3 Colo. Code Regs. § 716-1.1

Current through Register Vol. 47, No. 22, November 25, 2024

Section 3 CCR 716-1.1 - RULES AND REGULATIONS FOR THE LICENSURE OF PRACTICAL AND PROFESSIONAL NURSES

A.BASIS: The authority for the promulgation of these rules and regulations by the State Board of Nursing is set forth in sections 12-20-202(3), 12-20-204(1), 12-255-107(1)(b),(d) and (j), 12-255-109, 12-255-110, 12-255-114, 12-255-115, and 12-255-121, C.R.S.

B.PURPOSE: To specify requirements for obtaining and maintaining professional and practical nursing licensure.

C. DEFINITIONS:

For the purposes of Rule 1.1 , the following terms have the indicated meaning:

1. Applicant: Any individual seeking a license to practice as a professional or practical nurse in the State of Colorado.

2. Approved Nursing Education Program (Approved Professional Nursing Education Program/Approved Practical Nursing Education Program): A course of study which implements the basic professional or practical nursing curriculum prescribed and approved by the Board.

3. Board: The Colorado State Board of Nursing.

4. Clinical Experience for Continuing Competency: Any relevant experience accumulated as a practical or professional nurse, including paid or unpaid work experience, volunteer work, or student work. The gratuitous care of friends or members of the family is not included in Clinical Experience.

5. Clinical Supervision: The on-site guidance, direction, and review by a professional nurse designated as an instructor/preceptor of the nursing care provided by a holder of a special or student permit pursuant to Sections (H) and (I) of Rule 1.1 . This supervision includes assigning nursing responsibilities for patient care appropriately and evaluating the competency of the individual nurse.

6. Encumbered: Any current form of discipline against a professional or practical license that restricts the ability to practice, including but not limited to, fine, probation, suspension, revocation, restriction, condition, or limitation imposed on a license.

7. Executive Officer: The executive administrator of the Board appointed by the Director of the Division of Professions and Occupations pursuant to section 12-255-106, C.R.S. The Executive Officer has been delegated authority to administer examinations, issue licenses by endorsement and examination, renew licenses, reinstate licenses, inactivate and reactivate licenses, and issue temporary licenses and permits to qualified Applicants, and other delegated functions as stated and set forth in Board rules and policies.

8. Graduate: An individual who has successfully completed the requirements for a degree, diploma, or certificate from an Approved Nursing Education Program or United States armed services traditional nursing education program gained in military service outlined in section 12-20-202(4), C.R.S.

9. Licensee: An individual licensed to practice as a professional or practical nurse by the Board.

10. NCLEX: The National Council Licensure Examination maintained, owned, and created by the National Council of State Boards of Nursing.

11. Nontraditional Nursing Education Program: A program with curricula that does not include a faculty supervised teaching/learning component in clinical settings taught concurrently with theoretical content.

12. Practice: Any role which requires nursing skill and judgment.

13. Unencumbered: No current restriction on a license to practice on any professional or practical nursing license.

D.REQUIREMENTS FOR ALL APPLICANTS

1. Must apply in a manner approved by the Board.

2. Pay application fee.

3. Submit proof of successful completion of an Approved Nursing Education Program, as set forth in Sections (E) and (F) of Rule 1.1.

4. Submit proof of having passed:

a. The NCLEX RN or NCLEX PN examination for professional or practical nurses; or

b. The State Board Test Pool Examination for Professional Nurses given between 1951 and 1982/1983; or

c. The State Board Test Pool Examination for Practical Nurses given between 1952 and 1982/1983; or

d. A state licensing examination for professional nurses given prior to 1951 or a state licensing examination for practical nurses given prior to 1952.

e. In the event that Applicant examination results are lost or destroyed through circumstances beyond the control of the Board, the matter will be addressed and resolved by the Board on a case by case basis.

