067.00.07 Ark. Code R. 001
The performance for compensation of any acts involving the observation, care, and counsel of the ill, injured, or infirm; the maintenance of health or prevention of illness of others; the supervision and teaching of other personnel; the delegation of certain nursing practices to other personnel as set forth in rules established by the board; or the administration of medications and treatments as prescribed by practitioners authorized to prescribe and treat according to state law where such acts require substantial specialized judgment and skill based on knowledge and application of the principles of biological, physical, and social sciences.
The practice of advanced practice nursing means the delivery of health care services for compensation by professional nurses who have gained additional knowledge and skills through successful completion of an organized program of nursing education that certifies nurses for advanced practice roles as advanced nurse practitioners, certified registered nurse anesthetists, certified nurse midwives, and clinical nurse specialists.
The delivery of health care services for compensation in collaboration with and under the direction of a licensed physician or under the direction of protocols developed with a licensed physician. Registered nurse practitioners shall be authorized to engage in activities as recognized by the nursing profession and as authorized by the Board. Nothing in this subdivision is to be deemed to limit a registered nurse practitioner from engaging in those activities which normally constitute the practice of nursing, or those which may be performed by persons without the necessity of the license to practice medicine.
The performance for compensation of acts involving the care of the ill, injured, or infirm or the delegation of certain nursing practices to other personnel as set forth in rules established by the board; under the direction of a registered professional nurse, an advanced practice nurse, a licensed physician, or a licensed dentist, which acts do not require the substantial specialized skill, judgment, and knowledge required in professional nursing.
The performance for compensation of acts involving the care of the physically and mentally ill, retarded, injured, or infirm or the delegation of certain nursing practices to other personnel as set forth in rules established by the board, and the carrying out of medical orders under the direction of a registered professional nurse, an advanced practice nurse, a licensed physician or a licensed dentist, where such activities do not require the substantial specialized skill, judgment, and knowledge required in professional nursing.
ACCREDITED - The status granted by an accrediting agency through a voluntary process.
ACTIVITIES OF DAILY LIVING - Those self-care activities which must be accomplished each day in order for the client to care for his own needs and participate in society.
ADVANCED PRACTICE NURSE CATEGORIES - Advanced nurse practitioner, certified registered nurse anesthetist, certified nurse midwife, and clinical nurse specialist.
APPROVAL - Recognized by the Board as meeting the education standards for preparing graduates for registered or practical nurse licensure.
APPROVAL TYPES:
PREREQUISITE - Status authorizing a program to proceed in establishing a program of nursing.
INITIAL - Status awarded to a program that has met all initial requirements and authorizes the program to proceed to admission of students and completion of educational standards.
FULL - Status awarded to a program that has met all educational standards.
CONTINUED FULL - Status awarded to a program that continues to maintain the educational standards.
CONDITIONAL - Status of a program that has not maintained the educational standards. Serves as a warning that if the standards are not followed withdrawal of approval may be initiated.
BOARD - The Arkansas State Board of Nursing.
BOARD REPRESENTATIVE - A person appointed, hired, or otherwise authorized by the Board to carry out its functions.
CLINICAL FACILITY - A facility outside the framework of the program which provides educational experiences for the student.
COLLABORATING PHYSICIAN - A physician, licensed under the Arkansas Medical Practices Act, § 17-93-201 et seq., who has a practice comparable in scope, specialty or expertise to that of the advanced practice nurse or registered nurse practitioner.
COLLABORATIVE PRACTICE AGREEMENT - Document setting out how an advanced practice nurse and physician intend to cooperate in the delivery of client care.
CONSULTING PHYSICIAN - A physician licensed by the Arkansas Medical Practices Act who has obstetric privileges in a hospital.
CONTROLLED SUBSTANCE - Drug substance or immediate precursor in Schedules l-V.
CREDENTIAL - A license, certificate, or other evidence of qualifications.
DELEGATION - Entrusting the performance of a selected nursing task to an individual who is qualified, competent, and able to perform such tasks. The nurse retains the accountability for the total nursing care of the individual.
DISTANT LEARNING SITE - A location separate from the main campus where course offerings are delivered.
DOCUMENTATION - Written proof or evidence to substantiate factual claims or statements satisfactory to the Board.
