to NAC by Bd. of Nursing, eff. 8-18-88; A by R112-11, 2-15-2012)

���� NAC 632.0385�Competence� defined. (NRS 632.120)�Competence� means the ability to transform skill, knowledge, and performance into appropriate action.

���� (Added to NAC by Bd. of Nursing, eff. 5-9-96)

���� NAC 632.039�Competency evaluation test� defined. (NRS 632.120)�Competency evaluation test� means a system of evaluation which:

���� 1. Complies with federal and state standards;

���� 2. Includes one component consisting of a written or oral examination;

���� 3. Includes one component consisting of a test of manual skills; and

���� 4. Verifies a trainee�s knowledge of and ability to perform the duties of a nursing assistant or medication aide - certified, as applicable.

���� (Added to NAC by Bd. of Nursing, eff. 3-26-90; A by R112-11, 2-15-2012)

���� NAC 632.040�Contact hour� defined. (NRS 632.120)�Contact hour� means 60 minutes of participation in a course of continuing education.

���� [Bd. of Nursing, � II subsec. D par. 14 subpar. b, eff. 12-20-79; A 12-11-81] — (NAC A by R196-07, 4-17-2008)

���� NAC 632.045�Continuing education� defined. (NRS 632.120)�Continuing education� means participation in a learning experience offered in an organized course which is designed to increase or improve a nurse�s knowledge, skill or ability related to the authorized scope of practice of the nurse.

���� [Bd. of Nursing � II subsec. D par. 14 subpar. c, eff. 12-20-79] — (NAC A 8-8-94)

���� NAC 632.046�Delegable nursing duty� defined. (NRS 632.120)�Delegable nursing duty� means a duty which is included in the standard policies and procedures of an agency that employs a nurse and which leads to predictable results in the observation and care of patients.

���� (Added to NAC by Bd. of Nursing, eff. 5-9-96)

���� NAC 632.047�Delegation� defined. (NRS 632.120)�Delegation� means entrusting the performance of a delegable nursing duty to a person who is qualified and competent to perform the duty.

���� (Added to NAC by Bd. of Nursing, eff. 5-9-96)

���� NAC 632.0475 �Designated facility� defined. (NRS 632.120, 632.293)�Designated facility� means:

���� 1. A convalescent home.

���� 2. A facility for long-term care.

���� 3. A rehabilitation facility.

���� 4. A nursing home.

���� (Added to NAC by Bd. of Nursing by R112-11, eff. 2-15-2012)

���� NAC 632.048�Direct supervision� defined. (NRS 632.120)�Direct supervision� means the direction given by a supervisor of nurses who is periodically available at the site where care is provided to a patient or available for immediate guidance.

���� (Added to NAC by Bd. of Nursing, eff. 6-23-88)

���� NAC 632.049�Direction� defined. (NRS 632.120)�Direction� means monitoring and directing the nursing practice of another person, including by means of verbal and written communication.

���� (Added to NAC by Bd. of Nursing, eff. 5-9-96)

���� NAC 632.053�Focused nursing assessment� defined. (NRS 632.120)�Focused nursing assessment� means an appraisal of a patient�s current health status conducted by a licensed practical nurse, for the purpose of inclusion in the management of the patient�s case, that includes, without limitation:

���� 1. Identification of normal and abnormal findings related to the patient�s physical and mental health;

���� 2. Anticipation and recognition of changes or potential changes in the patient�s health status; and

���� 3. An evaluation of whether any information must be communicated to other members of the patient�s health care team and identification of the information to be shared.

���� (Added to NAC by Bd. of Nursing by R091-15, eff. 4-4-2016)

���� NAC 632.057�Graduate nurse� defined. (NRS 632.120)�Graduate nurse� means a person who:

���� 1. Has graduated from a nursing program approved by the Board;

���� 2. Holds an interim permit;

���� 3. Is awaiting the results of the examination for licensure; and

���� 4. Works under the supervision of a registered nurse who is at the site where care is provided.

���� (Added to NAC by Bd. of Nursing, eff. 8-18-88)

���� NAC 632.058�Home study� defined. (NRS 632.120)�Home study� means instruction presented in a format that does not require monitoring by the instructor or provider of continuing education, including, but not limited to, written text, modules, audiotapes, videotapes and computer programs.

���� (Added to NAC by Bd. of Nursing, eff. 3-4-92)

���� NAC 632.059�Immediate supervision� defined. (NRS 632.120)�Immediate supervision� means the direction given by a supervisor of nurses who is physically present at the site where care is provided to a patient and directly observing or assisting in that care.

���� (Added to NAC by Bd. of Nursing, eff. 6-23-88; A by R081-06, 6-28-2006)

���� NAC 632.060 �Intravenous therapy� defined. (NRS 632.120)�Intravenous therapy� means an infusion of fluids through a vein at a regulated rate of flow as prescribed by a licensed physician, a licensed physician assistant, a licensed dentist or a licensed podiatric physician for the purpose of replacing fluid, maintaining fluid balance or adding medications or nutrients.

���� [Bd. of Nursing, � V subsec. A par. 2, eff. 8-21-81] — (NAC A by R112-11, 2-15-2012)

���� NAC 632.0605�Nurse midwife� defined. (NRS 632.120)�Nurse midwife� means a registered professional nurse who has completed an organized formal program of training in the area of pregnancy, childbirth, the postpartum period, care of the newborn, family planning, and the gynecological and primary health needs of women.

���� (Added to NAC by Bd. of Nursing by R081-06, eff. 6-28-2006; A by R196-07, 4-17-2008)

���� NAC 632.061�Nurse practitioner� defined. (NRS 632.120)�Nurse practitioner� means a registered nurse who has completed an organized formal program of training for qualification to practice in a specialized area of nursing.

���� (Added to NAC by Bd. of Nursing by R140-97, eff. 4-17-98)

���� NAC 632.063�Nursing student� defined. (NRS 632.120)�Nursing student� means a person who is:

���� 1. Enrolled in a program of professional nursing or practical nursing at an accredited school of nursing;

���� 2. Taking at least three credits of nursing theory or clinical courses related to nursing in an academic semester; and

���� 3. Continuously progressing toward obtaining a certificate or degree in nursing.

���� (Added to NAC by Bd. of Nursing, eff. 8-18-88; A 6-21-94; R212-99, 5-8-2000)

���� NAC 632.070�Physician� defined. (NRS 632.120)�Physician� means a person who is licensed to practice medicine, including osteopathy, in this State or another state of the United States.

���� [Bd. of Nursing, � III subsec. C par. 1 subpar. e, eff. 5-16-79] — (NAC A 3-3-92)

���� NAC 632.0705�Physician assistant� defined. (NRS 632.120)�Physician assistant� means a person who is licensed as a physician assistant by the Board of Medical Examiners pursuant to chapter 630 of NRS.

���� (Added to NAC by Bd. of Nursing by R122-01, eff. 12-17-2001)

���� NAC 632.071�Prescription� defined. (NRS 632.120)�Prescription� means authorization to administer medications or treatments issued by an advanced practice registered nurse, a licensed physician, a licensed physician assistant, a licensed dentist or a licensed podiatric physician in the form of a written or oral order, a policy or procedure of a facility or a written protocol developed by the prescribing practitioner.

���� (Added to NAC by Bd. of Nursing, eff. 11-19-93; A by R122-01, 12-17-2001)

���� NAC 632.076�Qualified� defined. (NRS 632.120)�Qualified� means that a person possesses the appropriate authorization and training to perform the duties assigned to him or her pursuant to chapter 632 of NRS and this chapter.

���� (Added to NAC by Bd. of Nursing, eff. 5-9-96)

���� NAC 632.083�Social media� defined. (NRS 632.120)�Social media� means any form of electronic communication through which a person can create a community on the Internet to share information, ideas, personal messages and other content.

���� (Added to NAC by Bd. of Nursing by R112-11, eff. 2-15-2012)

���� NAC 632.085�Superimpose� defined. (NRS 632.120)�Superimpose� means to connect a container of fluid to tubing through which intravenous fluid from another container has been administered.

���� [Bd. of Nursing, � V subsec. A par. 3, eff. 8-21-81]

���� NAC 632.087�Supervision� defined. (NRS 632.120)�Supervision� means direction by a qualified nurse for the accomplishment of a nursing task or activity, including initial direction and periodic inspection of the actual accomplishment of the task or activity.

���� (Added to NAC by Bd. of Nursing, eff. 5-9-96)

���� NAC 632.091�To piggyback� defined. (NRS 632.120)�To piggyback� means to connect a secondary intravenous line to the upper or lower Y-port of a primary intravenous line for intermittent or simultaneous drug infusion.

���� (Added to NAC by Bd. of Nursing, eff. 1-24-92)

���� NAC 632.096�Trainee� defined. (NRS 632.120)�Trainee� means a person admitted to an approved program or an approved program for medication aides - certified, as applicable.

���� (Added to NAC by Bd. of Nursing, eff. 3-26-90; A by R112-11, 2-15-2012)

���� NAC 632.101�Write� and �written� defined. (NRS 632.120)�Write� or �written� in reference to an examination means to take the examination by paper and pencil, computer, or any other electronic device the Board deems appropriate.

���� (Added to NAC by Bd. of Nursing, eff. 11-19-93)

���� NAC 632.105�In the process of obtaining accreditation� defined for chapter 632 of NRS. (NRS 632.120)As used in chapter 632 of NRS, the term �in the process of obtaining accreditation� means an approved school of practical nursing or an approved school of professional nursing that has applied for accreditation from a nationally recognized association or an agency authorized by law to accredit such schools which has been approved by the Board.

���� (Added to NAC by Bd. of Nursing by R091-04, eff. 8-13-2004)

���� NAC 632.110Adoption by reference of Cumulative Index to Nursing and Allied Health Literature; review of revisions. (NRS 632.120)

���� 1. The Board hereby adopts by reference the Cumulative Index to Nursing and Allied Health Literature, Volume 50, 2005 Edition. A copy of this publication may be obtained from CINAHL Information Systems, Customer Service Department, 1509 Wilson Terrace, Glendale, California 91206, by telephone at (818) 409-8005, extension 5341, or at the Internet address http://www.cinahl.com/, at a price of $385.

���� 2. If the publication adopted by reference in subsection 1 is revised, the Board will review the revision to determine its suitability for this State. If the Board determines that the revision is not suitable for this State, the Board will hold a public hearing to review its determination and give notice of that hearing within 90 days after the date of the publication of the revision. If, after the hearing, the Board does not revise its determination, the Board will give notice that the revision is not suitable for this State within 90 days after the hearing. If the Board does not give such notice, the revision becomes part of the publication adopted by reference pursuant to subsection 1.

���� (Added to NAC by Bd. of Nursing by R081-06, eff. 6-28-2006)

LICENSING AND CERTIFICATION

���� NAC 632.150Qualifications for license. (NRS 632.120, 632.140, 632.270)

���� 1. In addition to those requirements contained in chapter 632 of NRS, an applicant for a license to practice as a registered nurse must:

���� (a) Have graduated from a nursing program approved by the Board.

���� (b) Have successfully completed courses on the theory of and have clinical experience in medical-surgical nursing, maternal and child nursing and psychiatric nursing if the applicant graduated from an accredited school of professional nursing after January 1, 1952.

���� (c) On or after July 1, 1982, pass the examination for licensure approved by the Board.

���� 2. An applicant for a license to practice as a licensed practical nurse must:

���� (a) Have graduated from high school or passed the general educational development test.

���� (b) Have graduated or received a certificate of completion from a program for registered nurses or practical nurses approved by the Board.

���� (c) Have successfully completed a course of study on the theory of and have clinical practice in medical-surgical nursing, maternal and child health nursing and principles of mental health if the applicant graduated from an accredited school of practical or vocational nursing after January 1, 1952.

���� (d) Pass the examination for licensure approved by the Board.

���� [Bd. of Nursing, part p. 8, eff. 10-11-58; A part p. 3, 7-1-65; A and renumbered as � II subsec. A par. 1, 7-11-69 & � II subsec. A par. 1, 11-26-69; A and renumbered as � II subsec. A par. 1, subpars. a & b, 7-10-75; 12-20-79; 4-20-82] — (NAC A 6-1-88; 7-16-92; 11-19-93; R112-11, 2-15-2012)

���� NAC 632.155Application and examination. (NRS 632.120, 632.140, 632.270, 632.2852)

���� 1. An application must be completed and filed in the office of the Board.

���� 2. The application must be accompanied by:

���� (a) A complete set of the applicant�s fingerprints or two completed fingerprint cards; and

���� (b) The appropriate fee.

���� 3. The candidate must write the first examination within 90 days after receiving authorization from the Board to write the examination.

���� [Bd. of Nursing, part p. 8, eff. 10-11-58; A and renumbered as � II subsec. 1 par. A part subpar. 3 & subpar. 4 & part par. B, 1964; A part p. 3, 7-1-65; + � II subsec. A par. 2 & part par. 4, 11-26-69; A and renumbered as � II subsec. A par. 1 part subpars. a & b & subpar. c, 7-10-75] — (NAC A 6-21-94; R029-97, 1-26-98; R081-06, 6-28-2006; R112-11, 2-15-2012)

���� NAC 632.160Interim permit. (NRS 632.120, 632.305)

���� 1. An interim permit may be issued to the applicant pursuant to NRS 632.305 to practice as a registered nurse or licensed practical nurse under the direct supervision of a registered nurse for not more than 3 months after the date on which the interim permit is issued.

���� 2. If it is determined that satisfactory proof of an applicant�s ability to read, write and speak English as required by NAC 632.180 is not evident, the Board will not issue an interim permit to the applicant.

���� [Bd. of Nursing, � II subsec. 1 par. A subpar. 5, eff. 1964; A p. 1 par. 7, 7-1-65; A and renumbered as � II subsec. A par. 3, 7-11-69 & � II subsec. A par. 3, 11-26-69; A and renumbered as � II subsec. A par. 1 subpar. d, 7-10-75] — (NAC A 9-6-88; R029-97, 1-26-98)

���� NAC 632.165Procedure for writing examination after initial attempt. (NRS 632.120, 632.305)

���� 1. An applicant for licensing as a registered nurse or as a practical nurse may write the examination four times.

���� 2. If the applicant is unsuccessful on the second attempt, before he or she may write the examination for the third time, the applicant must present to the Board a plan of study, acceptable to the Board, for preparation to write the examination.

���� 3. If the applicant is unsuccessful on the third attempt, the applicant must repeat courses in nursing theory in a nursing program approved by the Board before he or she may write the examination for the fourth time.

���� [Bd. of Nursing, � II subsec. 1 part par. B, 1964; A p. 2, 7-1-65; A and renumbered as � II subsec. A part par. 4, 7-11-69 & � II subsec. A part par. 4, 11-26-69; A and renumbered as � II subsec. A par. 1 subpar. e, 7-10-75; A 12-20-79] — (NAC A by R029-97, 1-26-98)

���� NAC 632.166Limitation on taking competency evaluation test. (NRS 632.120, 632.2858, 632.292)Each trainee who graduates from an approved program or an approved program for medication aides - certified may take a competency evaluation test not more than three times.

���� (Added to NAC by Bd. of Nursing, eff. 3-26-90; A 7-16-92; R112-11, 2-15-2012)

���� NAC 632.167 Application for certification: Submission to Board. (NRS 632.120, 632.2852, 632.292)

���� 1. A trainee who receives an application for certification to practice as a nursing assistant or a medication aide - certified must submit to the Board the completed application.

���� 2. The application must be accompanied by:

���� (a) A copy of a certificate or transcript received by the applicant upon the completion of an approved program or an approved program for medication aides - certified, as applicable.

���� (b) The appropriate fee.

���� (c) A complete set of the applicant�s fingerprints or two completed fingerprint cards.

���� (Added to NAC by Bd. of Nursing, eff. 3-26-90; A 11-19-93; 6-21-94; R081-06, 6-28-2006; R112-11, 2-15-2012)

���� NAC 632.168Competency evaluation test: Notification; application. (NRS 632.120, 632.2858)

���� 1. The Board will notify the testing service administering the test of those persons who are eligible to take a competency evaluation test.

���� 2. The applicant must apply to the testing service by the required deadline and submit the appropriate fee.

���� (Added to NAC by Bd. of Nursing, eff. 3-26-90; A 11-19-93; R112-11, 2-15-2012)

���� NAC 632.169Competency evaluation test: Failure of one or both components. (NRS 632.120, 632.2858)

���� 1. A trainee who fails one component of a competency evaluation test is required to retake only that component.

���� 2. A trainee who fails one or both components of a competency evaluation test three times must repeat an approved program. Upon the successful completion of that program, the trainee may reapply to take the competency evaluation test.

���� (Added to NAC by Bd. of Nursing, eff. 3-26-90; A 7-16-92)

���� NAC 632.170Qualifications for license or certificate without examination. (NRS 632.120, 632.140, 632.160, 632.270, 632.280, 632.2852, 632.292)To be licensed without examination:

���� 1. An applicant for a license to practice as a registered nurse must:

���� (a) Have completed a course of study in an accredited school of professional nursing. If the applicant graduated on or after January 1, 1952, he or she must have theory and clinical experience in medical-surgical nursing, maternal and child health nursing, and mental health and psychiatric nursing.

���� (b) Submit to the Board:

��������� (1) A completed application;

��������� (2) A complete set of his or her fingerprints or two completed fingerprint cards; and

��������� (3) The appropriate fee.

���� 2. An applicant for a license to practice as a licensed practical nurse must:

���� (a) Have graduated from high school or passed the general educational development test.

���� (b) Have completed a course of study in an accredited school of practical or vocational nursing. If the applicant graduated on or after January 1, 1952, he or she must have theory and clinical experience in medical-surgical nursing and maternal-child nursing, including mental health concepts.

���� (c) Hold a current license in good standing from another state or country which was issued by a recognized legal agency.

���� (d) Submit to the Board:

��������� (1) A completed application;

��������� (2) A complete set of his or her fingerprints or two completed fingerprint cards; and

��������� (3) The appropriate fee.

���� 3. An applicant for certification to practice as a nursing assistant or a medication aide - certified must:

���� (a) Submit to the Board a completed application accompanied by a complete set of his or her fingerprints or two completed fingerprint cards; and

���� (b) Request and confirm receipt by the Board of verification from the appropriate agency that he or she holds a current certificate to practice as a nursing assistant or a medication aide - certified, as applicable.

���� [Bd. of Nursing, part p. 1, eff. 10-4-63; A pp. 1 & 2, 7-1-65; A and numbered as � II subsec. B par. 1, 7-11-69 & � II subsec. B par. 1, 11-26-69; A 7-10-75; 12-20-79] — (NAC A 3-26-90; 7-16-92; 11-19-93; 6-21-94; R029-97, 1-26-98; R081-06, 6-28-2006; R196-07, 4-17-2008; R112-11, 2-15-2012)

���� NAC 632.173Additional requirements for obtaining license by endorsement. (NRS 632.120, 632.160, 632.280)In addition to complying with the requirements set forth in NAC 632.170, any person who has not practiced within the immediately preceding 5 years, but who has passed an examination in another jurisdiction, and wishes to obtain a license by endorsement must submit proof to the Board that:

���� 1. The person has passed the National Council Licensure Examination within the immediately preceding 5 years; or

���� 2. The person has successfully completed a review course within the immediately preceding 5 years which has been approved by the Board.

���� (Added to NAC by Bd. of Nursing, eff. 6-21-94; A by R112-11, 2-15-2012)

���� NAC 632.175Temporary license or certificate. (NRS 632.120, 632.292, 632.300, 632.341)

���� 1. A temporary license or certificate may be issued upon application for a period of 6 months.

���� 2. A nurse, nursing assistant or medication aide - certified seeking renewal of his or her license or certificate may be issued a temporary license or certificate if the nurse, nursing assistant or medication aide - certified needs additional time to provide the Board with evidence that he or she is of good moral character and is free from physical or mental disability which would impair or interfere with his or her ability to perform in his or her area of practice safely and competently.

���� 3. If it is determined that satisfactory proof of an applicant�s ability to read, write and speak English as required by NAC 632.180 is not evident, no temporary license or certificate will be issued.

���� [Bd. of Nursing, part p. 2, eff. 7-1-65; A and numbered as � II subsec. B par. 2, 7-11-69 & � II subsec. B par. 3, 11-26-69; A and renumbered as � II subsec. B par. 2, 7-10-75] — (NAC A 6-23-88; 9-6-88; 5-9-96; R081-06, 6-28-2006; R112-11, 2-15-2012)

���� NAC 632.180Graduation from program outside United States. (NRS 632.120, 632.140, 632.160, 632.270, 632.280)

���� 1. After an application for a license is filed by a graduate of a program outside of the United States who holds a license from another jurisdiction in the United States, the applicant�s credentials will be reviewed by the Board and eligibility for licensure established. Translations must be paid for by the applicant. The ability to read, write and speak English must be shown by proof that the applicant has satisfactorily passed:

���� (a) The State Board Test Pool Examination;

���� (b) The National Council Licensing Examination;

���� (c) The examination given by the Commission on Graduates of Foreign Nursing Schools; or

���� (d) Another test of competency in English acceptable to the Board.

���� 2. All graduates of programs in professional nursing outside of the United States who graduated on or after January 1, 1952, must have completed courses of study in the theory and clinical practice in medical nursing, surgical nursing, obstetric nursing, nursing of children and psychiatric nursing and must pass a licensing test in each of these areas. Deficiencies may be removed by participation in an accredited program in nursing or as determined by the Board.

���� 3. All graduates of programs in practical nursing outside of the United States who graduated on or after January 1, 1952, must have completed courses of study in the theory and clinical practice in medical nursing, surgical nursing, obstetric nursing, nursing of children and principles of mental health. Deficiencies may be removed by participation in an accredited program in nursing or as determined by the Board.

���� [Bd. of Nursing, part p. 1, eff. 10-4-63; A part p. 2, 7-1-65; A and numbered as � II subsec. C, 7-11-69 & � II subsec. C, 11-26-69; A 7-10-75; 12-20-79] — (NAC A 8-5-86; 9-6-88; 7-7-94)

���� NAC 632.185Lapse of application for license or certificate. (NRS 632.120)An application for a permanent license or certificate which is not completed within 1 year automatically lapses and the fees are forfeited.

���� [Bd. of Nursing, part p. 2, eff. 7-1-65; A and numbered as � II subsec. B par. 3, 7-11-69 & � II subsec. B par. 4, 11-26-69; A and renumbered as � II subsec. B par. 3, 7-10-75] — (NAC A 3-26-90)

���� NAC 632.188Issuance, renewal or denial of license or certificate; notice; hearing. (NRS 632.120)

���� 1. A member of the Board�s staff will issue a license or certificate or renew a license or certificate based on the criteria determined by the Board. Any member of the Board�s staff may submit a candidate�s credentials to the Board to determine the candidate�s eligibility for a license or certificate or renewal of a license or certificate. The applicant must demonstrate that his or her qualifications satisfy the criteria of the Board.

���� 2. If an applicant fails to demonstrate that his or her qualifications satisfy the criteria for licensure or certification, the Board may deny the application. A member of the Board�s staff will give any applicant for a license or certificate whose application is denied written notice stating:

���� (a) That the applicant has failed to qualify to be examined, licensed, or certificated;

���� (b) The reason for disqualification; and

���� (c) That the applicant may appeal the denial to the Board.

���� 3. A hearing will be granted to an applicant who, within 30 days after the notice required in subsection 2 is mailed to him or her, requests a hearing in a certified letter addressed to the Board.

���� 4. When a license or certificate is not renewed by a member of the Board�s staff, the licensee or holder of the certificate may appeal to the Board in writing within 30 days and request a hearing at the next regularly scheduled meeting of the Board.

���� [Bd. of Nursing, � II subsec. D par. 9, eff. 12-20-79; A and renumbered as � II subsec. D par. 10, 12-11-81] — (NAC A 8-5-86; 6-21-94; 5-9-96)

���� NAC 632.190Fees. (NRS 632.120, 632.345)The following fees are established:

���� [Bd. of Nursing, � II subsec. 1 par. A part subpar. 3, eff. 1964; A part p. 3, 7-1-65; A and renumbered as � II subsec. A part par. 4, 7-11-69 & � II subsec. A part par. 4, 11-26-69; A and renumbered as � II subsec. A par. 2, 7-10-75; A 7-26-77; 12-20-79; 4-20-82; + part p. 3, eff. 7-1-65; A and renumbered as � II subsec. D part par. 1, 7-11-69 & � II subsec. D part par. 1, 11-26-69; A 7-10-75; 7-26-77; 12-20-79] — (NAC A 12-14-83; 2-6-90; 3-26-90; 12-17-91; 1-24-92; 7-16-92; 11-19-93; R051-03, 10-30-2003; R196-07, 4-17-2008; R112-11, 2-15-2012; R114-13, 2-26-2014)

���� NAC 632.192Expiration and renewal of license or certificate. (NRS 632.120, 632.341, 632.342)

���� 1. Each licensee or holder of a certificate who wishes to renew his or her license or certificate must submit an application for renewal of the license or certificate to the Board before the expiration of the license or certificate. The application for renewal must be received by the Board on or before the end of the business day on which the authorization to practice expires.

