N.D. Admin. Code Title 54 — Board of Nursing

Article 54-01 General Administration

Chapter 54-01-01 Organization of Board

N.D. Admin. Code 54-01-01-01 Organization of board of nursing

1.History and functions. The 1915 legislative assembly passed a law governing the registration of nurses and created a board of nursing, codified as North Dakota Century Code

chapter 43-12. The 1947 legislative assembly passed a law governing practical nurses, codified as North Dakota Century Code chapter 43-21. The 1977 legislative assembly passed a Nurse Practices Act which combined the two laws, codified as North Dakota Century Code

chapter 43-12.1. The 1995 legislative assembly amended the law to define nursing and the requirements for the practice of nursing, and to require the governor to appoint a board of nursing to implement the law.

2.Board membership. The board consists of nine members appointed by the governor. Five members are registered nurses, one member is an advanced practice registered nurse, two members are licensed practical nurses, and one member is a public member. Members of the board serve four-year terms with the public member's appointment coinciding with that of the governor. No member may be appointed for more than two consecutive terms.

3.Executive director. The executive director is employed by the board and is responsible for the administration of the board's office and activities.

4.Inquiries. Inquiries concerning the board and nursing practice in North Dakota may be addressed to:

North Dakota Board of Nursing 919 S. 7th St., Suite 504 Bismarck, North Dakota 58504-5881 www.ndbon.org

November 1, 1996; April 1, 2004; April 1, 2014.

History

• History: Amended effective July 1, 1982; November 1, 1985; October 1, 1987; December 1, 1989;
• General Authority: NDCC 28-32-02.1
• Law Implemented: NDCC 28-32-02.1, 43-12.1

Chapter 54-01-02 Professional Nurse Appointments to Board [Repealed]

N.D. Admin. Code 54-01-02 Professional Nurse Appointments to Board [Repealed]

CHAPTER 54-01-02

PROFESSIONAL NURSE APPOINTMENTS TO BOARD [Repealed effective June 1, 1982]

Chapter 54-01-03 Definitions

N.D. Admin. Code 54-01-03-01 Definitions

The terms used in this title have the same meaning as in North Dakota Century Code chapter 43-12.1 and apply to North Dakota Administrative Code title 54 unless the context indicates otherwise.

1."Abandonment" means accepting the client assignment and disengaging the nurse and client relationship without giving notice to a qualified person.

2."Abuse" means any behavior that is designed to harass, intimidate, or injure another human being through the use of verbal, sexual, emotional, or physical harm.

3."Accreditation" means the official authorization or status granted by a nationally recognized agency other than a state board of nursing.

4."Activities of daily living" includes interventions associated with nutrition and hydration, elimination, maintaining mobility, assistance with self-administration of routine regularly scheduled medications, and personal cares. Personal care includes bathing, hair care, nail care, shaving, dressing, oral care, and supporting a safe and healthy environment.

5."Acts or omissions" means patterns of unsafe behavior, nursing practice deficits, failure to comply with acceptable standards of nursing practice, or grounds for discipline identified in North Dakota Century Code chapter 43-12.1 or these rules.

6."Advanced assessment" means the collection of the history, physical and psychological assessment data of a client's signs, symptoms, pathophysiologic status, and psychosocial variation in the determination of differential diagnoses and treatment by the advanced practice registered nurse.

7."Applicant" means an individual seeking official action by the board.

8."Approved" means that the standards established by the board are met.

9."Assign" means a licensed nurse designates the responsibility for performance of nursing interventions to another licensed nurse.

10."Assignment" means the distribution of work that each staff member is to accomplish.

11."Assisting with self-administration of routine, regularly scheduled medications" means helping the client with one or more steps in the process of taking medications. Examples of "assisting" include opening the medication container or reminding the client of the proper time to take the medication. Assisting with the administration of medication may be a delegated intervention.

12."Authority" means legal authority to provide nursing care granted through licensure as a registered nurse, licensure as a practical nurse, or through delegation of nursing interventions from the licensed nurse.

13."Certification" means a process of voluntary recognition by a national nursing organization or other entity of the person's specialty knowledge, skills, and abilities in a defined area of nursing practice. The certification process measures the theoretical and clinical content denoted in the specialty areas or scope of practice and is developed in accordance with generally accepted standards of validity and reliability.

14."Client" means the recipient of nursing care, which may include an individual, family, group, or a community.

15."Clinical learning experiences" means the planned, faculty-guided learning experiences that involve direct or indirect contact with clients.

16."Competence" means the application and integration of knowledge, skills, ability, and judgment necessary to meet standards.

17."Compliance" means the act of adhering to or conforming to the terms, conditions, or restrictions specified in a consent agreement by the alternative to discipline program or disciplinary order by the board.

18."Comprehensive nursing assessment" means analysis and synthesis of data collected by a registered nurse, which is used to establish a health status baseline, establish a plan of care, and address changes in a client's condition.

19."Consultative nurse" means a licensed nurse who provides guidance and information related to nursing procedures and interventions to the facility or agency but is not individually responsible to direct the plan of care for the client.

20."Continuing education" means planned, organized learning experiences designed to augment the knowledge, skills, and abilities for the delivery of safe and effective nursing care for the citizens of North Dakota which meets the criteria and reporting requirements established by the board.

21."Controlled substance" means a drug, substance, or immediate precursor in schedules I through V as set forth in North Dakota Century Code chapter 19-03.1 and any other drugs required by law to be monitored by the prescription drug monitoring program.

22."Criminal history record information" shall have the same meaning as defined in North Dakota Century Code section 12-60-16.1.

23."Delegation" means the authorization for the performance of selected nursing interventions from a licensed nurse to an unlicensed assistive person.

24."Denial" means the board's refusal to issue or renew a current license or registration.

25."Direction" means the provision of written or verbal guidance, or both, and supervision by a licensed nurse who is responsible to manage the provision of nursing interventions by another person.

26."Distance nursing education program" means a program that is approved by the board of nursing of the jurisdiction in which the program is headquartered, and is equivalent to an "instate nursing program".

27."Diversion" means illegal use, distribution, or abuse of controlled substances or use of prescription drugs for purposes not intended by the prescriber.

28."Emergency suspension" means action by the board when there are reasonable grounds to believe the licensee, registrant, applicant, or any individual with authority to practice nursing under any privilege has violated a statute or rule the board is empowered to enforce and continued practice would constitute a continuing and imminent threat to the public welfare.

29."Encumber" means to place on probation.

30."Evidence-based practice" means integration of research findings with clinical expertise and client values for optimum care.

31."Focused nursing assessment" means the collection and recording of baseline assessment data by a licensed practical nurse, which is used to observe, monitor, and report signs, symptoms, and changes in client condition in an ongoing manner. The licensed practical nurse reports to the supervising registered nurse or licensed practitioner.

32."Impaired" means the ability to practice nursing safely has been affected by the use or abuse of alcohol or other drugs, psychiatric or physical disorders, or practice deficiencies.

33."Inactive license or registration" means a license or registration which is not renewed.

34."Incompetence" means conduct that deviates from either standards of nursing practice approved by the board or the definition of competence in this section.

35."Instate nursing program", "nursing program", or "nursing education program" means a nurse program with faculty or facilities located in North Dakota and approved by the board.

36."Interdisciplinary team" means a group of health care professionals currently licensed under North Dakota Century Code title 43.

37."Internationally educated" means educated outside the United States.

38."Jurisdiction" means a state, territory, or country that administers the national council licensure examination for the purpose of licensure.

39."Licensed nurse" means a person licensed pursuant to North Dakota Century Code chapter 43-12.1 and North Dakota Administrative Code title 54.

40."Licensed practitioner" means a person lawfully authorized to prescribe medications or treatments under North Dakota Century Code title 43.

41."Licensee" means a person who has met all the requirements to practice as a licensed nurse pursuant to North Dakota Century Code chapter 43-12.1 and has been issued a license to practice nursing.

42."Licensure" means the process by which the board grants legal authority privilege to an individual to engage in the practice of nursing as a licensed practical nurse, registered nurse, advanced practice registered nurse, or specialty practice registered nurse upon finding that the individual has attained the essential degree of education and competence necessary to ensure that the public health, safety, and welfare will be protected.

43."Limit" means to restrict, qualify, or otherwise modify the license or registration.

44."Major incident" means an act or omission in violation of North Dakota Century Code chapter 43-12.1 or this title which indicates an applicant licensee's or registrant's continuing to practice poses a high risk of harm to the client or another person.

45."Medication administration" means the delivery of medication by a licensed nurse or an individual delegated to and supervised by a licensed nurse, to a client whose use of that medication must be monitored and evaluated applying specialized knowledge, skills, and abilities possessed by a licensed nurse.

46."Medication assistant III" means an individual who has a current registration as an unlicensed assistive person, has had additional training in administration of medication, and possesses a current registration from the board.

47."Medical assistant student" means an individual who is currently enrolled in an approved medical assistant program.

48."Minor incident" means an act or omission in violation of North Dakota Century Code chapter 43-12.1 or this title which indicates an applicant licensee's or registrant's continuing to practice poses a low risk of harm to the client or another person.

49."Misappropriation of property" means the patterned or knowing, willful, or intentional misplacement, exploitation, taking, or wrongful, temporary, or permanent use of a client's, employer's, or any other person's or entity's belongings, money, assets, or property without consent.

50."NCLEX-PN®" means the national council licensure examination for practical nurses.

51."NCLEX-RN®" means the national council licensure examination for registered nurses.

52."Neglect" means a disregard for and departure from the standards of care which has or could have resulted in harm to the client.

53."Noncompliance" means the failure to adhere to the terms, conditions, or restrictions specified in an alternative to discipline consent agreement or disciplinary order by the board.

54."Nurse administrator" means a person responsible for organized nursing services and who manages from the perspective of the organization as a whole.

55."Nurse faculty" means individuals employed by an academic institution who are responsible for developing, implementing, teaching, evaluating, and updating nursing program curricula.

56."Nursing intervention" means the initiation and completion of client-focused actions necessary to accomplish the goals defined in the plan of care which may include activities of daily living.

57."Participant" means a nurse who has voluntarily agreed to enter an agreement with the alternative to discipline program or a licensee or registrant who is encumbered through a disciplinary order by the board.

58."Practice deficiency" means a practice activity that does not meet the standards of nursing practice.

59."Practice site" means a facility that signs a written agreement with the nursing education program to provide practice experiences for students.

60."Preceptor" means an individual at or above the level of licensure that an assigned student is seeking who may serve as a teacher, mentor, role model, or supervisor for the assigned student in a clinical setting.

61."Prelicensure program" means a board-approved program of study that meets the requirements for nursing licensure.

62."Probation" means restrictions, requirements, or limitations placed against a licensee or registrant through monitoring for a prescribed period of time.

63."Professional-boundary crossing" means a deviation from an appropriate boundary for a specific therapeutic purpose with a return to establish limits of the professional relationship.

64."Professional-boundary violation" means a failure of a licensee or registrant to maintain appropriate boundaries with a client, client family member, or other health care provider.

65."Professional boundaries" means the provision of nursing services within the limits of the nurse and client relationship which promote the client's dignity, independence, and best interests and refrain from inappropriate involvement in the client's or client's family personal relationships.

66."Professional misconduct" means any practice or behavior that violates the applicable standards governing the individual's practice necessary for the protection of the public health, safety, and welfare.

67."Reactivation" means issuance of a previously active license or registration in the absence of disciplinary action.

68."Registrant" means an unlicensed assistive person as defined in North Dakota Century Code

section 43-12.1-02.

69."Reinstatement" means activation of a board-sanctioned license or registration from a surrendered, suspended, or revoked status.

70."Reissuance" means issuance of a license from probationary status to full licensure status.

71."Relicensure" means renewal, reinstatement, reactivation, or reissuance of a license or registration.

72."Reprimand" means action of the board stating the board's concerns regarding the professional conduct of the licensee or registrant.

73."Revocation" means the withdrawal by the board of the license or registration of the right to practice nursing or assist in the practice of nursing for a specified length of time of no less than one year. If no specified length of time is identified by the board, revocation is permanent.

74."Scope of practice" means the delineation of the nature and extent of practice.

75."Sponsor institution" means the governing organization that provides necessary administrative and fiscal resources for a nursing program.

76."Stable" means a situation in which the client's clinical and behavioral status and nursing care needs are determined by the registered nurse or licensed practitioner to be predictable, nonfluctuating, and consistent or in which the fluctuations are expected and the interventions are planned.

77."Stay" means the action of the board that does not immediately take place and may not take place if other conditions, such as probation terms, are met. Violations of the terms and conditions may result in lifting of the stay and imposition of the sanction.

78."Supervision" means maintaining accountability to determine whether or not nursing care is adequate and delivered appropriately. Supervision includes the assessment and evaluation of the client's condition and responses to the nursing plan of care and evaluation of the competence of the person providing nursing care.

a."Condition of supervision" means the method of supervision as direct or indirect, the identification of the persons to be supervised as well as the nursing interventions being provided, and the stability or predictability, or both, of the client's condition.

b."Direct supervision" means that the responsible licensed nurse or licensed practitioner is physically present in the client care area and is available to assess, evaluate, and respond immediately. Direct supervision does not mean that the responsible licensed nurse or licensed practitioner must be in the same room or "looking over the shoulder" of the persons providing nursing care.

c."Indirect supervision" means that the responsible licensed nurse or licensed practitioner is available through periodic inspection and evaluation or by telecommunication, or both, for direction, consultation, and collaboration.

79."Surrender" means an agreement by a licensee or registrant, approved by the board, to relinquish the license or registration to the board.

80."Survey" means an onsite visit or a paper review of a program approved by the board of nursing.

81."Suspension" means withholding by the board of the license or registration of the right to practice nursing or assist in the practice of nursing for a specified or indefinite period of time.

82."Technician" means an unlicensed assistive person who may perform limited nursing functions within the ordinary, customary, and usual roles in the person's field. Examples may include surgical and dialysis technicians and medical assistants.

83."Temporary permit" means the authority to practice nursing for a limited time period.

84."Unlicensed assistive person registry" means a listing of all persons who are authorized by the board or included on another state registry, which has been recognized by the board to perform nursing interventions delegated and supervised by a licensed nurse.

85."Work authorization" means the issuance of an authorization to practice nursing between the dates of graduation and notification of the results of the licensure examination.

History

• History: Effective June 1, 2002; amended effective April 1, 2004; August 1, 2005; July 1, 2008; April 1, 2011; October 1, 2011; April 1, 2014; October 1, 2016; April 1, 2024.
• General Authority: NDCC 43-12.1-08(2)
• Law Implemented: NDCC 43-12.1-08

Article 54-02 Nurse Licensure

Chapter 54-02-01 Licensure by Examination

N.D. Admin. Code 54-02-01-01 Official licensing examination

Each year the board of nursing shall contract to use the following examinations as the official North Dakota licensing examinations for nurses:

National council licensure examination for registered nurses.

National council licensure examination for practical nurses.

History

• History: Amended effective June 1, 1982.

N.D. Admin. Code 54-02-01-02 Passing score

Repealed effective October 1, 1987.

N.D. Admin. Code 54-02-01-03 Testing dates

Repealed effective April 1, 2004.

N.D. Admin. Code 54-02-01-04 Examination material

Repealed effective January 1, 1994. 54-02-01-04.1. Board authorization to write examination.

Candidates must complete application to the board for licensure by examination. Eligibility for testing will be submitted to the test center by the board when notification is received that all academic requirements have been met. In addition, the applicant's registration withthe testing vendor has been reported to the board office.

History

• History: Effective January 1, 1994; amended effective April 1, 2014.

N.D. Admin. Code 54-02-01-05 Examination results

Examination results will be reported to individual candidates and recorded in the candidate's permanent record in the board office. The examination results for the successful candidate will include the number of the permanent license that shall be issued to the candidate.