DRUG SAMPLE - A unit of a legend drug which is distributed to a practitioner by a manufacturer or a manufacturer's representative at no charge, is not intended to be sold, and is intended to promote the sale of the drug.
EMERGENCY CARE - Unanticipated care provided to a person who is unconscious, ill, or injured, when the circumstances require prompt decisions and actions, and when the necessity of immediate care is so apparent that any delay would seriously worsen the physical condition or endanger the life of the person.
GRADUATE COMPETENCIES - Educational outcomes expected of the nursing program's graduates.
LEGEND DRUG - A drug limited by Section 503(b)(1) of the Federal Food, Drug, and Cosmetic Act to being dispensed by or upon a practitioner's prescription.
MAY - Indicates permission.
MISSION - Beliefs accepted by the parent institution for the framework of the school's programs and offerings.
OBSERVATIONAL EXPERIENCE - One in which the nursing student provides no nursing care.
PARENT INSTITUTION - The official institution sponsoring the nursing program.
PERSONAL CARE - Assistance with activities of daily living not requiring a medical prescription.
PHILOSOPHY - Beliefs adopted by the nursing faculty for the framework of the program.
PRECEPTOR - A currently licensed nurse or physician, meeting the requirements of these rules, who serves as a facilitator of student learning in a practice setting.
PRECEPTORSHIP - Practice under the supervision of a qualified preceptor in the care of consumers of health services while a student in a Board approved program.
PRESCRIPTIVE AUTHORITY - Authorization, given by the Board, for an advanced practice nurse who meets established requirements to prescribe. Prescriptive authority for controlled substances shall only extend to drugs listed in Schedules III through V.
PROGRAM - The total educational curriculum in nursing, including theoretical and clinical components. Types of Programs are:
ASSOCIATE DEGREE PROGRAM - A professional nursing program leading to an associate degree with a major in nursing.
BACCALAUREATE DEGREE PROGRAM - A professional nursing program leading to a baccalaureate degree with a major in nursing.
DIPLOMA PROGRAM - A professional nursing program leading to a diploma with a major in nursing.
PRACTICAL NURSING PROGRAM - A nursing program leading to a certificate in practical nursing.
PSYCHIATRIC TECHNICIAN NURSING PROGRAM - A nursing program leading to a certificate in psychiatric technician nursing.
PROGRAM DIRECTOR - The person responsible for the specific educational unit in nursing, regardless of the official title in the institution.
PROTOCOL - A written statement which delineates agreed-upon approaches in client care and management.
SATELLITE CAMPUS - A separate geographic location where a program is offered which has a separate student body and a separate faculty leader/coordinator and/or faculty.
SHALL, WILL, MUST - Indicates a mandatory requirement.
SHOULD - Indicates a recommendation.
SURVEY - A visit to determine compliance with minimum requirements.
THERAPEUTIC DEVICE - An instrument or apparatus, requiring a prescription, that is intended for use in diagnosis or treatment, and in the prevention of disease or maintenance or restoration of health.
TRANSMITTING - Relaying an order for a medication, treatment, or therapeutic device.
UNDER THE DIRECTION OF A LICENSED PHYSICIAN - The performance of specific acts and procedures which have been authorized by a licensed physician and which may be performed outside the presence of the physician under conditions where a physician is readily available for consultation.
UNENCUMBERED LICENSE - Free of disciplinary limitations or pending action.
The office of the Board is in Little Rock, Arkansas. The office shall be open during business hours each day; Saturday, Sunday, and holidays excepted.
The Board may, through one or more of its members, or staff especially authorized, conduct at its office in Little Rock, Arkansas, or in any part of the state, any examination, inquiry or investigation, hearing, or other proceeding necessary to perform its duties and functions. The executive director shall have custody of the seal and official records and shall be responsible for the maintenance and custody of the files and records of the Board, including the credentials for all Arkansas licensed nurses, transcripts of testimony and exhibits, the minutes of all actions taken by the Board and all of its findings, determinations, reports, opinions, orders, rules, and approved forms.
All notices and other actions of the Board shall be authenticated or signed by the president, secretary, or such other person as may be authorized by the Board.
Upon order of the Board, the president, secretary, or executive director shall issue all notices of hearings and other process as may be directed by the Board.