���� 2. The Board will find that the licensee or holder of the certificate has made sufficient application for renewal of the authorization to practice and will renew that person�s license or certificate if:

���� (a) The application for renewal is:

��������� (1) Truthful, accurate and complete, and made on the form supplied by the Board.

��������� (2) Accompanied by payment of the required fee. If the fee is paid in a form other than cash, it must be made on an account with a sufficient amount of money for payment of the instrument or by a valid debit or credit card.

��������� (3) Accompanied by proof that the requirement of continuing education is met.

��������� (4) Accompanied by a complete set of the applicant�s fingerprints or two completed fingerprint cards, if so required by the Board.

��������� (5) Accompanied by proof that the licensee has satisfied the requirements of subsection 4, if the application is for renewal of a license and the licensee has not practiced nursing during the immediately preceding 5-year period.

��������� (6) Accompanied by the attestation required pursuant to NAC 632.193, if the application is for the renewal of a certificate to practice as a nursing assistant or medication aide - certified.

���� (b) The applicant attests that he or she committed no act which could subject his or her application to denial nor developed any condition which may interfere with his or her ability to practice in a safe and effective manner.

���� 3. If an application does not meet the requirements of subsection 2, the staff of the Board will not renew the license or certificate. If the applicant makes an application to appear before the Board, the staff may issue a temporary license or certificate which remains valid for not more than 6 months after the date on which the temporary license or certificate was issued. If the license or certificate is not renewed because the applicant paid the required fee with an instrument written on an account with an insufficient amount of money for payment of the instrument, the staff may require the payment of a late fee and a fee to cover the administrative cost of handling the instrument.

���� 4. An applicant for renewal of a license who has not practiced nursing during the immediately preceding 5-year period must complete a course or program approved by the Board if the applicant has otherwise satisfied the requirements for renewal set forth in this chapter and chapter 632 of NRS. The Board may issue to the applicant a temporary license for not more than 6 months after the date on which it was issued for the sole purpose of completing the course or program in which the applicant is enrolled. Upon submission of evidence of completion of the course or program, the Board will issue to the applicant a permanent license if he or she has satisfied the requirements of subsection 2.

���� 5. An original license or certificate is valid for the period from the date of issuance to the licensee�s or certificate holder�s second birthday after issuance. Thereafter, each license or certificate will expire biennially on the licensee�s or certificate holder�s birthday. In a leap year the license or certificate of a licensee or certificate holder born on February 29 expires on February 28.

���� (Added to NAC by Bd. of Nursing, eff. 11-19-85; A 11-2-87; 2-6-90; 11-19-93; 6-21-94; 6-26-96; R029-97, 1-26-98; R073-98, 6-26-98, eff. 1-1-99; R081-06, 6-28-2006; R002-10, 8-13-2010; R112-11, 2-15-2012)

���� NAC 632.193Renewal of certificate: Requirements; training programs; audits by Board to ensure compliance with certain requirements. (NRS 632.120, 632.292, 632.342)

���� 1. To renew his or her certificate, a nursing assistant must submit to the Board an attestation, on a form provided by the Board, attesting that he or she has completed:

���� (a) Twenty-four hours of continuing training in the immediately preceding 2 years; and

���� (b) At least 40 hours of employment as a nursing assistant under the direct supervision of a registered nurse or licensed practical nurse during the 2 years immediately preceding the date of the renewal of the certificate.

���� 2. To renew his or her certificate, a medication aide - certified must submit to the Board an attestation, on a form provided by the Board, attesting that he or she has completed:

���� (a) Twenty-four hours of continuing training in the immediately preceding 2 years; and

���� (b) At least 200 hours of employment as a medication aide - certified under the direct supervision of an advanced practice registered nurse or a registered nurse during the 2 years immediately preceding the date of the renewal of the certificate.

���� 3. The certificate of completion must include:

���� (a) The name of the participant;

���� (b) The name of the training program;

���� (c) The number of hours of the training program;

���� (d) The name and signature of the instructor who taught the training program; and

���� (e) The date and location of the training program.

���� 4. To be satisfactory to the Board a training program must relate to standards of care in nursing and must consist of one of the following:

���� (a) Training in the facility in which the nursing assistant or medication aide - certified works;

���� (b) An academic study or all of the courses required to obtain a license to practice as a registered nurse or a licensed practical nurse, if a nursing assistant or medication aide - certified is pursuing such a license, or both;

���� (c) A workshop conducted by a provider of continuing education that has been approved by the Board; or

���� (d) An online course for nursing assistants or medication aides - certified, as applicable.

���� 5. A medical facility, educational institution or other organization that offers a training program must keep a record of the information required pursuant to subsection 3 for at least 4 years.

���� 6. The Board will perform random audits of nursing assistants or medication aides - certified for compliance with the requirement for supervised employment set forth in paragraph (b) of subsection 1 or paragraph (b) of subsection 2, as applicable. If audited by the Board, a nursing assistant or medication aide - certified must prove that he or she has complied with the requirement for supervised employment set forth in paragraph (b) of subsection 1 or paragraph (b) of subsection 2, as applicable, by submitting to the Board a letter written by the employer of the nursing assistant or medication aide - certified on the stationery of the employer or on a form prescribed by the Board and must include in the letter or on the form:

���� (a) The name of the nursing assistant or medication aide - certified;

���� (b) The name of the employer;

���� (c) A statement indicating that, since his or her last renewal by the Board, the:

��������� (1) Nursing assistant provided at least 40 hours of nursing services or services related to the scope of practice of a nursing assistant for monetary compensation under the direct supervision of a registered nurse or licensed practical nurse; or

��������� (2) Medication aide - certified provided at least 200 hours of nursing services or services related to the scope of practice of a medication aide - certified for monetary compensation under the direct supervision of an advanced practice registered nurse or a registered nurse; and

���� (d) Any other information the Board may require for the renewal of the certificate.

���� (Added to NAC by Bd. of Nursing, eff. 3-4-92; A 11-19-93; R073-98, 6-26-98, eff. 1-1-99; R196-07, 4-17-2008; R112-11, 2-15-2012)

���� NAC 632.200Change of name. (NRS 632.120)The name of a registered nurse, certified nursing assistant, medication aide - certified or an applicant for registration will be changed on the records of the Board if the request is made on a form provided by the Board giving the required information.

���� [Bd. of Nursing, � II subsec. F, eff. 7-11-69 & � II subsec. F, eff. 11-26-69; A 7-10-75] — (NAC A 3-26-90; R112-11, 2-15-2012)

���� NAC 632.205Notification of address for mailing notices. (NRS 632.120)

���� 1. Each licensee or holder of a certificate shall file with the Board his or her current residential address.

���� 2. A licensee or holder of a certificate shall notify the Board of any change in his or her residential address within 30 days after the change.

���� 3. If the Board is required by law or the provisions of this chapter to deliver any notice by mail to a licensee or holder of a certificate, the notice shall be deemed validly given if it is mailed to the last address of the licensee or holder of a certificate which was filed with the Board.

���� (Added to NAC by Bd. of Nursing, eff. 2-6-90)

GENERAL STANDARDS FOR PRACTICE OF NURSING

Advisory Committees

���� NAC 632.211Committees to advise Board on certain matters regarding practice of nursing. (NRS 632.073, 632.120)

���� 1. The Board will appoint a committee to advise and report to the Board on matters related to the establishment of a scope of practice for nursing in this State. The committee will consist of at least 10 persons who are knowledgeable in all areas of general nursing practice in Nevada and trends in national nursing practice, and a member of the Board�s staff, who shall serve as chair of the committee.

���� 2. The Board will appoint a committee, consisting of at least seven persons, to advise and report to the Board on matters related to this chapter and chapter 632 of NRS as they relate to licensees and holders of certificates maintaining competency through:

���� (a) Academic education, including continuing education; and

���� (b) Acquisition of new knowledge, skills and abilities.

���� 3. The Board will appoint a committee to advise and report to the Board on matters related to the practice of advanced practice registered nurses. The committee will consist of not more than 10 persons who are knowledgeable in areas concerning the practice of advanced practice registered nurses.

���� 4. The Board will appoint a committee to advise and report to the Board on matters related to the practice of licensed practical nurses. The committee will consist of at least five persons who are knowledgeable in areas concerning the practice of licensed practical nurses.

���� 5. The Board will appoint a committee, consisting of at least six persons who are knowledgeable concerning any condition, diagnosis or addiction that may affect the safe practice of nursing, to advise and report to the Board on matters related to the protection of the public through the safe practice of nursing by any person who:

���� (a) Has previously practiced nursing while, with or without good cause, the person�s physical, mental or emotional condition has impaired his or her ability to act in a manner consistent with the established or customary standards of nursing; or

���� (b) Is participating in the Alternative Program for Chemically Dependent Nurses established by the Board to serve as an alternative to disciplinary action for persons who are licensed or certified pursuant to the provisions of this chapter or chapter 632 of NRS and have a substance use disorder.

���� 6. Each person appointed to a committee pursuant to this section, other than a member of the Board or the Board�s staff, serves as a volunteer.

���� (Added to NAC by Bd. of Nursing, eff. 11-19-93; A 5-9-96; R029-97, 1-26-98; R112-11, 2-15-2012; R125-17, 2-27-2018)

Registered Nurses

���� NAC 632.212Duties included; competency required. (NRS 632.120)

���� 1. The Board will interpret the practice of professional nursing to include, but not be limited to, the duties specified in NAC 632.214 to 632.224, inclusive.

���� 2. A registered nurse shall demonstrate in the performance of those duties competence in:

���� (a) The diagnosis and treatment of human responses to actual or potential health problems;

���� (b) Synthesizing the biological, psychological and social aspects of the patient�s condition;

���� (c) Exercising sound judgment;

���� (d) Making decisions;

���� (e) Carrying out his or her duties based on an established plan of care;

���� (f) Evaluating, assessing and altering, if appropriate, the established plan of care;

���� (g) Delegating appropriate duties to other persons;

���� (h) Supervising a person to whom the registered nurse has delegated nursing duties;

���� (i) Maintaining accountability in the delegation of care;

���� (j) Administering medication and carrying out treatments which are properly authorized;

���� (k) Determining the necessity and appropriateness of health care services for a patient or prospective patient and determining that patient�s eligibility for payment of those health care services by a licensed insurer;

���� (l) Managing the cases of patients assigned to him or her by coordinating services and collaborating with other health care professionals in the provision of health care services, including, without limitation, an ongoing evaluation of the patient�s focused nursing assessments conducted by a licensed practical nurse pursuant to NAC 632.232;

���� (m) Planning for the discharge of patients; and

���� (n) Managing risk in the provision of health care services.

���� (Added to NAC by Bd. of Nursing, eff. 11-2-87; A 6-26-96; R112-11, 2-15-2012; R091-15, 4-4-2016)

���� NAC 632.214Observation of patients; communication with other providers of health care; allowance for patients� choices. (NRS 632.120)A registered nurse shall:

���� 1. Perform or supervise the direct observation of patients under his or her care;

���� 2. Ensure the effectiveness, use and maintenance of procedures used to communicate to other providers of health care a patient�s symptoms, reactions and progress; and

���� 3. Recognize, understand and allow for a patient�s choice regarding his or her psychological, biological, social and cultural needs and religious beliefs.

���� (Added to NAC by Bd. of Nursing, eff. 11-2-87)

���� NAC 632.216Care of patients; additional authorized duties. (NRS 632.120)

���� 1. A registered nurse shall perform or supervise:

���� (a) The assessment and evaluation of the health of each patient under the care of the registered nurse based on his or her knowledge or understanding of the biological, psychological, social and cultural factors affecting the patient�s condition;

���� (b) The development of a written plan for the care of each patient under the care of the registered nurse based on the present and predicted needs of the patient, and shall review and revise that plan if necessary;

���� (c) The evaluation of a patient�s health and the initiation of acts which are necessary to provide adequate care to a patient when needed, giving direct care to a patient, assisting with the care of the patient or delegating the care of the patient to persons qualified to provide that care;

���� (d) Making judgments and decisions regarding the status of a patient and the planning, carrying out, evaluation, and modification of the patient�s care as needed;

���� (e) The documentation of observations, assessments and responses of patients and the care provided to those patients; and

���� (f) In situations which threaten the life of a patient, acts which are necessary to stabilize the patient�s condition and prevent more serious complications, performed pursuant to an established policy.

���� 2. A registered nurse may perform:

���� (a) The duties of a circulating nurse or surgical first assistant in an operating room; and

���� (b) Uncomplicated deliveries of infants if:

��������� (1) The registered nurse is an advanced practice registered nurse; and

��������� (2) The delivery is performed under the direction of a physician.

���� (Added to NAC by Bd. of Nursing, eff. 11-2-87; A by R112-11, 2-15-2012)

���� NAC 632.218Maintenance of patients� health. (NRS 632.120)A registered nurse shall perform or supervise:

���� 1. The identification of the immediate and long-term goals for the care of patients under his or her care;

���� 2. The assessment of the need for and the provision of health education and counseling of a patient under the care of the registered nurse based on the needs of the patient, involving the patient and his or her family and friends, so that the patient may better understand the immediate and long-term goals for his or her care;

���� 3. The recognition of the various psychological and social needs of the patients;

���� 4. The provision and encouragement of an environment conducive to the safety and health of patients;

���� 5. The collaboration with other providers of health care to provide safe care for the patient; and

���� 6. The use of resources in the community to continue the proper care of a patient after the patient leaves the care of the registered nurse.

���� (Added to NAC by Bd. of Nursing, eff. 11-2-87)

���� NAC 632.220Medication and treatment of patients; response to orders; adjustment of dosage or frequency of medication. (NRS 632.120)

���� 1. A registered nurse shall perform or supervise:

���� (a) The verification of an order given for the care of a patient to ensure that it is appropriate and properly authorized and that there are no documented contraindications in carrying out the order;

���� (b) Any act necessary to understand the purpose and effect of medications and treatments and to ensure the competence of the person to whom the administration of medications is delegated; and

���� (c) The initiation of intravenous therapy and the administration of intravenous medication.

���� 2. A registered nurse shall take orders only from a licensed physician, physician assistant, dentist, podiatric physician or advanced practice registered nurse. A registered nurse may refuse an order if he or she takes appropriate action to ensure the safety of a patient.

���� 3. If a prescription specifies a range of the dosage or frequency for the administration of a medication, a registered nurse may adjust the dosage or frequency of the medication within that range when he or she administers the medication to a patient.

���� (Added to NAC by Bd. of Nursing, eff. 11-2-87; A by R070-00, 6-20-2000; R122-01, 12-17-2001)

���� NAC 632.222Delegation and supervision of nursing care. (NRS 632.120)

���� 1. A registered nurse may delegate nursing care to other personnel and supervise other personnel in the provision of that care if those persons are qualified to provide that care.

���� 2. A registered nurse shall perform or supervise any act necessary to ensure the quality and sufficiency of delegated nursing care provided to a patient.

���� 3. Before delegating the care of a patient, a registered nurse shall consider the following:

���� (a) The amount of direction required by the person to whom the care is being delegated;

���� (b) The complexity of the nursing care needed by the patient, recognizing that simple care may be performed by following an established policy while more complex care requires greater knowledge and a higher level of judgment, direction and supervision;

���� (c) The educational preparation and demonstrated competency of the person to whom the care is delegated; and

���� (d) The established policies and procedures relating to the care of the patient and the procedures used to communicate to other providers of health care the patient�s symptoms, reactions and progress.

���� 4. A registered nurse who delegates nursing care or duties relating to that care to other personnel is responsible for the actions taken by those persons in carrying out the duties delegated or assigned.

���� (Added to NAC by Bd. of Nursing, eff. 11-2-87; A by R112-11, 2-15-2012)

���� NAC 632.224Supervision of others; duties of chief nurse; determination of authorized scope of practice; verification of competency. (NRS 632.120)

���� 1. A registered nurse who supervises other persons shall:

���� (a) Determine the priority of the needs of each patient and group of patients under his or her care;

���� (b) Provide direction in formulating, interpreting and carrying out the objectives and policies related to nursing care;

���� (c) Assist those persons who are being supervised to develop the skills needed for their competence in providing for the care of a patient;

���� (d) Assist the persons who are being supervised in carrying out the planned care of a patient; and

���� (e) Evaluate the effectiveness of the nursing care given to each patient or group of patients under his or her care.

���� 2. A registered nurse who is employed as a chief nurse is responsible for the management of other personnel under his or her supervision and shall:

���� (a) Establish the authorized scope of practice for the personnel he or she supervises and establish and document a process to carry out, maintain and improve the knowledge, skills and ability of those persons to provide safe and effective care.

���� (b) Before assigning those persons, verify their ability to carry out safely duties which are identified in a written policy and to follow the procedures established by the employing agency.

���� (c) Establish written guidelines to be followed by personnel under his or her supervision for receiving and administering prescriptions. The guidelines must include procedures for:

��������� (1) Identifying the type of patient to be served;

��������� (2) Identifying the intended medical treatment; and

��������� (3) Resolving any questions related to a prescription,

� if the prescription is not received directly from an advanced practice registered nurse, a licensed physician, a licensed physician assistant, a licensed dentist or a licensed podiatric physician.

���� (d) Ensure that the guidelines established pursuant to paragraph (c) are available at each site where nursing care is provided under the supervision of the chief nurse.

���� (e) Create a safe and effective system for delivery of nursing care which complies with nationally recognized standards.

���� (f) Maintain a list of the references used to determine the authorized scope of practice for the personnel he or she supervises and make them available to governmental agencies upon request.

���� 3. If a chief nurse is not assigned to the practice area of a registered nurse, the registered nurse must determine the authorized scope of his or her practice and establish and document verification of his or her competency.

���� (Added to NAC by Bd. of Nursing, eff. 11-2-87; A 11-19-93; 6-21-94; R122-01, 12-17-2001; R112-11, 2-15-2012)

���� NAC 632.225Additional duties in area of specialization. (NRS 632.120)

���� 1. A registered nurse may perform a skill, assessment, intervention or other duty in addition to those taught in a basic educational program for a professional nurse if:

���� (a) The performance of the skill, assessment, intervention or other duty is within the authorized scope of practice of a registered nurse in this State.

���� (b) In performing the skill, assessment, intervention or other duty the registered nurse follows the applicable written procedures and policies approved by the medical staff, the nursing administration and the administration of the employing agency.

���� (c) Before performing the skill, assessment, intervention or other duty the registered nurse submits to his or her employer proof that he or she:

��������� (1) Has completed a comprehensive program of study and supervised clinical practice which was approved by the Board on or after January 1, 1986;

��������� (2) Has completed a comprehensive program of study and supervised clinical practice from another state;

��������� (3) Maintains certification from a national organization recognized by the Board for this purpose; or

��������� (4) Has acquired the additional knowledge, skill and ability.

���� 2. The registered nurse and his or her employer shall each maintain evidence of:

���� (a) The original documentation and demonstration of the acquired knowledge, skill and ability; and

���� (b) Annual verification of the registered nurse�s continued competency regarding that knowledge, skill and ability through recertification or records of evaluations documenting satisfactory repeated performances of the knowledge, skill and ability in the nurse�s area of practice.

���� 3. For the purposes of paragraph (a) of subsection 1, a skill, assessment, intervention or other duty is within the authorized scope of practice of a registered nurse if it has been described as being performed by a registered nurse in two or more national nursing publications, national nursing practice guidelines or national standards for nursing practice, or any combination thereof, which:

���� (a) Are listed in the annual Cumulative Index to Nursing and Allied Health Literature that was most recently approved by the Board; or

���� (b) Have been individually approved by the Board.

���� (Added to NAC by Bd. of Nursing, eff. 3-17-86; A 6-1-88; 2-6-90; 7-16-92; 5-18-94; 9-9-94; R112-11, 2-15-2012)

���� NAC 632.226Employment as school nurse: Duties; delegation of nursing services; requirements for administering medication to pupils. (NRS 632.120)

���� 1. A school nurse who is a registered nurse shall direct and provide school nursing services.

���� 2. In carrying out a plan of nursing care for a pupil with special needs pursuant to NRS 391.292, a school nurse who is a registered nurse may delegate nursing services to a qualified person.

���� 3. A school nurse may delegate only those duties that the Board has approved. The Board will maintain a list of the duties it has approved for delegation and provide a copy of the list to a school nurse or member of the general public upon request.

���� 4. A licensed practical nurse who is employed by a school district to provide nursing services in a school may not delegate nursing services or assign duties relating to such services to another person.

���� 5. A school nurse shall develop safe and effective procedures for the administration of medication to pupils that comply with nationally recognized standards and the laws of this State.

���� 6. A school nurse may not administer medication to a pupil or delegate that duty to another person unless:

���� (a) The school nurse has obtained written authorization from the parent or legal guardian of the pupil to administer the medication;

���� (b) The medication is labeled; and

���� (c) The school nurse verifies that the medication has been prescribed and dispensed by a person authorized to do so pursuant to chapter 453, 454 or 639 of NRS or the laws of another state or the District of Columbia.

���� 7. A record of the medication administered to a pupil must be maintained at the school the pupil attends. Each time the school nurse or the person to whom he or she delegated the duty administers medication to the pupil, it must be indicated in the record.

���� 8. As used in this section:

���� (a) �Qualified person� means a person who is:

��������� (1) Certified or licensed by this State to provide nursing services to a pupil;

��������� (2) Willing to provide nursing services to a pupil and who the school nurse has determined has the knowledge and skill to provide the nursing services to the pupil in a safe and effective manner; or

��������� (3) Except as otherwise provided in this subparagraph, exempt from the requirement of obtaining a license to practice nursing pursuant to subsection 1 of NRS 632.316 and whom the parent or legal guardian of the pupil designates as a person who may provide nursing services to the pupil. A parent or legal guardian may not designate a person who is employed by the school district in which the pupil attends school as a person who may provide nursing services to the pupil.

���� (b) �School nurse� means a licensee who is qualified as set forth in subsection 2 of NRS 391.291 and the regulations adopted pursuant thereto as a school nurse and who is serving in that capacity.

���� (Added to NAC by Bd. of Nursing by R071-00, eff. 10-20-2000; A by R002-10, 8-13-2010; R112-11, 2-15-2012)

Practical Nurses

���� NAC 632.228Duties included. (NRS 632.120)The Board will interpret the practice of practical nursing to include, but not be limited to, those duties and acts specified in NAC 632.230 to 632.242, inclusive.

���� (Added to NAC by Bd. of Nursing, eff. 11-2-87)

���� NAC 632.230Limitations on performance of tasks; supervision of others. (NRS 632.120)A licensed practical nurse:

���� 1. May not independently carry out those duties which require the substantial judgment, knowledge and skill of a registered nurse.

���� 2. Shall determine before the performance of any task that he or she has the knowledge, skill and experience to perform the task competently.

���� 3. May supervise other personnel in the provision of care.

���� (Added to NAC by Bd. of Nursing, eff. 11-2-87; A by R112-11, 2-15-2012)

���� NAC 632.232Focused nursing assessment. (NRS 632.120)A licensed practical nurse shall contribute to the plan of care established for a patient by recording and reporting to the appropriate person his or her observations by conducting a focused nursing assessment.

���� (Added to NAC by Bd. of Nursing, eff. 11-2-87; A by R029-97, 1-26-98; R091-15, 4-4-2016)

���� NAC 632.234Performance of therapeutic procedures; duties of scrub nurse. (NRS 632.120)

���� 1. A licensed practical nurse shall assist in carrying out therapeutic procedures which provide for the emotional and physical comfort of the patient, including, but not limited to:

���� (a) Assisting the patient with activities of daily living and encouraging the patient to do those activities without help where appropriate;

���� (b) Contributing to the provision of an environment conducive to the safety and health of patients;

���� (c) Recognizing, understanding and allowing for a patient�s choices regarding his or her psychological, biological, social and cultural needs and religious beliefs;

���� (d) Assisting a patient to maintain present levels of functioning;

���� (e) Assisting with the education of a patient concerning his or her medical condition;

���� (f) Initiating standard procedures in emergencies and continuing to perform those procedures until a licensed registered nurse, advanced practice registered nurse, physician, physician assistant, dentist or podiatric physician is available;

���� (g) Clarifying with his or her supervisor which situations require a greater degree of direction and supervision than is being provided; and

���� (h) Carrying out other duties which are included in a curriculum for practical nurses approved by the Board.

���� 2. A licensed practical nurse with proper training may carry out the duties of a scrub nurse.

���� (Added to NAC by Bd. of Nursing, eff. 11-2-87; A by R122-01, 12-17-2001)

���� NAC 632.236Understanding and verifying orders. (NRS 632.120)Before carrying out an order, a licensed practical nurse must:

���� 1. Understand the reason for the order;

���� 2. Verify that the order is appropriate; and

���� 3. Verify that there are no documented contraindications in carrying out the order.