May 1, 1996; February 1, 1998; April 1, 2014.

History

• History: Amended effective November 1, 1979; October 1, 1989; December 1, 1991; January 1, 1994;
• General Authority: NDCC 43-12.1-08(1)

N.D. Admin. Code 54-02-01-06 Examination fees

The board shall set the fee for licensure by examination. The fee for licensure by examination shall be one hundred twenty-five dollars. The application is valid for a period of time not to exceed twelve months from the determination of eligibility and the fee is nonrefundable. The candidate shall be responsible for any payment of fees charged by the national council of state boards of nursing for use of the national council licensure examination.

September 1, 1994; June 1, 2001; June 1, 2002; July 1, 2020.

History

• History: Amended effective November 1, 1979; March 1, 1986; March 1, 1992; January 1, 1994;
• Law Implemented: NDCC 43-12.1-08(2)(d)

N.D. Admin. Code 54-02-01-07 Transcript

1.A graduate from another state or territory or an English-speaking Canadian nursing education program must provide an official completed transcript. The transcript must be sent directly from the nursing education program to the board office, as proof of satisfactory completion of the appropriate nursing education program.

2.A board-approved credentials evaluation service shall evaluate an internationally educated applicant's official nursing education program transcript.

a.The transcript must be sent directly from the nursing program to the credentials evaluation service.

b.The evaluation must be translated to English and the nursing education program's approval in the home country must be verified and must include a course-by-course evaluation to assure the nursing education program meets those requirements outlined in

article 54-03.2.

c.The nursing education program must include a clinical education equivalent in amount and time to board-approved programs.

d.The approved credentials evaluation service shall complete and send directly to the board the full credentials evaluation and official transcript that was evaluated.

e.The credentials evaluation must state specifically the language of instruction was English with English textbooks. If the nursing education program was not taught in English, evidence of the applicant's English language proficiency must be provided to the board.

f.This subsection does not apply to graduates of Canadian English-speaking nursing education programs.

History

• History: Amended effective June 1, 1982; January 1, 1994; February 1, 1998; April 1, 2004; April 1, 2014; April 1, 2024.

N.D. Admin. Code 54-02-01-08 Employment verification

Repealed effective May 1, 1996.

N.D. Admin. Code 54-02-01-09 Internationally educated applicants

Repealed effective April 1, 2024.

N.D. Admin. Code 54-02-01-10 Employment of unsuccessful candidates

A candidate who fails the licensing examination may not be employed in a position with functions that are usually assigned to licensed nurses.

History

• History: Effective November 1, 1979; amended effective June 1, 1982.
• Law Implemented: NDCC 43-12.1-03

N.D. Admin. Code 54-02-01-11 Qualifications for admission to the licensing examination

Repealed effective October 1, 1989.

N.D. Admin. Code 54-02-01-12 Early admission to the licensing examination

Repealed effective January 1, 1994.

N.D. Admin. Code 54-02-01-13 Authorization to practice nursing

Authorization to practice nursing between the dates of program completion and notification of results of the licensing examination will be issued to individuals accepted as candidates for the first licensing examination after program completion for which the candidate is eligible. Eligibility will be determined by the following criteria:

1.The applicant has submitted a completed application, the appropriate fee, and official transcript verifying program completion to the board office.

2.The applicant's registration with the testing vendor has been confirmed.

a.The applicant may use the appropriate title of graduate nurse or graduate practical nurse or the appropriate abbreviation of "G.N." or "G.P.N.".

b.The applicant must practice under the supervision of a registered nurse while the authorization to practice is valid. The work authorization to practice will expire in ninety days or upon notification of the testing results, whichever occurs first. The work authorization is nonrenewable and available only to graduates who complete an application for licensure within sixty days of graduation.

History

• History: Effective October 1, 1989; amended effective December 1, 1991; January 1, 1994; May 1, 1996; July 1, 2008; April 1, 2014.

N.D. Admin. Code 54-02-01-14 Recognition of programs from other jurisdictions

For the purpose of licensure by examination to practice as a registered nurse or licensed practical nurse, the board will recognize programs that are approved by another jurisdiction; and

1.Meet or exceed the education requirements set out in article 54-03.2 and have clinical education equivalent in amount and time to the board-approved programs; or

2.As otherwise approved by the board.

History

• History: Effective April 1, 2004; amended effective July 1, 2008.

Chapter 54-02-02 Reexamination

N.D. Admin. Code 54-02-02-01 Rewriting the practical nurse licensing examination

N.D. Admin. Code 54-02-02-02 Rewriting the registered nurse licensing examination

N.D. Admin. Code 54-02-02-03 Failure of licensing examination

Candidates who fail the licensing examination shall file a request for eligibility to retest and shall be responsible for payment of any fees charged by the national council of state boards of nursing for use of the national council licensure examination. The candidate's request for eligibility to retest will be accepted dependent upon a valid application to retest for licensure by examination.

History

• History: Amended effective March 1, 1986; January 1, 1994; September 1, 1994; April 1, 2004.
• General Authority: NDCC 43-12.1-08
• Law Implemented: NDCC 43-12.1-09(2)

N.D. Admin. Code 54-02-02-04 Time limit on rewriting parts of the registered nurse examination

Repealed effective June 1, 1982.

N.D. Admin. Code 54-02-02-05 Fee to rewrite the practical nurse examination

N.D. Admin. Code 54-02-02-06 Fee to rewrite the registered nurse examination

N.D. Admin. Code 54-02-02-07 Failure of licensing examination in another state

Repealed effective January 1, 1994.

N.D. Admin. Code 54-02-02-08 Failure of registered nurse licensing examination in another state

Repealed effective June 1, 1982.

N.D. Admin. Code 54-02-02-09 Unlimited attempts to write the licensing examination

Candidates will have unlimited attempts to pass the licensing examination.

History

• History: Effective January 1, 1994; amended effective May 1, 1996; June 1, 2001; April 1, 2004.
• General Authority: NDCC 43-12.1-08
• Law Implemented: NDCC 43-12.1-08(5), 43-12.1-09(1)

Chapter 54-02-03 Proctored Examinations [Repealed]

N.D. Admin. Code 54-02-03 Proctored Examinations [Repealed]

CHAPTER 54-02-03

PROCTORED EXAMINATIONS [Repealed effective January 1, 1994]

Chapter 54-02-04 Roster of Inactive Nurses [Repealed]

N.D. Admin. Code 54-02-04 Roster of Inactive Nurses [Repealed]

CHAPTER 54-02-04

ROSTER OF INACTIVE NURSES [Repealed effective June 1, 1982]

Chapter 54-02-05 Relicensure

N.D. Admin. Code 54-02-05-01 Residency or employment requirement

Repealed effective June 1, 2001.

N.D. Admin. Code 54-02-05-02 Renewal dates

Nursing licenses will be valid for two calendar years and will be subject to renewal before December thirty-first of the second year. Applicants for initial licensure by endorsement or examination shall receive a license expiring on December thirty-first of the following licensure year as a part of the application fee. Failure to receive the renewal notification does not relieve the licensee of the obligation to renew the license by the expiration date.

History

• History: Amended effective November 1, 1990; April 1, 2004; April 1, 2014.
• Law Implemented: NDCC 43-12.1-10(1)

N.D. Admin. Code 54-02-05-03 Renewal fees

The nonrefundable renewal fee for the registered nurse license will be one hundred forty dollars.

The nonrefundable renewal fee for the practical nurse license will be one hundred thirty dollars.

History

• History: Amended effective November 1, 1979; July 1, 1987; November 1, 1990; June 1, 2001; June 1, 2002; October 1, 2012; July 1, 2020.
• General Authority: NDCC 43-12.1-08(2)(d)(k)
• Law Implemented: NDCC 43-12.1-10(1)

N.D. Admin. Code 54-02-05-04 Late renewal fee

Repealed effective July 1, 2020.

N.D. Admin. Code 54-02-05-05 Nonpracticing nurses

Any nurse who has not actively practiced nursing in North Dakota for four years or more must meet the following requirements before a license to practice is issued:

1.Complete the reactivation application.

2.Submit the current reactivation fee.

3.Certify on the application one of the following:

a.Practice as a licensed registered nurse or licensed practical nurse which meets or exceeds four hundred hours within the preceding four years in another jurisdiction.

b.Completion of a refresher course in nursing, in accordance with board guidelines, within the preceding year.

c.Successful completion of a clinical nursing course in a board-recognized nursing program to further nursing education.

d.Other evidence the licensee wishes to submit which would provide proof of nursing competence.

Nursing practice for purposes of renewal must meet or exceed four hundred hours within the preceding four years. Nursing is defined in subsection 5 of North Dakota Century Code section 43-12.1-02. Hours practiced in another regulated profession cannot be used for nursing practice hours.

The board may initiate the issuance of a limited license when good cause exists to do so.

History

• History: Amended effective June 1, 1982; May 1, 1996; February 1, 1998; April 1, 2004; April 1, 2014.
• Law Implemented: NDCC 43-12.1-08(1) 54-02-05-05.1. Practice requirements for relicensure.
• History: Effective July 1, 1987; amended effective November 1, 1990; September 1, 1994; May 1, 1996; May 1, 2003; April 1, 2004; April 1, 2014.
• Law Implemented: NDCC 43-12.1-08(1) 54-02-05-05.2. Limited license.
• History: Effective July 1, 2008.
• Law Implemented: NDCC 43-12.1-08(f)

N.D. Admin. Code 54-02-05-06 Reactivating a license

A nurse previously licensed in North Dakota who applies for reactivation must meet board requirements and includes the following:

1.Complete the application and submit to a criminal history record check according to section 54-02-12-01;

2.Pay the nonrefundable renewal fee and fifty dollar reactivation fee; and

3.Meet the requirements in section 54-02-05-05.1, practice requirements for license renewal, and section 54-02-05-08, continuing education requirement for license renewal; or

4.Submit other evidence which would provide proof of nursing competence acceptable to the board.

History

• History: Amended effective June 1, 1982; June 1, 2002; April 1, 2004; July 1, 2008; July 1, 2020.
• General Authority: NDCC 12-60-24(1)(o), 43-12.1-08
• Law Implemented: NDCC 43-12.1-09.1, 43-12.1-10(1)

N.D. Admin. Code 54-02-05-07 Encumbered license

Repealed effective April 1, 2004.

N.D. Admin. Code 54-02-05-08 Continuing education requirement for relicensure

1.Continuing education for purposes of relicensure must be approved or recognized by the board and must meet or exceed twelve contact hours within the preceding two years.

2.All information concerning continuing education submitted with a renewal application is subject to audit. Upon request of the board, the licensee shall submit verification of successful completion of the required continuing education.

3.A licensee who does not meet the continuing education requirements for renewal or fails to provide verification of completion of the required continuing education will be ineligible for renewal and may be subject to grounds for disciplinary action.

4.A licensee who earns in excess of the number of contact hours of continuing education required during a reporting period shall not apply the excess hours to satisfy future continuing education requirements.

5.Continuing education that is required by the board pursuant to a board order shall not be accepted by the board to satisfy or partially satisfy the continuing education requirements for license renewal.

History

• History: Effective April 1, 2004; amended effective April 1, 2014.
• Law Implemented: NDCC 43-12.1-08(2)(n)

Chapter 54-02-06 License by Endorsement

N.D. Admin. Code 54-02-06-01 Application and fee

1.Applicants licensed as a nurse by examination in another jurisdiction may apply for license by endorsement and must meet board requirements, including submission of:

a.A completed application;

b.A criminal history record check according to chapter 54-02-12;

c.The nonrefundable endorsement fee of one hundred fifty dollars;

d.Evidence of completion of a nursing education program approved in a jurisdiction which meets or exceeds those requirements outlined in article 54-03.2; and

e.Evidence of nursing practice to demonstrate continued competency which meets or exceeds four hundred hours within the preceding four years or as otherwise approved by the board.

2.A board-approved evaluation service shall evaluate an internationally-educated nurse's official nursing education program transcript.

a.The transcript must be sent directly from the nursing program to the credentials evaluation service.

b.The nursing education program's approval in the home country must be verified and the evaluation must include a course-by-course evaluation to assure the nursing education program meets those requirements outlined in article 54-03.2. The nursing education program must include a clinical education equivalent in amount and time to boardapproved programs.

c.The approved credentials evaluation service shall complete and send directly to the board the full credentials evaluation and official transcript that was evaluated.

d.This subsection does not apply to graduates of Canadian English-speaking nursing education programs.

A licensee from another jurisdiction who has an insufficient number of practice hours must meet one of the alternative requirements of section 54-02-05-05.

February 1, 1998; June 1, 2001; June 1, 2002; April 1, 2004; July 1, 2008; April 1, 2011; October 1, 2012; April 1, 2014; July 1, 2020; April 1, 2024.

Upon receipt of the application for license by endorsement, payment of the fee as set by the board, and evidence that an applicant will meet all the requirements for licensure in North Dakota, the board may issue a temporary permit to practice as a registered nurse or licensed practical nurse in this state until the license is issued. The temporary permit expires at the end of ninety days and may be extended only for reasons satisfactory to the board.

History

• History: Amended effective November 1, 1979; March 1, 1986; March 1, 1992; May 1, 1996;
• General Authority: NDCC 12-60-24(2)(o), 43-12.1-09(2)(b)
• Law Implemented: NDCC 43-12.1-09(2)(b) 54-02-06-01.1. Temporary permit.
• History: Effective May 1, 1996; amended effective April 1, 2014.
• General Authority: NDCC 43-12.1-08
• Law Implemented: NDCC 43-12.1-09

N.D. Admin. Code 54-02-06-02 Fee nonrefundable

The endorsement fee is nonrefundable.

History

• History: Amended effective June 1, 2002.
• General Authority: NDCC 43-12.1-08
• Law Implemented: NDCC 43-12.1-10

N.D. Admin. Code 54-02-06-03 Exceptions

Repealed effective April 1, 2004. 54-02-06-03.1. Military spouses - Licensure.

Repealed effective April 1, 2024. 54-02-06-03.2. Military spouses - Temporary permit.

Repealed effective April 1, 2024.

Chapter 54-02-07 Disciplinary Action

N.D. Admin. Code 54-02-07-01 Definition of unprofessional conduct

Repealed effective August 1, 1988. 54-02-07-01.1. Grounds for discipline.

Practice inconsistent with acceptable standards of nursing practice by a licensee, applicant, or registrant means behavior that may place a client or other person at risk for harm or be in violation of the standards of nursing practice. Inconsistent practice includes incompetence by reason of negligence, patterns of behavior, or other behavior that demonstrates professional misconduct and includes the following:

1.Failure to provide nursing care because of client diagnosis, age, sexual preference, gender, marital status, socioeconomic status, disability, race, or religion.

2.Cause or permit verbal, physical, emotional, or sexual abuse or harassment or intimidation to a client, client's family, or other health care provider.

3.Assign or delegate the responsibility for performance of nursing interventions to unqualified persons.

4.Failure to appropriately supervise persons to whom nursing interventions have been assigned or delegated.

5.Practice of nursing without sufficient knowledge, skills, or nursing judgment.

6.Performance of nursing interventions in a manner inconsistent with acceptable nursing standards.

7.Inaccurate or incomplete documentation or recording, or the falsification, alteration, or destruction of board records or client, employee, or employer records.

8.Failure to adhere to the licensee's, registrant's, or applicant's professional code of ethics or other applicable standards governing the individual's practice.

9.Misappropriation of property, including any real or personal property of the client, employer, or any other person or entity or failure to take precautions to prevent such misappropriation.

10.Abandon or neglect a client who is in need of or receiving nursing care.

11.Failure to comply with mandatory requirements to report any violation of the Nurse Practices Act or duly promulgated rules, regulations, or orders of the board.

12.Practice nursing or assist in the practice of nursing while under the influence of alcohol or unauthorized drugs or while exhibiting impaired behavior.