The executive director of the Board shall be a registered nurse and meet the qualifications required by the Board.
The executive director shall enter, in permanent form, credentials of all nurses, records of official transactions and proceedings, and keep such records in safekeeping.
Meetings may be taped by a secretary as necessary for purposes of minute taking. Tapes may be erased after corresponding minutes have been approved.
The executive director may destroy or dispose of records in the office in accord with applicable law.
Upon written request and payment of a fee, the executive director shall provide to any nurse holding Arkansas licensure a certified copy of any of his or her records on file in the Board office.
Records shall be open to public inspection except as may be specifically exempted by statute.
Copies of rules of the Board will be furnished free of charge to any official of a government agency requesting them in the performance of his or her duties.
A registered nurse, practical nurse, or psychiatric technician nurse candidate who has failed the licensure examination may review his or her examination and/or challenge examination items according to the policies and procedures of the test development vendor.
Any Arkansas resident who is enrolled in, or has been accepted for admission to, an approved school of nursing in this state or in a nationally accredited school outside the state, in a course of study leading to qualification as a registered nurse or licensed practical nurse, shall be eligible to make application to the Arkansas State Board of Nursing for a loan according to guidelines established by the Board.
The applicant shall meet the licensure requirements of the Board.
The passing score on the licensure examination shall be determined by the Board.
For the purpose of the Compact:
Other terms used in these rules are to be defined as in the Interstate Compact.
For the purpose of this Compact:
Home state Boards shall include in all licensure disciplinary orders and/or agreements that limit practice and/or require monitoring the requirement that the licensee subject to said order and/or agreement will agree to limit the licensee's practice to the home state during the pendency of the disciplinary order and/or agreement. This requirement may, in the alternative, allow the nurse to practice in other party states with prior written authorization from both the home state and such other party state Boards.
Bureau of Investigation shall have been completed no earlier than twelve (12) months prior to the application for an initial license issued by the ASBN and at any other time thereafter that the Board deems necessary.
Each person holding an active license or applying for reinstatement of a license under the provisions of the Nurse Practice Act shall be required to complete certain continuing education requirements prior to licensure renewal or reinstatement.
Each nurse shall declare his or her compliance with the requirements for continuing education at the time of license renewal or reinstatement. The declaration shall be made on the form supplied by the Board.
Upon payment of a certification/verification fee, a nurse seeking licensure in another state may have a certified statement of Arkansas licensure issued to the Board of Nursing in that state.
This exposition of the Rules of Procedure formulated under the Administrative Procedure Act, as amended, Arkansas Code Annotated § 25-15-201 et seq, does not effect a repeal of the provisions of the nurse practice act, its amendments and related laws, except insofar as these Rules of Procedure were formulated under provisions of law which specifically contravenes provisions of the nurse practice act, its amendments and related laws.
Any such rule shall be made or amended only after a hearing upon notice as set forth in these Rules of Procedure.
PRIOR RULES-VALID
Rules of the Board formulated previously are declared to be still in force until amended and certified to the Arkansas Register.
In any case of rule-making, every person has a right to seek to cause the Board to act to make a rule. Every person also has the right to seek to cause an incorrect rule to be corrected.
Orders of the Board shall be effective only when in writing.
Each order shall contain its effective date and shall concisely state:
An order may be given by service upon or delivery to the person ordered by mail, postage prepaid, addressed to the person at his principal place of business or his home as last of record with the Board. An order may also be served by any officer authorized to serve legal process or by any member of the Board or any employee of the Board. An attempt to serve notice at the last address of record in the Board office shall constitute official notice.
There shall be an order formulated upon each adjudication made by the Board or its hearing officer.
Any person who alleges a rule, or its possible application, may injure or threaten to injure him, his business or property, may file a petition for a declaratory order as to the applicability of any rule to be enforced by the Board.
Such petition shall be promptly considered and a prompt disposition shall be made.
Declaratory orders shall have the same status as agency orders formulated upon adjudication.
Applicability of statutes or department orders as to any person may be determined in the same manner by declaratory orders.
All parties shall be afforded opportunity for hearing after reasonable notice. (See Section X I, subsection B.3. infra.)
Opportunity shall be afforded all people interested in the action to respond and present evidence and argument on all issues involved.