���� (Added to NAC by Bd. of Nursing, eff. 11-2-87)

���� NAC 632.238Preparing and administering medication. (NRS 632.120)A licensed practical nurse may:

���� 1. Prepare the required dosage of a medication; and

���� 2. Except as otherwise provided in NAC 632.455, administer medication.

���� (Added to NAC by Bd. of Nursing, eff. 11-2-87)

���� NAC 632.240Knowledge of community resources; participation concerning policies and procedures of practice. (NRS 632.120)A licensed practical nurse shall:

���� 1. Have the knowledge of the resources in the community which are available to continue proper care of a patient after the patient has left a medical facility; and

���� 2. Participate in developing, revising and carrying out policies and procedures for the practice of practical nursing.

���� (Added to NAC by Bd. of Nursing, eff. 11-2-87)

���� NAC 632.242Additional duties in area of specialization. (NRS 632.120)

���� 1. A licensed practical nurse may collect data and perform a skill, intervention or other duty in addition to those taught in an educational program for practical nurses if:

���� (a) The collection of data or performance of the additional skill, intervention or other duty is within the authorized scope of practice of a licensed practical nurse in this State.

���� (b) In collecting data and performing the additional skill, intervention or other duty, the licensed practical nurse follows the applicable written procedures and policies approved by the medical staff, the nursing administration and the administration of the employing agency.

���� (c) Before collecting data or performing the skill, intervention or other duty, the licensed practical nurse submits to his or her employer proof that he or she:

��������� (1) Has completed a comprehensive program of study and supervised clinical practice which was approved by the Board on or after January 1, 1986;

��������� (2) Has completed a comprehensive program of study and supervised clinical practice from another state; or

��������� (3) Has acquired the additional knowledge, skill and ability.

���� 2. The licensed practical nurse and his or her employer shall each maintain evidence of:

���� (a) The original documentation and demonstration of the acquired knowledge, skill and ability; and

���� (b) Annual verification of the nurse�s continued competency regarding that knowledge, skill and ability through recertification or records of evaluations documenting satisfactory repeated performances of the knowledge, skill and ability in the nurse�s area of practice.

���� 3. For the purposes of paragraph (a) of subsection 1, collection of data and a skill, intervention or other duty is within the authorized scope of practice of a licensed practical nurse if it has been described as being performed by a licensed practical nurse in two or more national nursing publications, national nursing practice guidelines or national standards for nursing practice, or any combination thereof, which:

���� (a) Are listed in the Cumulative Index to Nursing and Allied Health Literature, as adopted by reference in NAC 632.110; or

���� (b) Have been individually approved by the Board.

���� (Added to NAC by Bd. of Nursing, eff. 11-2-87; A 2-6-90; 7-16-92; 5-18-94; 9-9-94; R029-97, 1-26-98; R102-03, 10-30-2003; R081-06, 6-28-2006; R112-11, 2-15-2012)

Assignment of Duties

���� NAC 632.244Assignment of unauthorized acts prohibited. (NRS 632.120)A registered nurse or a licensed practical nurse shall not assign to a person the performance of an act that the person is not otherwise authorized by law to perform.

���� (Added to NAC by Bd. of Nursing by R211-97, eff. 9-25-98)

���� NAC 632.246Assignment to unauthorized person of duty to administer certain substances prohibited. (NRS 632.120)A registered nurse or a licensed practical nurse shall not assign the administration of a controlled substance, dangerous drug, poison or device to other personnel unless the person to whom it is assigned is authorized to administer the controlled substance, dangerous drug, poison or device.

���� (Added to NAC by Bd. of Nursing, eff. 11-2-87)

���� NAC 632.248Assignment to unlicensed personnel of certain nursing duties prohibited; exception. (NRS 632.120) Except as otherwise provided in NAC 632.226, unlicensed personnel may not be assigned those duties which require the knowledge and skill of a licensed professional nurse or a licensed practical nurse as described in chapter 632 of NRS.

���� (Added to NAC by Bd. of Nursing, eff. 11-2-87; A by R071-00, 10-20-2000)

Identification

���� NAC 632.249Identification by appropriate title required; identification requirements for telenursing. (NRS 632.120)

���� 1. Each registered nurse, licensed practical nurse, certified nursing assistant, medication aide - certified, nursing student and nurse certified in an advanced specialty shall identify himself or herself by his or her appropriate title:

���� (a) When recording information on a record;

���� (b) When introducing himself or herself to a client, patient or prospective patient; and

���� (c) On a name tag which:

��������� (1) Includes, at a minimum, his or her first name and the first initial of his or her last name, and his or her title;

��������� (2) Is prominently displayed on his or her clothing; and

��������� (3) Is clearly legible from a distance of at least 3 feet.

���� 2. In addition to the requirements set forth in subsection 1, each registered nurse, licensed practical nurse, certified nursing assistant, medication aide - certified, nursing student and nurse certified in an advanced specialty shall, when practicing telenursing, identify orally the state in which he or she is licensed or certified.

���� 3. As used in this section:

���� (a) �Nurse certified in an advanced specialty� includes, but is not limited to, a clinical nurse specialist, advanced practice registered nurse, certified registered nurse anesthetist and attendant as that term is defined in NAC 632.565.

���� (b) �Telenursing� means the provision of nursing care or advice from a remote location through the use of telecommunications equipment, including, but not limited to, a telephone, teletype, facsimile machine and any equipment capable of transmitting a video image.

���� (Added to NAC by Bd. of Nursing, eff. 7-11-96; A by R211-97, 9-25-98; R122-01, 12-17-2001; R112-11, 2-15-2012)

���� NAC 632.251Identification of graduate nurses. (NRS 632.120)Until he or she has been issued a license to practice as a registered nurse or practical nurse, a graduate nurse shall identify himself or herself as a graduate nurse on his or her name tag when recording patients� records and in his or her introduction to patients.

���� (Added to NAC by Bd. of Nursing, eff. 8-18-88)

Nursing Students

���� NAC 632.252Performance of tasks. (NRS 632.120)

���� 1. A nursing student may, as an apprentice nurse, perform those tasks which the nursing student has successfully demonstrated in his or her program of education if:

���� (a) The nursing student works as an apprentice nurse in a licensed hospital for acute care, a licensed hospital for long-term care, a community health clinic or a health maintenance organization and works under the supervision of a registered nurse who is at the site where care is provided;

���� (b) The nursing student presents to his or her employer satisfactory evidence from his or her school of nursing of successful demonstration of his or her skills;

���� (c) The nursing student has been evaluated by the chief nurse as safe to perform those tasks in the health care facility employing him or her;

���� (d) The description of the position of apprentice nurse provided by the health care facility employing the nursing student identifies the roles and responsibilities of the position;

���� (e) The tasks delegated to the nursing student acting as an apprentice nurse are identified in the health care facility�s description of the position and have been approved by the Board as tasks that are delegable to the nursing student;

���� (f) There is a formal procedure for the nursing student to refuse to perform any task until he or she is comfortable with his or her ability to do so safely; and

���� (g) The nursing student, acting as an apprentice nurse, identifies himself or herself as an apprentice nurse on his or her name tag when recording patients� records and in his or her introduction to patients.

���� 2. While performing nursing functions as an apprentice nurse, the nursing student is subject to the provisions of the Nurse Practice Act and regulations adopted by the Board.

���� (Added to NAC by Bd. of Nursing, eff. 8-18-88; A 3-3-92; 5-9-96)

���� NAC 632.253Prohibited acts. (NRS 632.120)A nursing student who is working as an apprentice nurse may not delegate his or her duties or supervise other personnel.

���� (Added to NAC by Bd. of Nursing, eff. 8-18-88)

ADVANCED PRACTICE REGISTERED NURSES

���� NAC 632.254Definitions. (NRS 632.120, 632.237)As used in NAC 632.254 to 632.295, inclusive, unless the context otherwise requires, the words and terms defined in NAC 632.2543 and 632.2547 have the meanings ascribed to them in those sections.

���� (Added to NAC by Bd. of Nursing by R114-13, eff. 2-26-2014; A by R105-15, 4-4-2016)

���� NAC 632.2543�Population of focus� defined. (NRS 632.120, 632.237)�Population of focus� means a population of focus recognized by the Board pursuant to subsection 5 of NAC 632.2597.

���� (Added to NAC by Bd. of Nursing by R114-13, eff. 2-26-2014)

���� NAC 632.2547�Role� defined. (NRS 632.120, 632.237)�Role� means a role described in subsection 1 of NAC 632.2597.

���� (Added to NAC by Bd. of Nursing by R114-13, eff. 2-26-2014)

���� NAC 632.255Scope of practice. (NRS 632.120, 632.237)An advanced practice registered nurse may perform the following acts in addition to the functions of a registered nurse if the advanced practice registered nurse is properly prepared and the acts are currently within the standard of practice for his or her role and population of focus:

���� 1. Systematically assess the health status of persons and families by:

���� (a) Taking, recording and interpreting medical histories and performing physical examinations; and

���� (b) Performing or initiating selected diagnostic procedures.

���� 2. Based on information obtained in the assessment of a person�s health, manage the care of selected persons and families with common, acute, recurrent or long-term health problems. Management may include:

���� (a) Initiation of a program of treatment;

���� (b) Evaluation of responses to health problems and programs of treatment;

���� (c) Informing a person or family of the status of the patient�s health and alternatives for care;

���� (d) Evaluation of compliance with a program of treatment agreed upon by the person or family and the advanced practice registered nurse;

���� (e) Modification of programs of treatment based on the response of the person or family to treatment;

���� (f) Referral to appropriate providers of health care; and

���� (g) Commencement of care required to stabilize a patient�s condition in an emergency.

���� 3. Any other act if:

���� (a) The advanced practice registered nurse is certified to perform that act by an organization recognized by the Board;

���� (b) The performance of the act was taught in the program of education attended by the advanced practice registered nurse;

���� (c) The performance of the act was taught in a comprehensive program of instruction successfully completed by the advanced practice registered nurse, which included clinical experience;

���� (d) The act is within the scope of practice of an advanced practice registered nurse as determined by the Board; or

���� (e) The advanced practice registered nurse is trained to perform that act by a physician or another advanced practice registered nurse and the act:

��������� (1) Has been described as being performed by an advanced practice registered nurse in two or more national nursing publications, national nursing practice guidelines or national standards for nursing practice, or any combination thereof, which are listed in the Cumulative Index to Nursing and Allied Health Literature, as adopted by reference in NAC 632.110; or

��������� (2) Has been individually approved by the Board.

���� [Bd. of Nursing, � III subsec. C par. 4, eff. 5-16-79] — (NAC A 4-27-84; 3-28-86, eff. 4-3-86; 9-6-88; R081-06, 6-28-2006; R113-11, 9-14-2012; R114-13, 2-26-2014)

���� NAC 632.2556Authorization to make certain evaluations, certifications and examinations and to execute a certain petition related to emergency and involuntary admissions of persons to mental health facilities. (NRS 632.120)An advanced practice registered nurse is authorized to make the evaluations described in NRS 433A.160, the certifications described in NRS 433A.170, 433A.195 and 433A.200 and the examinations described in NRS 433A.240 and 433A.430 and to execute the petition described in NRS 433A.210 if the advanced practice registered nurse has:

���� 1. Been issued a license by the Board to practice as an advanced practice registered nurse with a population of focus in mental health;

���� 2. Been issued a license by the Board to practice as an advanced practice registered nurse in a role as a clinical nurse specialist with an area of clinical specialty in psychiatric and mental health nursing; or

���� 3. Received a postgraduate certificate in psychiatric and mental health nursing from an institution accredited by a national accrediting organization recognized by the Board.

���� (Added to NAC by Bd. of Nursing by R105-15, eff. 4-4-2016; A by R126-17, 2-27-2018)

���� NAC 632.256Records; system of quality assurance. (NRS 632.120, 632.237)

���� 1. An advanced practice registered nurse shall maintain accurate records documenting all physical findings concerning a patient, the diagnosis and treatment, and any prescriptions written for a patient for whom the advanced practice registered nurse provides care.

���� 2. A system of quality assurance must be in place.

���� 3. All the records must be available for review by the Board. Any review will be conducted in accordance with the laws relating to the confidentiality of medical records.

���� (Added to NAC by Bd. of Nursing, 3-28-86, eff. 4-3-86; A 3-26-90; R081-06, 6-28-2006; R114-13, 2-26-2014)

���� NAC 632.2563 Portfolio: Duty to maintain; required contents. (NRS 632.120, 632.237)Each advanced practice registered nurse shall maintain a portfolio, which must include, without limitation:

���� 1. A copy of each license relating to nursing that the advanced practice registered nurse holds;

���� 2. A copy of the license issued by the Board pursuant to NAC 632.2595, if applicable;

���� 3. A copy of the policy of professional liability insurance required pursuant to NAC 632.2567;

���� 4. A list of all locations at which the advanced practice registered nurse:

���� (a) Currently practices; and

���� (b) Has practiced within the 2 years immediately preceding his or her most recent application for a license or renewal of a license to practice as an advanced practice registered nurse;

���� 5. Evidence of any national certifications or other certifications relating to nursing which the advanced practice registered nurse has received;

���� 6. The protocol required by paragraph (b) of subsection 3 of NRS 632.237, if the advanced practice registered nurse prescribes a controlled substance listed in schedule II and does not have the experience described in paragraph (a) of subsection 3 of NRS 632.237;

���� 7. Proof of the hours of continuing education that the advanced practice registered nurse has completed in the 4 years immediately preceding his or her most recent application for a license or renewal of a license to practice as an advanced practice registered nurse;

���� 8. Copies of the transcripts from the program completed by the advanced practice registered nurse as required pursuant to NAC 632.260 and from any other institution of higher education attended by the advanced practice registered nurse; and

���� 9. An attestation which states that the advanced practice registered nurse will not practice outside the scope of his or her education, role or population of focus.

���� (Added to NAC by Bd. of Nursing by R114-13, eff. 2-26-2014)

���� NAC 632.2567Professional liability insurance. (NRS 632.120, 632.237, 632.238)Each advanced practice registered nurse who is not otherwise covered under a policy of professional liability insurance shall maintain a policy of professional liability insurance.

���� (Added to NAC by Bd. of Nursing by R114-13, eff. 2-26-2014)

���� NAC 632.257Authorization to issue written prescriptions for controlled substances, poisons, dangerous drugs and devices. (NRS 632.120, 632.237)

���� 1. An applicant for a license to practice as an advanced practice registered nurse will be authorized to issue written prescriptions for controlled substances, poisons, dangerous drugs and devices only if the applicant:

���� (a) Is authorized to do so by the Board;

���� (b) Submits an application for authority to issue written prescriptions for controlled substances, poisons, dangerous drugs or devices to the Board; and

���� (c) Has successfully completed:

��������� (1) A program that complies with the requirements set forth in paragraph (a) of subsection 1 of NAC 632.260 and includes an advanced course in pharmacotherapeutics; or

��������� (2) A program of academic study that:

�������������� (I) Is approved by the Board;

�������������� (II) Consists of at least 2 semester credits or an equivalent number of quarter credits in advanced pharmacotherapeutics; and

�������������� (III) Is completed within the 2 years immediately preceding the date the application is submitted to the Board.

���� 2. In addition to the information contained in the application for a license to practice as an advanced practice registered nurse, an applicant who completes, before June 1, 2005, a program designed to prepare an advanced practice registered nurse and who does not hold a master�s or doctorate degree with a major in nursing must, in his or her application for authority to write a prescription for controlled substances, poisons, dangerous drugs and devices, include documentation of 1,000 hours of active practice prescribing medication in the immediately preceding 2 years as an advanced practice registered nurse.

���� 3. Except as otherwise provided in subsection 4, if an advanced practice registered nurse who is authorized to prescribe certain controlled substances, poisons, dangerous drugs and devices changes his or her role or population of focus, he or she must submit an application to the Board for authority to prescribe those controlled substances, poisons, dangerous drugs and devices which are currently within the standard of practice in that role or population of focus. In addition to the information contained in an application submitted pursuant to this subsection, an advanced practice registered nurse who completes, before June 1, 2005, a program designed to prepare an advanced practice registered nurse and who does not hold a master�s or doctorate degree with a major in nursing must include in his or her application documentation of 1,000 hours of active practice prescribing medication in the new role or population of focus as an advanced practice registered nurse.

���� 4. An advanced practice registered nurse who:

���� (a) Is authorized to prescribe certain controlled substances, poisons, dangerous drugs and devices; and

���� (b) Changes his or her role or population of focus to a role or population of focus that is substantially similar to his or her former role or population of focus,

� is not required to submit to the Board the application required pursuant to subsection 3 if the Board has authorized him or her to prescribe controlled substances, poisons, dangerous drugs and devices in the practice of his or her former role or population of focus.

���� (Added to NAC by Bd. of Nursing, eff. 4-27-84; A 3-28-86, eff. 4-3-86; 8-5-86; 3-26-90; R141-97, 1-26-98; R122-01, 12-17-2001; R091-04, 8-13-2004; R196-07, 4-17-2008; R113-11, 9-14-2012; R114-13, 2-26-2014)

���� NAC 632.258Review of application for authority to prescribe controlled substances, poisons, dangerous drugs or devices. (NRS 632.120, 632.237)Each application for authority to prescribe controlled substances, poisons, dangerous drugs or devices will be reviewed by the Board or its designee for compliance with current policy established by the Board.

���� (Added to NAC by Bd. of Nursing, 3-28-86, eff. 4-3-86; A by R122-01, 12-17-2001)

���� NAC 632.259Controlled substances, poisons, dangerous drugs or devices that may be prescribed. (NRS 632.120, 632.237)An advanced practice registered nurse may only prescribe controlled substances, poisons, dangerous drugs or devices which are currently within the standard of practice in his or her identified role or population of focus.

���� (Added to NAC by Bd. of Nursing, 3-28-86, eff. 4-3-86; A 3-26-90; R122-01, 12-17-2001; R081-06, 6-28-2006; R113-11, 9-14-2012; R114-13, 2-26-2014)

���� NAC 632.2595License to dispense controlled substances, poisons, dangerous drugs and devices. (NRS 632.120, 632.237)

���� 1. The State Board of Nursing will issue a license to dispense controlled substances, poisons, dangerous drugs and devices to an advanced practice registered nurse if the advanced practice registered nurse:

���� (a) Successfully completes an examination administered by the State Board of Nursing on Nevada law relating to pharmacy; and

���� (b) Submits to the State Board of Nursing his or her affidavit verifying that he or she has made application with the State Board of Pharmacy for a certificate of registration.

���� 2. An advanced practice registered nurse who receives a certificate of registration from the State Board of Pharmacy shall, upon receipt, submit a copy of the certificate to the State Board of Nursing.

���� (Added to NAC by Bd. of Nursing, eff. 1-24-92; A by R114-13, 2-26-2014)

���� NAC 632.2597License: Authorization to practice in certain roles; specification of role and population of focus. (NRS 632.120, 632.237)

���� 1. The Board will issue a license to practice as an advanced practice registered nurse authorizing the licensee to practice in a role as:

���� (a) A nurse midwife;

���� (b) A nurse practitioner;

���� (c) A clinical nurse specialist; or

���� (d) Any combination thereof.

���� 2. An applicant for a license to practice as an advanced practice registered nurse must submit to the Board documentation of completion of the educational requirements set forth in:

���� (a) NAC 632.260, to practice as a nurse midwife or a nurse practitioner; or

���� (b) NAC 632.260 and 632.300, to practice as a clinical nurse specialist.

���� 3. If an applicant wishes to obtain a license to practice as an advanced practice registered nurse to practice in more than one role listed in subsection 1, the applicant must submit to the Board the documentation required pursuant to subsection 2 for each role for which he or she seeks a license.

���� 4. An applicant who wishes to obtain a license to practice as an advanced practice registered nurse must request that the Board issue the license to specify the role of the applicant and the population of focus of the applicant within that specific role.

���� 5. The Board recognizes the following populations of focus:

���� (a) Women�s health or gender-specific health;

���� (b) Family health and caring for a patient across the life span of the patient;

���� (c) Mental health;

���� (d) Adult health;

���� (e) Gerontology;

���� (f) Pediatrics;

���� (g) Neonatal; and

���� (h) Any other population of focus approved by the Board.

���� 6. An applicant must submit to the Board documentation of completion of the educational requirements prescribed by the Board for the population of focus for the specific role for which the license is requested.

���� (Added to NAC by Bd. of Nursing by R140-97, eff. 4-17-98; A by R113-11, 9-14-2012; R114-13, 2-26-2014)

���� NAC 632.260License: Qualifications; practice by student. (NRS 632.120, 632.237)

���� 1. An applicant for a license to practice as an advanced practice registered nurse must:

���� (a) Have completed a program designed to prepare an advanced practice registered nurse which must:

��������� (1) Be at least 1 academic year in length, which must include, without limitation, didactic instruction and clinical experience with a qualified physician or advanced practice registered nurse;

��������� (2) Be accredited or approved by an organization approved by the Board to accredit or approve those programs;

��������� (3) Include an advanced course in the following areas of study:

�������������� (I) The assessment of the health of patients;

�������������� (II) Pathophysiology; and

�������������� (III) The preparation for practice as an advanced practice registered nurse;

��������� (4) Include a concentration of courses for preparation in a specific role or population of focus;

��������� (5) Include clinical experience that requires the student to integrate the knowledge and skills that are taught in the program and emphasizes the specific role and population of focus chosen by the student; and

��������� (6) Include training in making clinical decisions, including, but not limited to, diagnosing health conditions and providing appropriate care.

���� (b) Present evidence to the Board that:

��������� (1) Within 2 years before the date of his or her application, the applicant completed a program to prepare an advanced practice registered nurse; or

��������� (2) He or she will complete 1,000 hours of practice, without the privilege of writing prescriptions, under the supervision of a qualified physician or advanced practice registered nurse, within a time specified by the Board.

���� (c) If previously licensed or certified as an advanced practice registered nurse in another state or jurisdiction, have maintained the licensure or certification in good standing and complied with the requirements for continuing education of that state or jurisdiction.

���� (d) If the applicant completes a program designed to prepare an advanced practice registered nurse on or after July 1, 1992, but before June 1, 2005:

��������� (1) Be certified as an advanced practice registered nurse by a nationally recognized certification agency; and

��������� (2) Hold a bachelor�s degree in nursing from an accredited school.

���� (e) If the applicant completes a program designed to prepare an advanced practice registered nurse on or after June 1, 2005, but before July 1, 2014, hold a master�s or doctorate degree in nursing.

���� (f) If the applicant completes a program designed to prepare an advanced practice registered nurse on or after July 1, 2014:

��������� (1) Hold a master�s or doctorate degree in nursing; and

��������� (2) Be certified as an advanced practice registered nurse by the American Board of Nursing Specialties, the National Commission for Certifying Agencies of the Institute for Credentialing Excellence or any other nationally recognized certification agency approved by the Board.

���� 2. A student enrolled in a formal educational program for an advanced practice registered nurse may perform the functions of an advanced practice registered nurse, except writing prescriptions, if he or she does so under the supervision of a licensed physician or an advanced practice registered nurse. The student must hold a license as a registered nurse in this State.

���� [Bd. of Nursing, � III part subsec. C, eff. 7-10-75; A and renumbered as � III subsec. C par. 2, 5-16-79] — (NAC A 3-28-86, eff. 4-3-86; 9-6-88; 3-26-90; 8-27-91; 7-7-94; R141-97, 1-26-98; R122-01, 12-17-2001; R081-06, 6-28-2006; R113-11, 9-14-2012; R114-13, 2-26-2014)

���� NAC 632.265License: Submission of application and other documents. (NRS 632.120, 632.237)A nurse registered in this State who wishes to obtain a license to practice as an advanced practice registered nurse must submit the following for the approval of the Board:

���� 1. An application on forms provided by the Board.

���� 2. The documentation required pursuant to NAC 632.2597.

���� 3. Any other information deemed relevant by the Board.

���� [Bd. of Nursing, � III part subsec. C, eff. 7-10-75; A and renumbered as � III subsec. C par. 3, 5-16-79] — (NAC A 3-28-86, eff. 4-3-86; 9-6-88; 3-26-90; 3-3-92; R140-97, 4-17-98; R113-11, 9-14-2012; R114-13, 2-26-2014)

���� NAC 632.285Change in role, population of focus or location of practice. (NRS 632.120, 632.237)An advanced practice registered nurse shall immediately:

���� 1. Submit to the Board a new application for a license if there is any change in his or her role or population of focus; and

���� 2. Notify the Board in writing of any change in the location of the practice of the advanced practice registered nurse.

���� [Bd. of Nursing, � III subsec. C par. 3 subpar. e, eff. 5-16-79] — (NAC A 3-28-86, eff. 4-3-86; R113-11, 9-14-2012; R114-13, 2-26-2014)

���� NAC 632.290Expiration and renewal of license. (NRS 632.120, 632.237)

���� 1. The license issued to an advanced practice registered nurse expires at the same time as a license for a registered nurse.

