Policy & Advocacy for Population Health
Title here
Regulation for Nursing Practice Staff Development Meeting
Name
Class
Date
OBJECTIVES
Discuss
Discuss differences between a board of nursing and a professional nurse association
Identify
Identify board members and describe how you become a board member
Identify
Identify a federal regulation and describe how it influences health care
Identify
Identify a state regulation and describe how it influences nursing scope of practice and health care
Identify
Identify a state regulation and describe how it influences Advanced Practice Registered Nurses and health care
Differences between a Board of Nursing and a Professional Nurse Association
| Board of Nursing |
| State Agency: protect and promote the public’s health and welfare |
| Supervises and Assures: licensed nurses from every level of practice are providing safe and competent care |
| 59 in total: which comprise the National Council of State Boards of Nursing (NCSBN), an independent, not for profit organization. |
Differences between a Board of Nursing and a Professional Nurse Association
| Professional Nursing Associations |
| National/International/State: serve as a united voice for nurses and work actively to empower the profession and advance quality health care through practice, education, advocacy, research and leadership. |
| Private membership organizations: requiring members to pay dues in order to enjoy the benefits of membership. |
| Political Advocacy: represent its members in legislative, political and practice matters, and can lobby the legislature and Governor for the interests of its members and the nursing profession. |
| Professional development: help advance nurses in their career by offering opportunities for continuing education, certification, role-related competencies and educational conferences. |
Board Members of Boards of Nurses and Nurses Associations
Individual Boards of Nursing and the National Council of State Boards of Nursing are led by an elected Board of Directors
Most are Nurses, other members may be of other professions
A Delegate Assembly of two representatives from each individual Board of Nursing act as the voting body that governs the National Council of State Boards of Nursing
Convene every year to discuss and vote on business items as well as elect individuals to the National Council of State Boards of Nursing’s Board of Directors
Board Members of Boards of Nurses and Nurses Associations
Nursing Associations are also governed by a Board of Directors but they are elected by members of the association.
The American Nurses Association board members consist of nine individuals. All members are Nurses of varying levels of education.
Idaho State Board of Nursing
| Geographic Distribution | Academic Credentials | Practice Positions | Licensure Status of Members of the Board |
| Board members are divided, approximately half reside in northern Idaho and the other half in southern Idaho. Members are appointed by the Governor | 1- MSN 1- APRN 1- Consumer 2- LPN’s 4- RN’s (unknown if ADN or BSN) | One chair is listed, the remainder of the board members do not have a title listed. Terms are 4 years. | Those that are Nurses must hold an active license in Idaho. |
Federal Regulation for Healthcare
Center for Medicare and Medicaid Services (CMS) publishes its regulations in the daily national "Federal Register".
A "proposed rule" or proposed regulation announces CMS' intent to issue a new regulation or modify an existing regulation.
A proposed regulation beseeches public statements during a comment period.
It sets forth proposed amendments to the Code of Federal Regulations (CFR), but does not amend the CFR.
Quarterly Provider Update-Regulations January 1 – March 31, 2019
| CODE | SUBJECT | PUBLICATION DATE | PROVIDER TYPE |
| CMS-9926-P | Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2020 | 1/24/2019 | All Providers |
CMS-9926-P Proposed Rule
SUMMARY: This proposed rule sets forth payment parameters and
provisions related to the risk adjustment and risk adjustment data
validation programs; cost-sharing parameters; and user fees for
Federally-facilitated Exchanges (FFEs) and State-based Exchanges on the
Federal Platform (SBE-FPs). It proposes changes that would allow
greater flexibility related to the duties and training requirements for
the Navigator program and proposes changes that would provide greater
flexibility for direct enrollment entities, while strengthening program
integrity oversight over those entities. It proposes policies that are
intended to reduce the costs of prescription drugs. It includes
proposed changes to Exchange standards related to eligibility and
enrollment; exemptions; and other related topics.
CMS-9926-P and it’s effects on healthcare
Improve consumers' access to information about health care costs
Increase understanding of potential out-of-pocket costs for various services
Promote consumers' ability to shop for covered services
Idaho State Board of Nursing; RN& APRN Scope of Practice
In accordance to ISBN Regulations and Nurses Practice Act, section 400, p 36, scopes of practice are defined by the Decision Making Model.
The decision-making model is the process by which a licensed nurse evaluates whether a particular act is within the legal scope of that nurse’s practice and determines whether to delegate the performance of a particular nursing task in a given setting. This model applies to all licensure categories permitting active practice, regardless of practice setting. (5-3-03)
Idaho State Board of Nursing; RN& APRN Scope of Practice
Registered Nurse
Section 401, ISBN Regulations
In addition to providing hands-on nursing care, licensed registered nurses work and serve in a broad range of capacities including, but not limited to, regulation, delegation, management, administration, teaching, and case management. Licensed registered nurses, also referred to as registered nurses or as “RNs,” are expected to exercise competency in judgment, decision making, implementation of nursing interventions, delegation of functions or responsibilities, and administration of medications and treatments prescribed by legally authorized persons. (5-3-03)
Advanced Practice RN
Section 320, ISBN Regulations
The Board recognizes advanced practice registered nurse certification organizations that meet criteria as defined by the National Council of State Boards of Nursing. (7-1-13)
The NCSBN utilizes the Consensus Model for APRN Regulation, Licensure, Accreditation, Certification and Education.
Must adhere to individual state practice authority rules
Regulations Influence on Nursing Roles and Delivery of Care
Regulations set forth by State Boards of Nursing confine nurses to work within their level of education or expertise in order to maintain public safety.
Although, as long as regulatory requirements differ from state to state, each state border represents an obstacle to portability—potentially preventing access to professionals and access to care.
Summary
The development of Boards of Nursing was for the purpose of regulating Nursing education, practice, and licensure in order to protect the public’s health and welfare. Understanding the subtle differences between practice authority and scope of practice is crucial.
Nursing associations represent the interest of all licensed and registered nurses. Their purpose is to help the field of nursing advance and to affect positive change for healthcare.
References
American Nurses Association (ANA). (n.d.). About Us. Retrieved from https://www.nursingworld.org/ana/
Centers for Medicare and Medicaid Services (CMS). (n.d.). Regulation and Guidance. Retrieved from https://www.cms.gov/
Idaho State Board of Nursing. (n.d.). Rules of the Board. Retrieved from https://ibn.idaho.gov/IBNPortal/AgencyAdditional.a spx?Agency=426&AgencyLinkID=80
National Council of State Boards of Nursing (NCSBN). (n.d.). About NCSBN. Retrieved from https://www.ncsbn.org/index.htm
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