13.Alter or falsify a license, registration, transcript, diploma, certificate, program of study, or continuing education document.

14.Use or permit the use of a nursing license or registration that has been fraudulently purchased, created, obtained, issued, counterfeited, or altered.

15.Failure to submit to a mental health, chemical dependency, or physical evaluation within the time frame required by the board.

16.Violate any term of probation, condition, or limitation imposed by the board.

17.Failure to adhere to professional boundaries with a client or client's family.

18.Failure to comply with licensure or registration requirements.

19.Submit to a drug screen that results in a positive test for unauthorized drugs.

20.Failure to provide a written notice or report required under section 54-02-07-03.1 of this

chapter.

April 1, 2004; April 1, 2011; April 1, 2014.

History

• History: Effective December 1, 1995; amended effective July 1, 1996; February 1, 1998; June 1, 2002;

N.D. Admin. Code 54-02-07-02 Definitions

Repealed effective June 1, 2002.

N.D. Admin. Code 54-02-07-03 Complaints

Repealed effective December 1, 1995. 54-02-07-03.1. Reporting violations.

Protection of the public is enhanced by reporting of incidents that may be violations of North Dakota statutes or grounds for discipline by the board. Licensees, registrants, applicants, or citizens should use the following process to report any knowledge of acts or omissions of any individual that violate North Dakota Century Code chapter 43-12.1 or these rules:

1.Minor incident. If the act or omission meets the criteria for management of a minor incident, the applicant, licensee, or registrant should be aware of and follow the established policy within the practice setting for minor incidents. The established policy in the licensee's or registrant's practice setting should detect patterns of unsafe behavior that may be considered minor incidents and take corrective action resulting in safe practice.

a.A minor incident may be handled in the practice setting with a corrective action process if all the following factors exist:

(1)Potential risk of harm to others is low;

(2)There is no pattern of recurrence;

(3)The licensee or registrant exhibits evidence of remediation and adherence to standards of nursing practice; and (4)The corrective action process results in the licensee or registrant possessing the knowledge, skills, and abilities to practice nursing safely.

b.Other factors may be considered in determining the need to report such as the significance of the event in the particular practice setting, the situation in which the event occurred, and the presence of contributing or mitigating circumstances in the nursing care delivery system.

c.Nothing in this rule is intended to prevent reporting of a minor incident or potential violation directly to the board.

2.Major incident. If the act or omission is a major incident or factors are present that indicate a duty to report, the licensee, applicant, or registrant and the licensee's, applicant's, or registrant's supervisor must report the alleged violation to the board in the manner and form provided by the board. The report should include requested information about the act or omission, the individuals involved, and the action taken within the practice setting.

3.Termination of employment. When a licensee, applicant, or registrant terminates from the practice setting, either voluntarily or by request, due to conduct that may be grounds for discipline under the Nurse Practices Act, a report shall be made to the board by the licensee, applicant, or registrant and by the licensee's, applicant's, or registrant's supervisor in the manner and form provided by the board.

4.Self-reporting. A licensee, registrant, or applicant shall provide written notice of explanation and a copy of the applicable documents to the board within thirty days from the date of any criminal, malpractice, administrative, civil, or disciplinary action in another jurisdiction or any other action taken against the licensee, registrant, or applicant for any conduct that may affect patient safety or otherwise relates adversely to the practice of nursing.

April 1, 2011.

History

• History: Effective December 1, 1995; amended effective June 1, 2002; April 1, 2004; July 1, 2008;
• Law Implemented: NDCC 43-12.1-11

N.D. Admin. Code 54-02-07-04 Investigation

Complaints, requests for investigation, and reports of acts or omissions that are in violation of North Dakota Century Code chapter 43-12.1 or are grounds for disciplinary action will be investigated by the board or by its direction in order to determine whether sufficient grounds exist to file a complaint according to North Dakota Century Code chapter 28-32. The board or its investigative panel may subpoena witnesses, records, and any other evidence relating to the investigation. Any medical record of an individual, or any other document containing personal health information which is obtained by the board, is an exempt record as defined in North Dakota Century Code section 44-04-17.1.

The board may require the individual subject to an investigation to submit to a mental health, chemical dependency, or physical evaluation if, during the course of the investigation, there is reasonable cause to believe that any licensee, registrant, or applicant is unable to practice with reasonable skill and safety or has abused alcohol or drugs. The board may require a copy of the evaluation to be submitted from the evaluating professional directly to the board.

1.Upon failure of the person to submit to the evaluation within thirty days of the request, the board may suspend the individual's license or registration or deny or suspend consideration of any pending application until the person submits to the required evaluation.

2.The licensee, registrant, or applicant shall bear the cost of any mental health, chemical dependency, or physical evaluation and treatment required by the board.

3.The board may suspend or revoke an individual's license or registration if it is determined that the individual is unsafe to practice. The suspension or revocation will remain in effect until the individual demonstrates to the satisfaction of the board the ability to safely return to the practice of nursing or assist in the practice of nursing.

4.The board may deny the individual's application for licensure or registration if it is determined that the individual is unsafe to practice. The denial will remain in effect until the individual demonstrates to the satisfaction of the board the ability to safely practice nursing or assist in the practice of nursing.

History

• History: Effective August 1, 1988; amended effective December 1, 1995; July 1, 2008; April 1, 2014.
• Law Implemented: NDCC 43-12.1-13 54-02-07-04.1. Evidence and evaluation of treatment.
• History: Effective June 1, 2002; amended effective July 1, 2008; April 1, 2011; April 1, 2014.

N.D. Admin. Code 54-02-07-05 Settlements

Repealed effective December 1, 1995. 54-02-07-05.1. Disposition.

Requests for investigation may result in:

1.Informal resolution and disposition by the board;

2.Formal resolution and disposition by the board. The board may use an administrative law judge to preside over the entire administrative proceeding and prepare recommended findings of fact, conclusions of law, and recommended order for board consideration, or the board may use a procedural hearing officer for the conduct of the hearing at which a majority of board members must be present at the hearing;

3.Dismissal. If the board's investigative panel determines that the alleged violation is frivolous, would not constitute grounds for disciplinary action, is outside the jurisdiction of the board, or is otherwise inappropriate for board action, the complainant and the affected licensee or registrant shall be notified in writing that the board will not pursue the matter, stating the grounds for the decision;

4.Referral to another agency; or

5.Other action as directed by the board.

The executive director or the executive director's authorized designee may issue, upon authorization from the board's investigative panel, an emergency suspension of a license, registration, permit, or privilege to practice when continued practice of a licensee, registrant, applicant, or any individual with authority to practice nursing under any privilege would constitute a continuing and imminent threat to the public welfare.

1.The order of emergency suspension shall take effect upon written notice to the licensee, registrant, applicant, or any other individual with authority to practice nursing under any privilege and shall remain in effect until either retracted, modified, or superseded by final disciplinary action by the board or upon agreement between the board and the licensee, registrant, applicant, or individual. If a hearing is not requested by the licensee, registrant, applicant, or individual within twenty days of the notice, the emergency suspension shall become effective as a final order, for a suspension period of five years, without further notice.

2.In cases when disciplinary action is imposed, the board may additionally order that the emergency suspension continue in effect until the later of expiration of the time permitted for appeal or termination of the appellate process.

The board may accept the return and surrender of a license or registration without formal charges, notice, or opportunity of hearing if the licensee or registrant surrenders the license or registration to the board and executes a statement that the individual does not desire to be licensed or registered.

An individual who is under investigation for violation of North Dakota Century Code chapter 43-12.1 may surrender a license or registration to the board. Any license or registration surrender shall be deemed to be an admission of the alleged facts of any pending investigation or disciplinary matter.

1.A surrender deactivates the license or registration at the time of its relinquishment.

2.The surrender of a license or registration is disciplinary action and shall be reported and processed in the same manner as final disciplinary actions of the board.

3.Surrender of a license or registration shall not preclude the board from investigating or completing a disciplinary proceeding.

4.Individuals who surrender their licenses or registrations are not eligible to seek reinstatement of their license or registration for a minimum of two years and shall comply with the requirements for reinstatement of license or registration.

When it appears by credible evidence that a cease and desist order may be necessary, the executive director of the board or the executive director's authorized designee may issue an order directing a licensee, registrant, applicant, or any other individual with authority to practice nursing under any privilege to cease and desist certain actions.

History

• History: Effective December 1, 1995; amended effective June 1, 2002; July 1, 2008; April 1, 2014. 54-02-07-05.2. Emergency suspension.
• History: Effective June 1, 2002; amended effective April 1, 2011; April 1, 2014. 54-02-07-05.3. Surrender of license or registration.
• History: Effective June 1, 2002; amended effective April 1, 2014. 54-02-07-05.4. Cease and desist order.
• History: Effective July 1, 2008; amended effective April 1, 2011.

N.D. Admin. Code 54-02-07-06 Board decision

The final decision will be adopted by a simple majority of the board and will include findings of fact, conclusions of law, and order. The decision of the board to impose or modify any restrictions upon the licensee or registrant or the licensee's or registrant's practice or to reinstate a license or registration will be communicated to the licensee or registrant in the form of a board order. In addition to the terms and conditions imposed by the board, the following may apply:

1.Revocation. If the board issues a revocation order, it may also indicate in the order the specific action necessary for the reinstatement for licensure or registration by the individual.

The national nursing licensing examination may be waived by the board as a condition for the reinstatement of a previously revoked license. The initial licensure or registration fee will be assessed for the reinstatement of a revoked license or registration.

2.Suspension. If the board issues a suspension order, it may also indicate the specific action necessary for the reinstatement of the license or registration. An individual whose license or registration is suspended may request reinstatement by the board at any regularly scheduled meeting following the conclusion of the time period specified in the order. The current renewal fee will be required for reinstatement of a suspended license or registration.

3.Encumbrance. If the board issues an encumbrance order, the license shall be designated in the board's records as "encumbered" or as the board may otherwise require. If a licensee or registrant has more than one license and registration, the encumbrance applies to all licenses and registrations.

April 1, 2011; April 1, 2014.

History

• History: Effective August 1, 1988; amended effective December 1, 1995; June 1, 2002; April 1, 2004;
• Law Implemented: NDCC 28-32-13, 43-12.1-14

N.D. Admin. Code 54-02-07-07 Fees

1.Costs and disbursements, including witness fees and reimbursement of the board's expenses in any administrative hearing or other proceeding, may be recovered from the licensee, applicant, or registrant following any disciplinary action.

2.Penalty fees for each separate violation as established by the board may be imposed against the licensee, applicant, or registrant following any disciplinary action.

3.Administrative fees may be imposed by the board against the licensee, applicant, or registrant following the issuance of nondisciplinary action.

4.If a witness is subpoenaed by the board to appear at the request of the licensee or registrant, the licensee or registrant is to deposit with the board sufficient funds to cover expenses for mileage, food, lodging, and witness fees as allowed by state reimbursement policies.

5.In the case of any request by the licensee, applicant, or registrant for the subpoena by the board of an expert witness, sufficient funds will also be deposited with the board, prior to the issuance of such subpoena, to cover such expert witness fees. The deposit with the board of funds for witness fees and expenses must be made prior to the issuance of the subpoena.

The request for the subpoena by the board of a witness for the licensee, applicant, or registrant must be made in writing.

April 1, 2014.

History

• History: Effective August 1, 1988; amended effective December 1, 1995; June 1, 2002; April 1, 2004;
• Law Implemented: NDCC 28-32-26, 43-12.1-13

N.D. Admin. Code 54-02-07-08 Application for reinstatement

Any person whose license, privilege, or registration has been suspended, surrendered, or revoked by the board shall submit a written application for reinstatement in the manner and form required by the board at the conclusion of the time period specified in the order. The burden of proof is on the licensee or registrant to prove to the satisfaction of the board that the condition that led to a sanction no longer exists or no longer has a material bearing on the licensee's professional ability or registrant's ability, or both. The board will consider the written application for reinstatement at the next regularly scheduled board meeting. If the board votes for reinstatement, the board may impose reasonable terms and conditions to be imposed prior to reinstatement, or as a condition of reinstatement. If the board denies reinstatement, reasons for denial must be communicated to the applicant.

April 1, 2014.

History

• History: Effective August 1, 1988; amended effective December 1, 1995; June 1, 2002; April 1, 2004;

N.D. Admin. Code 54-02-07-09 Practice without a license or registration

1.During the first month of unauthorized practice, an individual seeking to initiate licensure or registration or to renew a license or registration who has failed to complete the registration process within the required time period and has been found to have been practicing nursing or assisting in the practice of nursing without a current license or registration shall be required to:

a.Submit double the licensure or registration fee;

b.Submit an administrative fee; and

c.Complete all other licensure or registration requirements as established by the board.

2.After the first month of unauthorized practice, an individual who has been unintentionally practicing nursing or assisting in the practice of nursing without proper authorization shall be required to:

a.Submit double the licensure or registration fee;

b.Submit an administrative fee;

c.Submit to a criminal history check;

d.Successfully complete a course of study on the North Dakota Nurse Practices Act within sixty days; and

e.Complete all other licensure or registration requirements as established by the board.

3.The license or registration of an individual who has unintentionally practiced nursing or assisted in the practice of nursing without proper authorization shall be automatically suspended without further proceedings if the requirements of the license or registration are not met within the time specified by the board. The suspension shall remain in effect until the board receives satisfactory evidence of successful completion of the requirements for licensure or registration.

4.If an unlicensed assistive person, whose registration has expired, assists in the practice of nursing without a current registration for a period not exceeding four months from the person's initial date of employment, and if the person has not previously been determined to have assisted in the practice of nursing without a current registration, then the provisions of subsections 1, 2, and 3 of this section shall not apply to that person; instead, the person shall receive a letter of concern and be required to complete all registration requirements as established by the board.

5.Upon compliance with the board rules regarding licensure or registration and the remittance of all fees, a current license or registration shall be issued.

6.Disciplinary action for practicing without a license or registration may be expunged from the licensee's or registrant's record if no further violations occur within two years after the imposition of the board's order.

History

• History: Effective August 1, 1988; amended effective September 1, 1994; December 1, 1995; June 1, 2002; April 1, 2004; April 1, 2014; July 1, 2020.

N.D. Admin. Code 54-02-07-10 Nurse assistant without registry status

Repealed effective February 1, 1998.

N.D. Admin. Code 54-02-07-11 Applicant statement

If an applicant for initial or renewal of licensure or registry status has been arrested, charged, or convicted of a felony offense, the applicant must provide the necessary information to determine the bearing upon that person's ability to serve as a licensed nurse or an unlicensed assistive person. Upon receipt of evidence of sufficient rehabilitation as outlined in North Dakota Century Code section 12.1-33-02.1, the license or registration may be issued. If the information does not substantiate the rehabilitation, the applicant may ask for a hearing pursuant to North Dakota Century Code chapter 28-32.

History

• History: Effective December 1, 1995; amended effective June 1, 2002; April 1, 2014.

N.D. Admin. Code 54-02-07-12 Unlicensed assistive persons on board-recognized registries

Repealed effective October 1, 2011.

Chapter 54-02-08 Temporary License [Repealed]

N.D. Admin. Code 54-02-08 Temporary License [Repealed]

CHAPTER 54-02-08

TEMPORARY LICENSE [Repealed effective December 1, 1995]

Chapter 54-02-08.1 Transitional License [Repealed]

N.D. Admin. Code 54-02-08.1 Transitional License [Repealed]

CHAPTER 54-02-08.1

TRANSITIONAL LICENSE [Repealed effective April 1, 2004]

Chapter 54-02-09 Limited License

N.D. Admin. Code 54-02-09-01 Statement of intent

It is the policy of the board to permit individuals who are unable to practice safely within the full scope of nursing, but who can practice safely within a modified scope, or practice safely with accommodations, or both, to be granted a limited license.

History

• History: Effective September 1, 1996; amended effective April 1, 2004.