5. Applicant must submit fingerprints for the purpose of obtaining criminal history record information from the Federal Bureau of Investigation and the Colorado Bureau of Investigation responsible for retaining the state's criminal records set forth in section 24-60-380(III)(c)(6), C.R.S.

E.LICENSURE BY EXAMINATION

1. A Graduate of a Colorado Approved Professional Nursing Education Program is eligible to take the NCLEX examination for professional or practical nursing, provided that:

a. An official school transcript reflecting completion of institutional requirements for the degree/diploma/certificate and the date of completion is provided to the Board in a secure manner;

b. All other requirements of state law and Rule 1.1 are met.

2. A Graduate of a Colorado Approved Practical Nursing Education Program is eligible to take the NCLEX examination for practical nursing, provided that:

a. An official school transcript reflecting completion of institutional requirements for the degree/diploma/certificate and the date of completion is provided to the Board in a secure manner;

b. All other requirements of state law and Rule 1.1 are met.

3. A Graduate of a nursing education program approved by a board of nursing of another state or territory of the United States is eligible to take the NCLEX examination for professional or practical nursing, provided that:

a. The applicant graduated from a traditional nursing education program that was accredited by an agency recognized by the United States Department of Education and/or Council for Higher Education Accreditation and approved by a board of nursing of a state or territory of the United States;

b. An official school transcript reflecting completion of institutional requirements for the degree/diploma/certificate and the date of completion is provided in a manner approved by the Board; and

c. All other requirements of state law and Rule 1.1 are met.

4. A Graduate of a United States armed services traditional nursing education program gained in military service as provided for in section 12-20-202(4), C.R.S., that is determined to be substantially equivalent to the criteria set forth in Sections (E)(1) through (E)(3) of Rule 1.1 is eligible to take the NCLEX examination for professional or practical nursing provided that:

a. An official transcript reflecting completion of institutional requirements for the degree/ diploma/certificate and the date of completion is provided in a manner approved by the Board; or satisfactory evidence of the education provided and assessed on a case by case basis; and

b. All other requirements of state law and Rule 1.1 are met.

5. A Graduate of a Non-traditional Nursing Education Program may take the NCLEX if the requirements as outlined in Section (I) of Rule 1.1 are met.

6. A Graduate of a foreign nursing education program is eligible to take the NCLEX examination only after:

a. Board review of nursing education credentials as evaluated by a Board-recognized educational credentialing agency; and

b. Having met the standards set by the United States Department of Education on the English competency exam.

7. Applicants must provide official school transcripts in a manner approved by the Board. Applicants of foreign nursing education programs must provide official school transcripts to a Board-recognized educational credentialing agency.

8. Notwithstanding the requirements of Section (I) of Rule 1.1 , Graduates of a Nontraditional Nursing Education Program that were enrolled in the program on or before January 1, 2006, and with continuous enrollment are deemed to be Graduates of an Approved Nursing Education Program and are eligible to take the NCLEX pursuant to Section (E)(1) of Rule 1.1. If the Graduate is unable to establish continuous enrollment, the Graduate must comply with Section (I) of Rule 1.1.

9. Applicants once approved may take the NCLEX a maximum of three times within three years of the date the Applicant first took the NCLEX in any state or territory of the United States, or foreign country. Any applicant who wishes to take the NCLEX a fourth time must:

a. Evaluate his/her deficiencies;

b. Educate and prepare him/herself appropriately, such as, but not limited to, completing appropriate coursework, NCLEX review, or a didactic portion of a refresher course; and

c. Submit, in writing, a petition for a waiver to take the NCLEX a fourth time, documenting evidence of successful completion of Sections (E)(9)(a) and (E)(9)(b) of Rule 1.1. The applicant may also include any circumstances they wish the Board to consider. The decision to grant or deny any such waiver is at the sole discretion of the Board. It is anticipated that such waivers will be rare.

d. All requirements of Section (E)(9) of Rule 1.1 must be completed within two years of the date of the third NCLEX examination date. If not completed, the application file will be purged.

e. An applicant who has not met criteria as set forth in Sections (E)(9)(a-d) of Rule 1.1, is not eligible for application by examination in Colorado.