���� 2. In addition to renewing his or her license as a registered nurse, an advanced practice registered nurse must renew his or her license to practice as an advanced practice registered nurse by submitting the information required pursuant to NAC 632.291 to renew a license to practice as an advanced practice registered nurse and submitting the fee for renewal of the license to practice as an advanced practice registered nurse.

���� [Bd. of Nursing, � III subsec. C par. 5, eff. 5-16-79] — (NAC A 3-28-86, eff. 4-3-86; 3-3-92; R081-06, 6-28-2006; R113-11, 9-14-2012; R114-13, 2-26-2014)

���� NAC 632.291Requirements for renewal of license; continuing education; issuance of temporary license; audits by Board to ensure compliance with certain requirements. (NRS 632.120, 632.237, 632.2375, 632.343)

���� 1. When he or she renews his or her license, an advanced practice registered nurse must submit, on forms supplied by the Board:

���� (a) An attestation that the advanced practice registered nurse:

��������� (1) Has not been named as a defendant in any malpractice suits;

��������� (2) Has never had his or her clinical privileges limited, suspended or revoked; and

��������� (3) Has completed satisfactorily 45 hours of continuing education which:

�������������� (I) Must be directly related to his or her role or population of focus, unless the hours of continuing education were completed in accordance with sub-subparagraph (III) or (IV);

�������������� (II) May include the requirements for continuing education for renewal of a license for a registered nurse;

�������������� (III) Must include 2 hours of training that relate specifically to the misuse and abuse of controlled substances, the prescribing of opioids or addiction if the advanced practice registered nurse is authorized to prescribe controlled substances, poisons, dangerous drugs and devices pursuant to NRS 639.2351 or is registered to dispense controlled substances pursuant to NRS 453.231; and

�������������� (IV) Must include 2 hours of instruction on suicide prevention and awareness if the advanced practice registered nurse is required pursuant to NRS 632.343 to complete those hours of instruction for the renewal period.

���� (b) If the advanced practice registered nurse completes a program designed to prepare an advanced practice registered nurse on or after July 1, 2014, proof that the advanced practice registered nurse has maintained certification as an advanced practice registered nurse by an entity described in subparagraph (2) of paragraph (f) of subsection 1 of NAC 632.260.

���� (c) Any other information required by the Board.

���� 2. If an advanced practice registered nurse attests in the affirmative to subparagraphs (1) and (2) of paragraph (a) of subsection 1, a temporary license may be issued until the next meeting of the Board.

���� 3. The Board will perform random audits of advanced practice registered nurses to ensure compliance with the continuing education requirements of this section and compliance with the requirement to maintain a portfolio pursuant to NAC 632.2563.

���� 4. If audited by the Board, an advanced practice registered nurse shall submit:

���� (a) Proof that he or she has completed the continuing education described in paragraph (a) of subsection 1 during the 24 months which immediately precede the most recent birthday of the advanced practice registered nurse by presenting to the Board authenticated photocopies of original certificates of completion or computer printouts from approved providers of continuing education. A certificate of completion must include, without limitation:

��������� (1) The title of the course;

��������� (2) The name of the provider of the course;

��������� (3) The name of the body which approved the course;

��������� (4) The date on which the course was presented;

��������� (5) The name and license number of the advanced practice registered nurse; and

��������� (6) The number of contact hours earned in the course.

���� (b) The portfolio required to be maintained pursuant to NAC 632.2563.

���� (c) Proof that the advanced practice registered nurse has maintained licensure as an advanced practice registered nurse pursuant to NAC 632.2597.

���� 5. An advanced practice registered nurse shall retain documentation of completion of the requirements for continuing education for at least 4 years.

���� (Added to NAC by Bd. of Nursing, 3-28-86, eff. 4-3-86; A 9-6-88; 3-26-90; R081-06, 6-28-2006; R113-11, 9-14-2012; R114-13, 2-26-2014; R062-18, 12-19-2018)

���� NAC 632.292License: Placement on inactive status. (NRS 632.120, 632.237)An advanced practice registered nurse must submit to the Board a written notification that he or she wishes his or her license to be placed on inactive status.

���� (Added to NAC by Bd. of Nursing, eff. 3-26-90; A by R211-97, 9-25-98; R114-13, 2-26-2014)

���� NAC 632.293Application to renew practice after period of inactivity or infrequent activity. (NRS 632.120, 632.237)If an advanced practice registered nurse has not engaged in at least 1,000 hours of practice during the previous 5 years, or wishes to return from inactive to active status, the advanced practice registered nurse must submit to the Board an application to renew his or her practice which includes evidence that:

���� 1. He or she has satisfactorily completed the continuing education required for that period; and

���� 2. He or she has entered into an agreement with a physician or an advanced practice registered nurse which provides that the practice of the applicant will be closely supervised by that physician or advanced practice registered nurse for a period of at least 1,000 hours.

���� (Added to NAC by Bd. of Nursing, 3-28-86, eff. 4-3-86; A 3-26-90; 3-3-92; R081-06, 6-28-2006; R113-11, 9-14-2012; R114-13, 2-26-2014)

���� NAC 632.295Denial, suspension or revocation of license; unprofessional conduct. (NRS 632.120, 632.237)

���� 1. The Board may deny the issuance or renewal of, or suspend or revoke a license to practice as an advanced practice registered nurse after a hearing if it finds that an advanced practice registered nurse has:

���� (a) Performed tasks beyond those permitted pursuant to this chapter or otherwise authorized by the Board, or breached a protocol with a collaborating physician;

���� (b) Been negligent in performing services for patients;

���� (c) Impersonated a physician or permitted others to represent to the public that he or she is a physician;

���� (d) Violated any provision or failed to meet any requirement of this chapter;

���� (e) Made, or caused to be made, a false, fraudulent or forged statement or representation to procure or attempt to procure a license to practice as an advanced practice registered nurse;

���� (f) Violated any statute or regulation relating to prescribing, dispensing or administering any controlled substance, poison, dangerous drug or device;

���� (g) Failed to maintain the portfolio required to be maintained pursuant to NAC 632.2563; or

���� (h) Failed to perform nursing functions in a manner consistent with established or customary standards.

���� 2. Any licensed practical nurse or registered nurse who:

���� (a) Uses the title �advanced practice registered nurse� or any similar title or who acts as an advanced practice registered nurse without having obtained a license pursuant to this section; or

���� (b) Prescribes or dispenses, without authority, controlled substances, poisons, dangerous drugs or devices,

� is guilty of unprofessional conduct.

���� 3. As used in this section:

���� (a) �Collaborating physician� means a person licensed to practice medicine in this State who is responsible for conferring with an advanced practice registered nurse concerning the prescription of controlled substances by the advanced practice registered nurse.

���� (b) �Protocol� means the written directions for the prescription of controlled substances that the advanced practice registered nurse and collaborating physician have agreed upon.

���� [Bd. of Nursing, � III subsec. C par. 6, eff. 5-16-79] — (NAC A 3-28-86, eff. 4-3-86; 3-3-92; R141-97, 1-26-98; R122-01, 12-17-2001; R114-13, 2-26-2014)

CLINICAL NURSE SPECIALISTS

���� NAC 632.300General requirements; recognition as advanced practice registered nurse. (NRS 632.120)A nurse using the title �clinical nurse specialist�:

���� 1. Must:

���� (a) Be licensed to practice nursing as a registered nurse in this State;

���� (b) Have a master�s or doctorate degree in nursing; and

���� (c) Be educated in an area of clinical specialty by completing a program designed to prepare clinical nurse specialists.

���� 2. Shall present his or her credentials to any client, employer or representative of the Board upon request.

���� 3. May seek recognition as an advanced practice registered nurse if he or she meets the requirements set forth in this section and NAC 632.260.

���� (Added to NAC by Bd. of Nursing, eff. 8-18-88; A by R081-06, 6-28-2006)

���� NAC 632.305Duties; scope of practice. (NRS 632.120)

���� 1. A clinical nurse specialist must, in addition to other duties, demonstrate competence in the ability to:

���� (a) Assess, conceptualize and diagnose nursing problems; and

���� (b) Analyze complex problems related to health.

���� 2. A clinical nurse specialist may act directly in the care of patients as an expert clinician and indirectly as a consultant, leader of other nurses, educator, researcher and agent to ensure the quality of health care provided.

���� (Added to NAC by Bd. of Nursing, eff. 8-18-88)

���� NAC 632.310Unauthorized use of title. (NRS 632.120)

���� 1. Any person who does not meet the requirements set forth in NAC 632.300 may not use the title �clinical nurse specialist� or any abbreviation or other words, letters or signs to indicate that the person is a clinical nurse specialist.

���� 2. Any nurse who misrepresents himself or herself as a clinical nurse specialist in violation of this section is guilty of unprofessional conduct and subject to disciplinary proceedings.

���� (Added to NAC by Bd. of Nursing, eff. 8-18-88)

MEDICATION AIDES - CERTIFIED

���� NAC 632.320Submission of application to employ medication aides - certified; required policies and procedures. (NRS 632.120, 632.293)

���� 1. Before a designated facility may employ medication aides - certified, the designated facility must submit an application, on a form prescribed by the Board, to the Board for approval. The application must include, without limitation:

���� (a) Documentation demonstrating that the designated facility is certified to participate in Medicare and Medicaid.

���� (b) The job description of the medication aide - certified.

���� (c) The name of the advanced practice registered nurse or registered nurse who will be supervising or delegating duties to the medication aide - certified.

���� (d) The policies and procedures developed by the designated facility to carry out the duties to be delegated to a medication aide - certified, including, without limitation, policies and procedures to ensure patient safety and reporting errors in the administration of medication.

���� 2. The policies and procedures submitted to the Board pursuant to paragraph (d) of subsection 1 must include, without limitation, provisions requiring:

���� (a) A medication aide - certified to report to his or her supervising advanced practice registered nurse or registered nurse:

��������� (1) Any signs or symptoms exhibited by a patient which the medication aide - certified believes may indicate a threat to the life of the patient;

��������� (2) Any event which occurs that the medication aide - certified believes may be a present threat to the life of a patient; and

��������� (3) Medication that has been administered to a patient that the medication aide - certified believes has not produced the expected result or appears to be adversely affecting the health of a patient.

���� (b) An advanced practice registered nurse or registered nurse who supervises a medication aide - certified to retain responsibility for:

��������� (1) The overall provision of care by the medication aide - certified; and

��������� (2) Supervising and evaluating the medication aide - certified, including, without limitation, ensuring that the medication aide - certified administers medication and performs delegated duties in accordance with the accepted standard of care required for a medication aide - certified.

���� (c) An advanced practice registered nurse or a registered nurse who supervises a medication aide - certified to review:

��������� (1) Each order for medication submitted by a licensed physician, licensed physician assistant, licensed dentist, licensed podiatric physician or an advanced practice registered nurse; and

��������� (2) The record of each patient relating to medication.

���� (Added to NAC by Bd. of Nursing by R112-11, eff. 2-15-2012)

���� NAC 632.325Review and approval of application; resubmission of application; withdrawal of approval. (NRS 632.120, 632.293)

���� 1. The Board will review the application submitted pursuant to NAC 632.320 and provide written notice to the designated facility of its determination within 30 days after the application is received.

���� 2. If the Board denies an application submitted pursuant to NAC 632.320, the designated facility may correct any deficiencies and resubmit the application to the Board within 30 days after receipt of the written notice of denial pursuant to subsection 1.

���� 3. The Board may withdraw the approval to employ medication aides - certified if the Board determines that the designated facility has violated any statute or regulation or the facility no longer qualifies as a designated facility. If the Board withdraws approval, the Board must send a written notice by certified mail to the designated facility specifying the reasons for the withdrawal. The designated facility may rebut the reasons for the withdrawal contained in the notice within 15 days after the date on which the notice is received. The Board will send a written notice of its final determination to the designated facility.

���� (Added to NAC by Bd. of Nursing by R112-11, eff. 2-15-2012)

���� NAC 632.330Authorized duties; prohibited acts; reporting of errors. (NRS 632.120, 632.294)

���� 1. A medication aide - certified may administer medication using the methods set forth in NRS 632.294 and perform other related duties of a medication aide - certified:

���� (a) At a designated facility that has been approved by the Board to employ medication aides - certified pursuant to NAC 632.325;

���� (b) Under the supervision of an advanced practice registered nurse or a registered nurse; and

���� (c) If the duties are directly related to the administration of medication and have been delegated to the medication aide - certified by an advanced practice registered nurse or a registered nurse who is present in the designated facility.

���� 2. In addition to the acts prohibited pursuant to subsection 3 of NRS 632.294, a medication aide - certified shall not:

���� (a) Administer medication:

��������� (1) If the patient must be assessed to determine whether the medication is necessary; or

��������� (2) If the dosage of the medication has not been calculated or converted;

���� (b) Administer medication or carry out other related duties if the supervising advanced practice registered nurse or registered nurse of the medication aide - certified is not present in the designated facility;

���� (c) Administer medication or carry out other related duties if the health or needs of the patient change;

���� (d) Administer medication if the medication has not been reconstituted or mixed; or

���� (e) Care for a patient or perform other related duties.

���� 3. A medication aide - certified who has reason to believe that he or she has made an error in the administration of medication shall follow the policies and procedures adopted by the designated facility pursuant to NAC 632.320 to report the possible error to the advanced practice registered nurse or registered nurse who is supervising the medication aide - certified. An advanced practice registered nurse or registered nurse who receives such a report shall assist the medication aide - certified to complete the documentation for the report.

���� (Added to NAC by Bd. of Nursing by R112-11, eff. 2-15-2012)

CONTINUING EDUCATION

���� NAC 632.340Attestation of compliance; audits of nurses; proof of completion. (NRS 632.120, 632.343)

���� 1. Each nurse shall attest to his or her compliance with the requirements for continuing education at the time for the renewal of his or her license. The attestation must be made on forms provided by the Board.

���� 2. The Board will perform random audits of nurses for compliance with the requirements for continuing education.

���� 3. If audited by the Board, a nurse shall prove that he or she has participated in 30 contact hours of continuing education during the 24 months which immediately precede the nurse�s most recent birthday by presenting authenticated photocopies of original certificates of completion or computer printouts from approved providers of continuing education to the Board. A certificate of completion or computer printout must include:

���� (a) The title of the course;

���� (b) The name of the provider of the course;

���� (c) The name of the body which approved the course;

���� (d) The date on which the course was presented;

���� (e) The name and license number of the nurse; and

���� (f) The number of contact hours earned in the course.

���� 4. A nurse shall retain documentation of completion of the requirements for continuing education for 4 years.

���� 5. A nurse, while licensed pursuant to chapter 632 of NRS, shall retain documentation of completion of a course of instruction relating to the medical consequences of an act of terrorism that involves the use of a weapon of mass destruction required by subsection 3 of NRS 632.343.

���� (Added to NAC by Bd. of Nursing, eff. 8-8-94; A by R063-08, 9-18-2008)

���� NAC 632.355Courses: Approval; employment of coordinator; review; audits. (NRS 632.120, 632.343)

���� 1. A course of continuing education shall be deemed to be approved by the Board if the course:

���� (a) Meets the requirements of NRS 632.343; and

���� (b) Is provided by:

��������� (1) A provider approved by the Board;

��������� (2) A national nursing organization;

��������� (3) An academic institution;

��������� (4) A provider of continuing education that is recognized by another board of nursing; or

��������� (5) A provider of continuing education that is recognized by the regulatory body of a related discipline that approves courses of continuing education.

���� 2. Each provider shall employ a coordinator and shall notify the Board of the name of its coordinator. A coordinator shall hold a current license as a registered nurse in Nevada and is responsible for ensuring that:

���� (a) The contents of the course of continuing education meet the national standards for the continuing education of nurses;

���� (b) The course incorporates principles of instruction which are specifically designed to facilitate learning by adult students; and

���� (c) The certificates of completion which are provided to the successful participants of the course are accurate and comply with the requirements set forth in NAC 632.340.

���� 3. The Board will review all courses offered for the completion of the requirements for continuing education by:

���� (a) Considering each application to the Board for approval to act as a provider of continuing education;

���� (b) Maintaining a list of all providers approved by the Board; and

���� (c) Investigating any complaint regarding a course of continuing education.

���� 4. The Board will perform random audits of courses of continuing education. For the purposes of an audit by the Board, a provider shall maintain a description of the contents of a course of continuing education, a list of the persons who attended the course and copies of the certificates of completion provided to the participants of the course for at least 4 years after the course was presented. If a provider or its coordinator fails to reflect the national requirements for the continuing education of nurses in its business practices, the Board will remove the provider from the list of providers approved by the Board.

���� [Bd. of Nursing, � II subsec. D par. 4, eff. 12-20-79; � II subsec. D par. 5, eff. 12-20-79; A 12-11-81] — (NAC A 11-19-85; 2-6-90; 3-4-92; 8-8-94; R113-11, 9-14-2012)

���� NAC 632.400Reinstatement of inactive or delinquent license. (NRS 632.120, 632.343)When a licensee holds an inactive or delinquent license and wishes to reinstate it, the licensee must submit evidence to the Board of his or her participation in 30 contact hours of continuing education during the 2 years immediately preceding the period for which the license is requested.

���� [Bd. of Nursing, � II subsec. D par. 7, eff. 12-20-79; A and renumbered as � II subsec. D par. 8, 12-11-81] — (NAC A 8-5-86)

���� NAC 632.415Unprofessional conduct. (NRS 632.120, 632.343, 632.347)The Board may discipline a licensee for unprofessional conduct if the licensee:

���� 1. Within 30 days after a request by the Board, fails to provide the Board with information of his or her participation in a course of continuing education; or

���� 2. Submits to the Board false or inaccurate information of his or her participation in a course of continuing education.

���� [Bd. of Nursing, � II subsec. D par. 12, eff. 12-20-79; � II subsec. D par. 13 subpar. j, eff. 12-20-79; A and renumbered as � II subsec. D par. 13 subpar. m, 12-11-81] — (NAC A 12-21-82; 8-8-94)

VENIPUNCTURE AND INTRAVENOUS THERAPY

���� NAC 632.450 Procedures delegable to licensed practical nurses. (NRS 632.120)

���� 1. A licensed practical nurse who has completed a course in intravenous therapy approved by the Board pursuant to NAC 632.242 and who acts pursuant to a written order issued by an advanced practice registered nurse, a licensed physician, a licensed physician assistant, a licensed dentist or a licensed podiatric physician and, as applicable, under the immediate supervision of a physician, physician assistant or registered nurse may:

���� (a) Start peripheral intravenous therapy that does not include midline or midclavicular catheters;

���� (b) Introduce one or more solutions of electrolytes, nutrients or vitamins;

���� (c) Administer, by adding a solution, any of the following medications:

��������� (1) Antimicrobials;

��������� (2) Blood and blood products if under the supervision of a registered nurse;

��������� (3) Histamine H2 receptor antagonists;

��������� (4) Proton pump inhibitors; and

��������� (5) Steroids;

���� (d) Administer intravenous fluid and medications from a container which is commercially prepared or premixed and properly labeled by a pharmacist or a registered nurse designated by the pharmacist;

���� (e) Flush locks;

���� (f) Except as otherwise provided in paragraph (g), administer fluid by continuous or intermittent infusion through a peripheral device which uses a mechanism to control the flow;

���� (g) Administer fluid to a patient with a temporary central venous catheter by continuous or intermittent infusion by an electronic mechanism to control the flow;

���� (h) Maintain patency of a peripheral intermittent vascular access device, including, without limitation, a peripherally inserted central catheter, using a nontherapeutic dose of flush solutions;

���� (i) Withdraw blood from a peripherally inserted central venous catheter if performed in accordance with specific institutional policies and after specific institutional in-service training;

���� (j) Discontinue peripheral intravenous catheters; and

���� (k) Change a central venous catheter dressing.

���� 2. In addition to the procedures set forth in subsection 1, a licensed practical nurse who has completed a course in intravenous therapy approved by the Board pursuant to NAC 632.242 and who acts pursuant to a written order of a physician and under the direct supervision of a registered nurse may assist the registered nurse in the intravenous administration of blood and blood products by collecting data and performing simple nursing tasks related to that administration of blood or blood products.

���� [Bd. of Nursing, � V subsec. B, eff. 8-21-81] — (NAC A 3-26-90; 1-24-92; R122-01, 12-17-2001; R102-03, 10-30-2003; R091-04, 8-13-2004; R063-08, 9-18-2008; R002-10, 8-13-2010; R091-15, 4-4-2016)

���� NAC 632.455Procedures not delegable to licensed practical nurses. (NRS 632.120)A licensed practical nurse may not administer intravenously:

���� 1. Any medication other than those listed in NAC 632.450;

���� 2. Any drug which is under investigation by the United States Food and Drug Administration, is an experimental drug or is being used in an experimental method;

���� 3. Any antineoplastic medications;

���� 4. Colloid therapy, including hyperalimentation;

���� 5. Any medication administered by intravenous push; or

���� 6. Any medication used for purposes of sedation.

���� [Bd. of Nursing, � V subsec. C, eff. 8-21-81] — (NAC A 1-24-92; R102-03, 10-30-2003; R091-04, 8-13-2004; R091-15, 4-4-2016)

���� NAC 632.460 Labeling required on containers. (NRS 632.120)The following information must be on a container before its contents may be administered by a licensed practical nurse:

���� 1. The name of the patient for whom the contents are intended;

���� 2. An identification of the contents;

���� 3. The dosage;

���� 4. The rate at which the contents are to be administered;

���� 5. The date and time when the container and its contents were prepared;

���� 6. The expiration date and time of the contents;

���� 7. The name or initials of the person who prepared the container and its contents; and

���� 8. The name or initials of the person who superimposed the container, if applicable.

���� [Bd. of Nursing, � V subsec. D, eff. 8-21-81]

���� NAC 632.465Course on intravenous therapy: Prerequisites to offering. (NRS 632.120)Any course on intravenous therapy must comply with the requirements set forth in NAC 632.475 before it is offered to licensed practical nurses for the purpose of complying with the requirements of NAC 632.450 to 632.475, inclusive.

���� [Bd. of Nursing, � V subsec. E par. 1, eff. 8-21-81] — (NAC A 11-6-95)

���� NAC 632.470Course on intravenous therapy: Place of instruction; faculty. (NRS 632.120)

���� 1. The course must be taught in an educational institution or a medical facility as defined in NRS 449.0151.

���� 2. The course must be taught by a registered nurse who has had:

���� (a) Recent clinical experience providing intravenous therapy; or

���� (b) Experience in teaching courses in intravenous therapy.

���� 3. The ratio of faculty members to students in the laboratory or in an area used for clinical practice in the course must not be more than 1 to 10.

���� [Bd. of Nursing, � V subsec. E pars. 2, 4 & 5, eff. 8-21-81] — (NAC A 1-24-92; R081-06, 6-28-2006; R112-11, 2-15-2012)

���� NAC 632.475Subjects and hours required for course on intravenous therapy; evidence of maintenance or improvement of knowledge and skills. (NRS 632.120)

���� 1. The course must include the following subjects:

���� (a) The current regulation concerning licensed practical nurses and intravenous therapy;

���� (b) The anatomy, physiology and physics related to intravenous therapy;

���� (c) Identifying the purposes of intravenous therapy;

���� (d) Identifying the major routes for fluid replacement;

���� (e) Locating and naming the common intravenous sites;

���� (f) Identifying the types of fluids used in intravenous therapy;

���� (g) Preparing patients for intravenous therapy;

���� (h) Administering intravenous therapy, including:

��������� (1) Setting up equipment for intravenous therapy;

��������� (2) Inserting devices that act like needles in the periphery;

��������� (3) Inserting tubing into bottles of additives;

��������� (4) Calculating drops per minute;

��������� (5) Regulating intravenous flow according to calculation;

��������� (6) Using electronic regulating mechanisms;

��������� (7) Superimposing and piggybacking containers of solutions;

��������� (8) Discontinuing peripheral intravenous devices that act like needles; and

��������� (9) Recording intravenous therapy;

���� (i) Identifying possible complications from intravenous therapy;

���� (j) The management of intravenous therapy;

���� (k) The pharmacology of medications and solutions used in intravenous therapy;

���� (l) The appropriate technique for changing a sterile dressing on a peripheral and central venous site; and

���� (m) Flushing and drawing blood from a peripherally inserted central catheter.

���� 2. The course must include at least 30 hours of instruction and 10 hours of clinical or laboratory practice. The clinical or laboratory practice must include three successful venipunctures on live subjects or through the use of a simulator.

���� 3. A licensed practical nurse shall provide evidence of the maintenance or improvement of his or her knowledge and skills required to perform venipuncture and intravenous therapy to his or her employer or the Board, or both, upon request.