N.D. Admin. Code 54-02-09-02 Definitions

Repealed effective April 1, 2004.

N.D. Admin. Code 54-02-09-03 Identification of need

The board may be informed of the potential need for limited licensure by the written submission to the board of any of the following:

1.A request from an individual for limited licensure;

2.Information provided by an approved nursing education program that a student requires accommodation to accomplish educational objectives;

3.Information provided by an endorsing state as part of nursing license verification process;

4.Information provided by an individual on application for licensure by examination, licensure by endorsement, or licensure renewal;

5.An employer referral; or

6.Referral from others including family members, peers, clients, and health care providers.

N.D. Admin. Code 54-02-09-04 Procedure for granting

1.The board may issue a limited license for the practice of nursing. The board may initiate the issuance of a limited license when good cause exists to do so. The board may also consider an application to issue a limited license, under the procedure set out in this chapter.

2.Following the receipt by the board of the information required in section 54-02-09-03, the board will review the information regarding the potential need for an individual to be granted a limited license including:

a.Evidence of the need for accommodation and its effect upon the individual's ability to practice nursing; and

b.A written plan for providing notice to employers of the required modifications to the licensee's scope of practice or the recommended accommodations, or both.

3.If the board and a licensee agree that accommodations are needed for the licensee to perform essential nursing functions then, upon signing such agreement, the licensee will be issued a limited license.

4.If the board and an applicant for licensure by examination or licensure by endorsement agree that accommodations are needed for the applicant to perform essential nursing functions then, upon signing such agreement and upon completion of all other applicable licensure requirements, the applicant will be issued a limited license.

5.If the board and an applicant or licensee cannot reach agreement regarding the need for accommodations, the board will issue its order designating the level of limited license granted to the applicant. In such cases, the applicant or licensee may request an administrative hearing, pursuant to the provisions of North Dakota Century Code chapter 28-32.

N.D. Admin. Code 54-02-09-05 Reconsideration

A nurse granted a limited license may apply to the board for reconsideration if the licensee's circumstances change.

Chapter 54-02-10 RN and LPN Nurse Licensure Compact [Repealed]

N.D. Admin. Code 54-02-10 RN and LPN Nurse Licensure Compact [Repealed]

CHAPTER 54-02-10

RN AND LPN NURSE LICENSURE COMPACT [Repealed effective July 1, 2018]

Chapter 54-02-11 Short-Term Clinical Education [Repealed]

N.D. Admin. Code 54-02-11 Short-Term Clinical Education [Repealed]

CHAPTER 54-02-11

SHORT-TERM CLINICAL EDUCATION [Repealed effective July 1, 2025]

Chapter 54-02-12 Criminal History Record Checks for Licensure

N.D. Admin. Code 54-02-12-01 Criminal history record checks

Individuals must submit a set of fingerprints to the board or its agent for the purpose of obtaining a state and federal criminal history record check in the manner provided by North Dakota Century Code

section 12-60-24 and as set forth by the board. An authorization and release form must be signed by the applicant authorizing the release of the criminal history record information to the board. The fingerprint card, authorization and release form, and fee for the criminal history record check must be submitted with the application for licensure.

1.The following individuals must submit to a criminal history record check:

a.Applicants for initial licensure, including licensure by examination or endorsement.

b.Applicants for initial licensure or reactivation of advanced practice licensure or specialty practice licensure.

c.Applicants for reactivation or reinstatement of RN or LPN license.

2.The following individuals may be required to submit to a criminal history record check:

a.Applicants for renewal of license.

b.Applicants for advanced practice or specialty practice licensure.

c.An individual who is under investigation for violation of North Dakota Century Code

chapter 43-12.1. If a criminal history record check is required as part of a disciplinary investigation or proceeding, the fingerprint card, authorization and release form, and fee for the criminal history record check must be submitted within twenty days of the request.

History

• History: Effective July 1, 2008.
• General Authority: NDCC 12-60-24.2(o)
• Law Implemented: NDCC 43-12.1-09.1

Article 54-03.2 Standards for Nursing Education Programs

Chapter 54-03.2-01 General Provisions

N.D. Admin. Code 54-03.2-01 General Provisions

ARTICLE 54-03.2

STANDARDS FOR NURSING EDUCATION PROGRAMS 54-03.2-01General Provisions 54-03.2-02Organization and Administration 54-03.2-03Nurse Administrator 54-03.2-04Faculty 54-03.2-05Students 54-03.2-06Curriculum 54-03.2-07Nursing Education Program Approval 54-03.2-08New Nursing Education Programs 54-03.2-09Closure of a Nursing Education Program 54-03.2-10Innovation in Nursing Education

CHAPTER 54-03.2-01

GENERAL PROVISIONS

Section 54-03.2-01-01Statement of Intent 54-03.2-01-02Definitions [Repealed] 54-03.2-01-03Standards for Nursing Education 54-03.2-01-01. Statement of intent.

The legislative assembly enacted legislation to permit the board to periodically review and approve nursing education programs. The purpose of the review is to ensure that graduates of nursing education programs are prepared to provide safe and effective nursing care. The nursing education program standards established by the board serve as a guide for the development of new nursing education programs and the closure of programs. The standards also foster the continued improvement of established nursing education programs to meet the changing needs of society and the development of the profession. The standards provide criteria for the evaluation of new and established nursing education programs. The graduate of a program approved by the board is eligible to apply for admission to the licensure examination for nurses.

History: Effective November 1, 1996.

General Authority: NDCC 43-12.1-17

Law Implemented: NDCC 43-12.1-17(1) 54-03.2-01-02. Definitions.

Repealed effective April 1, 2004. 54-03.2-01-03. Standards for nursing education.

Programs of nursing education shall prepare nurses to deliver client-centered care as members of an interdisciplinary team emphasizing evidence-based practice, quality improvement approaches, and information management consistent with scope of practice and level of licensure sought.

1.The purpose and outcomes of the nursing education program must be consistent with the Nurse Practices Act and administrative rules and other relevant statutes.

2.The purpose and outcomes of the nursing education program must be consistent with generally accepted standards of nursing practice appropriate for graduates of the type of nursing program education offered.

3.The input from the community of interest must be considered in the development and evaluation of the purpose and outcomes of the program.

4.The nursing education program shall implement a comprehensive, systematic plan for ongoing evaluation that is based on program and student learning outcomes and incorporates continuous improvement.

5.The faculty and students shall participate in program planning, implementation, evaluation, and continuous improvement.

6.The curriculum must be evidence-based and provide diverse learning experiences consistent with program and student learning outcomes.

7.The fiscal, human, physical, and learning resources must be adequate to support program processes and outcomes.

8.The nursing education program administrator must be a registered nurse who is academically qualified and has institutional authority with administrative responsibility for the program.

9.Academically and clinically qualified and registered nurse faculty must be sufficient in numbers and expertise to accomplish program outcomes and quality improvement.

10.Program information communicated by the nursing education program must be fair, accurate, inclusive, consistent, and readily available to the public.

History: Effective April 1, 2004; amended effective July 1, 2008; April 1, 2014.

General Authority: NDCC 43-12.1-17

Law Implemented: NDCC 43-12.1-17(1)

Chapter 54-03.2-02 Organization and Administration

N.D. Admin. Code 54-03.2-02 Organization and Administration

CHAPTER 54-03.2-02

ORGANIZATION AND ADMINISTRATION

Section 54-03.2-02-01Accreditation Requirements 54-03.2-02-02Organizational Design 54-03.2-02-03Nursing Education Program Organizational Design 54-03.2-02-04Nursing Education Program Consistency With Sponsor Institution 54-03.2-02-05Nursing Education Program Evaluation 54-03.2-02-06Financial Support 54-03.2-02-01. Accreditation requirements.

The sponsor institution offering the nursing education program must be accredited by a United States department of education-recognized regional or national accreditation entity.

History: Effective November 1, 1996; amended effective April 1, 2004; April 1, 2014. 54-03.2-02-02. Organizational design.

There must be an organizational design of the sponsor institution that demonstrates the relationship of the nursing education program to the administration and to comparable programs within the institution, and that clearly delineates the lines of authority, responsibility, and channels of communication. The program faculty is given the opportunity to participate in the governance of the program and sponsor institution.

History: Effective November 1, 1996; amended effective April 1, 2004; April 1, 2014. 54-03.2-02-03. Nursing education program organizational design.

The nursing education program must have an organizational design with clearly defined authority, responsibility, and channels of communication that assures both faculty and student involvement.

History: Effective November 1, 1996; amended effective April 1, 2004; April 1, 2014. 54-03.2-02-04. Nursing education program consistency with sponsor institution.

The program must have a written purpose that is consistent with the mission of the sponsor institution. The program must have written policies that are congruent with the sponsor institution policies and are periodically reviewed.

History: Effective November 1, 1996; amended effective April 1, 2004; April 1, 2014. 54-03.2-02-05. Nursing education program evaluation.

A comprehensive nursing education program evaluation must be ongoing and must include student achievement of program and student learning outcomes, multiple measures of student success after graduation, licensing examination pass rates, and evaluating program resources. Use of evaluation findings for relevant decisionmaking must be evident.

History: Effective November 1, 1996; amended effective April 1, 2004; July 1, 2008; April 1, 2014. 54-03.2-02-06. Financial support.

There must be evidence of financial support and resources adequate to achieve the purpose of the nursing education program. Resources include facilities, equipment, supplies, and qualified administrative, instructional, and support personnel.

History: Effective November 1, 1996; amended effective April 1, 2004; April 1, 2014.

Chapter 54-03.2-03 Nurse Administrator

N.D. Admin. Code 54-03.2-03 Nurse Administrator

CHAPTER 54-03.2-03

NURSE ADMINISTRATOR

Section 54-03.2-03-01Administrator Responsibilities 54-03.2-03-02Practical or Associate Degree Nurse Education Program Administrator Qualifications 54-03.2-03-03Baccalaureate or Master's Degree Nurse Education Program Administrator Qualifications 54-03.2-03-.03.1Doctoral Degree Nurse Education Program Administrator Qualifications 54-03.2-03-04Graduate Program Qualifications [Repealed] 54-03.2-03-05Employment of Academically Unqualified Administrator 54-03.2-03-01. Administrator responsibilities.

The administrator provides the leadership and is accountable for the administration, planning, implementation, and evaluation of the program. The administrator responsibilities include the following:

1.Develop and maintain an environment conducive to the teaching and learning processes;

2.Maintain a relationship with administrative and other units within the academic setting;

3.Provide leadership within the faculty for the development and implementation of the curriculum;

4.Manage the program budget; and

5.Provide oversight of faculty recruitment, development, performance review, promotion, and retention.

History: Effective November 1, 1996; amended effective April 1, 2004.

Law Implemented: NDCC 43-12.1-17(1) 54-03.2-03-02. Practical or associate degree nurse education program administrator qualifications.

The qualifications for an administrator in a program leading to a certificate in practical nursing or associate degree in nursing are:

1.A minimum of a master's degree from an accredited institution with a major in nursing;

2.A current unencumbered registered nurse license or privilege to practice;

3.Experience in teaching and knowledge of learning principles for adult education, including nursing curriculum development, administration, and evaluation; and

4.A current knowledge of nursing practice at the practical or associate degree nurse level or as otherwise approved by the board.

History: Effective November 1, 1996; amended effective April 1, 2004; April 1, 2014.

Law Implemented: NDCC 43-12.1-17(2) 54-03.2-03-03. Baccalaureate or master's degree nurse education program administrator qualifications.

The qualifications for an administrator in a program leading to a baccalaureate or master's degree of nursing are:

1.An earned doctoral degree in nursing or an earned master's degree in nursing and an earned doctoral degree from an accredited institution;

2.A current unencumbered registered nurse license or privilege to practice;

3.Experience in teaching and knowledge of learning principles for adult education, including nursing curriculum development, administration, and evaluation; and

4.A current knowledge of nursing practice at the baccalaureate or master's degree nurse level or as otherwise approved by the board.

History: Effective November 1, 1996; amended effective April 1, 2004; April 1, 2014.

Law Implemented: NDCC 43-12.1-17(3) 54-03.2-03-03.1. Doctoral degree nurse education program administrator qualifications.

The qualifications for an administrator in a program leading to a doctoral degree of nursing are:

1.An earned doctoral degree in nursing or an earned master's degree in nursing and an earned doctoral degree from an accredited institution;

2.A current unencumbered registered nurse license or privilege to practice; and

3.A current knowledge or nursing practice at the doctoral degree level or as otherwise approved by the board.

History: Effective April 1, 2014.

Law Implemented: NDCC 43-12.1-17(1) 54-03.2-03-04. Graduate program qualifications.

Repealed effective April 1, 2004. 54-03.2-03-05. Employment of academically unqualified administrator.

The board may approve a nursing education program that employs an administrator who does not meet the educational requirements in section 54-03.2-03-03 in the following circumstances:

1.The program maintains full approval by the board and the sponsoring institution demonstrates to the satisfaction of the board that substantial effort was used to recruit a candidate with the required credentials, and the candidate is currently enrolled in a doctoral degree program offered by an accredited institution and can demonstrate to the satisfaction of the board a specific plan of completion within seven years of hire for a doctoral degree; and

a.The institution demonstrates to the satisfaction of the board that eighty-five percent of the program's nursing faculty full-time equivalents have the required degree; or

b.A faculty of seven or fewer members will have no more than one nursing faculty full-time equivalent that is unqualified.

2.As otherwise as approved by the board.

History: Effective April 1, 2004; amended effective July 1, 2008; April 1, 2011; April 1, 2014.

Law Implemented: NDCC 43-12.1-17

Chapter 54-03.2-04 Faculty

N.D. Admin. Code 54-03.2-04 Faculty

CHAPTER 54-03.2-04

FACULTY

Section 54-03.2-04-01Faculty Responsibilities 54-03.2-04-02Faculty Policies 54-03.2-04-03Practical or Associate Degree Nurse Education Program Faculty Qualifications 54-03.2-04-04Baccalaureate or Master's Degree Nurse Education Program Faculty Qualifications 54-03.2-04-04.1Doctoral Degree Nurse Education Program Faculty Qualifications 54-03.2-04-05Graduate Program Faculty Qualifications [Repealed] 54-03.2-04-06Nonnursing Faculty Qualifications 54-03.2-04-07Preceptors 54-03.2-04-08Employment of Academically Unqualified Faculty 54-03.2-04-08.1Faculty Developmental Program 54-03.2-04-01. Faculty responsibilities.

There must be sufficient number of qualified faculty to meet the objectives and outcomes of the nursing education program. Nursing education program faculty responsibilities include the following:

1.Plan, implement, evaluate, and update the program and curriculum using a written plan;

2.Develop, implement, evaluate, and update policies for student admission, progression, retention, and graduation in keeping with the policies of the sponsor institution;

3.Participate in academic advisement and guidance of students;

4.Provide theoretical instruction and practice experiences;

5.Select, monitor, and evaluate preceptors and the student learning experience as defined in

section 54-03.2-04-07;

6.Evaluate student achievement of curricular outcomes related to nursing knowledge and practice;

7.Evaluate student learning outcomes and participate in the evaluation of program outcomes; and

8.Participate in activities that facilitate maintaining the faculty members' own nursing competence and professional expertise in the area of teaching responsibility.

History: Effective November 1, 1996; amended effective April 1, 2004; July 1, 2008; April 1, 2014. 54-03.2-04-02. Faculty policies.

The policies and procedures are available in writing and include:

1.Qualifications for the position;

2.Rights and responsibilities related to the position;

3.Criteria for evaluation of performance; and

4.Promotion, retention, and tenure policies.

History: Effective November 1, 1996; amended effective April 1, 2004. 54-03.2-04-03. Practical or associate degree nurse education program faculty qualifications.