F.LICENSURE BY ENDORSEMENT

1. Pursuant to the Occupational Credential Portability Program under section 12-20-202(3), C.R.S., an applicant is entitled to licensure as a professional or practical nurse by endorsement in Colorado if the applicant has met the requirements of Sections (D)(1), (2) and (5) of Rule 1.1 is currently licensed in good standing in another state or U.S. territory, or through the federal government, or holds a military occupational specialty, as defined in section 24-4-201, C.R.S., and has submitted satisfactory proof under penalty of perjury that:

a. The applicant:

(1) Has substantially equivalent experience or credentials that are required by Article 255 of Title 12, C.R.S.; or

(2) Has held for at least one year a current and valid license as a professional or practical nurse in a jurisdiction with a scope of practice that is substantially similar to the scope of practice for professional and practical nurses specified in Article 255 of Title 12, C.R.S.

2. The Board may deny such license if:

a. The Board demonstrates by a preponderance of evidence, after notice and opportunity for a hearing, that the applicant:

(1) Lacks the requisite substantially equivalent education, experience, or credentials for a license; or

(2) Has committed an act that would be grounds for disciplinary action under Article 255 of Title 12, C.R.S.

3. An applicant who is not currently licensed in good standing in another state or U.S. territory or through the federal government is eligible for licensure as a professional or practical nurse by endorsement in Colorado if the applicant has met the requirements of Section (D) of Rule 1.1 (D) and:

a. Has been previously licensed in another state or territory of the United States or through the federal government, graduated from an Approved Nursing Education Program or a recognized military education program approved by a board of nursing of a state or territory of the United States, passed the NCLEX exam, and has demonstrated competency as defined in section 12-20-202(3), C.R.S.; or

b. Has been previously licensed as a professional nurse in another state or territory of the United States or through the federal government, graduated from a Nontraditional Nursing Education Program, and has worked a minimum of 2,000 hours as a professional nurse and has provided evidence of demonstrated continued competency requirements as defined in section 12-20-202(3), C.R.S.; or

c. Has an encumbered license in another state or territory of the United States or through the federal government, only after review and approval by the Board.

G.REINSTATEMENT AND REACTIVATION

1. A licensee who does not renew his or her license within the sixty day grace period, as set forth in section 12-20-202(1)(e), C.R.S., will have an expired license and is ineligible to practice until such license is reinstated.

2. A licensee may elect inactive status in accordance with section 12-255-122, C.R.S. A licensee may not apply for inactive status to avoid disciplinary action. Upon inactivation, any and all authorities attached to that license will be cancelled.

3. The licensee must apply for reinstatement or reactivation in a manner approved by the Board.

4. The licensee applying for reinstatement or reactivation must pay an application fee.

5. A licensee who has practiced on an expired or inactive license may be subject to disciplinary action.

6. A licensee whose license has been expired or inactive less than two years must comply with requirements of Sections (G)(3) and (G)(4) of Rule 1.1.

7. An individual whose professional or practical nursing license has been inactive or expired for two or more but less than five years must demonstrate competency. The Program Director or designee may accept proof of competency through 20 contact hours of continuing education for each two years without an active license. Hours of clinical experience for clinical competency may also be considered.

8. An individual whose professional or practical nursing license has been expired or inactive for five or more years must demonstrate competency. The Program Director or designee may accept proof of competency through successful completion of remedial or refresher courses under a restricted license as defined in (a) and (b), below. "Successful completion" means achieving a grade of "C" or better or the equivalent in each course. The Program Director or designee may refer any case to an Inquiry Panel for review.

a. The remedial or refresher courses must have medical/surgical focus, must clearly differentiate knowledge and skill level for RNs and LPNs, and have the following minimum content:

(1) Physical assessment, history taking, documentation, and health information technologies;

(2) Pharmacology, medication administration, and IV therapy;