Nothing in these rules shall prohibit informal disposition by stipulation, settlement, consent order, or default.
The record shall include:
Findings of fact shall be based exclusively on the evidence received and on matters officially noticed.
In every case of adjudication there shall be a final decision, or order, which shall be in writing or stated in the record.
Parties shall be served either personally or by mail with a copy of any decision or order.
Where a formal hearing before a hearing officer has been held at which the parties were given proper notice, and at which opportunity was offered to them to be present in person and by counsel to present testimony, briefs, and argument, a proposal for decision will not be required.
Where convenient and appropriate, a hearing officer may be appointed to take testimony and prepare the record for the consideration of the Board. The hearing officer may conduct hearings at any place within the State of Arkansas. In the conduct of such hearings, the hearing officer shall preside and have the power and duties of a presiding official as set forth in Section X.D. The decision on the record made by the hearing officer shall be made by a majority of the members of the Board.
In every case of adjudication, and in cases of rule making where rules are to be made after hearing, there shall be a hearing.
Any person compelled to appear before the Board or a hearing officer shall have the right to counsel.
Every member of the Board present shall conduct her/himself in an impartial manner and the presiding official may withdraw if she/he deems her/himself disqualified. Any party may file an affidavit of personal bias or disqualification which shall be ruled upon by the Board and granted if it is timely, sufficient, and filed in good faith.
The presiding officer of the hearing shall have power to:
The proponent of a rule or order shall have the burden of proof.
Irrelevant, immaterial, and unduly repetitious evidence shall be excluded.
Any other evidence, oral or documentary, not privileged, may be received if it is of a type commonly relied upon by reasonably prudent person in the conduct of their affairs.
Objections to evidence may be made and shall be noted of record.
When a hearing can be so expedited (and the interests of the parties will not be prejudiced) any part of the evidence may be received in written form.
Parties shall have the right to conduct such cross-examination as may be required for a full, true disclosure of the facts.
Official notice may be taken of judicially cognizable facts and of generally recognized technical or scientific facts peculiarly within the Board's specialized knowledge.
Proceedings shall be as follows.
Except as provided in subsection 2 below, every licensee or applicant for a license shall be afforded notice and an opportunity to be heard before the Board. The Board shall have authority to take any action the effect of which would be to:
The Board may, after providing notice and a hearing, levy civil penalties in an amount not to exceed one thousand dollars ($1,000.00) for each violation against those individuals or entities found to be in violation of this Chapter or Rules promulgated thereunder.
The APN shall submit his/her DEA Registration to the Board upon request following disciplinary hearing in which the registration is encumbered or suspended.
Any notice required by subsection B.3 above, may be served either personally or by an officer authorized by law to serve process, or by registered mail or certified mail with return receipt requested, directed to the licensee or applicant at his or her last known address as shown by the records of the Board. If notice is served personally, it shall be deemed to have been served at the time when the officer delivers the notice to the person addressed.
Board hearings held under the provisions of this rule shall be conducted at the Board office or elsewhere in Pulaski County.
Use of Hearing Office - All hearings under this section shall be open to the public.
At all such hearings at least a quorum of the Board shall be present to hear and determine the matter.
A person entitled to be heard pursuant to this section shall have the right to:
In connection with any hearing held pursuant to the provisions of this section, the Board or its hearing officer shall have power to:
In proceedings held pursuant to this rule, the Board may admit any evidence and may give probative effect to evidence that is of a kind commonly relied on by reasonably prudent men in the conduct of serious affairs. The Board may in their discretion exclude incompetent, irrelevant, immaterial, and unduly repetitious evidence.
Witness fees and mileage, if claimed, shall be allowed the same as for testimony in a Circuit Court.
After a hearing has been completed, the members of the Board shall proceed to consider the case and as soon as practicable shall render their decision. If the hearing was conducted by a hearing officer, the decision shall be rendered by the Board at a meeting where a quorum of the members of the Board are present and participating in the decision. In any case the decision must be rendered within ninety (90) days after the hearing.