There must be sufficient faculty with graduate preparation and nursing expertise to achieve the

purpose of the program and comply with the following:

1.The nurse faculty who have responsibility for planning, implementing, and evaluating a nursing course in a program leading to practice as a practical nurse or an associate degree-registered nurse must have:

a.A minimum of a master's degree from an accredited institution. If the master's degree is in a discipline other than nursing, evidence of acceptable graduate level coursework in nursing, which includes learning principles for adult education, nursing curriculum development, administration, and evaluation, must be submitted to the board;

2.Clinical faculty that supervise nursing practice experiences of students enrolled in a program leading to practice as an associate degree-registered nurse shall meet the same requirements.

a.A minimum of a master's degree from an accredited institution. If the master's degree is in a discipline other than nursing, submit evidence of acceptable graduate level coursework in nursing, which includes learning principles for adult education, nursing curriculum development, administration, teaching, and evaluation.

3.Clinical faculty that supervise nursing practice experiences of students enrolled in a practical nurse program shall meet the following requirements:

a.A minimum of a baccalaureate degree in nursing;

History: Effective November 1, 1996; amended effective April 1, 2004; April 1, 2014. 54-03.2-04-04. Baccalaureate or master's degree nurse education program faculty qualifications.

There must be sufficient faculty with graduate preparation and nursing expertise to achieve the

purpose of the program and comply with the following:

1.Nurse faculty must have a minimum of a master's degree from an accredited institution. If a master's degree is in a discipline other than nursing, the faculty member must submit evidence of acceptable graduate level coursework in nursing, which includes learning principles for adult education, nursing curriculum development, administration, and evaluation.

a.The majority of graduate program faculty must hold an earned doctoral degree;

b.Nurse faculty must be registered nurses with a current unencumbered license or privilege to practice; and

2.Clinical faculty that supervise nursing practice experiences of students enrolled in a program leading to practice as baccalaureate or master's degree registered nurse shall meet the same requirements.

a.A minimum of a master's degree from an accredited institution. If the master's degree is in a discipline other than nursing, the facultty member must submit evidence of acceptable graduate level coursework in nursing, which includes learning principles for adult education, nursing curriculum development, administration, and evaluation;

History: Effective November 1, 1996; amended effective April 1, 2004; July 1, 2008; April 1, 2014. 54-03.2-04-04.1. Doctoral degree nurse education program faculty qualifications.

There must be sufficient faculty with doctoral graduate preparation and nursing expertise to achieve the purpose of the program and comply with the following:

1.Nurse faculty must have an earned doctoral degree in nursing or an earned master's degree in nursing and an earned doctoral degree from an accredited institution, and shall meet the following requirements:

a.An unencumbered registered nurse license or privilege to practice; and

b.Evidence of prior nursing practice experience.

2.Clinical faculty that supervise nursing practice experiences of students enrolled in a program leading to practice as a doctoral level degree registered nurse must have an earned doctoral degree in nursing, or an earned master's degree in nursing and an earned doctoral degree from an accredited institution, and shall meet the following requirements:

a.A current unencumbered registered nurse license or privilege to practice; and

b.Evidence of prior nursing practice experience.

3.An individual currently employed as a full-time equivalent faculty member in a doctoral program in this state as of March 31, 2014, shall be deemed to be qualified under the provisions of this chapter through December 31, 2025.

4.Other circumstances as approved by the board.

History: Effective April 1, 2014. 54-03.2-04-05. Graduate program faculty qualifications.

Repealed effective April 1, 2004. 54-03.2-04-06. Nonnursing faculty qualifications.

Faculty, who have primary responsibility for teaching supportive courses in a nursing education program, must hold a master's degree from an accredited institution or a comparable professional credential in their respective discipline.

History: Effective November 1, 1996; amended effective April 1, 2004; April 1, 2014. 54-03.2-04-07. Preceptors.

A preceptor provides supervision of a nursing student's practice experience and precepts at the direction of the faculty member responsible for the course in which the student is enrolled.

1.Clinical preceptors may be used to enhance clinical learning experiences, after a student has received clinical and didactic instruction in foundation courses;

2.Preceptors may not be used to replace clinical faculty in prelicensure certificate, associate, or baccalaureate degree nursing programs;

3.Interdisciplinary preceptors must hold credentials for their applicable practice;

4.The preceptor must be educated at the same or higher level as the academic program in which the student is enrolled or must have demonstrated competencies that are appropriate for the student's learning experience;

5.Criteria for selecting preceptors must be in writing;

6.The functions and responsibilities of the preceptor must be delineated in writing and provided to the preceptor;

7.The faculty member retains responsibility for the student's learning experiences and confers periodically with the preceptor and student for the purposes of monitoring and evaluating the learning experiences; and

8.A preceptor shall supervise no more than two students during any one scheduled work time or shift.

History: Effective November 1, 1996; amended effective April 1, 2004; April 1, 2011. 54-03.2-04-08. Employment of academically unqualified faculty.

Any individual engaged in a teaching relationship who does not meet the qualifications in section 54-03.2-04-03, 54-03.2-04-04, or 54-03.2-04-04.1 is considered academically unqualified faculty regardless of the title assigned by the institution. A program may receive continued approval with faculty who do not meet the educational requirements in section 54-03.2-04-03, 54-03.2-04-04, or 54-03.2-04-04.1 in the following circumstances:

1.The program maintains full approval by the board and the administrator demonstrates to the satisfaction of the board that substantial effort was used to recruit a candidate with the required credentials, and the candidate is currently enrolled in a master's or doctoral degree program offered by an accredited institution and can demonstrate to the satisfaction of the board a specific plan of completion within four years of hire for the master's degree or seven years for a doctorate degree; and

a.The administrator demonstrates to the satisfaction of the board that eighty-five percent of the program's nursing faculty full-time equivalents have the required degree; or

b.A program with faculty of seven or fewer members will have no more than a total of one nursing faculty full-time equivalent held by an unqualified individual;

2.The board may extend the time allowed for the candidate to complete the degree by one year due to severe extenuating circumstances; or

3.Other circumstances as approved by the board.

4.A program with faculty holding less than a baccalaureate degree in nursing shall not be approved.

History: Effective November 1, 1996; amended effective April 1, 2004; July 1, 2008; April 1, 2011;

April 1, 2014. 54-03.2-04-08.1. Faculty developmental program.

A faculty developmental program that is approved by the board must be provided for all unqualified faculty. The faculty developmental program shall comply with the following requirements:

1.Each academically unqualified individual must be assigned a mentor who will supervise and interact with the individual in person at designated intervals as determined by the board.

2.The program director must notify the board of changes in mentors.

3.The program director must submit to the board the names of academically unqualified individuals employed as faculty and the number of full-time equivalents filled by these individuals each semester.

4.The program director must submit verification that academically unqualified individuals are continuously enrolled in a graduate program and making progress in the curriculum that will allow completion of the graduate program within the required time frame.

History: Effective April 1, 2011.

Chapter 54-03.2-05 Students

N.D. Admin. Code 54-03.2-05 Students

CHAPTER 54-03.2-05

STUDENTS

Section 54-03.2-05-01Student Policies 54-03.2-05-02Practical Nurse Competencies [Repealed] 54-03.2-05-03Registered Nurse Competencies [Repealed] 54-03.2-05-04Performance of Graduates on Licensing Examination [Repealed] 54-03.2-05-05Graduate Prepared Registered Nurse Competencies [Repealed] 54-03.2-05-01. Student policies.

Student policies shall facilitate mobility and articulation and be consistent with the sponsoring institution. Nursing education program policies, recruitment, and advertising shall demonstrate fair and ethical practices. The following policies must be in writing:

1.Admission, readmission, progression, retention, graduation, dismissal, and withdrawal;

2.Health requirements and other standards as may be required for protection of student health and public safety, including any required background checks;

3.Student responsibilities;

4.Student rights and grievance procedures;

5.Student opportunity to participate in nursing education program governance and evaluation; and

6.Refund of fees and tuition that complies with state law.

History: Effective November 1, 1996; amended effective April 1, 2004; April 1, 2014.

General Authority: NDCC 43-12.1-17

Law Implemented: NDCC 15-20.4-06, 43-12.1-17(1) 54-03.2-05-02. Practical nurse competencies. 54-03.2-05-03. Registered nurse competencies. 54-03.2-05-04. Performance of graduates on licensing examination. 54-03.2-05-05. Graduate prepared registered nurse competencies.

Chapter 54-03.2-06 Curriculum

N.D. Admin. Code 54-03.2-06 Curriculum

CHAPTER 54-03.2-06

CURRICULUM

Section 54-03.2-06-01General Curriculum 54-03.2-06-02Programmatic Changes 54-03.2-06-03Practice Sites 54-03.2-06-04Practical Nurse Curriculum [Repealed] 54-03.2-06-05Registered Nurse Curriculum [Repealed] 54-03.2-06-06Graduate Program Curriculum [Repealed] 54-03.2-06-07Nursing Education Program Curriculum 54-03.2-06-01. General curriculum.

The curriculum must:

1.Be planned, implemented, and evaluated by the faculty with provisions for student input;

2.Reflect the mission and purpose of the nursing education program;

3.Be organized and sequenced to meet the program outcomes;

4.Require a number of credits consistent with other programs at the same degree level;

5.Facilitate articulation for upward mobility;

6.Have a syllabus for each nursing course; and

7.Have written, measurable program outcomes, which include student learning outcomes that reflect the role and scope of practice for which the graduate is being prepared.

History: Effective November 1, 1996; amended effective April 1, 2004; July 1, 2008; April 1, 2011. 54-03.2-06-02. Programmatic changes.

Major programmatic changes must be submitted to the board for approval prior to implementation.

History: Effective November 1, 1996; amended effective April 1, 2004. 54-03.2-06-03. Practice sites.

The program shall have:

1.Current written agreements with cooperating sites; and

2.A student to faculty ratio no greater than eight to one for beginning nursing students in clinical areas involving direct client care.

History: Effective November 1, 1996; amended effective April 1, 2004. 54-03.2-06-04. Practical nurse curriculum. 54-03.2-06-05. Registered nurse curriculum. 54-03.2-06-06. Graduate program curriculum. 54-03.2-06-07. Nursing education program curriculum.

The curriculum of the nursing education program must assure the development of evidence-based clinical judgement, and skills in clinical management for the level, scope, and standards of nursing practice. The program outcomes must reflect the scope of practice and level of licensure sought as defined in chapters 54-05-01, 54-05-02, and 54-05-03.1.

1.The curriculum of all practical nurse programs must include:

a.Content regarding biological, physical, social, and behavioral sciences and legal and ethical responsibilities for practical nursing practice;

b.Nursing process concepts;

c.Communication and documentation skills;

d.Pharmacologic concepts and medication administration;

e.Nutritional concepts;

f.Theory and clinical experience related to health promotion and disease prevention for individual clients across the lifespan and in a variety of clinical settings, including basic safety and infection control;

g.Learning experiences that promote client-centered care that:

(1)Involves clients in decisionmaking, self-care, and healthy lifestyles;

(2)Respects client differences, values, preferences, and expressed needs; and (3)Is based on scientific evidence;

h.Learning experiences that promote supervision skills and socialization consistent with role and scope of practice and:

(1)Promotes functioning as a part of an interdisciplinary team; and (2)Supervised clinical practice that includes management and care of groups of clients and delegation and supervision of unlicensed assistive persons;

i.Sufficient practice experiences to assure the development of nursing competencies of the specific role and scope; and

j.Learning experiences and methods of instruction which are consistent with the written curriculum plan.

2.Additional requirements for associate degree practical nurse programs include:

a.Historical trends in nursing;

b.Theory and clinical experience related to section 54-05-01-06 relating to role of the licensed practical nurse intravenous therapy;

c.Data collection skills;

d.Use of available health information:

(1)Contributing to plan of care and care implementation; and (2)Computer literacy;

e.Management skills; and

f.Courses that meet the sponsoring institution's general education requirements for the associate degree.

3.The curriculum of an associate degree program leading to registered nurse licensure must include content and sufficient clinical experience to prepare the graduate to:

a.Deliver client-centered care that respects client differences, values, preferences, and expressed needs and is based on scientific evidence:

(1)Biological, physical, social, and behavioral sciences, including disease process, nutrition, and pharmacology;

(2)Content regarding legal, ethical responsibilities and historical trends in nursing;

(3)Nursing process;

(4)Written, verbal, and therapeutic communication;

(5)Basic decisionmaking skills;

(6)Data collection skills to obtain obvious information; and (7)Health promotion and maintenance for the individual and families.

b.Function effectively in an interdisciplinary team:

(1)Group dynamics;

(2)Goal-setting strategies; and (3)Management concepts, including delegation and supervision of other members of the health care team.

c.Deliver evidence-based practice, including application of evidence in managing common clinical problems.

d.Apply quality improvement concepts in nursing care:

(1)Basic safety and infection control standards; and (2)Quality improvement processes.

e.Use available health information:

(1)Documentation of care plan, nursing care implementation, and evaluation of care provided; and (2)Computer literacy.

f.Inform and counsel patients and families:

(1)Concepts of informational readiness;

(2)Discharge planning; and (3)Implementation of preestablished patient teaching plans.

g.Demonstrate nursing values and roles consistent with the scope of practice:

(1)Registered nurse standards of practice; and (2)Ethical concepts.

h.Courses that meet the sponsoring institution's general education requirements for the associate degree.

4.The curriculum of a baccalaureate nurse program or a direct entry, prelicensure graduate program must include:

a.Content regarding legal and ethical issues; history, trends, and theories in nursing; biological, physical, social, and behavioral sciences, including pharmacotherapy; nutritional therapy; and pathophysiology;

b.Nursing process;

c.Didactic instruction and clinical experience in health promotion, prevention, restoration, and maintenance of clients across the lifespan and in a variety of clinical settings:

(1)Communicate, manage knowledge, and support decisionmaking using information technology; and (2)Provide client-centered care that:

(a)Respects client differences, values, preferences, and expressed needs;

(b)Involves clients in decisionmaking and care management;

(c)Coordinates an interdisciplinary team to cooperate, collaborate, communicate, and integrate client care and health promotion;

(d)Employs evidence-based practice to integrate best research with clinical expertise and client values for optimal care; and (e)Applies quality improvement processes: [1]Quality improvement theory; [2]Measurement of quality in terms of structure, process, and client outcomes; and [3]Participation in development of changes in processes through utilization of change theory and systems of care with the objective of improving quality;

d.Experiences that promote the development of leadership and management skills and professional socialization:

(1)Responsibilities as a member of the profession;

(2)Management and leadership;

(3)Group dynamics and group leadership skills; and (4)Systems and organizational theory;

e.Learning experiences and clinical practice to include management and care of groups of clients and delegation and supervision of health care providers:

(1)Infection control and safety;

(2)Quality and safety;

(3)Public or community health; and (4)Case management;

f.Sufficient practice experiences to assure the development of nursing competencies to:

(1)Provide development of client-centered care;

(2)Provide opportunities to participate in interdisciplinary teams;

(3)Utilize or integrate research with clinical experience;

(4)Apply the principles of quality improvement; and (5)Utilize technology and information management;

g.Learning experiences and methods of instruction must be consistent with the written curriculum plan; and

h.Courses that meet the sponsoring institution's general education requirements for the degree.

5.The curriculum preparing for licensure as an advanced practice registered nurse must include content and sufficient experience from nursing and related academic disciplines to meet requirements for a graduate degree with a nursing focus:

a.The curriculum must prepare the graduate to practice:

(1)One of the following four identified advanced practice registered nursing roles as a certified registered nurse anesthetist, certified nurse midwife, clinical nurse specialist, and certified nurse practitioner; and (2)At least one of the following six population foci: family individual across the lifespan, adult-gerontology, neonatal, pediatrics, women's health, or gender-related or psychiatric mental health.

b.The curriculum shall include separate graduate level courses in the following:

(1)An advanced practice nursing core, including legal, ethical, and professional responsibilities of the advanced practice registered nurse.