���� [Bd. of Nursing, � V subsec. E pars. 3 & 6, eff. 8-21-81] — (NAC A 3-26-90; 1-24-92; R112-11, 2-15-2012; R091-15, 4-4-2016)

CERTIFIED REGISTERED NURSE ANESTHETISTS

���� NAC 632.500Authorized functions. (NRS 632.120)

���� 1. A certified registered nurse anesthetist may, in addition to those functions authorized for the registered nurse, perform the following acts, when it has been determined by a patient�s physician, dentist or podiatric physician that an anesthetic is necessary for a procedure, test or other treatment, in accordance with the applicable policies and procedures regarding the administration of anesthetics:

���� (a) Obtain a history of the patient�s health, as appropriate to the anticipated procedure, test or treatment;

���� (b) Assess the client�s condition, as appropriate to the anticipated procedure, test or treatment;

���� (c) Recommend, request and order pertinent diagnostic studies and evaluate the results of those studies;

���� (d) Prepare a written preanesthetic evaluation of the patient and obtain the patient�s informed consent for the anesthesia;

���� (e) Select, order and administer preanesthetic medication;

���� (f) Order, prepare and use any equipment and supplies necessary for the administration of anesthesia and perform or order any necessary safety checks on the equipment;

���� (g) Order and prepare any drugs used for the administration of anesthesia;

���� (h) Select and order anesthesia techniques, agents and adjunctive drugs;

���� (i) Perform and manage general, regional and local anesthesia and techniques of hypnosis;

���� (j) Perform tracheal intubation and extubation and provide mechanical ventilation;

���� (k) Provide perianesthetic invasive and noninvasive monitoring, as appropriate, and respond to any abnormal findings with corrective action;

���� (l) Manage the patient�s fluid, blood and balance of electrolytes and acid base;

���� (m) Recognize abnormal response by a patient during anesthesia, select and take corrective action;

���� (n) Identify and manage any related medical emergency requiring such techniques as cardiopulmonary resuscitation, airway maintenance, ventilation, tracheal intubation, pharmacological cardiovascular support and fluid resuscitation;

���� (o) Evaluate the patient�s response during emergence from anesthesia and institute pharmacological or supportive treatment to ensure adequate recovery from anesthesia;

���� (p) Provide care consistent with the principles of infection control and anesthesia safety to prevent the spread of disease and prevent harm to the anesthetized patient and others in the anesthetizing environment;

���� (q) Select, order and administer postanesthetic medication;

���� (r) Report to the person providing postanesthetic care the patient�s physical and psychological condition, perioperative course and any anticipated problems;

���� (s) Initiate, order and administer respiratory support to ensure adequate ventilation and oxygenation in the immediate postanesthetic period;

���� (t) Release the patient from the postanesthetic care unit or discharge the patient from the ambulatory surgical setting;

���� (u) Include in a timely manner as a part of the patient�s medical records a thorough report on all aspects of the patient�s anesthesia care; and

���� (v) Assess the patient�s postanesthetic condition, evaluate the patient�s response to anesthesia and take corrective action.

���� 2. In addition, the nurse anesthetist may accept additional responsibilities which are appropriate to the practice setting and within his or her expertise. Such responsibilities may include, but are not limited to, the selection and administration of drugs and techniques for the control of pain in the preoperative, intraoperative and postoperative setting.

���� (Added to NAC by Bd. of Nursing, eff. 8-5-86; A 5-12-93)

���� NAC 632.510Performance of duties in accordance with guidelines of facility. (NRS 632.120)A certified registered nurse anesthetist practicing in a facility shall practice in accordance with written guidelines that are approved by that facility and conform to NAC 632.500 to 632.550, inclusive. A review of the guidelines may be conducted by the Board to determine if they conform to NAC 632.500 to 632.550, inclusive.

���� (Added to NAC by Bd. of Nursing, eff. 8-5-86; A 5-12-93)

���� NAC 632.515Qualifications for initial approval. (NRS 632.120)

���� 1. An applicant for initial approval as a certified registered nurse anesthetist must:

���� (a) Hold a current license in Nevada in good standing as a registered nurse;

���� (b) Submit to the Board evidence of successful completion of a program for training as a nurse anesthetist that has been accredited by a national organization recognized by the Board;

���� (c) Submit an application, on forms supplied by the Board, which substantiates that the applicant meets the requirements of this section and chapter 632 of NRS; and

���� (d) Submit evidence that the applicant has passed an examination for initial certification and evidence that he or she is currently certified by a nationally organized group recognized by the Board.

���� 2. In addition to the requirements of subsection 1, any applicant who is a graduate of a program for training as a nurse anesthetist, after:

���� (a) June 1, 1988, must submit evidence that he or she has received a baccalaureate degree in nursing; or

���� (b) June 1, 2005, must submit evidence that he or she has received a master�s degree in nursing or anesthetic care.

���� (Added to NAC by Bd. of Nursing, eff. 8-5-86; A 5-12-93; R081-06, 6-28-2006)

���� NAC 632.520Requirements if approved in another jurisdiction. (NRS 632.120)Any person seeking to be approved as a certified registered nurse anesthetist in this State and who is approved as a certified registered nurse anesthetist, or its equivalent, in another jurisdiction must comply with all the requirements set forth in NAC 632.500 to 632.550, inclusive.

���� (Added by NAC by Bd. of Nursing, eff. 8-5-86)

���� NAC 632.530Certificate of recognition: Issuance; restrictions. (NRS 632.120)If the Board finds that the applicant has met all the appropriate requirements set forth in NAC 632.500 to 632.550, inclusive, the applicant will be issued a certificate of recognition as a certified registered nurse anesthetist. The certificate may be restricted to administering certain types of anesthetics or to general, regional or local anesthesia or monitored anesthesia care, or any combination thereof.

���� (Added to NAC by Bd. of Nursing, eff. 8-5-86; A by R081-06, 6-28-2006)

���� NAC 632.535Temporary approval to practice. (NRS 632.120)

���� 1. A recent graduate of an accredited program for training as a nurse anesthetist may apply for temporary approval to practice as a nurse anesthetist. If temporary approval is granted, the applicant must take the first examination for certification available. During the period of the temporary approval, the applicant must practice under the direct supervision of a currently certified registered nurse anesthetist.

���� 2. A temporary approval to practice may also be issued to an applicant who has practiced as a nurse anesthetist in another state, has a license in this State as a registered nurse, is in good standing and not under investigation in any state, and is currently certified as a nurse anesthetist by a nationally organized group recognized by the Board.

���� 3. The temporary approval expires automatically:

���� (a) On the date designated by the Board;

���� (b) If the applicant fails the examination; or

���� (c) If the applicant does not take the first examination available.

���� (Added to NAC by Bd. of Nursing, eff. 8-5-86; A 2-6-90)

���� NAC 632.540Certificate of recognition: Expiration and renewal. (NRS 632.120)

���� 1. A certificate of recognition as a certified registered nurse anesthetist expires biennially upon expiration of the holder�s license as a registered nurse.

���� 2. A certificate of recognition as a certified registered nurse anesthetist will be renewed upon:

���� (a) Submission of evidence of the renewal of a current license as a registered nurse in Nevada;

���� (b) Submission of evidence of current certification as a nurse anesthetist from the Council on Certification of Nurse Anesthetists or the Council on Recertification of Nurse Anesthetists; and

���� (c) Except as otherwise provided in subsection 3, documentation of 45 contact hours of continuing education related to practice as a nurse anesthetist.

���� 3. If the national recertification occurs within 1 year before the nurse anesthetist�s birthday, the Board will consider it sufficient evidence of:

���� (a) The successful completion of 40 contact hours of continuing education related to practice as a nurse anesthetist; and

���� (b) Validation of his or her professional practice during the previous 2 years.

���� (Added to NAC by Bd. of Nursing, eff. 8-5-86; A 5-12-93; R081-06, 6-28-2006; R063-08, 9-18-2008)

���� NAC 632.545Certificate of recognition: Expiration due to lapse in national certification. (NRS 632.120)A certificate of recognition as a certified registered nurse anesthetist expires automatically whenever there is a lapse in his or her national certification that is issued by the Council on Certification of Nurse Anesthetists.

���� (Added to NAC by Bd. of Nursing, eff. 8-5-86; A 2-6-90; 5-12-93; R081-06, 6-28-2006)

���� NAC 632.550Certificate of recognition: Revocation, suspension or denial of issuance or renewal. (NRS 632.120)The Board may revoke, suspend or deny issuance or renewal of a certificate of recognition of a certified registered nurse anesthetist if the certified registered nurse anesthetist:

���� 1. Commits any acts constituting a ground for disciplinary action against a registered nurse;

���� 2. Exceeds his or her authority or fails to adhere to practice as designated by NAC 632.500 to 632.545, inclusive;

���� 3. Administers an anesthetic without the consent of a licensed physician, podiatric physician or dentist;

���� 4. Makes or causes to be made a false or a forged statement or representation in procuring or attempting to procure approval or renewed certification as a nurse anesthetist;

���� 5. Violates any statute or regulation relating to prescribing, possessing, administering or dispensing drugs; or

���� 6. Practices below the accepted standard of practice.

���� (Added to NAC by Bd. of Nursing, eff. 8-5-86; A 5-12-93)

AMBULANCE ATTENDANTS

���� NAC 632.565�Attendant� defined. (NRS 450B.160, 632.120) As used in NAC 632.565 to 632.590, inclusive, unless the context otherwise requires, �attendant� has the meaning ascribed to it in NRS 450B.050.

���� (Added to NAC by Bd. of Nursing, eff. 7-7-94)

���� NAC 632.570Certificate of completion of training: Application. (NRS 450B.160, 632.120)A registered nurse who wishes to obtain a certificate of completion of training as an attendant pursuant to subsections 7 and 8 of NRS 450B.160 must submit to the Board an application on a form provided by the Board.

���� (Added to NAC by Bd. of Nursing, eff. 7-7-94)

���� NAC 632.575Certificate of completion of training: Renewal. (NRS 450B.160, 632.120)A registered nurse who is employed as an attendant must submit to the Board an application for renewal of his or her certificate of completion of training as an attendant on a form provided by the Board with the application the registered nurse submits for renewal of his or her license as a registered nurse pursuant to NAC 632.192.

���� (Added to NAC by Bd. of Nursing, eff. 7-7-94; A by R112-11, 2-15-2012)

���� NAC 632.580Submission of certificate of compliance to employer required. (NRS 450B.160, 632.120)A registered nurse shall, not later than 30 days after he or she begins his or her employment as an attendant or not later than 30 days after the registered nurse completes the requirements for training as an attendant pursuant to subsections 7 and 8 of NRS 450B.160, submit to his or her employer a copy of his or her certificate of compliance with the requirements of subsections 7 and 8 of NRS 450B.160.

���� (Added to NAC by Bd. of Nursing, eff. 7-7-94)

���� NAC 632.590Certificate of completion of training: Verification of issuance by employer required. (NRS 450B.160, 632.120)

���� 1. An employer who employs a registered nurse as an attendant shall:

���� (a) Verify that the Board has issued to the registered nurse a certificate of completion of training as an attendant; and

���� (b) Place in the personnel file of the registered nurse a copy of the registered nurse�s certificate of completion of training as an attendant issued by the Board.

���� 2. The employer shall comply with the provisions of subsection 1 not later than 30 days after the registered nurse begins his or her employment as an attendant or not later than 30 days after the registered nurse completes the requirements for training as an attendant pursuant to subsections 7 and 8 of NRS 450B.160.

���� (Added to NAC by Bd. of Nursing, eff. 7-7-94)

PROGRAMS FOR EDUCATION OF NURSES

���� NAC 632.600Definitions. (NRS 632.120, 632.430, 632.440)As used in NAC 632.600 to 632.711, inclusive, unless the context otherwise requires:

���� 1. �Conditional approval� means approval, with conditions or restrictions, granted by the Board to a program of nursing which does not meet the standards for curriculum established by the Board.

���� 2. �Full approval� means approval granted by the Board to a program of nursing if it meets the standards established by the Board and the requirements of law.

���� 3. �Provisional approval� means approval granted by the Board to a program of nursing which has not graduated its first class and demonstrated eligibility for full approval.

���� 4. �Teach out� means a process by which a program of nursing may fulfill educational and contractual obligations to currently enrolled students before closing as the result of the Board�s denial or withdrawal of full approval for the program pursuant to subsection 1 or 2 of NAC 632.635.

���� (Added to NAC by Bd. of Nursing, eff. 9-17-90; A 6-21-94; R212-99, 5-8-2000; R090-15, 4-4-2016)

���� NAC 632.605Submission of application and statement of intent to establish program. (NRS 632.120, 632.430, 632.440)

���� 1. A university or college which wishes to establish a program of nursing in this State must submit an application to the Board. The Board will prescribe the form for the application.

���� 2. The administrator of the program shall submit to the Board, at least 6 months before the program is offered, a statement of intent which must include:

���� (a) Proof that the program is approved by the system of universities or community colleges of the state in which it is accredited;

���� (b) The results of a survey which demonstrates the need for the program of nursing;

���� (c) The type of program which will be offered;

���� (d) The name, address and status of the accreditation of the institution offering the program;

���� (e) The relationship of the program of nursing to that institution;

���� (f) Evidence of budgetary support, including, without limitation, a notarized accounting statement which conforms to generally accepted standards of accounting and which demonstrates funding sufficient to establish and sustain a program of nursing;

���� (g) A detailed schedule of the entire cost of enrollment in the program of nursing, including, without limitation, tuition, fees and any cost associated with the use or purchase of equipment;

���� (h) The projected enrollment;

���� (i) Evidence that a sufficient number of qualified members of the faculty are available to conduct the program;

���� (j) Evidence that a sufficient number of clinical placements are available in each area of nursing for which the program offers education;

���� (k) A description of the proposed clinical facilities to be used;

���� (l) The resources available at the site of the program;

���� (m) The proposed schedule for beginning the program;

���� (n) The plan for the mentoring and development of the administrator of the program developed by the administrator pursuant to NAC 632.660, if any;

���� (o) A written plan describing how the program will ensure that, within 2 years after the first class is graduated, the graduates of the program have a rate of passage on the National Council Licensure Examination of not less than 80 percent the first time the graduate takes the examination;

���� (p) A statement of the transferability of credits earned in the program to institutions of the Nevada System of Higher Education; and

���� (q) Any additional information requested by the Board.

���� (Added to NAC by Bd. of Nursing, eff. 9-17-90; A 6-21-94; R091-04, 8-13-2004; R063-08, 9-18-2008; R112-11, 2-15-2012)

���� NAC 632.610Review of application; inspection of facilities; notice of decision. (NRS 632.120, 632.430, 632.440)

���� 1. A representative of the university or college that wishes to establish a program of nursing must meet with the Board to review the application.

���� 2. A representative of the Board shall visit the educational and clinical facilities to be used and submit a written report to the Board.

���� 3. The Board will notify the university or college of its decision.

���� (Added to NAC by Bd. of Nursing, eff. 9-17-90)

���� NAC 632.615Provisional approval: Requirements for application; administrator required to meet with Board before approval. (NRS 632.120, 632.430, 632.440)

���� 1. A university or college may apply for provisional approval of a program of nursing offered by the university or college if:

���� (a) A qualified administrator is at the site and there are sufficient qualified members of the faculty to begin the program;

���� (b) A written proposal for the program, developed in accordance with the national curriculum and patient safety standards for nursing education approved by the Board, has been submitted to the Board; and

���� (c) A visit to the facilities has been conducted by the Board.

���� 2. The provisional approval of a program of nursing may not be awarded until after the qualified administrator of the program has met with the Board to review the proposal for the program.

���� (Added to NAC by Bd. of Nursing, eff. 9-17-90; A by R212-99, 5-8-2000; R063-08, 9-18-2008; R112-11, 2-15-2012; R090-15, 4-4-2016)

���� NAC 632.620Provisional approval: Reports to Board. (NRS 632.120, 632.430, 632.440)

���� 1. If the Board grants provisional approval to a program of nursing offered by a university or college, the administrator of the program shall submit a report concerning the program to the Board every 6 months.

���� 2. A self-evaluation report demonstrating compliance with the standards for nursing education approved by the Board must be submitted by the administrator of the program to the Board within 6 months after graduation of the first class.

���� (Added to NAC by Bd. of Nursing, eff. 9-17-90; A by R212-99, 5-8-2000; R091-04, 8-13-2004)

���� NAC 632.625Full approval: Application; qualifications; bases for granting. (NRS 632.120, 632.430, 632.440)

���� 1. A university or college which has been granted provisional approval for a program of nursing and wishes to receive full approval for the program must apply for that approval within 2 years after the first class is graduated.

���� 2. The Board will grant full approval to the program of nursing:

���� (a) If 80 percent or more of the graduates of the program who take the National Council Licensure Examination for the first time pass the examination.

���� (b) Based on information:

��������� (1) Included in the application for approval submitted to the Board;

��������� (2) Submitted concerning the pass rate of graduates of the program who take the National Council Licensure Examination for the first time; and

��������� (3) Obtained by the Board from visits to the program.

���� (Added to NAC by Bd. of Nursing, eff. 9-17-90; A 7-16-92; R212-99, 5-8-2000)

���� NAC 632.630Conditional approval: Identification and correction of deficiencies; proof of compliance with Board�s plan; withdrawal of approval; removal from list of approved programs. (NRS 632.120, 632.430, 632.440)

���� 1. A program of nursing which does not meet the minimum standards prescribed by the Board or by statute must be placed on conditional approval.

���� 2. If a program of nursing has a pass rate of less than 80 percent for graduates of the program who take the National Council Licensure Examination for the first time, the administrator of the program shall conduct a study to determine the deficiencies of the program and the measures which must be taken to correct those deficiencies. The administrator shall submit a copy of the study to the Board within 3 months after the program receives the results of that examination.

���� 3. If a program of nursing has a pass rate of less than 80 percent for graduates of the program who take the National Council Licensure Examination for the first time, for two such examinations within 2 years, the Board will place the program on conditional approval and conduct a review of the program at the site of the program.

���� 4. The Board will notify the administrator of the program of any deficiencies in the program and establish a plan to correct those deficiencies. The administrator shall submit a report to the Board within 6 months after the Board establishes the plan. The report must include proof of compliance with the Board�s plan.

���� 5. If the program complies with the plan, the Board will withdraw the conditional approval. If the program does not comply with the plan, the Board will remove the program from the list of programs approved by the Board.

���� (Added to NAC by Bd. of Nursing, eff. 9-17-90; A 7-16-92; R212-99, 5-8-2000)

���� NAC 632.633Application to implement innovative educational approaches; guidelines; approval by Board. (NRS 632.120, 632.430, 632.440)A program of nursing that has obtained full approval may apply to the Board to implement innovative educational approaches which prepare students to practice nursing safely, competently and ethically. The Board may establish guidelines for the application process for the consideration of such innovative educational approaches. A program of nursing must obtain Board approval for any innovative educational approach before implementing such an approach.

���� (Added to NAC by Bd. of Nursing by R090-15, eff. 4-4-2016)

���� NAC 632.635Denial, withdrawal and reinstatement of approval program authorized to conduct teach out under certain circumstances. (NRS 632.120, 632.430, 632.440)

���� 1. The Board will deny the approval of a program of nursing if it determines that the program fails to comply with the standards for nursing education approved by the Board or the requirements of the law.

���� 2. The Board may withdraw the approval of a program of nursing if it determines that the administrator of the program has not provided sufficient evidence of the program�s compliance with the standards for nursing education approved by the Board and the requirements of the law.

���� 3. The Board may reinstate the approval of a program of nursing if the administrator of the program submits proof that the program has complied with the standards of nursing education approved by the Board and the requirements of the law.

���� 4. The Board may permit a teach out by a program of nursing for which approval has been denied or withdrawn by the Board pursuant to subsection 1 or 2. A program of nursing which requests approval to conduct a teach out must submit a plan in writing acceptable to the Board to retain members of the faculty, provide sufficient clinical resources and enlist the services of a consultant who has been approved by the Board to monitor the progress of the teach out.

���� (Added to NAC by Bd. of Nursing, eff. 9-17-90; A by R212-99, 5-8-2000; R090-15, 4-4-2016)

���� NAC 632.640Requirements for operation; policies and procedures; accreditation required. (NRS 632.120, 632.430, 632.440)

���� 1. A program of nursing offered by a university or college must:

���� (a) Be an integral part of the university or college or, if the program is a program for licensed practical nurses, be licensed by the Nevada Commission on Postsecondary Education;

���� (b) Adopt statements of purpose, philosophy and objectives which are consistent with those of the institution offering the program;

���� (c) Be organized with clearly defined lines of authority, areas of responsibility and channels of communication;

���� (d) Allow the members of the faculty to participate in the determination of academic policies and procedures and the development and evaluation of the curriculum;

���� (e) Allow students to participate in the evaluation of the curriculum and other aspects of the program to which they may be able to contribute; and

���� (f) Ensure that students are prepared for the safe and effective practice of nursing.

���� 2. The policies and procedures of the program of nursing must be in writing and must include policies and procedures to ensure the safety of patients during clinical experiences.

���� 3. A program of nursing must be accredited, or be in the process of obtaining accreditation, by a nationally recognized association approved by the Board or an agency authorized by law to accredit such programs.

���� (Added to NAC by Bd. of Nursing, eff. 9-17-90; A 6-21-94; R063-08, 9-18-2008; R090-15, 4-4-2016)

���� NAC 632.645Resources and facilities; agreements regarding provision of experience. (NRS 632.120, 632.430, 632.440)

���� 1. A program of nursing must have sufficient resources and facilities to prepare the students in accordance with the philosophy and objectives of the program and the policies of the institution offering the program.

���� 2. Facilities must include:

���� (a) Offices for administrative, instructional and clerical personnel;

���� (b) Classrooms, laboratories, conference rooms and equipment for use for various teaching methods;

���� (c) Library resources which are appropriate and accessible to students for the purpose of the program with consideration given to their usefulness and scope and the currency of their books and periodicals; and

���� (d) Clinical facilities sufficient to achieve the objectives of the program, including written criteria for the selection of those facilities approved by the Board.

���� 3. Written contractual agreements must be entered into by the administrator of the program and all agencies and institutions which provide educational experiences for students of that program.

���� (Added to NAC by Bd. of Nursing, eff. 9-17-90; A by R091-04, 8-13-2004)

���� NAC 632.650Allocation of money for program. (NRS 632.120, 632.430, 632.440)A sufficient amount of money must be allocated to a program of nursing for members of the faculty, other necessary personnel, equipment, supplies and services.

���� (Added to NAC by Bd. of Nursing, eff. 9-17-90)

���� NAC 632.655Presence of qualified administrator required. (NRS 632.120, 632.430, 632.440)A qualified administrator must be at the site of a program of nursing offered by a university or college before the first class is admitted to the program.

���� (Added to NAC by Bd. of Nursing, eff. 9-17-90)

���� NAC 632.660Administrator: Qualifications. (NRS 632.120, 632.430, 632.440)

���� 1. Each administrator of a program of nursing must:

���� (a) Be licensed to practice as a registered nurse in this State;

���� (b) Have at least 5 years of experience as a registered nurse, 3 years of which must be teaching in a program of nursing accredited by a nationally recognized association approved by the Board or an agency authorized by law to accredit such programs;

���� (c) Have experience in academic and professional administration; and

���� (d) If the administrator does not have experience in the administration of a program of nursing, develop and complete a plan for his or her own mentoring and development.

���� 2. The administrator of a program of nursing which grants a bachelor�s degree in nursing must have a master�s degree with a major in nursing and a doctorate degree in nursing or a related field from an accredited school.

���� 3. The administrator of a program of nursing which grants an associate degree in nursing must have a master�s degree in nursing from an accredited school.

���� 4. The administrator of a program of practical nursing must have a master�s degree in nursing from an accredited school.

���� (Added to NAC by Bd. of Nursing, eff. 9-17-90; A by R063-08, 9-18-2008; R112-11, 2-15-2012; R090-15, 4-4-2016)

���� NAC 632.665Administrator: Duties. (NRS 632.120, 632.430, 632.440)

���� 1. The administrator of a program of nursing shall:

���� (a) Devote a sufficient amount of time to administer the program;

���� (b) Prepare and administer the budget for the program;

���� (c) Notify the Board of any substantial change in the program or its administration;

���� (d) Notify the Board of any sentinel event;

���� (e) Devote sufficient time to faculty development and faculty mentoring programs; and

���� (f) Ensure that the program complies with the written plan submitted to the Board pursuant to paragraph (o) of subsection 2 of NAC 632.605.

���� 2. The instructional duties of the administrator of a program of nursing must be consistent with the scope of his or her administrative duties.

���� 3. As used in this section, �sentinel event� has the meaning ascribed to it in NRS 439.830.

���� (Added to NAC by Bd. of Nursing, eff. 9-17-90; A by R091-04, 8-13-2004; R063-08, 9-18-2008; R112-11, 2-15-2012)

���� NAC 632.670Faculty: Licensing required for teaching certain courses; other qualifications required. (NRS 632.120, 632.430, 632.440)

���� 1. A member of the faculty of a program of nursing who teaches didactic or clinical nursing courses must be licensed to practice as a registered nurse in this State.