(3) Nursing knowledge and skills update, based on best evidence;

(4) Legal, ethical, and professional issues;

(5) Manage patient conditions effectively in order to minimize sentinel events;

(6) Rapid response to critical incidents;

(7) Prioritize cares when caring for multiple patients; and

(8) Critical reasoning for clinical decision making.

b. The number of successfully completed contact hours required of each individual to demonstrate competency prior to reinstatement, reactivation, or endorsement will be determined by the number of years that his or her license has been inactive or expired, as follows:

5-10 years	Contact Hours:	120 Theory (including lab) and 120 Clinical (one-hundred percent may be conducted in a simulation environment)
more than 10 years	Contact Hours:	120 Theory (including lab) and 120 Clinical (seventy-five percent may be conducted in a simulation environment); and possible additional hours as determined by the Board on a case-by-case basis.

9. Upon a petition by the licensee, and with due consideration of the need to protect the public, the Board may accept an alternative method for establishing competency, to include hours worked under a temporary emergency license. The decision to accept an alternative method for establishing competency is at the sole discretion of the Board.

10. An Applicant for reinstatement or reactivation of advanced practice authorities must provide proof that the licensee has maintained national certification in each Role/Specialty and Population Focus or meets the current requirements in accordance with Rule 1.14 , or meets current requirements for prescriptive authority in accordance with Rule 1.15.

11. An Applicant for reinstatement or reactivation of practical nurse IV authority must meet the current requirements for practical nurse IV authority in accordance with Rule 1.9.

H.SPECIAL PERMITS

1. Permits may be granted, in the Board's discretion, to individuals possessing active and unencumbered licenses to practice professional or practical nursing in other states or territories of the United States, to allow for occasional nursing practice which is patient- or procedure-specific for educational purposes and/or clinical practice of professional development. However, if such nurse has any established or regularly used healthcare agency connections in this state for the provision of such services, the nurse must possess a license to practice nursing in Colorado, except as otherwise provided in these Rules.

2. All individuals seeking a permit must apply in a manner approved by the Board.

3. A permit may be denied if the Applicant has committed any of the acts that would be grounds for discipline under section 12-255-120, C.R.S.

I.STUDENT PERMITS

1. Student permits are intended for students in Nontraditional Nursing Education Programs who must obtain in-state clinical training and experience.

2. Eligibility.

a. An individual who is a Graduate of a Nontraditional Nursing Education Program is eligible for a student permit if:

(1) The program is physically located in another state or territory of the United States; and

(2) The program is accredited by the United States Department of Education and is approved by a board of nursing of a state or territory of the United States.

b. A student permit is not required for persons actively enrolled in an Approved Nursing Education Program in Colorado and who participate in clinical training as defined in Section (C)(5) of Rule 1.2 for Approval of Nursing Education Programs.

3. Nontraditional Nursing Education Program Graduate Requirements to take the NCLEX Examination.

a. The Applicant is able to demonstrate satisfactory completion of 750 hours of supervised clinical experience in the role of a professional nurse; or

b. The Applicant has an active license to practice as a practical nurse in any state and is able to demonstrate satisfactory completion of 350 hours of supervised clinical experience in the role of a professional nurse.

c. The required elements for satisfactory completion of the supervised clinical experience are as follows:

(1) Acceptable clinical sites that take place in acute care or subacute care settings, skilled nursing facilities, or other sites as approved by the Board.

(2) Clinical Supervision may be provided either in a traditional format with one instructor directly overseeing a group of students or as a preceptorship experience where a direct ongoing 1:1 relationship is established.

(3) Qualified instructor/preceptor is educated at or above the level of the Applicant with at least two years of experience in a practice setting and has an active, unencumbered license to practice as a professional registered nurse in Colorado. The Applicant must provide documentation that the instructor/preceptor meets these requirements when he/she applies for a permit and must also provide a written agreement between the Applicant, the preceptor, the faculty, and the facility where the Clinical Supervision will occur.