(2)Advanced physiology and pathophysiology, including general principles that apply across the lifespan.

(3)Advanced health assessment, including assessment of all human systems, advanced assessment techniques, concepts, and approaches.

(4)Advanced pharmacology, which includes pharmacodynamics, pharmacokinetics, and pharmacotherapeutics of all broad categories of agents.

c.Each instructional track or major shall have supervised clinical experience that is directly related to the role and population foci, including pharmacotherapeutic management of patients.

(1)A preceptor for an advanced practice registered nurse student must be a licensed practitioner with graduate level preparation with comparable practice focus.

(2)Clinical supervision must be congruent with current national professional organizations and nursing accrediting body standards applicable to the advance practice registered nurse role and population focus.

d.The curriculum must include the following:

(1)Preparation that provides a basic understanding of the principles for decisionmaking in the identified role.

(2)Provisions for the recognition of prior learning and advanced placement for individuals who hold a master's degree in nursing and are seeking preparation in a different role and population foci.

(3)Preparation in a speciality area of practice is optional, but if included, must build on the advanced practice registered nurse role and competencies in at least one of the six population foci.

(4)Courses to meet the sponsoring institution's requirements for a graduate degree.

(5)Additional required components of graduate education programs preparing advanced practice registered nurses as determined by the board.

e.Post-master's nursing students shall complete the requirements of the master's advanced practice registered nurse program through a formal graduate level certificate in the desired role and population foci and must demonstrate the same advanced practice registered nurses outcome competencies as the master's level student.

6.Delivery of instruction by distance education methods must meet the standards for nursing education according to article 54-03.2, be congruent with the nursing program curriculum plan, and enable students to meet the goals, competencies, and objectives of the education program and standards of the board.

7.Distance nursing education prelicensure programs provided in this state must meet the standards for nursing education according to article 54-03.2, and must apply for board recognition prior to clinical placement of students.

History: Effective April 1, 2004; amended effective August 1, 2005; July 1, 2008; April 1, 2011; April 1, 2014.

Law Implemented: NDCC 43-12.1-17

Chapter 54-03.2-07 Nursing Education Program Approval

N.D. Admin. Code 54-03.2-07 Nursing Education Program Approval

CHAPTER 54-03.2-07

NURSING EDUCATION PROGRAM APPROVAL

Section 54-03.2-07-01Evaluation of Compliance With the Standards for Nursing Education Programs 54-03.2-07-01.1Performance of Graduates on Licensing Examination 54-03.2-07-02Initial Approval Status 54-03.2-07-03Full Approval Status 54-03.2-07-03.1Program Delivery 54-03.2-07-04Conditional Approval Status 54-03.2-07-05Withdrawal of Approval 54-03.2-07-06Reinstatement of Approval Status 54-03.2-07-07Certificate of Approval 54-03.2-07-08Publishing Approval Status 54-03.2-07-09Continuing Compliance 54-03.2-07-01. Evaluation of compliance with the standards for nursing education programs.

Evaluation of continuing compliance with the standards of nursing education involves the submission of a self-study report by the nursing education program and a survey by a board representative. This process includes the following elements:

1.Dates mutually acceptable to the board and the nursing education program will be set at least three months in advance of the scheduled survey;

2.No less than one month prior to a survey, a program must submit a narrative self-evaluation report that provides evidence of compliance with the standards of nursing education;

3.Unscheduled surveys may be conducted at the discretion of the board;

4.The program shall schedule survey activities;

5.The surveyor shall make a verbal report to the program at the end of the survey;

6.The surveyor's written report shall be sent to the program prior to the review by the board;

7.The board shall assess a fee for each program surveyed; and

8.Written notification of the board action regarding the program approval must be sent to the nurse administrator.

History: Effective November 1, 1996; amended effective April 1, 2004; April 1, 2014. 54-03.2-07-01.1. Performance of graduates on licensing examination.

Acceptable performance on the licensing examination for each program is a pass rate of eighty percent for its first-time writers in any given fiscal year. A program with a pass rate that falls below eighty percent for first-time writers in any two consecutive fiscal years shall:

1.Present to the board a plan for identifying possible contributing factors and for correcting any identified deficiencies; and

2.Submit a periodic progress report to the board on a schedule determined by the board.

History: Effective April 1, 2004. 54-03.2-07-02. Initial approval status.

1.The board may grant initial approval status to a proposed nursing education program that complies with chapter 54-03.2-08.

2.The board may continue initial approval status:

a.Prior to the graduation of the first class, when review of materials specified in article 54-03.2, the most recent annual report, and the most recent survey report reveals substantial compliance with the rules; or

b.After graduation of the first class, when review of the criteria for full approval reveals time is needed to fully comply with the rules.

History: Effective November 1, 1996; amended effective April 1, 2004; July 1, 2008; April 1, 2011;

April 1, 2014. 54-03.2-07-03. Full approval status.

The board may grant full approval status under the following circumstances to:

1.A program with initial approval status that demonstrates compliance with the rules after:

b.The most recent survey report;

c.The first class graduates; and

d.The program pass rate for first-time writers of the licensing examination is eighty percent or greater in the first fiscal year.

2.A program with full approval status that demonstrates continued compliance with the rules by:

b.The most recent survey report; and

c.The program pass rate for first-time writers of the licensing examination do not fall below an average of eighty percent pass rate for two consecutive fiscal years.

3.A program with conditional approval status that demonstrates compliance with the rules by:

b.The most recent survey report; and

c.The program pass rate for first-time writers of the licensing examination do not fall below an average of eighty percent pass rate for two consecutive fiscal years.

History: Effective November 1, 1996; amended effective April 1, 2004; July 1, 2008. 54-03.2-07-03.1. Program delivery.

The board may grant approval for changes or expansion in program delivery as long as the program:

1.Holds full approval status;

2.Demonstrates to the satisfaction of the board that there is sufficient qualified faculty available; and

3.Has sufficient resources to maintain compliance with the standards for nursing education according to this article.

History: Effective July 1, 2008. 54-03.2-07-04. Conditional approval status.

If the board determines that a nursing education program does not meet board rules, the program must be notified in writing detailing the deficiencies requiring correction within a given time period set by the board. The board may impose conditional approval for a length of time to be determined by the board but not to exceed two years following the date of written notification. Conditional approval status allows the program to continue to operate while the program corrects the deficiencies and works toward full approval. If at the end of that time period established by the board the deficiencies have not been corrected, board approval shall be withdrawn and a date to discontinue the program shall be set by the board.

The deficiencies are evidenced by:

1.The review of the most recent annual report;

2.The most recent survey report; or

3.The program pass rate for first-time writers of the licensing examination fall below an average of eighty percent pass rate for two consecutive fiscal years.

History: Effective November 1, 1996; amended effective April 1, 2004; July 1, 2008; April 1, 2014. 54-03.2-07-05. Withdrawal of approval.

The board may withdraw approval of a nursing education program as specified in section 54-03.2-09-03.

History: Effective November 1, 1996; amended effective April 1, 2014. 54-03.2-07-06. Reinstatement of approval status.

1.Upon receipt of notice of intent to withdraw approval, the administrator of the program may request a hearing pursuant to North Dakota Century Code chapter 28-32.

2.After demonstration of compliance with rules and nursing education standards, a program may petition the board in writing for reinstatement of approval status.

3.Upon written request, representatives of the program may appear before the board to review board findings regarding program deficiencies or the adequacy of corrective actions taken by the program.

4.If denied reinstatement, the school must comply with all rules for the development and implementation of a new nursing education program.

History: Effective November 1, 1996; amended effective April 1, 2014. 54-03.2-07-07. Certificate of approval.

Following the board's review and action regarding the survey report, a certificate shall be issued by the board to the program indicating the approval status.

History: Effective November 1, 1996; amended effective April 1, 2004; July 1, 2008. 54-03.2-07-08. Publishing approval status.

The board shall annually publish a list of programs and the approval status for each program.

History: Effective November 1, 1996; amended effective July 1, 2008. 54-03.2-07-09. Continuing compliance.

1.Each program shall submit an annual report to the board providing requested information pertaining to the time period between July first and June thirtieth.

2.A program with continuing compliance shall be reevaluated:

a.At a minimum of every five years to ensure compliance with the standards for nursing education;

b.At the request of the nursing education program; or

c.At the discretion of the board.

History: Effective November 1, 1996; amended effective April 1, 2004.

Chapter 54-03.2-08 New Nursing Education Programs

N.D. Admin. Code 54-03.2-08 New Nursing Education Programs

CHAPTER 54-03.2-08

NEW NURSING EDUCATION PROGRAMS

Section 54-03.2-08-01Development of a New Program [Repealed] 54-03.2-08-02Initial Requirements of a New Nursing Education Program 54-03.2-08-03First Survey Visit 54-03.2-08-04Board Review and Initial Approval Status 54-03.2-08-05Admission of Students 54-03.2-08-06Progress Reports 54-03.2-08-07Annual Survey 54-03.2-08-01. Development of a new program.

Repealed effective April 1, 2004. 54-03.2-08-02. Initial requirements of a new nursing education program.

The sponsor institution shall employ a qualified nurse administrator to develop the program and submit a written application for approval to the board at least six months before the proposed starting date or at such earlier time as the board and the nursing education program may agree. The written application must include evidence of meeting the requirements in article 54-03.2. Three copies of the application for the new program must be submitted to the board.

History: Effective November 1, 1996; amended effective April 1, 2004; July 1, 2008; April 1, 2014. 54-03.2-08-03. First survey visit.

After the proposal has been received, a survey of the nursing education program must be made by the board's designee. A written copy of the surveyor's report must be submitted to the nursing program nurse administrator.

History: Effective November 1, 1996; amended effective April 1, 2004. 54-03.2-08-04. Board review and initial approval status.

The board shall act on the application and the surveyor's report within three months of the survey.

The program must be notified in writing of the board's decision whether to grant or deny initial approval status. The board may continue initial approval status as specified in section 54-03.2-07-02.

History: Effective November 1, 1996; amended effective April 1, 2004; July 1, 2008; April 1, 2014. 54-03.2-08-05. Admission of students.

Students may be admitted to the program only after initial approval status has been granted by the board according to section 54-03.2-07-02. The number of students admitted to a program must be determined by:

1.Number of qualified faculty;

2.Adequate educational facilities and resources; and

3.Availability of appropriate practice sites.

History: Effective November 1, 1996; amended effective April 1, 2014. 54-03.2-08-06. Progress reports.

Following initial approval progress reports that demonstrate implementation of approved plans under section 54-03.2-08-03 shall be submitted by the program administrator upon the board's request.

History: Effective November 1, 1996. 54-03.2-08-07. Annual survey.

The board's designee shall survey the program annually until the first class has graduated.

Following graduation of the first class, a self-evaluation report of compliance with the rules shall be submitted by the program. The board's designee shall conduct a survey for consideration of full approval.

History: Effective November 1, 1996; amended effective April 1, 2004.

Chapter 54-03.2-09 Closure of a Nursing Education Program

N.D. Admin. Code 54-03.2-09 Closure of a Nursing Education Program

CHAPTER 54-03.2-09

CLOSURE OF A NURSING EDUCATION PROGRAM

Section 54-03.2-09-01Closure of Nursing Education Program 54-03.2-09-02Voluntary Closing 54-03.2-09-03Closing as a Result of Withdrawal of Approval 54-03.2-09-04Storage of Academic Records 54-03.2-09-01. Closure of a nursing education program.

A nursing education program may close voluntarily or must be closed following withdrawal of board approval.

1.The board may withdraw initial approval status when a new program fails to qualify for full approval status within eighteen months following the graduation date of the first class.

2.The board may withdraw any approval status when a program fails to correct documented deficiencies within a period of time specified by the board.

History: Effective November 1, 1996; amended effective April 1, 2004; April 1, 2014. 54-03.2-09-02. Voluntary closing.

When the sponsor institution decides to close a nursing education program, the school shall notify the board in writing of the plan for discontinuation and the intended date of closing.

1.The nursing education program may choose one of the following closing procedures:

a.Continue the nursing education program until the last class enrolled is graduated; or

b.Transfer currently enrolled students to other board-approved nursing education programs.

2.The nursing education program shall continue to meet the standards for nursing education until closed.

History: Effective November 1, 1996; amended effective April 1, 2004; April 1, 2014. 54-03.2-09-03. Closing as a result of withdrawal of approval.

When the board withdraws approval of a nursing education program:

1.The board shall establish a date of closure.

2.The nursing education program shall present a plan for the transfer of students to other board-approved programs within a time frame established by the board.

History: Effective November 1, 1996; amended effective April 1, 2004; April 1, 2014. 54-03.2-09-04. Storage of academic records.

When a nursing education program closes, the board must be advised of the arrangements for maintenance of academic transcripts. If the sponsor institution ceases to exist, the academic transcripts of each student and graduate must be transferred to the board.

History: Effective November 1, 1996; amended effective April 1, 2004; April 1, 2014.

Chapter 54-03.2-10 Innovation in Nursing Education

N.D. Admin. Code 54-03.2-10 Innovation in Nursing Education

CHAPTER 54-03.2-10

INNOVATION IN NURSING EDUCATION

Section 54-03.2-10-01Statement of Intent 54-03.2-10-02Eligibility 54-03.2-10-03Application 54-03.2-10-04Standards for Approval 54-03.2-10-05Review of Application and Board Action 54-03.2-10-06Periodic Evaluation 54-03.2-10-07Requesting Continuation of the Innovative Approach 54-03.2-10-01. Statement of intent.

A nursing education program may apply to implement an innovative approach by complying with the provisions in this chapter. Nursing education programs approved to implement innovative approaches shall continue to provide quality nursing education that prepares graduates to practice safely, competently, and ethically within the scope of practice as defined in North Dakota Century Code

chapter 43-12.1. The rules set forth in this chapter are intended to:

1.Foster innovative models of nursing education to address the changing needs in health care;

2.Assure that innovative approaches are conducted in a manner consistent within the board's role of protecting the public; and

3.Assure that innovative approaches conform to the quality outcome standards and core education criteria established by the board. 54-03.2-10-02. Eligibility.

A nursing education program is eligible to apply under the following conditions:

1.The nursing education program shall hold full board approval without conditions for the past five years;

2.There have been no substantial complaints against the program in the past five years; and

3.There have been no violations of article 54-03.2 in the past two years. 54-03.2-10-03. Application.

The following information shall be provided to the board at least sixty days prior to the board meeting upon which action will be taken. The application may be no more than fifteen pages, including appendices, with a one-page executive summary.

1.Identifying information.

a.Name of program.

b.Name of program administrator.

c.Contact information.

2.A brief description of the current program, including accreditation and board approval status.

3.Identification of regulations affected by the proposed innovative approach.

4.Length of time that the proposed innovative approach will be implemented and studied.

5.Description of the proposed innovative approach, including objectives.

6.Brief explanation of reason to implement innovative approach at the current time.

7.Explanation of differences between proposed innovative approach and current program operation.

8.Rationale with available evidence to support proposed innovative approach.

9.Identification of resources that support the proposed innovative approach.

10.Expected impact of proposed innovative approach on program, including the following:

a.Administration.

b.Student policies.

c.Student learning outcomes.

d.Faculty resources.

e.Fiscal resources.

11.Plan for implementation, including timeline.

12.Plan for evaluation of proposed innovation, including the following:

a.Measurable criteria and outcomes.

b.Method for evaluation.

c.Frequency of evaluation.

13.Additional application information as requested by the board. 54-03.2-10-04. Standards for approval.

Approval of innovations in nursing education involves submission of a comprehensive report by the nursing program that ensures quality nursing education that prepares nurses to provide client-centered care as a member of the interdisciplinary team. The report should include the following:

1.Eligibility criteria in section 54-03.2-10-03 and application criteria in section 54-03.2-10-04 are met.

2.The innovative approach will not compromise the quality of education or safe practices of students.

3.Human and financial resources are sufficient to support the innovative approach.