���� 2. An interdisciplinary member of the faculty of a program of nursing who does not teach didactic or clinical nursing courses:

���� (a) Must possess advanced knowledge appropriate for the content being taught; and

���� (b) Is not required to be licensed to practice as a registered nurse in this State.

���� (Added to NAC by Bd. of Nursing, eff. 9-17-90; A by R091-04, 8-13-2004; R090-15, 4-4-2016)

���� NAC 632.675Faculty: General requirements. (NRS 632.120, 632.430, 632.440)

���� 1. A program of nursing must have a competent and stable faculty. The majority of the members of the faculty must be full-time employees.

���� 2. Of the faculty who are hired after August 13, 2004:

���� (a) At least 75 percent of the members must hold at least a master�s degree with a major in nursing and have completed training which is related to the area of teaching of the member; and

���� (b) Except as otherwise provided in subsection 3, the remainder of such members, if any, must hold at least:

��������� (1) A master�s or doctoral degree with a major in nursing;

��������� (2) A bachelor�s degree with a major in nursing and a master�s or doctoral degree in a field related to nursing; or

��������� (3) A graduate degree from an accredited school of nursing as defined in NRS 632.011.

���� 3. The Executive Director of the Board may, for good cause shown, waive the requirements of paragraph (b) of subsection 2.

���� 4. The members of the faculty shall develop and evaluate the curriculum and the educational practices of the program.

���� 5. Except as otherwise provided in this subsection, in courses relating to the care of patients, there must be at least one member of the faculty for every eight students. The Executive Director of the Board may, upon a showing of good cause, waive the requirement.

���� 6. A program of nursing that uses the personnel of a clinical facility as preceptors to instruct the clinical experience of students must require:

���� (a) Each preceptor to have clinical expertise and to have demonstrated competence in the specialty of the students whom he or she will instruct;

���� (b) Each preceptor to be approved by the faculty of the program of nursing;

���� (c) The faculty of the program of nursing to provide to each preceptor an orientation concerning the roles and responsibilities of students, members of the faculty and preceptors; and

���� (d) The faculty of the program of nursing to develop written objectives and provide a copy of those objectives to each preceptor,

� before the preceptor begins his or her instruction of the students.

���� 7. In addition to the requirements set forth in subsection 6, a program of nursing that uses the personnel of a clinical facility as preceptors to instruct the clinical experience of students:

���� (a) Must ensure that each preceptor is assigned to instruct not more than two students at the same time;

���� (b) Must designate a member of the faculty to serve as a liaison between the preceptor and each student who participates in the clinical experience;

���� (c) Must require that each preceptor be present in the clinical facility and available to the students at all times when the students provide nursing services to patients; and

���� (d) May use a preceptor to reinforce basic nursing skills or to teach nursing skills which build on the basic nursing skills that the students have acquired.

���� 8. There must be at least one qualified administrator for each department or division of the program.

���� 9. If a university or college offers a program of nursing for more than one level of preparation, there must be one person who is responsible for each such level.

���� (Added to NAC by Bd. of Nursing, eff. 9-17-90; A by R141-97, 1-26-98; R091-04, 8-13-2004; R196-07, 4-17-2008; R112-11, 2-15-2012)

���� NAC 632.680Students: Admission; policies. (NRS 632.120, 632.430, 632.440)

���� 1. The requirements for admission to a program of nursing must be clearly stated. The number of students enrolled in the program of nursing must be determined by the number of members of the faculty and the availability of clinical learning experiences.

���� 2. Students who seek admission to a program of nursing by transferring from a program of nursing from another accredited school of nursing or who seek readmission for the completion of a program must comply with the requirements for admission which are effective at the time of the transfer or readmission.

���� 3. All policies concerning students must be in writing and must include, without limitation, processes for revision of the policies and requirements for providing notice of any revisions to the students.

���� 4. The administrator of a program of nursing shall establish a policy for the resolution of complaints and disputes concerning students.

���� 5. The administrator of a program of nursing shall establish a policy of accountability for the professional behavior of students, including, without limitation, honesty and integrity.

���� (Added to NAC by Bd. of Nursing, eff. 9-17-90; A by R212-99, 5-8-2000; R063-08, 9-18-2008; R090-15, 4-4-2016)

���� NAC 632.685Curriculum; awarding of credits; standardized examination for completion prohibited. (NRS 632.120, 632.430, 632.440)

���� 1. The curriculum of a program of nursing must:

���� (a) Reflect the philosophy and objectives of the program;

���� (b) Be based on a rationale that ensures sufficient preparation for the safe and effective practice of nursing; and

���� (c) Contain theory and clinical experiences that are integrated throughout the program of nursing.

���� 2. Credits for courses must be awarded appropriately.

���� 3. A program of nursing must not use a standardized examination for determining the successful completion of the program.

���� (Added to NAC by Bd. of Nursing, eff. 9-17-90; A by R091-04, 8-13-2004; R196-07, 4-17-2008; R112-11, 2-15-2012)

���� NAC 632.690Requirements for instruction; records of evaluation of curriculum. (NRS 632.120, 632.430, 632.440)

���� 1. A program of nursing which educates practical nurses must include instruction in the following areas of nursing:

���� (a) Care provided to persons who require medical and surgical care;

���� (b) Evidence-based patient safety;

���� (c) Geriatric care;

���� (d) Maternal and child health;

���� (e) Mental health; and

���� (f) Patient care in community settings.

���� 2. A program of nursing which educates registered nurses must include instruction relating to:

���� (a) Basic principles of biology, microbiology, psychology, sociology, mathematics and therapeutic communication;

���� (b) The theory and practice of nursing, including, without limitation, the attainment, intervention and maintenance of physical and mental health and the prevention of illness across the life span of patients, in a variety of clinical settings, and must include, without limitation, instruction in evidence-based nursing practice and technological skills commensurate with safely delivering patient care;

���� (c) Professional values, boundaries and ethics, including, without limitation, the appropriate use of social media;

���� (d) The maintenance of physical and mental health in patients of diverse cultures, ethnicities and social and economic backgrounds;

���� (e) The provisions of this chapter and chapter 632 of NRS; and

���� (f) The role of regulation and accreditation in the provision of health care and patient safety.

���� 3. Courses relating to theory and clinical experience must:

���� (a) Be taught in a concurrent or sequential manner; and

���� (b) Include, without limitation, principles relating to national patient safety standards and bioethics.

���� 4. The administrator of a program of nursing shall prepare and maintain records of the evaluation of the curriculum by members of the faculty and students enrolled in the program.

���� (Added to NAC by Bd. of Nursing, eff. 9-17-90; A by R091-04, 8-13-2004; R063-08, 9-18-2008; R112-11, 2-15-2012; R090-15, 4-4-2016)

���� NAC 632.695Substantial revision of curriculum. (NRS 632.120, 632.430, 632.440)If the curriculum of a program of nursing is substantially revised, the administrator of the program shall submit the revision to the Board for approval at least 4 months before the revision is effective. A substantial revision means:

���� 1. A reorganization of the curriculum;

���� 2. A revision of the length of the program;

���� 3. A revision of the objectives of the program;

���� 4. Any revision of the curriculum of a program that affects the ability of the program to comply with the requirements of this chapter or chapter 632 of NRS; or

���� 5. A revision of the type or amount of clinical experience approved for the program.

� The term does not include a change in the order in which courses must be taken.

���� (Added to NAC by Bd. of Nursing, eff. 9-17-90; A by R141-97, 1-26-98; R063-08, 9-18-2008)

���� NAC 632.701Annual reports to Board. (NRS 632.120, 632.430, 632.440)The administrator of a program of nursing shall submit an annual report to the Board in the form prescribed by the Board.

���� (Added to NAC by Bd. of Nursing, eff. 9-17-90)

���� NAC 632.703Reports by program which conducts portion of its program in Nevada; visits to determine eligibility for approval; approval required for nontraditional courses of instruction; faculty required to be licensed in Nevada. (NRS 632.120, 632.430, 632.440)

���� 1. A program of nursing which conducts a portion of its program in Nevada shall submit to the Board a report, on a form provided by the Board, which includes:

���� (a) Proof of its current accreditation or approval by the state in which the program originates or by any applicable national nursing accreditation body;

���� (b) All correspondence received within the preceding year from the accrediting body or bodies; and

���� (c) Evidence satisfactory to the Board that the portion of the program conducted in Nevada is conducted in compliance with the provisions of this chapter and chapter 632 of NRS relating to conducting a program of nursing.

���� 2. The administrator of the program of nursing shall:

���� (a) Notify the Board in writing of any action taken in favor of or against the program by the accrediting body or bodies within 30 days after the action is taken; and

���� (b) Complete and submit an annual school report on forms provided by the Board.

���� 3. The Board may conduct a complete visit to the program of nursing to determine its eligibility for approval at any time, or may accept all or part of the survey and findings on accreditation from the state in which the program originates.

���� 4. A program of nursing conducted over the Internet or any other nontraditional course of instruction in nursing shall not provide clinical instruction in this State without the approval of the Board.

���� 5. Each member of the faculty of a program of nursing who conducts a portion of the program in this State must be licensed in this State.

���� (Added to NAC by Bd. of Nursing, eff. 6-21-94; A by R212-99, 5-8-2000; R091-04, 8-13-2004; R063-08, 9-18-2008; R112-11, 2-15-2012)

���� NAC 632.706Periodic surveys; required reports; objections to report of Board. (NRS 632.120, 632.430, 632.440, 632.470)

���� 1. Except as otherwise provided in NAC 632.708, the Board will survey each program of nursing, under the direction of the Executive Director appointed by the Board, at least every 4 years.

���� 2. The Board, a member of the Board�s staff or an educational consultant working on behalf of the Board will visit the site of the program during the survey. The visits must be scheduled at a time agreed upon by the Board and the administrator of the program.

���� 3. The administrator of the program shall submit to the Board a self-evaluation report prepared by the administrator and members of the faculty in the form prescribed by the Board.

���� 4. The self-evaluation report which is required by a nationally recognized association that accredits schools of nursing may be submitted in lieu of the report required by subsection 3 if a national accreditation survey of the program is scheduled in the same year as the Board�s review or was completed in the previous year.

���� 5. The Board will prepare a report of the visits to the site of the program and furnish a copy of the report to the administrator of the program. If the administrator objects to the report, the administrator may submit to the Board a written statement which sets forth his or her objections to the report.

���� (Added to NAC by Bd. of Nursing, eff. 9-17-90; A by R212-99, 5-8-2000)

���� NAC 632.708Board may deem program as being surveyed in certain circumstances. (NRS 632.120, 632.430, 632.440, 632.470)In lieu of a survey of a program of nursing required by NAC 632.706, the Board may deem a program of nursing as being surveyed if:

���� 1. The program has received accreditation from a nationally recognized association that accredits schools of nursing, as approved by the Board; and

���� 2. The Board issues a written statement which sets forth the reasons the Board deemed the program as being surveyed.

���� (Added to NAC by Bd. of Nursing by R212-99, eff. 5-8-2000; A by R091-04, 8-13-2004)

���� NAC 632.711Termination of program. (NRS 632.120, 632.430, 632.440)

���� 1. If a university or college wishes to terminate a program of nursing, it shall notify the Board in writing of the reasons for and the proposed date of the termination of the program.

���� 2. The program must continue to comply with the standards for approval until all the matriculating students are graduated from the program.

���� 3. The university or college shall notify the Board if the actual closing date will be different from the proposed closing date.

���� 4. If the university or college closes or terminates its program of nursing, it is responsible for the management and storage of the records of the students who enrolled in that program and shall notify the Board of the arrangement made for the management and storage of those records.

���� (Added to NAC by Bd. of Nursing, eff. 9-17-90; A by R212-99, 5-8-2000)

TRAINING PROGRAMS FOR NURSING ASSISTANTS

���� NAC 632.721Application for approval: Form; fee; renewal; evaluation. (NRS 632.120, 632.2856)

���� 1. Before a person may provide training to nursing assistants in this State, the person must apply to the Board for approval of the training program. The application must be in writing on a form provided by the Board and include, but not be limited to:

���� (a) The content of the training program to be offered.

���� (b) The number of hours of clinical instruction and instruction in the classroom and laboratory.

���� (c) The behavioral objectives of each unit of instruction.

���� (d) The methods to be used to teach each unit of instruction.

���� (e) The methods to be used to evaluate the achievement of behavioral objectives.

���� (f) A description of the facilities to be used for clinical instruction and instruction in the classroom and laboratory.

���� 2. The application must be accompanied by the appropriate fee.

���� 3. The application is valid for 1 year after the date of receipt by the Board and must be renewed annually if the applicant wishes to continue to provide training to nursing assistants in this State.

���� 4. The Board will evaluate the application to determine whether the training program qualifies as an approved program.

���� (Added to NAC by Bd. of Nursing, eff. 3-26-90; A 7-16-92)

���� NAC 632.726Determinations required before approval. (NRS 632.120, 632.2856)Before the Board approves a training program for nursing assistants, it will determine that the program will be:

���� 1. Administered as required by law and the provisions of this chapter.

���� 2. Administered by a registered nurse who has the qualifications required by the Federal Government and is qualified to maintain the records required by NAC 632.790.

���� 3. Coordinated by a registered nurse who has the qualifications required by the Federal Government and is qualified to perform the duties set forth in NAC 632.785.

���� (Added to NAC by Bd. of Nursing, eff. 3-26-90; A by R196-07, 4-17-2008)

���� NAC 632.731Notice and effect of failure to approve program; limitation on authority of Board. (NRS 632.120, 632.2856)

���� 1. If the Board fails to approve a program of training for nursing assistants, it will notify the applicant by mail of the reasons the program was not approved.

���� 2. A trainee who successfully completes a program which is not approved by the Board is not eligible to take a competency evaluation test.

���� 3. The Board may not approve a program to be given by a medical facility if the facility does not comply with the requirements set forth in 42 C.F.R. � 483.151(b), which is hereby adopted by reference. A copy of this regulation may be purchased from the Bureau of Licensing and Certification for the price of 60 cents per page.

���� (Added to NAC by Bd. of Nursing, eff. 3-26-90; A 7-16-92)

���� NAC 632.736General requirements. (NRS 632.120, 632.2856)An approved program must enable each trainee to:

���� 1. Learn to react in a sensitive manner to the emotional, social and mental health needs of patients.

���� 2. Communicate and interact competently on a one-to-one basis with patients.

���� 3. Assist patients in attaining and maintaining independence.

���� 4. Learn to exhibit behavior in support and promotion of the rights of patients.

���� 5. Learn skills in observation and documentation.

���� (Added to NAC by Bd. of Nursing, eff. 3-26-90)

���� NAC 632.741Required instruction. (NRS 632.120, 632.2856)

���� 1. Each approved program must provide at least 75 hours of instruction which must include:

���� (a) Instruction in the classroom and clinical practice in:

��������� (1) The roles and responsibilities of a nursing assistant;

��������� (2) Basic nursing;

��������� (3) Personal care;

��������� (4) The needs of patients concerning mental health and social services;

��������� (5) Basic restorative services; and

��������� (6) Interrelationships with patients.

���� (b) At least 16 hours of instruction in the classroom, completed before a trainee is directly involved with a patient, in the areas of:

��������� (1) Communication and interpersonal skills;

��������� (2) The control of infections;

��������� (3) Safety and emergency procedures, including, but not limited to, the Heimlich maneuver;

��������� (4) Promoting the independence of patients; and

��������� (5) Respecting the rights of patients.

���� 2. The primary instructor shall provide each trainee with:

���� (a) The objectives of the program which the trainee is expected to achieve;

���� (b) The duties and skills expected to be learned by the trainee;

���� (c) The objectives of each unit of instruction, stated in behavioral terms; and

���� (d) The criteria used to measure performance.

���� (Added to NAC by Bd. of Nursing, eff. 3-26-90; A 7-16-92)

���� NAC 632.746Instruction in basic nursing skills. (NRS 632.120, 632.2856)Units of instruction in basic nursing skills must include instruction in the classroom and clinical practice in:

���� 1. Assisting in the care of the patient when death is imminent.

���� 2. Taking and recording vital signs.

���� 3. Measuring and recording height and weight.

���� 4. Caring for the environment of the patient.

���� 5. Measuring and recording the intake and output of fluids and food.

���� 6. Observing, reporting and recording changes in condition, abnormal signs and symptoms.

���� 7. Procedures for noninvasive elimination, including:

���� (a) The care of the external part of the catheter;

���� (b) Emptying the drainage bag for the catheter;

���� (c) Perineal care of the bladder and the bowel;

���� (d) Cleansing enema; and

���� (e) The external care of an established colostomy.

���� 8. The collection of specimens (stool and urine).

���� 9. The application of unsterile warm and cold.

���� 10. Reporting and recording incidents.

���� 11. Reporting and recording patient care provided.

���� (Added to NAC by Bd. of Nursing, eff. 3-26-90; A 7-16-92; R081-06, 6-28-2006)

���� NAC 632.751Instruction in personal care skills. (NRS 632.120, 632.2856)Units of instruction in personal care skills must include instruction in the classroom and clinical practice in:

���� 1. Bathing, including the care of the mouth;

���� 2. Grooming;

���� 3. Dressing;

���� 4. The use of the toilet;

���� 5. Assisting with eating and hydration;

���� 6. Proper feeding techniques; and

���� 7. The care of the skin.

���� (Added to NAC by Bd. of Nursing, eff. 3-26-90)

���� NAC 632.756Instruction in needs of patients concerning mental health and social services. (NRS 632.120, 632.2856)Units of instruction in the needs of patients concerning mental health and social services must include instruction in the classroom and clinical practice in the identification of the psychosocial characteristics of a patient, including training in:

���� 1. Modifying the trainee�s behavior in response to the behavior of the patient;

���� 2. Identifying the developmental tasks associated with the aging process;

���� 3. Providing patients with the opportunity and training to care for themselves, according to their capabilities;

���� 4. Using the family of the patient as a source of emotional support;

���� 5. Reality orientation; and

���� 6. The principles of managing behavior by reinforcing appropriate behavior and reducing or eliminating inappropriate behavior.

���� (Added to NAC by Bd. of Nursing, eff. 3-26-90)

���� NAC 632.758Instruction in care of cognitively impaired persons. (NRS 632.120, 632.2856)Units of instruction in the care of cognitively impaired persons must include instruction in the classroom and clinical practice in:

���� 1. Techniques for meeting the needs and managing the behavior of persons with dementia, including, but not limited to, Alzheimer�s disease;

���� 2. Communicating with cognitively impaired persons;

���� 3. Understanding the behavior of cognitively impaired persons;

���� 4. Appropriate responses to the behavior of cognitively impaired persons; and

���� 5. Methods for reducing the effects of cognitive impairments.

���� (Added to NAC by Bd. of Nursing, eff. 7-16-92)

���� NAC 632.761Instruction in basic restorative services. (NRS 632.120, 632.2856) Units of instruction in basic restorative services must include instruction in the classroom and clinical practice in:

���� 1. The use of devices which assist in ambulation, eating and dressing;

���� 2. Maintenance and range of motion;

���� 3. Proper turning and positioning in a bed and chair;

���� 4. Transferring patients;

���� 5. Assisting in bowel and bladder training; and

���� 6. Assisting in the care and use of prosthetic devices, such as hearing aids, artificial eyes and artificial limbs.

���� (Added to NAC by Bd. of Nursing, eff. 3-26-90)

���� NAC 632.765Instruction in rights of patients. (NRS 632.120, 632.2856)Units of instruction in the rights of patients must include instruction in the classroom and clinical practice in:

���� 1. Providing privacy and maintaining the confidentiality of a patient;

���� 2. Promoting the right of a patient to make personal choices to accommodate his or her needs;

���� 3. Providing assistance in resolving grievances;

���� 4. Providing for the care and security of the possessions of a patient;

���� 5. Recognizing, reporting and preventing the abuse, neglect or exploitation of a patient; and

���� 6. Maintaining the environment of a patient and providing care to minimize the need for physical and chemical restraints.

���� (Added to NAC by Bd. of Nursing, eff. 3-26-90)

���� NAC 632.770Number of instructors required. (NRS 632.120, 632.2856)An approved program must not have less than 1 instructor for each 15 trainees to instruct nursing skills, laboratory practice or clinical practice.

���� (Added to NAC by Bd. of Nursing, eff. 3-26-90)

���� NAC 632.775Instructors: Qualifications; certificate of approval. (NRS 632.120, 632.2856)

���� 1. Except as otherwise provided in this section, instructors for an approved program must be registered nurses who are approved by the Board.

���� 2. The Board will approve a registered nurse to be an instructor if the nurse:

���� (a) Holds a current active license in good standing to practice nursing in this State;

���� (b) Has at least 2 years of experience in nursing, 1 year of which must be in the caring for the elderly or the chronically ill;

���� (c) Has successfully completed a course designated by the Board;

���� (d) Complies with the requirements for continuing education prescribed by the Board; and

���� (e) Meets any federal and state criteria established for instructors of an approved program.

���� 3. The Board will approve a licensed practical nurse to be an instructor if:

���� (a) The Board determines that the circumstances require his or her appointment; and

���� (b) The nurse meets the requirements set forth in paragraphs (a) to (d), inclusive, of subsection 2.

���� 4. The Board will issue a certificate of approval to teach if the instructor:

���� (a) Meets the requirements of subsection 2 or 3;

���� (b) Submits an application to the Board; and

���� (c) Pays the applicable fee to the Board.

���� 5. The Board will renew a certificate of approval to teach annually if an instructor provides evidence satisfactory to the Board that the instructor meets the requirements of this section and has received compensation for teaching at least once in the preceding 2 years.

���� 6. The coordinator of an approved program may select a person who is qualified to carry out the duties set forth in NAC 632.785 to act as an instructor in his or her area of specialization, even though the person is not a registered or licensed practical nurse. The person so selected must:

���� (a) Have at least 1 year of experience in caring for the elderly or chronically ill, or its equivalent; and

���� (b) Where applicable, be licensed, registered or certified in good standing in his or her area of specialization.

� Such an instructor may not be the primary instructor or supervise the testing of manual skills.

���� (Added to NAC by Bd. of Nursing, eff. 3-26-90; A 7-16-92; R212-99, 5-8-2000)

���� NAC 632.780Requirements for classrooms and clinical facilities. (NRS 632.120, 632.2856)

���� 1. Each classroom and clinical facility used by an approved program must be:

���� (a) Adequate in size, number and type.

���� (b) Clean and in a safe condition.

���� (c) Maintained at a comfortable temperature.

���� (d) Adequately lighted.

���� 2. Each clinical facility selected for training must be approved by the Board. Before the Board will approve a facility as a clinical facility, it will consider:

���� (a) Whether the facility complies with statutes and regulations governing medical facilities;

���� (b) Whether the facility has not been allowed to participate in the program for Medicare or Medicaid during the preceding 2 years;

���� (c) Whether the facility has administrative support;

���� (d) The number of programs and trainees using the facility; and

���� (e) Whether the facility is able to provide learning experiences in the care of the elderly or the chronically ill.

���� (Added to NAC by Bd. of Nursing, eff. 3-26-90)

���� NAC 632.785Duties of coordinator of approved program. (NRS 632.120, 632.2856)The coordinator of an approved program shall:

���� 1. Assist with the development of the budget of the program.

���� 2. Assist with the development of procedures for admission to the program.

���� 3. Select and supervise such number of qualified instructors as is necessary to carry out the program.

���� 4. Obtain adequate educational facilities for training, including areas to practice nursing skills.

���� 5. Obtain adequate clinical facilities for training.

���� 6. Provide each trainee with instructional materials during those hours in which they can be put to maximum use.

���� 7. Plan an orientation program for trainees at each clinical facility used for training. The time spent for orientation may not be included in the 75 hours required for training.

���� 8. Ensure that each trainee is clearly identified as a trainee in a manner which is easily recognizable to each patient, member of a patient�s family, visitor or member of the medical staff with whom the trainee works.

���� 9. Develop a system of maintaining permanent records which are essential to the operation of the program, including:

���� (a) The current and final records of each trainee, which may include a list of the duties to be performed and the skills to be learned in the program, with notations of satisfactory or unsatisfactory performance, the date of the performance and the name of the supervising instructor.

���� (b) The current records of the activities of the program.

���� (c) The records of each instructor.

� Records maintained pursuant to this subsection must be retained by the coordinator of the approved program for at least 4 years after the date on which the record was created.

���� 10. Develop written policies for admission to, continuance in, and dismissal and withdrawal from the program.

���� 11. Report to the academic administrator of the Board the name of each trainee who satisfactorily completes the program within 30 days after the completion of the program.

���� 12. Submit annual reports on forms provided by the Board containing information required by the Board.

���� (Added to NAC by Bd. of Nursing, eff. 3-26-90; A by R212-99, 5-8-2000)

���� NAC 632.790Records and reports. (NRS 632.120, 632.2856)The administrator of an approved program shall provide for the safekeeping of the permanent records and reports of the program. Those records must include:

���� 1. The name, address, birthdate and social security number of each trainee who enters and completes the program.