(4) Required components of the supervised clinical experience include:

(a) Clinical decision making and critical thinking;

(b) Patient assessment as part of the nursing process;

(c) Interdisciplinary collaboration and evaluation of care evidenced in caring for multiple patients with both predictable and unpredictable outcomes across the variety of learning options appropriate for contemporary nursing; and

(d) Nursing delegation and supervision.

(e) A signed, original checklist and instructor/preceptor agreement, provided by the Board, must be completed by the primary instructor/preceptor, documenting the Applicant's satisfactory completion of the required components in a manner approved by the Board.

4. Limitations of student permits.

a. Individuals practicing under a student permit are subject to the Nurse and Nurse Aide Practice Act.

b. Student permit holders may not supervise Licensees or other permit holders.

c. Individuals practicing under a student permit are responsible for arranging and obtaining their own clinical hours.

d. Individuals practicing under a student permit may not exceed the terms of the permit.

e. A student permit may be issued for a period of twelve consecutive months.

J.CHANGE OF NAME AND ADDRESS

1. The licensee must supply to the Board legal evidence of a name change within thirty days of the effective date of the name change.

2. The licensee must notify the Board within thirty days of any change of address. This notification may be submitted in writing or through the Board's on-line system.

3. Any notification by the Board to licensees required or permitted under the Nurse and Nurse Aide Practice Act, sections 12-255-101 to 134, C.R.S., or the State Administrative Procedure Act, sections 24-4-101 to 108, C.R.S., will be addressed to the last address provided in writing to the Board by the Licensee and any such mailing will be deemed proper service on said licensee.

K.INCOMPLETE APPLICATIONS

1. Any application not completed within one year of the date of receipt of the original application expires and will be purged.

L.VOLUNTEER NURSE LICENSURE

1. Applicants for Volunteer Licensure must meet all requirements of section 12-255-115, C.R.S.

a. An applicant who at the time the application is received holds an emergency active license shall be deemed to satisfy the requirement of holding an active license pursuant to section 12-255-115, C.R.S.

2. A licensee on volunteer status in accordance with section 12-255-115, C.R.S., may apply to reinstate to active status. The reinstatement application must be submitted as described in Section (G) of Rule 1.1 and the applicant must demonstrate competency by one of the following:

a. Proof they have actively volunteered as a nurse during the two year period immediately preceding application.

b. Proof they meet the Board's requirements for demonstrated competency as defined in section 12-20-202(2), C.R.S. Experience under an emergency active license may be considered as evidence of competency.

M.LICENSURE AS MILITARY SPOUSE

1. The spouse of a person who is actively serving the in the United States Armed forces and who is stationed in Colorado in accordance with military orders shall be entitled to a temporary license as set forth in section 12-20-202, C.R.S.

Adopted: October 21, 2009

Revised: April 26, 2012

Effective: July 1, 2012

Revised: October 24, 2012

Effective: December 15, 2012

Revised: January 22, 2013

Effective: March 18, 2013

Revised: January 23, 2019

Effective: March 17, 2019

Revised: October 27, 2021

Effective: December 30, 2021

3 CCR 716-1.1

38 CR 16, August 25, 2015, effective 9/14/2015

38 CR 20, October 25, 2015, effective 11/14/2015

38 CR 22, November 25, 2015, effective 12/30/2015

40 CR 10, May 25, 2017, effective 6/14/2017

40 CR 16, August 25, 2017, effective 9/14/2017

42 CR 04, February 25, 2019, effective 3/17/2019

44 CR 10, May 25, 2021, effective 6/14/2021

44 CR 22, November 25, 2021, effective 12/15/2021

45 CR 20, October 25, 2022, effective 9/22/2022

45 CR 23, December 10, 2022, effective 11/11/2022

46 CR 01, January 10, 2023, effective 12/10/2022

45 CR 22, November 25, 2022, effective 12/15/2022

46 CR 02, January 25, 2022, effective 1/9/2023