4.Rationale supported with current evidence supports the implementation of the innovative approach.

5.Implementation plan is reasonable to achieve the desired outcomes of the innovative approach.

6.Timeline provides for a sufficient period to implement and evaluate the innovative approach.

7.Plan for periodic evaluation is comprehensive and supported by appropriate methodology. 54-03.2-10-05. Review of application and board action.

1.Annually the board may establish the number of innovative approach applications it will accept, based upon board resources.

2.The board shall evaluate all applications to determine if they meet eligibility criteria in section 54-03.2-10-03 and the standards established in section 54-03.2-10-04.

3.The board shall inform the education program of the approval process.

4.If the application meets the standards, the board may:

a.Approve the application; or

b.Approve the application with modifications as agreed between the board and the nursing education program.

5.If the submitted application does not meet the criteria in sections 54-03.2-10-03 and 54-03.2-10-04, the board may deny approval or request additional information.

6.The board may rescind the approval or require program modifications if:

a.The board receives substantial evidence indicating adverse impact; or

b.The nursing education program fails to implement the innovative approach as presented and approved.

History: Effective April 1, 2011; amended effective April 1, 2014. 54-03.2-10-06. Periodic evaluation.

1.The education program shall submit progress reports conforming to the evaluation plan annually or as requested by the board.

2.The final evaluation report shall conform to the evaluation plan, detailing and analyzing the outcomes data.

3.If any report indicates that students were adversely impacted by the innovation, the nursing education program shall provide documentation of corrective measures undertaken and their effectiveness.

4.Nursing education programs must maintain eligibility with criteria in section 54-03.2-10-03.

History: Effective April 1, 2011; amended effective April 1, 2014. 54-03.2-10-07. Requesting continuation of the innovative approach.

1.If the innovative approach has achieved the desired outcome and the final evaluation has been submitted, the program may request that the innovative approach be continued.

2.Request for the innovative approach to become an ongoing part of the education program must be submitted with supporting evidence thirty days before a regular board meeting.

3.The board may grant the continued approval for an extended time of the innovative approach if the desired outcomes were met and public protection has not been compromised.

4.All continued innovations will be considered by the board for possible revisions to the applicable rules.

Article 54-04.2 Nursing Education Scholarship Program

Chapter 54-04.2-01 Nursing Education Scholarship Program

N.D. Admin. Code 54-04.2-01 Nursing Education Scholarship Program

ARTICLE 54-04.2

NURSING EDUCATION SCHOLARSHIP PROGRAM

Chapter 54-04.2-01Nursing Education Scholarship Program

CHAPTER 54-04.2-01

NURSING EDUCATION SCHOLARSHIP PROGRAM

Section 54-04.2-01-01Nursing Education Scholarship and Separation of Funds 54-04.2-01-02Qualifications 54-04.2-01-03Disbursements 54-04.2-01-01. Nursing education scholarship and separation of funds.

To the extent funds are available, the nursing education scholarships may be funded by:

1.A separate nursing education scholarship fund, consisting of ten dollars of each licensed practical nurse and registered nurse biennial renewal fee.

2.Donations from individuals wishing to further the intent of nursing education.

3.Additional funds as designated by the board. 54-04.2-01-02. Qualifications.

To qualify for a nursing education scholarship, the applicant shall:

1.Submit a completed application and required forms by the designated due date; and

2.Demonstrate the applicant is one of the following:

a.A resident of North Dakota who is accepted and enrolled in a North Dakota boardapproved undergraduate nursing education program for practical nurses or registered nurses;

b.A resident of North Dakota who has a current North Dakota license and is accepted and enrolled in an educational program that is accredited by a United States department of education-recognized regional or national accreditation entity, which is acceptable to the board; or

c.A resident of North Dakota and is accepted in a refresher course that meets board requirements. 54-04.2-01-03. Disbursements.

Funds from the nurse education scholarship program must be disbursed directly to the educational institution or as otherwise approved by the board.

Article 54-05 Standards of Practice

Chapter 54-05-00.1 Definitions [Repealed]

N.D. Admin. Code 54-05-00.1 Definitions [Repealed]

ARTICLE 54-05

STANDARDS OF PRACTICE

Chapter 54-05-00.1Definitions [Repealed] 54-05-01Standards of Practice for Licensed Practical Nurses 54-05-01.1Standards of Practice for Licensed Practical Nurses Providing Specialized Nursing Care [Repealed] 54-05-02Standards of Practice for Registered Nurses 54-05-03Registered Nurse Practice in Expanded Roles [Repealed] 54-05-03.1Advanced Practice Registered Nurse 54-05-03.2Specialty Practice Registered Nurse 54-05-04Standards for Delegation [Repealed]

CHAPTER 54-05-00.1

DEFINITIONS [Repealed effective June 1, 2002]

Chapter 54-05-01 Standards of Practice for Licensed Practical Nurses

N.D. Admin. Code 54-05-01-01 Statement of intent

N.D. Admin. Code 54-05-01-02 Licensed practical nurse's contribution to, and responsibility for, the nursing process

Repealed effective February 1, 1998. 54-05-01-02.1. Licensed practical nurse's contribution to, and responsibility for, the nursing process. 54-05-01-02.2. Assigning of nursing interventions.

N.D. Admin. Code 54-05-01-03 Licensed practical nurse responsibilities as a member of the health care team

N.D. Admin. Code 54-05-01-04 Criteria for delegation to licensed practical nurses

Repealed effective February 1, 1998.

N.D. Admin. Code 54-05-01-05 Criteria for delegation of specialized nursing care to the licensed practical nurse

Repealed effective May 1, 1996.

N.D. Admin. Code 54-05-01-06 Role of the licensed practical nurse in intravenous therapy

Selected components in the nursing management of intravenous therapy as defined by the board may be performed by a licensed practical nurse who has completed a board-approved associate degree program that includes intravenous therapy in the curriculum or one who has successfully completed a course in intravenous therapy which was developed according to board guidelines and approved by the board.

History

• History: Effective May 1, 1996.
• Law Implemented: NDCC 43-12.1-08

N.D. Admin. Code 54-05-01-07 Standards related to license practical nurse professional accountability

Each licensed practical nurse is responsible and accountable to practice according to the standards of practice prescribed by the board and the profession. It is not the setting or the position title that determines a nursing practice role, but rather the application of nursing knowledge. The licensed practical nurse practices nursing dependently under the direction of the registered nurse, advanced practice registered nurse, or licensed practitioner through the application of the nursing process and the execution of diagnostic or therapeutic regimens prescribed by licensed practitioners. The administration and management of nursing by the licensed practical nurse includes assigning and delegating nursing interventions. Unlicensed assistive persons complement the licensed nurse in the performance of nursing interventions but may not substitute for the licensed nurse. The licensed practical nurse practices within the legal boundaries for practical nursing through the scope of practice authorized in the Nurse Practices Act and rules governing nursing. The licensed practical nurse shall:

1.Demonstrate honesty and integrity in nursing practice;

2.Base nursing decisions on nursing knowledge and skills, the needs of clients, and licensed practical nursing standards;

3.Accept responsibility for individual nursing actions, competence, decisions, and behavior in the course of practical nursing practice;

4.Maintain competence through ongoing learning and application of knowledge in practical nursing practice; and

5.Report violations of the act or rules by self or other licensees and registrants.

History

• Law Implemented: NDCC 43-12.1-02(5)

N.D. Admin. Code 54-05-01-08 Standards related to licensed practical nurse scope of practice

The licensed practical nurse assists in implementing the nursing process. The licensed practical nurse practices under the supervision of the registered nurse, advanced practice registered nurse, or licensed practitioner. The licensed practical nurse shall:

1.Participate in nursing care, health maintenance, client teaching, counseling, collaborative planning, and rehabilitation, to the extent of the licensed practical nurse's basic nursing education and additional skills through subsequent education and experiences;

2.Conduct a focused nursing assessment and contribute data to the plan of care;

3.Plan for client care, including planning nursing care for a client whose condition is stable or predictable;

4.Participate with other licensed practitioners in the development and modification of the client-centered plan of care;

5.Assist the registered nurse or other licensed practitioner in the identification of client needs, priorities of care, and goals. The licensed practical nurse:

a.Demonstrates attentiveness and provides client surveillance and monitoring;

b.Assists and contributes in the evaluation of the client-centered health care plan;

c.Obtains orientation or training for competency when encountering new equipment and technology or unfamiliar care situations;

d.Recognizes client characteristics that may affect the client's health status;

e.Implements nursing interventions and prescribed medical regimens in a timely and safe manner; and

f.Documents nursing care provided accurately and timely.

6.Collaborate and communicate relevant and timely client information with clients and other health team members to ensure quality and continuity of care;

7.Take preventive measures to promote an environment that is conducive to safety and health for clients, others, and self;

8.Respect client diversity and advocates for the client's rights, concerns, decisions, and dignity;

9.Maintain appropriate professional boundaries;

10.Participate in the health teaching approved by a licensed practitioner;

11.Participate in systems, clinical practice, and client care performance improvement efforts to improve client outcomes;

12.Contribute to evaluation of the plan of care by gathering, observing, recording, and communicating client responses to nursing interventions;

13.Modify the plan of care in collaboration with a registered nurse, advanced practice registered nurse, or licensed practitioner based on an analysis of client responses;

14.Function as a member of the health care team, contributing to the implementation of an integrated client-centered health care plan;

15.Assume responsibility for nurse's own decisions and actions;

16.Promote a safe and therapeutic environment by providing appropriate monitoring and surveillance of the care environment;

17.Participate in quality improvement activities to evaluate and modify practice;

18.Demonstrate knowledge and understanding of the statutes and rules governing nursing and function within the legal boundaries of licensed practical nursing practice; and

19.Observe and follow the duly adopted standards, policies, directives. and orders of the board as they may relate to the licensed practical nurse.

History

• Law Implemented: NDCC 43-12.1-02(5)

N.D. Admin. Code 54-05-01-09 Standards related to licensed practical nurse responsibility to organize, manage, and supervise the practice of nursing

In the administration and management of nursing care, a licensed practical nurse may assign or delegate the responsibility for performance of nursing interventions to other persons. In maintaining accountability for the delegation of nursing interventions, the licensed practical nurse shall:

1.Assign nursing interventions.

a.Assign nursing care within the licensed practical nurse scope of practice to other licensed practical nurses who are authorized to provide nursing care through licensure as a licensed practical nurse; and

b.Monitor and evaluate the care assigned to a licensed practical nurse.

2.Delegate to another only those nursing interventions for which that person has the necessary skills and competence to accomplish safely. The delegation of the intervention must pose minimal risk to the client and consequences of performing the intervention improperly are not life-threatening. Unlicensed assistive persons complement the licensed nurse in the performance of nursing interventions but may not substitute for the licensed nurse. A licensed practical nurse may delegate an intervention to a technician who may perform limited nursing functions within the ordinary, customary, and usual roles in the individual's field. In maintaining accountability for the delegation, the licensed practical nurse shall:

a.Ensure that the unlicensed assistive person is on a registry and has the education and demonstrated competency to perform the delegated intervention;

b.Ensure that results of interventions are reasonably predictable;

c.Ensure that interventions do not require assessment, interpretation, or independent decisionmaking during its performance or at completion;

d.Provide clear directions and guidelines regarding the delegated intervention or routine interventions on stable clients;

e.Verify that the unlicensed assistive person follows each written facility policy or procedure;

f.Provide supervision and feedback to the unlicensed assistive person;

g.Observe, evaluate, and communicate the outcomes;

h.Intervene when problems are identified;

i.Assist in the revisions to the plan of care; and

j.Retain accountability for the nursing care.

History

• Law Implemented: NDCC 43-12.1-08

Chapter 54-05-01.1 Standards of Practice for Licensed Practical Nurses Providing Specialized Nursing Care [Repealed]

N.D. Admin. Code 54-05-01.1 Standards of Practice for Licensed Practical Nurses Providing Specialized Nursing Care [Repealed]

CHAPTER 54-05-01.1

STANDARDS OF PRACTICE FOR LICENSED PRACTICAL NURSES PROVIDING

SPECIALIZED NURSING CARE [Repealed effective January 1, 1994]

Chapter 54-05-02 Standards of Practice for Registered Nurses

N.D. Admin. Code 54-05-02-01 Statement of intent

N.D. Admin. Code 54-05-02-02 Registered nurse responsibility to implement the nursing process

Repealed effective February 1, 1998. 54-05-02-02.1. Registered nurse responsibility to implement the nursing process. 54-05-02-02.2. Assigning of nursing interventions.

N.D. Admin. Code 54-05-02-03 Registered nurse responsibilities as a member of the nursing profession

N.D. Admin. Code 54-05-02-04 Standards related to registered nurse professional accountability

Each registered nurse is responsible and accountable to practice according to the standards of practice prescribed by the board and the profession. It is not the setting or the position title that determines a nursing practice role, but rather the application of nursing knowledge. Through the application of the nursing process, the registered nurse practices nursing independently and interdependently. Registered nurses also practice nursing dependently through the execution of diagnostic or therapeutic regimens prescribed by licensed practitioners. The administration and management of nursing by registered nurses includes assigning and delegating nursing interventions that may be performed by others. The registered nurse practices within the legal boundaries for nursing through the scope of practice authorized in the Nurse Practices Act and rules governing nursing. The registered nurse shall:

1.Demonstrate honesty and integrity in nursing practice;

2.Base nursing decisions on nursing knowledge and skills, the needs of clients, and registered nursing standards;

3.Accept responsibility for judgements, individual nursing actions, competence, decisions, and behavior in the course of nursing practice;

4.Maintain competence through ongoing learning and application of knowledge in registered nursing practice; and

5.Report violations of the act or rules by self or other licensees and registrants.

N.D. Admin. Code 54-05-02-05 Standards related to registered nurse scope of practice

The registered nurse utilizes the nursing process to assess, diagnose, establish a plan with outcome criteria, intervene, evaluate, and document health problems in nursing practice settings. The registered nurse shall:

1.Participate in nursing care, health maintenance, client teaching, counseling, collaborative planning, and rehabilitation, to the extent of the registered nurse's basic nursing education and additional skills through subsequent education and experiences;

2.Conduct a comprehensive nursing assessment determined by the knowledge, skills, and abilities of the registered nurse and by the client's immediate condition or needs;

3.Apply nursing knowledge based upon the integration of the biological, psychological, and social aspects of the client's condition;

4.Develop a plan of care based on nursing assessment and diagnoses that prescribe interventions to attain expected outcomes;

5.Revise nursing interventions consistent with the client's overall health care plan;

6.Utilize decisionmaking, critical thinking, and clinical judgment to make independent nursing decisions and nursing diagnoses;

7.Implement the plan of care which includes the nursing interventions, treatment, and therapy, including medication administration and delegated medical and independent nursing functions;

8.Evaluate and document the client's response to nursing care and other therapy;

9.Identify changes in client's health status and comprehend clinical implications of client's signs and symptoms as part of expected. unexpected, and emergent client situations;

10.Communicate, collaborate, and consult with other health team members;

11.Provide comprehensive nursing and health care education in which the registered nurse:

a.Assesses and analyzes educational needs of learners;

b.Plans educational programs based on learning needs and teaching-learning principles;

c.Implements an educational plan either directly or by assigning selected aspects of the education to other qualified persons; and

d.Evaluates the education to meet the identified goals.

12.Participate in quality improvement activities to evaluate and modify practice;

13.Promote a safe and therapeutic environment;

14.Demonstrate knowledge and understanding of the statutes and rules governing nursing and function within the legal boundaries of registered nursing practice; and

15.Observe and follow the duly adopted standards, policies, directives, and orders of the board as they may relate to the registered nurse.