���� 2. The name, address, birthdate and social security number of each trainee who enters and withdraws or is dismissed from the program before completing it.

���� 3. The final grade of each trainee.

���� 4. A copy of the certificate of completion given to each trainee.

���� 5. The date on which each training program is begun and completed.

���� 6. The name, address and approval number of each instructor.

���� (Added to NAC by Bd. of Nursing, eff. 3-26-90)

���� NAC 632.795Revision of approved program. (NRS 632.120, 632.2856)Any revision of an approved program must be approved by the Board before it is used. Revisions include changes or additions in:

���� 1. The objectives of the program.

���� 2. The number of hours of instruction required for the successful completion of the program.

���� 3. The content of the program.

���� 4. The facilities used for training.

���� 5. The administrators, coordinators or instructors for the program.

���� (Added to NAC by Bd. of Nursing, eff. 3-26-90)

���� NAC 632.800Periodic review; inspection of facilities; bases for continued approval. (NRS 632.120, 632.2856)

���� 1. The Board will:

���� (a) Review an approved program annually; and

���� (b) Inspect the facilities used by the program at least one time in every 24-month period or more frequently if the Executive Director determines a need exists.

���� 2. Continued approval of the program will be based on:

���� (a) Information contained in the application for approval which is submitted pursuant to NAC 632.721;

���� (b) The annual review conducted in accordance with subsection 1 and the inspection of the facilities, if any; and

���� (c) The resolution of any deficiencies identified by the Board in previous inspections.

���� 3. The Board will notify the administering body and the coordinator of the program of the outcome of its review by listing commendations, recommendations and deficiencies in the program.

���� (Added to NAC by Bd. of Nursing, eff. 3-26-90; A 7-16-92)

���� NAC 632.805Withdrawal of approval. (NRS 632.120, 632.2856)

���� 1. The Executive Director will send a written notice by certified mail to the administrative body and coordinator of an approved program if the Board intends to withdraw its approval of that program. The notice must specify the reasons for the withdrawal. The coordinator of a program or the administrative body may rebut the reasons for the withdrawal contained in the notice within 15 days after the date the notice is received. The Executive Director will send a written notice of the final determination of the Board to the administrative body and the coordinator of the program.

���� 2. The Board may withdraw its approval of an approved program if:

���� (a) The program fails to comply with the requirements of any statute or regulation;

���� (b) Twenty percent or more of the trainees in the program fail the competency evaluation test;

���� (c) The program has not admitted any trainees within the previous 12 months; or

���� (d) The Board finds three or more instances in which one or more trainees of the program have engaged in unsafe or abusive conduct during the competency evaluation test. For the purposes of conducting an investigation pursuant to NRS 632.310, three documented and substantiated incidents of unsafe or abusive conduct by trainees of a program during the competency evaluation test make out a prima facie case.

���� 3. If the Board withdraws its approval, the administrator of the program shall take such action as is necessary to retain safely the records of each trainee in the program and to ensure that the trainees complete training.

���� (Added to NAC by Bd. of Nursing, eff. 3-26-90; A 7-16-92)

TRAINING PROGRAMS FOR MEDICATION AIDES - CERTIFIED

���� NAC 632.810Application for approval: Form; fee; renewal; evaluation. (NRS 632.120, 632.292)

���� 1. Before a person may provide training to medication aides - certified in this State, the person must apply to the Board for approval of the training program. The application must be in writing on a form provided by the Board and include, without limitation:

���� (a) The content of the training program to be offered.

���� (b) The number of hours of clinical instruction and instruction in the classroom and laboratory.

���� (c) The behavioral objectives of each unit of instruction.

���� (d) The methods to be used to teach each unit of instruction.

���� (e) The methods to be used to evaluate the achievement of behavioral objectives.

���� (f) A description of the facilities to be used for clinical instruction and instruction in the classroom and laboratory.

���� 2. The application must be accompanied by the appropriate fee.

���� 3. The application is valid for 1 year after the date of receipt by the Board and must be renewed annually if the applicant wishes to continue to provide training to medication aides - certified in this State.

���� 4. The Board will evaluate the application to determine whether the training program qualifies as an approved program for medication aides - certified.

���� (Added to NAC by Bd. of Nursing by R112-11, eff. 2-15-2012)

���� NAC 632.815Determinations required before approval. (NRS 632.120, 632.292)Before the Board approves a training program for medication aides - certified, it will determine if the program will be:

���� 1. Administered in accordance with the provisions of this chapter and any other applicable law.

���� 2. Administered by a registered nurse licensed in this State.

���� (Added to NAC by Bd. of Nursing by R112-11, eff. 2-15-2012)

���� NAC 632.820Notice and effect of failure to approve program. (NRS 632.120, 632.292)

���� 1. If the Board fails to approve a training program for medication aides - certified, it will notify the applicant by mail of the reasons the program was not approved.

���� 2. A trainee who successfully completes a training program for medication aides - certified which is not approved by the Board is not eligible to take a competency evaluation test.

���� (Added to NAC by Bd. of Nursing by R112-11, eff. 2-15-2012)

���� NAC 632.825General requirements. (NRS 632.120, 632.292)An approved program for medication aides - certified must provide training to enable each trainee to:

���� 1. Learn the fundamentals of safety and the proper care of patients by a medication aide - certified at a designated facility.

���� 2. Demonstrate the proper procedures for:

���� (a) The administration of medication:

��������� (1) In the appropriate manner;

��������� (2) At the appropriate time;

��������� (3) To the correct patient; and

��������� (4) In the correct dosage; and

���� (b) Documenting the administration of medication.

���� 3. Perform three safety checks to ensure the proper administration of medication.

���� 4. Understand the causes of errors in the administration of medication.

���� 5. Support and promote the rights of patients.

���� 6. Understand the scope of practice of a medication aide - certified and the role of the delegating and supervising nurse.

���� 7. Understand that a medication aide - certified may not accept the delegation of any duty that is beyond the scope of practice of the medication aide - certified.

���� 8. Understand the ethical and legal issues regarding the administration of medication and the rights of patients regarding the administration of medication.

���� (Added to NAC by Bd. of Nursing by R112-11, eff. 2-15-2012)

���� NAC 632.830Required instruction. (NRS 632.120, 632.292)Each approved program for medication aides - certified must provide at least 60 hours of instruction in theory and laboratory skills and at least 40 hours in supervised clinical experience. The instruction and clinical experience must provide training in:

���� 1. The fundamental roles and responsibilities of a medication aide - certified relating to medication, including, without limitation:

���� (a) The proper procedure for the administration of medication so that the medication aide - certified is prepared to demonstrate the procedure required pursuant to subsection 2 of NAC 632.825;

���� (b) Mathematics necessary to provide the proper dosage, including, without limitation, weights and measurements;

���� (c) The basics of the administration of medication, including, without limitation, understanding:

��������� (1) Terminology and abbreviations used in relation to medication;

��������� (2) Range of dosages for medication;

��������� (3) The medical need for the medication;

��������� (4) The therapeutic effect of certain medication;

��������� (5) The possible side effects of certain medication;

��������� (6) Precautions that must be taken before administering certain medication;

��������� (7) The contraindications of certain medication;

��������� (8) Allergies or adverse reactions to certain medication;

��������� (9) Patient tolerance of certain medication;

��������� (10) The interactions between certain medications;

��������� (11) The additive or antagonist effect of certain medication; and

��������� (12) The idiosyncratic and paradoxical reactions of certain medication;

���� (d) The manner in which medication is ordered, documented, stored and disposed; and

���� (e) The proper manner in which to prepare and administer medication.

���� 2. The safety and care of patients by a medication aide - certified in a designated facility, including, without limitation:

���� (a) How to prevent errors in the administration of medication;

���� (b) The causes of errors in the administration of medication;

���� (c) The procedure for reporting errors in the administration of medication;

���� (d) The manner in which a medication aide - certified may promote the independence of patients; and

���� (e) Respecting the rights of patients.

���� 3. Communication with the patient and personnel of the designated facility and documentation of the administration of medication, including, without limitation:

���� (a) The ability to listen effectively and build relationships with patients and personnel of the designated facility;

���� (b) Reporting symptoms or side effects exhibited by a patient;

���� (c) Reporting any changes in a patient�s condition; and

���� (d) Understanding the role of the delegating or supervising nurse.

���� 4. Other relevant information relating to the administration of medication, including, without limitation:

���� (a) Various manners in which to administer medication;

���� (b) Factors which affect the manner in which the body processes medication;

���� (c) Different types of medication that affect the different systems of the body and the manner in which the body processes those medications; and

���� (d) The manner in which to locate information on specific types of medication, including, without limitation, through the use of reference manuals.

���� 5. The ethical and legal issues of the administration of medication, including, without limitation:

���� (a) The role of a medication aide - certified;

���� (b) The legal and ethical responsibilities of a medication aide - certified who accepts a delegated duty;

���� (c) The legal and ethical issues relating to the rights of patients; and

���� (d) The legal and ethical issues relating to the:

��������� (1) Administration of medication:

�������������� (I) In the appropriate manner;

�������������� (II) At the appropriate time;

�������������� (III) To the correct patient; and

�������������� (IV) In the correct dosage.

��������� (2) Documentation of the administration of medication.

���� (Added to NAC by Bd. of Nursing by R112-11, eff. 2-15-2012)

���� NAC 632.835Instructors: Number required. (NRS 632.120, 632.292)An approved program for medication aides - certified must provide:

���� 1. At least one instructor for each 15 trainees to provide theoretical instruction in the classroom; and

���� 2. At least one instructor for each four trainees to provide instruction on nursing skills and the administration of medication in clinical practice or through the use of simulators.

���� (Added to NAC by Bd. of Nursing by R112-11, eff. 2-15-2012)

���� NAC 632.840Instructors: Qualifications; certificate of approval. (NRS 632.120, 632.292)

���� 1. The instructors for an approved program for medication aides - certified must be registered nurses who are approved by the Board.

���� 2. The Board will approve a registered nurse to be an instructor if the nurse:

���� (a) Holds a current active license in good standing to practice nursing in this State;

���� (b) Has at least 3 years of experience in nursing, 1 year of which must be in the caring for the elderly or the chronically ill;

���� (c) Has obtained experience administering medication in a designated facility within the immediately preceding 5 years or has observed other nurses administering medication in a designated facility within the immediately preceding 2 years;

���� (d) Complies with the continuing education requirements prescribed by the Board;

���� (e) Holds a current certificate as a medication aide - certified instructor; and

���� (f) Has successfully completed a course of training for instructors of medication aides - certified approved by the Board.

���� 3. The Board will issue a certificate of approval to teach medication aides - certified if the instructor:

���� (a) Meets the requirements of subsection 2;

���� (b) Submits an application to the Board; and

���� (c) Pays the applicable fee to the Board.

���� 4. The Board will renew a certificate of approval to teach medication aides - certified annually if the instructor provides evidence satisfactory to the Board that the instructor meets the requirements of this section and has received compensation for teaching at least once in the preceding 2 years.

���� (Added to NAC by Bd. of Nursing by R112-11, eff. 2-15-2012)

���� NAC 632.845Requirements for classroom and clinical facilities. (NRS 632.120, 632.292)

���� 1. Each classroom and clinical facility used by an approved program for medication aides - certified must be:

���� (a) Adequate in size, number and type.

���� (b) Clean and in a safe condition.

���� (c) Maintained at a comfortable temperature.

���� (d) Adequately lighted.

���� 2. Each clinical facility selected for training must be approved by the Board. Before the Board will approve a facility as a clinical facility, it will consider:

���� (a) Whether the facility complies with the statutes and regulations governing medical facilities;

���� (b) Whether the facility has not been allowed to participate in the program for Medicare or Medicaid during the immediately preceding 2 years;

���� (c) Whether the facility has administrative support;

���� (d) The number of programs and trainees using the facility; and

���� (e) Whether the facility is able to provide learning experiences in the care of the elderly or the chronically ill.

���� (Added to NAC by Bd. of Nursing by R112-11, eff. 2-15-2012)

���� NAC 632.850Duties of coordinator of approved program. (NRS 632.120, 632.292)The coordinator of an approved program for medication aides - certified shall:

���� 1. Assist with the development of the budget of the program.

���� 2. Assist with the development of procedures for admission to the program.

���� 3. Select and supervise as many qualified instructors as necessary to carry out the program.

���� 4. Obtain adequate education facilities for training, including areas to practice nursing skills, and sufficient equipment for administering medication.

���� 5. Obtain long-term care clinical facilities for training.

���� 6. Provide each trainee with instructional materials during those hours in which they can be put to maximum use.

���� 7. Plan an orientation program for trainees at each clinical facility used for training. The time spent for orientation may not be included in the 100 hours required for training pursuant to NAC 632.830.

���� 8. Ensure that each trainee is clearly identified as a trainee in a manner which is easily recognizable to each patient, member of a patient�s family, visitor or member of the medical staff for whom the trainee works.

���� 9. Develop a system of maintaining permanent records which are essential to the operation of the program, including, without limitation:

���� (a) The current and final records of each trainee, which must include, without limitation, a list of the duties relating to the administration of medication to be performed and the skills to be learned in the program, with notations of satisfactory or unsatisfactory performance, the date of the performance and the name of the supervising instructor.

���� (b) The current records of the activities of the program.

���� (c) The records of each instructor.

� Records maintained pursuant to this subsection must be retained by the coordinator of the approved training program for medication aides - certified for not less than 4 years after the date on which the record is created.

���� 10. Develop written policies for admission to, continuance in, and dismissal and withdrawal from the program.

���� 11. Report to the academic administrator of the Board the name of each trainee who satisfactorily completes the program within 30 days after the completion of the program.

���� 12. Report to the Board the name of any trainee involved in an error in the administration of medication, including a root cause analysis of the error.

���� 13. Submit annual reports on forms provided by the Board containing information required by the Board.

���� (Added to NAC by Bd. of Nursing by R112-11, eff. 2-15-2012)

���� NAC 632.855Records and reports. (NRS 632.120, 632.292)The administrator of an approved program for medication aides - certified shall provide for the safekeeping of the permanent records and reports of the program. Those records must include, without limitation:

���� 1. The name, address and birthdate of each trainee who enters and completes the program.

���� 2. The name, address and birthdate of each trainee who enters and withdraws or is dismissed from the program before completing it.

���� 3. The final grade of each trainee.

���� 4. A copy of the certificate of completion given to each trainee.

���� 5. The date on which each training program is begun and completed.

���� 6. The name, address and approval number of each instructor.

���� (Added to NAC by Bd. of Nursing by R112-11, eff. 2-15-2012)

���� NAC 632.860Revision of approved program. (NRS 632.120, 632.292)Any revision of an approved program for medication aides - certified must be approved by the Board before it is used. A revision includes, without limitation, a change or addition in:

���� 1. The objectives of the program.

���� 2. The number of hours of instruction required for the successful completion of the program.

���� 3. The content of the program.

���� 4. A facility used for training.

���� 5. An administrator, coordinator or instructor for the program.

���� (Added to NAC by Bd. of Nursing by R112-11, eff. 2-15-2012)

���� NAC 632.865Periodic review; inspection of facilities; bases for continued approval. (NRS 632.120, 632.292)

���� 1. The Board will:

���� (a) Review an approved program for medication aides - certified annually; and

���� (b) Inspect the facilities used by an approved program for medication aides - certified at least one time in every 24-month period, or more frequently if the Executive Director determines a need exists.

���� 2. Continued approval of an approved program for medication aides - certified will be based upon:

���� (a) Information contained in the application for approval which is submitted pursuant to NAC 632.810;

���� (b) The annual review conducted in accordance with subsection 1 and the inspection of the facilities, if any;

���� (c) Whether the graduates of the program have a passage rate on the national medication aide - certified examination approved by the Board of not less than 80 percent; and

���� (d) The resolution of any deficiencies identified by the Board in previous inspections.

���� 3. The Board will notify the administering body and the coordinator of the approved program for medication aides - certified of the outcome of its review by listing commendations, recommendations and deficiencies in the program.

���� (Added to NAC by Bd. of Nursing by R112-11, eff. 2-15-2012)

���� NAC 632.870Withdrawal of approval. (NRS 632.120, 632.292)

���� 1. The Executive Director will send a written notice by certified mail to the administrative body and coordinator of an approved program for medication aides - certified if the Board intends to withdraw its approval of that program. The notice must specify the reasons for the withdrawal. The coordinator of the program or the administrative body may rebut the reasons for the withdrawal contained in the notice within 15 days after the date on which the notice was received. The Executive Director will send a written notice of the final determination of the Board to the administrative body and the coordinator of the program.

���� 2. The Board may withdraw its approval of an approved program for medication aides - certified if:

���� (a) The program fails to comply with the requirements of any statute or regulation;

���� (b) More than 20 percent of the trainees in the program fail the national medication aide - certified certification examination approved by the Board;

���� (c) The program has not admitted any trainees within the immediately preceding 12 months; or

���� (d) The Board finds three or more instances in which one or more trainees of the program have engaged in unsafe or abusive conduct during the medication administration evaluation test. For the purposes of conducting an investigation pursuant to NRS 632.310, three documented and substantiated incidents of unsafe or abusive conduct by trainees of an approved program for medication aides - certified during the competency evaluation test make out a prima facie case for the withdrawal of approval of an approved program for medication aides - certified.

���� 3. If the Board withdraws its approval, the administrator of the approved program for medication aides - certified must take such action as is necessary to retain safely the records of each trainee in the program and to ensure that the trainees complete training.

���� (Added to NAC by Bd. of Nursing by R112-11, eff. 2-15-2012)

DISCIPLINARY ACTION AND PRACTICE BEFORE THE BOARD

���� NAC 632.890Unprofessional conduct. (NRS 632.120, 632.347)The Board will consider the following acts, among others, by a licensee or holder of a certificate as unprofessional conduct:

���� 1. Discriminating on the basis of race, religious creed, color, national origin, age, disability, ancestry, sexual orientation or sex in the rendering of nursing services.

���� 2. Performing acts beyond the scope of the practice of nursing.

���� 3. Assuming duties and responsibilities within the practice of nursing without adequate training.

���� 4. Assuming duties and responsibilities within the practice of nursing if competency is not maintained or the standards of competence are not satisfied, or both.

���� 5. Disclosing the contents of the examination for licensure or certification, or soliciting, accepting or compiling information regarding the contents of the examination before, during or after its administration.

���� 6. Assigning or delegating functions, tasks or responsibilities of licensed or certified persons to unqualified persons.

���� 7. Failing to supervise a person to whom functions of nursing are delegated or assigned, if responsible for supervising that person.

���� 8. Failing to safeguard a patient from the incompetent, abusive or illegal practice of any person.

���� 9. Practicing nursing while, with or without good cause, his or her physical, mental or emotional condition impairs his or her ability to act in a manner consistent with established or customary nursing standards, or both.

���� 10. Practicing nursing, if any amount of alcohol or a controlled substance or dangerous drug that is not legally prescribed is present in the body of the nurse, nursing assistant or medication aide - certified as determined by a test of the blood, saliva, breath, hair or urine of the nurse, nursing assistant or medication aide - certified given while the nurse, nursing assistant or medication aide - certified is on duty.

���� 11. Having present in the body of the nurse, nursing assistant or medication aide - certified alcohol or a controlled substance or dangerous drug that is not legally prescribed during a test of the blood, saliva, breath, hair or urine of the nurse, nursing assistant or medication aide - certified given as a condition of employment.

���� 12. Failing to respect and maintain a patient�s right to privacy.

���� 13. Violating a patient�s confidentiality.

���� 14. Performing or offering to perform the functions of a licensee or holder of a certificate by false representation or under a false or an assumed name.

���� 15. Failing to report the gross negligence of a licensee or holder of a certificate in the performance of his or her duties or a violation of the provisions of this chapter or chapter 632 of NRS.

���� 16. Failing to document properly the administration of a controlled substance, including, but not limited to:

���� (a) Failing to document the administration of a controlled substance on the Controlled Substance Administration Record, the patient�s Medication Administration Record and the Nursing Progress Notes, including the patient�s response to the medication;

���� (b) Documenting as wastage a controlled substance and taking that controlled substance for personal or other use;

���� (c) Failing to document the wastage of a controlled substance that was not legally administered to a patient;

���� (d) Soliciting the signature on any record of a person as a witness to the wastage of a controlled substance when that person did not witness the wastage; or

���� (e) Signing any record as a witness attesting to the wastage of a controlled substance which he or she did not actually witness.

���� 17. Soliciting services or soliciting or borrowing money, materials or other property, or any combination thereof, from a:

���� (a) Patient;

���� (b) Family member of a patient;

���� (c) Person with significant personal ties to a patient, whether or not related by blood; or

���� (d) Legal representative of a patient.

���� 18. Diverting supplies, equipment or drugs for personal or unauthorized use.

���� 19. Aiding, abetting or assisting any person in performing any acts prohibited by law.

���� 20. Inaccurate recording, falsifying or otherwise altering or destroying records.

���� 21. Obtaining, possessing, furnishing or administering prescription drugs to any person, including himself or herself, except as directed by a person authorized by law to prescribe drugs.

���� 22. Leaving an assignment without properly notifying the appropriate personnel or abandoning a patient in need of care.

���� 23. Exploiting a patient for financial gain or offering, giving, soliciting or receiving fees or gifts for the referral of a:

���� (a) Patient;

���� (b) Family member of a patient;

���� (c) Person with significant personal ties to a patient, whether or not related by blood; or

���� (d) Legal representative of a patient.

���� 24. Failing to collaborate with other members of a health care team as necessary to meet the health needs of a patient.

���� 25. Failing to observe the conditions, signs and symptoms of a patient, to record the information or to report significant changes to the appropriate persons.

���� 26. Failing to abide by any state or federal statute or regulation relating to the practice of nursing.

���� 27. Failing to perform nursing functions in a manner consistent with established or customary standards.

���� 28. Causing a patient or the family of the patient physical, mental or emotional harm by taking direct or indirect actions or failing to take appropriate actions.

���� 29. Engaging in sexual contact with a patient or client.

���� 30. Failing as a chief nurse to:

���� (a) Institute standards of nursing practice so that safe and effective nursing care is provided to patients;

���� (b) Institute standards of competent organizational management and management of human resources so that safe and effective nursing care is provided to patients; or

���� (c) Create a safe and effective environment, including the failure to assess the knowledge, skills and ability of a licensee or holder of a certificate and determine his or her competence to carry out the requirements of his or her job.

���� 31. Failing to report the unauthorized practice of nursing.

���� 32. Endangering the safety of the general public, patients, clients or coworkers by making actual or implied threats of violence or carrying out an act of violence.

���� 33. Abusing a patient.

���� 34. Neglecting a patient.

���� 35. Misappropriating the property of a patient.

���� 36. Failing to comply with a condition, limitation or restriction which has been placed on his or her license or certificate.

���� 37. Engaging in the practice of nursing or performing the services of a nursing assistant or medication aide - certified without a license or certificate issued pursuant to the provisions of this chapter and chapter 632 of NRS.

���� 38. Displaying a license, certificate, diploma or permit, or a copy of a license, certificate, diploma or permit, which has been fraudulently purchased, issued, counterfeited or materially altered.

���� 39. Engaging in a pattern of conduct that demonstrates failure to exercise the knowledge, skills, and abilities using the methods ordinarily exercised by a reasonable and prudent nurse to protect the public.

���� 40. Committing an error in the administration or delivery of medication to a patient.

���� 41. Failing to cooperate with an investigation conducted by the Board.

���� 42. Engaging in any other unprofessional conduct with a patient or client that the Board determines is outside the professional boundaries generally considered acceptable in the profession, including, without limitation, a violation of the guidelines of the American Nurses Association or the National Council of State Boards of Nursing concerning the appropriate use of social media.

���� (Added to NAC by Bd. of Nursing, eff. 8-5-86; A 6-30-88; 2-6-90; 11-19-93; 5-18-94; 5-9-96; R029-97, 1-26-98; R081-06, 6-28-2006; R196-07, 4-17-2008; R063-08, 9-18-2008; R112-11, 2-15-2012)

���� NAC 632.895Interpretations for purposes of disciplinary action. (NRS 632.120, 632.347)For the purposes of disciplinary action on the following grounds, the following interpretations apply:

���� 1. An offense involving moral turpitude includes an act of dishonesty, baseness, vileness or depravity in the private or social duties which a person owes to another person or to society contrary to the accepted and customary rule of right and duty between human beings.

���� 2. Gross negligence in carrying out usual nursing functions includes a departure from established and customary standards of care which would have been exercised by a licensed nurse or an act or omission where there is a legal duty to act or to refrain from acting. An exercise of so slight a degree of care as to justify the belief that there was a conscious or overt disregard or indifference for the health, safety, well-being or welfare of the public is considered a substantial departure from the accepted standard of care.