Within a reasonable time after the decision is rendered, the Board shall serve upon the person whose license is involved a written copy of the decision, either personally or by registered mail to the last address of record in the Board office. If notice is served personally, it shall be deemed to have been served at the time when the officer delivers the notice to the person addressed. Where notice is served by registered mail, it shall be deemed to have been served on the date borne by the return receipt showing delivery of the notice to the addresses or refusal to accept the notice. An attempt to serve notice at the last address of record shall constitute official notice.
If a person duly notified fails to appear for a disciplinary hearing and no continuance has been granted, the Board, or its hearing officer, shall hear the evidence of such witnesses as may have appeared, and the Board shall proceed to consider the matter and dispose of it on the basis of the evidence before it in the manner required by subsection L. of Section XI. Failure of the licensee to keep the Board informed of a change of address shall not be grounds to have the hearing reopened.
Where because of accident, sickness, or other cause a person fails to appear for a hearing which has been scheduled by the Board, the person may, within a reasonable time, apply to the Board to reopen the proceeding; and the Board, upon finding such cause sufficient, shall immediately fix a time and place for hearing, and give such person notice thereof as required by Sections XI.B.3. and XI.E. At the time and place fixed, a hearing shall be held in the same manner as would have been employed if the person had appeared in response to the original notice of hearing.
The decision of the Board shall contain:
Judicial review of proceedings under this rule shall be set out in Section XII.
The validity or applicability of a rule may be determined in an action of declaratory judgment if it is alleged that the rule (or its threatened application) injures or threatens to injure the plaintiff.
An application for declaratory judgment may be brought in the circuit court of Pulaski County.
The Board shall be named defendant.
A declaratory judgment may be sought and rendered whether or not the plaintiff requested the Board to act upon the validity or applicability of the questioned rule.
RULE MAKING
If the Board shall unlawfully, unreasonably, or capriciously fail, refuse, or delay to act in respect to rule-making, any person may sue for an order commanding the Board to act.
VENUE - CHANCERY COURTS
The suit may be brought in the chancery court of Pulaski County.
Any person who considers himself injured by a failure to act in a case of adjudication has the same judicial review as in a matter of failure to act pertaining to rule-making.
VENUE - CHANCERY COURTS
The plaintiff may bring suit for an order commanding the Board to act. The suit shall be in the Pulaski Chancery Court.
In cases of adjudication, any person who considers himself injured in his person, business, or property by final Board action shall be entitled to judicial review.
Nothing in this section shall be construed to limit other means of review provided by law.
Proceedings for review may be instituted by filing a petition in the circuit court of Pulaski County or the county in which the person resides.
The petition shall be filed within thirty days after service of the Board's final decision of the adjudication upon petitioner.
Service shall be had by serving a copy of the petition upon the Board and all other parties of record either by personal service or by mail.
The court may permit other interested parties to intervene.
Filing of the petition shall not automatically stay enforcement of the Board decision. The Board, upon its own action, or the reviewing court may stay the order upon such terms as may be just.
Response shall be made within thirty (30) days after service of the petition, or within such time as the court may allow, but not exceeding a total of ninety (90) days.
The Board shall transmit the record to the reviewing Court.
Additional evidence may be had if, before the date for hearing, application is made to the Court for leave to present additional evidence.
The review shall be conducted by the court without jury and shall be confined to the record.
EXCEPTION:
The reviewing court may affirm the decision of the Board, or it may remand the case for further proceedings. It also may reverse or modify the decision if substantive rights of the petitioner have been prejudiced because the administrative findings, inferences, conclusions, or decisions are:
In cases of disciplinary proceedings any respondent shall be entitled to judicial review of the final Board action.
Proceedings for review may be instituted by filing a petition in the Circuit Court of Pulaski County or the county in which the person resides.
The petition shall be filed within thirty (30) days after service of the Board's final decision of the adjudication upon petitioner.
Service shall be had by serving a copy of the petition upon the president or the secretary of the Board.
Filing of the petition shall not automatically stay enforcement of the Board decision. The Board, upon its own action, or the reviewing court may stay the decision or order upon such terms as may be just.
Response shall be made within thirty (30) days after service of petition, or within such time as the court may allow, but not exceeding a total of ninety (90) days.
The Board shall transmit the record to the reviewing court.
Additional evidence may be had if, before the date for hearing, application is made to the court for leave to present additional evidence.