���� 3. Habitual intemperance or addiction to the use of any controlled substance includes the use of those substances to the extent that the person�s judgment, skills or ability to provide safe and competent nursing care are impaired, that the person is unable to care for himself or herself, his or her property or the members of his or her family, or that it is medically determined that the person is in need of medical or psychiatric care, treatment, rehabilitation or counseling.

���� 4. Unfitness to practice nursing or mental incompetence includes an order of a court adjudging that a person is mentally incompetent, an evaluation by a qualified professional person indicating that he or she is mentally or physically incapable of engaging in professional or practical nursing in a manner consistent with sound care of patients, or an uncorrected physical defect that precludes him or her from safely performing nursing functions.

���� 5. An offense involving abuse or neglect includes an act by a licensee or holder of a certificate that constitutes the failure to provide such service, care or supervision as is reasonable and necessary to maintain the health or safety of a patient if:

���� (a) The act or omission is intentional, reckless or grossly negligent;

���� (b) The act or omission is such a departure from what would be the conduct of an ordinarily prudent, careful person under the same circumstances that it is contrary to a proper regard for danger to human life or constitutes indifference to the resulting consequences;

���� (c) The consequences of the act or omission could have been reasonably foreseen; and

���� (d) The danger to human life was not the result of:

��������� (1) The failure to attend to a duty under circumstances that require the attention of the licensee or holder of a certificate;

��������� (2) A mischance, accident or casualty caused by the licensee or holder of a certificate upon a person without an intent to harm or hurt the person but which results in injury to or the death of the person; or

��������� (3) An unintentional act, omission or error in judgment by the licensee or holder of a certificate,

� but was the natural and probable result of the act or omission.

���� 6. An act of patient abandonment occurs if:

���� (a) A licensee or holder of a certificate has been assigned and accepted a duty of care to a patient;

���� (b) The licensee or holder of a certificate departed from the site of the assignment without ensuring that the patient was adequately cared for; and

���� (c) As a result of the departure, the patient was in potential harm or actually harmed.

���� (Added to NAC by Bd. of Nursing, eff. 8-5-86; A 5-18-94; 5-9-96)

���� NAC 632.901Definitions. (NRS 632.120)As used in NAC 632.901 to 632.930, inclusive, unless the context otherwise requires:

���� 1. �Complaint� means a document which contains:

���� (a) A concise statement of the act or omission of the licensee or holder of a certificate which is alleged to be in violation of a statute or regulation, or both; and

���� (b) The citation of the statute or regulation, or both, alleged to have been violated.

���� 2. �Contested case� has the meaning ascribed to it in NRS 233B.032.

���� 3. �Notice of hearing� means a document which contains the information required by NRS 233B.121.

���� 4. �Petitioner� means the representative of the Board who files a complaint against a licensee or holder of a certificate and who has the burden of proving the alleged violation.

���� 5. �Respondent� means the licensee or holder of a certificate against whom a complaint is filed.

���� (Added to NAC by Bd. of Nursing, eff. 11-6-95)

���� NAC 632.910Informal action for certain complaints and controversies; discovery of new evidence. (NRS 632.120)Complaints or controversies that do not justify or require formal proceedings may be considered and resolved by the Board or the Executive Director or a person designated by the Executive Director through informal conferences, meetings, agreements, stipulations or other informal action as may be appropriate under the circumstances. Such informal action is held without prejudice to the Board, and formal proceedings may be instituted subsequently by the Board or the Executive Director or a person designated by the Executive Director for the same or related matters. If new evidence is discovered, the matter may at any time be opened again and investigated further if the circumstances so warrant.

���� [Bd. of Nursing, Practice Rule � IV subsec. A pars. 2-4, eff. 7-10-75] — (NAC A 8-5-86; 1-13-94; 5-9-96)

���� NAC 632.915Executive Director�s response to report of investigation; disciplinary action determined unnecessary; discovery of new evidence. (NRS 632.120)

���� 1. The Executive Director or a person designated by the Executive Director may, in response to the report of an investigation:

���� (a) Dismiss any complaint and notify the complainant, the applicant or licensee named in the complaint, and any other interested parties, stating the reasons for the dismissal.

���� (b) Cause, through legal counsel, a formal disciplinary hearing to be brought before the Board.

���� 2. If an investigation discloses that disciplinary action is not necessary or warranted for the protection of the public health, safety and welfare, the file on that investigation will be closed. If new evidence is discovered, the matter may at any time be opened again and investigated further if the circumstances so warrant.

���� [Bd. of Nursing, Practice Rule � IV subsec. A pars. 6, 7 & 10, eff. 7-10-75] — (NAC A 8-5-86; 5-9-96)

���� NAC 632.916Complaint and notice of hearing on disciplinary matter; waiver of claim of improper notice. (NRS 632.120, 632.350)

���� 1. At least 20 days before a hearing on any formal disciplinary matter, the complaint and notice of the hearing will be mailed to the person named in the complaint by certified mail to the last known address shown on the records of the Board. The complaint and notice of hearing may be included in the same document. There is a rebuttable presumption that a complaint and notice of hearing has been received by a respondent 10 days after the date the complaint and notice of hearing were deposited with the United States Postal System.

���� 2. Any contention that improper notice was given is deemed to be waived unless the respondent raises the issue to the Board before the commencement of arguments on any other motion related to the complaint or the opening statement of the petitioner, whichever occurs first.

���� (Added to NAC by Bd. of Nursing, eff. 8-5-86; A 11-6-95)

���� NAC 632.9165Complaint: Amendment; continuance; withdrawal. (NRS 632.120, 632.350)

���� 1. A complaint may be amended at any time.

���� 2. The Board will grant a continuance if the amendment materially alters the complaint or a respondent demonstrates an inability to prepare for the case in a timely manner.

���� 3. A complaint may be withdrawn at any time before the hearing begins.

���� (Added to NAC by Bd. of Nursing, eff. 11-6-95)

���� NAC 632.9175Consolidation of cases. (NRS 632.120)The Board may consolidate two or more cases whenever it appears that the cases involve common issues of law or fact and the interests of the parties will not be prejudiced by the consolidation.

���� (Added to NAC by Bd. of Nursing, eff. 11-6-95)

���� NAC 632.918Hearings: Board not bound by strict rules of procedure; stenographic notes of oral proceedings; record of charges and evidence. (NRS 632.120)

���� 1. The Board will not be bound by strict rules of procedure in the conduct of its proceedings.

���� 2. A request by any party that the oral proceedings, or any part thereof, be taken in the form of stenographic notes must be submitted 5 days before the hearing and those notes may be transcribed at the party�s own expense.

���� 3. A record of the charges and a record of all evidence produced will be filed in the Office of the Board.

���� (Added to NAC by Bd. of Nursing, eff. 8-5-86)

���� NAC 632.9185Hearings: Applicability; deviations from provisions. (NRS 632.120)

���� 1. A hearing held pursuant to the provisions of NAC 632.901 to 632.930, inclusive, will be conducted pursuant to the provisions of chapter 233B of NRS.

���� 2. The Board may permit deviations from the provisions of NAC 632.901 to 632.930, inclusive, if:

���� (a) The deviation will not adversely affect the substantial interests of the parties;

���� (b) Good cause for the deviation appears; and

���� (c) The deviation does not violate the provisions of chapter 233B of NRS.

���� 3. If a deviation from the provisions of NAC 632.901 to 632.930, inclusive, is allowed by the Board, the deviation and the reasons for the deviation will be stated on the record.

���� (Added to NAC by Bd. of Nursing, eff. 11-6-95)

���� NAC 632.919Legal representation of respondent; rules of conduct; attorney�s fees. (NRS 632.120)

���� 1. A respondent may be represented by an attorney licensed to practice law in this State. If the attorney is not licensed to practice law in this State, he or she must be associated with an attorney who is so licensed. The respondent may appear on his or her own behalf.

���� 2. An attorney appearing in a hearing before the Board shall ensure that his or her conduct complies with the Nevada Rules of Professional Conduct.

���� 3. All persons appearing in a hearing before the Board shall conform to the standards of ethical and courteous conduct required in the courts of this State.

���� 4. If a person fails to conform his or her conduct to the standards required by this section, the Board may:

���� (a) Limit the evidence presented by that person; or

���� (b) Exclude the person or the person�s representative from the hearing.

���� 5. Any action taken by the Board pursuant to this section and the specific reasons for that action will be stated on the record.

���� 6. The respondent shall pay the cost for representation by his or her attorney at a hearing before the Board.

���� (Added to NAC by Bd. of Nursing, eff. 11-6-95)

���� NAC 632.9195Withdrawal of attorney: Notice; denial of request. (NRS 632.120)An attorney may withdraw from his or her representation of a respondent upon notice to the respondent and the Board. The notice must include the reason for the requested withdrawal. The Board may deny permission to withdraw if the withdrawal would unreasonably delay the hearing.

���� (Added to NAC by Bd. of Nursing, eff. 11-6-95)

���� NAC 632.9205Hearing officer: Duties; authority. (NRS 632.120. 632.355)

���� 1. The Board may appoint an attorney, who is licensed to practice law in this State, or a nurse, who is licensed by the Board, to serve as a hearing officer in a contested case. The hearing officer may, upon the request of the Board:

���� (a) Conduct hearings;

���� (b) Question witnesses;

���� (c) Make rulings on motions and objections; and

���� (d) Submit suggested findings of fact or conclusions of law to the Board at the conclusion of the case.

� In any contested case in which a hearing officer is designated pursuant to the provisions of this section, the Board will make the final determination of all findings in the case.

���� 2. If the hearing officer is an attorney licensed to practice law in this State, the hearing officer may, upon the request of the Board, provide such legal counsel to the Board as the Board may require during the hearing and deliberation on a complaint.

���� 3. If the Board does not appoint a hearing officer pursuant to subsection 1, the Board will designate the Executive Director, a presiding officer or any other member of the Board to serve as the hearing officer.

���� (Added to NAC by Bd. of Nursing, eff. 11-6-95)

���� NAC 632.921Motions: Subject matter; service; written response. (NRS 632.120)

���� 1. A motion must be made in writing, unless otherwise authorized by the Board or hearing officer during the hearing.

���� 2. Only the following motions may be made:

���� (a) To request the dismissal of the complaint for a failure to state facts which, if true, would form a sufficient basis for discipline.

���� (b) To request the dismissal of the complaint if the petitioner has concluded the presentation of his or her case and has failed to meet his or her burden of proof.

���� (c) To request a continuance or extension of time.

���� (d) To request an order granting a rehearing.

���� (e) To request a reconsideration of the decision of the Board.

���� (f) To request the exclusion of a member of the Board or the hearing officer from participation in the hearing or deliberation for good cause.

���� (g) To request that an order be vacated or modified.

���� (h) To request the separation of cases which have been consolidated pursuant to NAC 632.9175.

���� (i) To limit or quash a subpoena issued by the Board.

���� 3. The Board may require oral argument and the submission of additional facts or evidence to decide a motion.

���� 4. A written motion must be served on the opposing party and the Board at least 10 days before the time set for the hearing on the motion.

���� 5. An opposing party may file a written response to a motion within 7 days after the receipt of the motion by serving the written response on all parties and the Board, but in no case may a written response be filed less than 3 days before the time set for the hearing on the motion except for good cause shown and with the permission of the Board.

���� (Added to NAC by Bd. of Nursing, eff. 11-6-95)

���� NAC 632.922Request for continuance of formal hearing. (NRS 632.120)A request for a continuance of a formal hearing must be presented to the Board, in writing, before the date of the hearing or orally at the time of the hearing. The request will be heard by the Board at the time set for the hearing or at its next scheduled meeting, whichever comes first.

���� (Added to NAC by Bd. of Nursing, eff. 11-19-93)

���� NAC 632.923Failure to appear. (NRS 632.120)If a party fails to appear at a hearing scheduled by the Board and a continuance has not been requested or granted, upon an offer of proof by the other party that the absent party was given proper notice and upon a determination by the Board that proper notice was given, the Board may proceed to consider the case without the participation of the absent party and may dispose of the matter on the basis of the evidence before it. If the respondent fails to appear at the hearing or fails to reply to the notice, the charges specified in the complaint may be considered as true.

���� (Added to NAC by Bd. of Nursing, eff. 11-6-95)

���� NAC 632.924Examination of witnesses. (NRS 632.120)

���� 1. A party may call any other party or witness as an adverse witness. The party may question such a witness as if conducting a cross-examination.

���� 2. Any party who is surprised by the testimony of a witness, called in good faith as a witness on the party�s behalf, may question the witness as if conducting a cross-examination.

���� (Added to NAC by Bd. of Nursing, eff. 11-6-95)

���� NAC 632.925Appearance by interested person. (NRS 632.120)Anyone desiring to appear before the Board shall advise the Executive Director in writing at least 20 days preceding the next scheduled meeting, stating briefly what matter the person wishes the Board to consider.

���� [Bd. of Nursing, Practice Rule � IV subsec. A par. 11, eff. 7-10-75] — (NAC A 11-6-95)

���� NAC 632.9255Procedure for hearing; transcript of proceedings; burden of proof. (NRS 632.120)

���� 1. Except as otherwise provided in this section, a hearing in a contested case will be conducted in the following order:

���� (a) The hearing will be called to order by the President of the Board or the appointed hearing officer.

���� (b) Introduction of the parties and members of the Board or the appointed hearing officer will be made.

���� (c) The complaint and notice of hearing will be placed in evidence.

���� (d) The parties will be asked whether they wish to have witnesses, except as otherwise provided in this paragraph, excluded from the hearing except during their testimony. If excluded, witnesses will be instructed not to discuss the case during the pendency of the proceeding. The respondents will be permitted to remain in the hearing. The petitioner may designate a person, who may also be a witness, to act as its representative. Such a representative will be permitted to remain in the hearing.

���� (e) Any preliminary motions, stipulations or orders upon which the parties agree will be heard and any administrative details will be addressed.

���� (f) The petitioner and then the respondent may make opening statements.

���� (g) The petitioner may call witnesses and present evidence. Each witness will be sworn and questioned in the following manner:

��������� (1) The petitioner will question the witness.

��������� (2) The respondent may cross-examine the witness.

��������� (3) If the respondent cross-examines the witness, the petitioner may question the witness on redirect examination.

��������� (4) If the petitioner questions the witness on redirect examination, the respondent may recross-examine the witness.

��������� (5) After the petitioner and respondent complete the questioning pursuant to subparagraphs (1) to (4), inclusive, the members of the Board or hearing officer may question the witness.

��������� (6) If the witness is questioned by the members of the Board or the hearing officer, the petitioner and then the respondent may question the witness. Questions asked by the petitioner and respondent may question the witness. Questions asked by the petitioner and respondent will be limited to those areas addressed by the questions asked by the members of the Board or hearing officer.

���� (h) The respondent may call witnesses and present evidence. Each witness will be sworn in and questioned in the following manner:

��������� (1) The respondent will question the witness.

��������� (2) The petitioner may cross-examine the witness.

��������� (3) If the petitioner cross-examines the witness, the respondent may question the witness on redirect examination.

��������� (4) If the respondent questions the witness on redirect examination, the petitioner may recross-examine the witness.

��������� (5) After the respondent and petitioner complete the questioning pursuant to subparagraphs (1) to (4), inclusive, the members of the Board or hearing officer may question the witness.

��������� (6) If the witness is questioned by the members of the Board or the hearing officer, the respondent and then the petitioner may question the witness. Questions asked by the respondent and petitioner will be limited to those areas addressed by the questions asked by the members of the Board or hearing officer.

���� (i) The petitioner and respondent may be allowed to call appropriate rebuttal and rejoinder witnesses with examination of those witnesses proceeding as set forth in paragraph (g) or (h), as appropriate.

���� (j) The petitioner may present a closing argument, followed by the closing argument of the respondent and then the rebuttal closing argument of the petitioner.

���� (k) The Board or the hearing officer may deliberate the case.

���� 2. The Board may waive any provision of this section if necessary to expedite or ensure the fairness of the hearing.

���� 3. Oral proceedings, or any part thereof, will be transcribed at the request of any party at the expense of that party.

���� 4. The petitioner has the burden of proof in a contested case.

���� (Added to NAC by Bd. of Nursing, eff. 11-6-95)

���� NAC 632.926Actions by Board; surrender of license. (NRS 632.120, 632.347, 632.349)Based on the evidence presented at the hearing, the Board will do one of the following:

���� 1. Dismiss or close the complaint.

���� 2. Reprimand the licensee or holder of a certificate.

���� 3. Deny licensure or certification.

���� 4. Deny renewal or reissuance of a license or certificate.

���� 5. Impose and collect an administrative fine.

���� 6. Accept the voluntary surrender of the license or certificate in lieu of imposing any other disciplinary action set forth in this section.

���� 7. Suspend the license or certificate and order its surrender.

���� 8. Revoke the license or certificate and order its surrender.

���� 9. Enter an order of suspension or revocation but stay the order for good cause subject to probation of a designated period and issue a restricted license.

���� 10. Take any other action deemed appropriate by the Board.

���� (Added to NAC by Bd. of Nursing, eff. 8-5-86; A 11-6-95; R081-06, 6-28-2006; R112-11, 2-15-2012)

���� NAC 632.927Stay of order for revocation or suspension of license or certificate. (NRS 632.120, 632.347, 632.349)

���� 1. If the Board stays an order for revocation or suspension of a license or certificate, subject to probation of a designated period, the Board will determine such conditions as it considers appropriate to regulate, monitor or supervise, or any combination thereof, the practice of the licensee or holder of a certificate during the period of probation. These terms may include, but are not limited to, the following:

���� (a) Informing the Board of the name and address of his or her employer.

���� (b) Evaluations of his or her performance submitted to the Board by the employer at designated intervals.

���� (c) Counseling with a qualified professional counselor.

���� (d) Reports submitted to the Board by the counselor at designated intervals.

���� (e) Submitting self-evaluation reports at designated intervals.

���� (f) Reports of random screening for alcohol or drugs submitted, at designated intervals.

���� (g) Meeting with the professional staff of the Board, at designated intervals.

���� (h) Working under supervision as approved by the professional staff of the Board.

���� (i) Successfully completing any educational courses required by the Board.

���� 2. Before expiration of the period of probation, the file and reports concerning the licensee or holder of a certificate may be reviewed and evaluated by the Board and action may be taken to reinstate the license or certificate. If at any time the Board determines that the terms of probation are violated or that the progress and performance under the probation are unsatisfactory, the period of probation may be extended summarily, the terms of probation may be modified or the order of suspension or revocation may be invoked summarily.

���� 3. The licensee or holder of a certificate shall pay the cost to comply with the terms of his or her probation required by the Board pursuant to this section.

���� (Added to NAC by Bd. of Nursing, eff. 8-5-86; A 11-6-95)

���� NAC 632.928 Request for reconsideration or rehearing. (NRS 632.120)

���� 1. Within 10 days after receipt of an order of the Board, a person may request, by certified letter, a reconsideration or rehearing based on the following grounds:

���� (a) Newly discovered or available relevant evidence.

���� (b) Error in the proceeding or decision of the Board that would be grounds for reversal or judicial review of the order.

���� (c) The need in the public interest for further consideration of the issues and the evidence.

���� 2. The Board will deny the request, order a rehearing or reconsideration or direct such other proceeding as it considers appropriate.

���� 3. The hearing will be confined to those grounds upon which reconsideration or the rehearing was ordered.

���� (Added to NAC by Bd. of Nursing, eff. 8-5-86)

���� NAC 632.929Reissuance of license or certificate: Period during which licensee or certificate holder may not apply for reissuance; requirements for reissuance. (NRS 632.120, 632.330)

���� 1. The Board will, in each order of revocation it issues, prescribe a period during which a licensee or holder of a certificate may not apply for the reissuance of his or her license or certificate. The period will not be less than 1 year or more than 20 years.

���� 2. An applicant for reissuance of a license or certificate must:

���� (a) Submit an application for reissuance on a form provided by the Board;

���� (b) If he or she is applying for reissuance of a license, satisfy all requirements for renewal of a license;

���� (c) If he or she is applying for reissuance of a certificate, satisfy all requirements for renewal of a certificate;

���� (d) Attest that he or she has not, during the period of revocation of the license or certificate, violated any state or federal statute or regulation governing the practice of nursing or the practice of a nursing assistant or medication aide - certified; and

���� (e) Attest that there is no disciplinary action pending against him or her before any board or other regulatory body having jurisdiction over the practice of nursing or the practice of a nursing assistant or medication aide - certified.

���� 3. The Board may designate requirements in addition to the requirements of subsection 2 that must be satisfied before an applicant will be considered for reissuance of a license or certificate, including, without limitation, completion of additional courses or programs.

���� 4. The Executive Director of the Board or a person designated by the Executive Director:

���� (a) May review an application for reissuance of a license or certificate to determine whether the application satisfies the requirements of this section.

���� (b) May deny an application which he or she determines does not satisfy the requirements.

���� 5. In considering the reissuance of a license or certificate which has been revoked, the Board will evaluate:

���� (a) The severity of the act which resulted in revocation of the license or certificate;

���� (b) The conduct of the applicant after the revocation of the license or certificate;

���� (c) The lapse of time since revocation;

���� (d) The degree of compliance with all conditions the Board may have stipulated as a prerequisite for reissuance of the license or certificate;

���� (e) The degree of rehabilitation attained by the applicant as evidenced by statements to the Board from qualified people who have professional knowledge of the applicant; and

���� (f) The truthfulness of the attestations made by the applicant pursuant to subsection 2.

���� 6. An applicant for reissuance of a license or certificate may be requested to appear before the Board.

���� 7. After evaluation, the Board will deny or grant the reissuance of the license or certificate.

���� (Added to NAC by Bd. of Nursing, eff. 8-5-86; A 5-9-96; R112-11, 2-15-2012)

���� NAC 632.930Reporting of disciplinary action or denial of application for license or certificate. (NRS 632.120)

���� 1. The Board may report any disciplinary action it takes against a licensee or holder of a certificate to:

���� (a) Any national repository which records disciplinary action taken against licensees or holders of certificates; or

���� (b) Any agency of another state which regulates the practice of nursing.

���� 2. The Board may report its denial of an application for a license or certificate and any other disciplinary action the Board takes against an applicant for a license or certificate to:

���� (a) Any national repository which records disciplinary action taken against licensees or holders of certificates; or

���� (b) Any agency of another state which regulates the practice of nursing.

���� (Added to NAC by Bd. of Nursing, eff. 11-6-95; A by R122-01, 12-17-2001)

���� NAC 632.935Advisory opinion, declaratory order or practice decision. (NRS 632.120)

���� 1. A person requesting an advisory opinion, a declaratory order or a practice decision of the Board shall submit the request to the Executive Director. Nine typewritten, double-spaced copies of the request must be submitted and signed by the person. The request must state clearly the facts involved and the question to which the Board is requested to reply.

���� 2. Before issuing an opinion, order or decision, an informal or formal hearing may be scheduled on the question raised in the petition.

���� 3. A violation of an advisory opinion, a declaratory order or a practice decision:

���� (a) Is cause for an informal hearing by the Board to determine the applicability of the statutes to the conduct at issue.

���� (b) Constitutes a violation of the statutes or the regulations of the Board, and is cause for a formal disciplinary hearing.

���� [Bd. of Nursing, Practice Rule � IV subsec. C pars. 1-5, eff. 7-10-75] — (NAC A 8-5-86; R112-11, 2-15-2012)

���� NAC 632.938Issuance of citation for practicing or offering to practice nursing without license; administrative fine; appeal. (NRS 632.120, 632.495)

���� 1. Before the Board issues a citation pursuant to NRS 632.495, the Board will investigate the alleged violation of NRS 632.315 and make a determination, based upon substantial evidence, whether a violation of NRS 632.315 has occurred.

���� 2. A citation may be served on a person:

���� (a) By sending a copy of the citation by registered or certified mail, return receipt requested, to the person�s last known address; or

���� (b) Personally by the Executive Director of the Board or the Executive Director�s designee.

���� 3. A citation which assesses an administrative fine must be paid by a cashier�s check or money order made payable to the Board.

���� 4. A person served with a citation which assesses an administrative fine may submit a written request to the Office of the Board for approval of a payment schedule. Within the discretion of the Board, the staff of the Board may establish such a schedule.

���� 5. If the Board grants an appeal pursuant to subsection 2 of NRS 632.495, the Board may schedule a hearing on the appeal at the next scheduled meeting of the Board. The Board will send written notice to the person requesting an appeal of the time and place of the hearing. The notice will be sent by registered or certified mail, return receipt requested, to the person�s last known address.

���� (Added to NAC by Bd. of Nursing, eff. 5-9-96)

���� NAC 632.940Violation of statutes or regulations. (NRS 632.120)Any alleged violation of the statutes or regulations must be brought to the attention of the Executive Director or his or her designee.

���� [Bd. of Nursing, Practice Rule � IV subsec. A par. 9, eff. 7-10-75] — (NAC A by R112-11, 2-15-2012)

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