The review shall be conducted by the court without a jury and shall be confined to the record,
In cases of alleged irregularities in procedure before the Board (not shown in the record) testimony may be taken before the court.
The reviewing court may affirm the decision of the Board, or it may remand the case for further proceedings. It also may reverse or modify the decision if substantive rights of the petitioner have been prejudiced because the administrative findings, inferences, conclusions, or decisions are:
Appeals to the Arkansas Supreme Court from any final action of a chancery or circuit court shall follow the procedure prescribed by law.
The Board may institute such civil suits or other legal proceedings as may be required for enforcement of any provisions of ACA § 17-87-101 through § 17-87-711(Nurse Practice Act), as amended, and related acts.
If the Board has reason to believe that any person has violated any provisions of the Nurse Practice Act, as amended, or related acts for which criminal prosecution would be in order, it shall so inform the prosecuting attorney in whose district any such purported violation may have occurred.
DESIGNATED FACILITY - a nursing home.
MEDICATION ASSISTANT-CERTIFIED - (MA-C) a person who is certified by the Board to administer certain nonprescription and legend drugs in designated facilities.
SUPERVISION -the oversight of the medication assistant-certified by a licensed nurse on the premises of a nursing home.
LEGEND DRUG - a drug limited by § 503(b) (1) of the federal Food, Drug, and Cosmetic Act to being dispensed by or upon a medical practitioner's prescription.
I NITIAL MEDICATION - a new medication that the patient has not been receiving and/or changes in dosage, route, or frequency of a medication that a patient is currently receiving.
The applicant shall meet the certification requirements of the Board.
The passing score on the certification examination shall be determined by the Board.
Examination results shall be available to all applicants and to their respective schools.
The routes in which nonprescription and legend drugs may be administered by a MA-C when delegated by a licensed nurse include:
Tasks which shall not be delegated to the MA-C include, but are not limited to:
A licensed nurse shall not supervise more than two (2) medication assistant-certified persons during a shift.
Nursing homes utilizing MA-C persons shall notify the Board, on forms supplied by the Board. The notification shall be signed by the facility administrator and director of nursing.
Upon payment of a certification/verification fee, a MA-C seeking certification in another jurisdiction may have a certified statement of Arkansas Certification issued to the appropriate entity in that jurisdiction.
Each person holding an active certificate or applying for reactivation of a certificate under the provisions as stated in these rules shall be required to complete certain continuing education requirements prior to certification renewal or reactivation.
Each MA-C shall declare his/her compliance with the requirements for continuing education at the time of certification renewal or reactivation. The declaration shall be made on the form supplied by the Board.
The parent institution shall be approved by the appropriate state body.
There shall be adequate financial support to provide stability, development and effective operation of the program.
There shall be written policies for admission, readmission, progression, and completion for students which includes documentation of the student's qualifications which comply with ACA § 17-87-704.
The Arkansas State Board of Nursing shall have jurisdiction to investigate all cases of suspected violation of ACA § 17-87-701 et. seq.
If the Arkansas State Board of Nursing's investigative determination of founded is upheld during the administrative hearing process or if the offender does not make a timely appeal for or waives the right to an administrative hearing, the Board shall report the final investigative determination in writing to all interested parties.
The Board may, after providing notice and a hearing, levy civil penalties in an amount not to exceed one thousand dollars ($1,000.00) for each violation against those individuals or entities found to be in violation of this Chapter or Rules promulgated there under.
The Advisory Committee shall be composed of six (6) members appointed by the Board and approved by the Governor. Two (2) members shall be certified MA-C. One (1) member shall be a licensed nursing home administrator who has worked in that capacity for at least five (5) years of the last ten (10) years. One (1) member shall be a registered nurse who has been in a practice using certified nurse aides for at least five (5) years of the last ten (10) years. One (1) member shall be a lay person representing the interest of consumers of health care services. One (1) member shall be a registered nurse educator from an institution that offers a MA-C program.
Members shall serve three (3) year terms and may be reappointed. The Board may remove any advisory committee member after notice and hearing for incapacity, incompetence, neglect of duty, or malfeasance in office.
Advisory committee members shall serve without compensation, but may be reimbursed to the extent special monies are appropriated therefore for actual and necessary expenses incurred in the performance of their official Board duties.
067.00.07 Ark. Code R. 001