N.D. Admin. Code 54-05-02-06 Standards related to registered nurse responsibility to act as an advocate for the client

The registered nurse is responsible and accountable for the care provided and for assuring the safety and well-being of the client. The registered nurse provides care based upon client care needs; the knowledge, skills, and abilities of the registered nurse; and organization policy. The registered nurse functions as a member of a health care team by collaborating with the client and health care team in providing client care. The registered nurse shall:

1.Respect the client's rights, concerns, decisions, and dignity;

2.Promote safe client environment and takes appropriate preventive interventions to protect client, others, and self;

3.Communicate client choices, concerns, and special needs with other health team members regarding:

a.Client status and progress;

b.Client response or lack of response to therapies; and

c.Significant changes in client condition.

4.Maintain appropriate professional boundaries; and

5.Assume responsibility for nurse's own decisions and actions.

N.D. Admin. Code 54-05-02-07 Standards related to registered nurse responsibility to organize, manage, and supervise the practice of nursing

In the administration and management of nursing care, registered nurses may assign and delegate the responsibility for performance of nursing interventions to other persons. Assigning of nursing interventions may be made by registered nurses to others who are authorized to provide nursing care through licensure as a registered nurse or licensed practical nurse. The registered nurse shall:

1.Assign to another only those nursing interventions that are included within that nurse's scope of practice, education, experience, and competence including:

a.Assigning nursing care within the registered nurse scope of practice to other registered nurses;

b.Assigning nursing care to a licensed practical nurse within the licensed practical nurse scope of practice based on the registered nurse's assessment of the client and the licensed practical nurse's ability; and

c.Supervise. monitor, and evaluate the care assigned to a licensed practical nurse.

2.Delegate to another only those nursing interventions for which that person has the necessary skills and competence to accomplish safely. The delegation of the intervention must pose minimal risk to the client and consequences of performing the intervention improperly are not life-threatening. Unlicensed assistive persons complement the licensed nurse in the performance of nursing interventions but may not substitute for the licensed nurse. A licensed nurse may delegate an intervention to a technician who may perform limited nursing functions within the ordinary, customary, and usual roles in the individual's field. In maintaining accountability for the delegation of nursing interventions, the licensed registered nurse shall:

a.Ensure that the unlicensed assistive person is on a registry and has the education and demonstrated competency to perform the delegated intervention;

b.Ensure that results of interventions are reasonably predictable;

c.Ensure that interventions do not require assessment, interpretation, or independent decisionmaking during its performance or at completion;

d.Provide clear directions and guidelines regarding the delegated intervention or routine interventions on stable clients;

e.Verify that the unlicensed assistive person follows each written facility policy or procedure;

f.Provide supervision, observation, and feedback to the unlicensed assistive person;

g.Observe, evaluate, and communicate the outcomes;

h.Monitor performance, progress, and outcomes and assure documentation of the delegated intervention;

i.Intervene and provide followup as needed;

j.Revise plan of care as needed; and

k.Retain professional accountability for the nursing care as provided.

3.The registered nurse administrator shall select nursing service delivery models for the provisions of nursing care, which does not conflict with this chapter and includes the following:

a.Assess the health status of groups of clients, analyze the data, and identify collective nursing care needs, priorities, and necessary resources.

b.Be responsible to determine that licensed nurses have the required competencies expected for the nurses' current nursing practice roles.

c.Establish training, supervision, and competency requirements of all individuals providing nursing care.

d.Shall identify nursing personnel by a position title, job description, and qualifications.

e.Ensure that the unlicensed assistive person is on a registry and has the education and demonstrated competency to perform the delegated intervention.

History

• General Authority: NDCC 43-12.1-08
• Law Implemented: NDCC 43-12.1-08(1)

N.D. Admin. Code 54-05-02-08 Dispensing in title X clinic

A registered nurse may dispense oral contraceptive pills, transdermal contraceptive patches, and vaginal contraceptive rings, pursuant to an order of an authorized prescriber, in the course of working in a title X clinic.

History

• History: Effective July 1, 2020.
• General Authority: NDCC 43-12.1, 43-15
• Law Implemented: NDCC 43-15-02(7)

Chapter 54-05-03 Registered Nurse Practice in Expanded Roles [Repealed]

N.D. Admin. Code 54-05-03 Registered Nurse Practice in Expanded Roles [Repealed]

CHAPTER 54-05-03

REGISTERED NURSE PRACTICE IN EXPANDED ROLES [Repealed effective March 1, 1992]

Chapter 54-05-03.1 Advanced Practice Registered Nurse

N.D. Admin. Code 54-05-03.1 Advanced Practice Registered Nurse

CHAPTER 54-05-03.1

ADVANCED PRACTICE REGISTERED NURSE

Section 54-05-03.1-01Statement of Intent 54-05-03.1-02Board Authority - Title - Abbreviation 54-05-03.1-03Definitions [Repealed] 54-05-03.1-03.1Standards of Practice for the Advanced Practice Registered Nurse 54-05-03.1-03.2Scope of Practice as an Advanced Practice Registered Nurse 54-05-03.1-04Initial Requirements for Advanced Practice Registered Nurse Licensure 54-05-03.1-05Temporary Permit 54-05-03.1-06Requirements for Advanced Practice Registered Nurse Licensure Renewal 54-05-03.1-06.1Reactivation of a License 54-05-03.1-06.2Scope of Practice 54-05-03.1-07Disciplinary Action Against Advanced Practice Registered Nurse License [Repealed] 54-05-03.1-08Prescriptive Authority Review Committee [Repealed] 54-05-03.1-09Requirements for Prescriptive Authority 54-05-03.1-10Authority to Prescribe 54-05-03.1-11Prescriptive Authority Renewal 54-05-03.1-12Change in Physician Collaboration Regarding Prescriptive Authority [Repealed] 54-05-03.1-13Suspension or Enjoining of Prescriptive Authority 54-05-03.1-14Encumbered License [Repealed] 54-05-03.1-15Recognition at Effective Date 54-05-03.1-01. Statement of intent.

The 1977 legislative assembly enacted legislation that recognized the performance of additional acts to be performed by registered nurses practicing in expanded roles and gave the board of nursing the power to set standards for nurses practicing in specialized roles. From 1980 to 1991, the board licensed advanced practitioners in nursing as nurse clinicians, nurse practitioners, clinical nurse specialists, certified nurse midwives, and certified registered nurse anesthetists. The 1991 legislative assembly added prescriptive practices to the acts an advanced practice registered nurse may perform, if qualified. The 1995 legislative assembly further defined the educational requirements for the advanced practice registered nurse.

The scope of practice for a registered nurse with advanced licensure is based upon an understanding that a broad range of health care services can be appropriately and competently provided by a registered nurse with validated knowledge, skills, and abilities in specific practice areas.

The health care needs of citizens in North Dakota require that nurses in advanced practice roles provide care to the fullest extent of their scope of practice. The advanced practice registered nurse retains the responsibility and accountability for that scope of practice and is ultimately accountable to the patient within the Nurse Practices Act.

The advanced practice registered nurse is responsible and accountable to practice according to the standards of practice prescribed by the board and the profession. The purpose of the standards is:

1.To establish practice parameters for safe nursing practice.

2.To serve as a guide for the board to regulate the practice of the advanced practice registered nurse.

History: Effective March 1, 1992; amended effective November 1, 1996; April 1, 2004.

Law Implemented: NDCC 43-12.1-02(1)(7) 54-05-03.1-02. Board authority - Title - Abbreviation.

The board shall authorize advanced nursing practice to a registered nurse who has submitted evidence of advanced knowledge, skills, and abilities in a defined area of nursing practice. Individuals are licensed as advanced practice registered nurses in the roles of certified nurse practitioner, certified registered nurse anesthetist, certified nurse midwife, or certified clinical nurse specialist and in the population foci of family across the lifespan, adult-gerontology, neonatal, pediatrics, women's health or gender related or psychiatric mental health. Each advanced practice registered nurse shall use the designation APRN and applicable role designation for purposes of identification and documentation. No person may use the advanced practice registered nurse (APRN) title plus the person's respective role title without the express authority of the board of nursing to do so.

History: Effective March 1, 1992; amended effective November 1, 1996; April 1, 2011; April 1, 2014. 54-05-03.1-03. Definitions. 54-05-03.1-03.1. Standards of practice for the advanced practice registered nurse.

The standards of practice for the registered nurse found in chapter 54-05-02 are the core standards of practice for all categories of advanced practice registered nurses. The advanced practice registered nurse has evolved into the roles of certified nurse practitioner, certified registered nurse anesthetist, certified nurse midwife, or certified clinical nurse specialist.

The advanced practice registered nurse functions in any setting as a member of the interdisciplinary team and provides care to the fullest extent of the scope of practice which includes:

1.Complete the assessment of the health status and health needs based on interpretation of health-related data and preventive health practices;

2.Analyze multiple sources of data, identify alternative possibilities as to the nature of a health care problem and select appropriate treatment;

3.Coordinate human and material resources for the provision of care;

4.Maintain accountability and responsibility for the quality of nursing care provided; and

5.Collaborate with the interdisciplinary team.

History: Effective November 1, 1996; amended effective April 1, 2004; March 24, 2004; April 1, 2014. 54-05-03.1-03.2. Scope of practice as an advanced practice registered nurse.

The scope of practice must be consistent with the nursing education and advanced practice certification.

1.Practice as an advanced practice registered nurse may include:

a.Perform a comprehensive assessment of clients and synthesize and analyze data within a nursing framework;

b.Identify, develop, plan, and maintain evidence-based, client-centered nursing care;

c.Prescribe a therapeutic regimen of health care, including diagnosing, prescribing, administering, and dispensing legend drugs and controlled substances;

d.Evaluate prescribed health care regimen;

e.Assign and delegate nursing interventions that may be performed by others;

f.Promote a safe and therapeutic environment;

g.Provide health teaching and counseling to promote, attain, and maintain the optimum health level of clients;

h.Communicate and collaborate with the interdisciplinary team in the management of health care and the implementation of the total health care regimen;

i.Manage and evaluate the clients' physical and psychosocial health-illness status;

j.Manage, supervise, and evaluate the practice of nursing;

k.Utilize evolving client information management systems;

l.Integrate quality improvement principles in the delivery and evaluation of client care;

m.Teach the theory and practice of nursing;

n.Analyze, synthesize, and apply research outcomes in practice; and

o.Integrate the principles of research in practice.

2.Notwithstanding the above, all services rendered by the licensee shall be commensurate with the academic preparation, knowledge, skills, and abilities of the advanced practice licensed nurse's experience, continuing education, and demonstrated competencies. The nurse must recognize individual limits of knowledge, skills, and abilities and plan for situations beyond the licensee's expertise.

History: Effective April 1, 2004; amended effective March 24, 2004; July 1, 2008; April 1, 2014. 54-05-03.1-04. Initial requirements for advanced practice registered nurse licensure.

Applicants for advanced practice registered nurse licensure must:

1.Possess a current license to practice as a registered nurse in North Dakota or in a compact state;

2.Submit evidence of completion of an accredited graduate level advanced practice registered nurse program in one of the four roles and with at least one population focus;

3.Submit evidence of current certification by a national nursing certifying body in the advanced practice registered nurse role and population foci appropriate to educational preparation.

Primary source verification of certification is required;

4.Not have an encumbered license or privilege to practice in any state or territory;

5.Submit a completed notarized application and pay the fee of one hundred twenty-five dollars;

6.Certify that scope of practice is consistent with their nursing education and nursing certification; and

7.After December 31, 2015, all applicants for advanced practice registered nurse licensure must meet the licensure requirements in this chapter.

History: Effective March 1, 1992; amended effective November 1, 1996; December 1, 1997; June 1, 2001; April 1, 2004; July 1, 2008; April 1, 2011; April 1, 2014; July 1, 2020.

Law Implemented: NDCC 43-12.1-09(2)(c)(d) 54-05-03.1-05. Temporary permit.

An applicant for advanced licensure who possesses a current registered nurse license, and has submitted a complete application, the required fee, and evidence of meeting all educational requirements, may be issued a ninety-day temporary advanced practice registered nurse permit for practice in an advanced practice registered nurse category if the applicant:

1.Is applying for licensure under section 54-05-03.1-04;

2.Has applied as a first-time candidate to the next national nursing certification examination for the advanced practice registered nurse category;

3.Is awaiting certification results based upon initial application; or

4.Temporary permit will not include prescriptive authority.

History: Effective March 1, 1992; amended effective November 1, 1996; April 1, 2011.

Law Implemented: NDCC 43-12.1-09(2)(c)(d) 54-05-03.1-06. Requirements for advanced practice registered nurse licensure renewal.

The advanced practice registered nurse license is valid for the same period of time as the applicant's registered nurse license. Applicants for renewal of the advanced practice registered nurse license must possess a current license to practice as a registered nurse in North Dakota or in a compact state and must comply with the following:

1.Complete the advanced practice registered nurse license renewal application;

2.Pay an advanced practice registered nurse licensure renewal fee of eighty dollars; and

3.Submit evidence of current national certification in the appropriate advanced practice registered nurse role and with at least one population focus, or participate in a competence maintenance program recognized by the board.

Any individual holding a license to practice nursing as an advanced practice licensee in this state that is valid on December 31, 2015, shall be deemed to be licensed as an advanced practice registered nurse under the provisions of this chapter with the individual's current privileges and shall be eligible for renewal of such license under the conditions and standards prescribed in this chapter.

History: Effective March 1, 1992; amended effective November 1, 1996; June 1, 2001; April 1, 2004;

April 1, 2011; April 1, 2014; July 1, 2020. 54-05-03.1-06.1. Reactivation of a license.

An advanced practice registered nurse previously licensed in North Dakota who applies for reactivation of APRN only must meet board requirements and includes the following:

1.Complete the application and submit to a criminal history record check according to section 54-02-12-01;

2.Pay the nonrefundable renewal fee and fifty dollar reactivation fee; and

3.Meet the requirements in section 54-02-05-05.1, practice requirements for license renewal,

section 54-02-05-08, continuing education requirement for license renewal and section 54-05-03.1-06 requirements for advanced practice registered nurse licensure renewal; or

4.Submit other evidence the applicant wishes to submit which would provide proof of nursing competence acceptable to the board.

History: Effective July 1, 2008; amended effective July 1, 2020.

General Authority: NDCC 12-60-24.2(o), 43-12.1-08

Law Implemented: NDCC 43-12.1-09.1, 43-12.1-10(1) 54-05-03.1-06.2. Scope of practice.

The scope of practice of the advanced practice registered nurse must be consistent with the nursing education and nursing certification.

History: Effective April 1, 2011; amended effective April 1, 2014. 54-05-03.1-07. Disciplinary action against advanced practice registered nurse license. 54-05-03.1-08. Prescriptive authority review committee. Repealed effective October 1, 2011. 54-05-03.1-09. Requirements for prescriptive authority.

Applicants for prescriptive authority shall:

1.Be currently licensed as an advanced practice registered nurse in North Dakota.

2.Submit a complete, notarized prescriptive authority application and pay the fee of seventy-five dollars.

3.Submit a completed transcript with degree posted from an accredited graduate level advanced practice registered nurse program and which includes evidence of completion of advanced pharmacotherapy, physical assessment, and pathophysiology.

4.Provide evidence of completion of thirty contact hours of education or equivalent in pharmacotherapy related to the applicant's scope of advanced practice that:

a.Have been obtained within a three-year period of time immediately prior to the date of application for prescriptive authority; or

b.May otherwise be approved by the board.

History: Effective March 1, 1992; amended effective November 1, 1996; December 1, 1997; April 1, 2004; March 24, 2004; April 1, 2011; October 1, 2011; July 1, 2020.

Law Implemented: NDCC 43-12.1-02(7), 43-12.1-09(2)(c)(d) 54-05-03.1-10. Authority to prescribe.

The advanced practice registered nurse plans and initiates a therapeutic regimen that includes ordering and prescribing medical devices and equipment, nutrition, diagnostic and supportive services including home health care, hospice, and physical and occupational therapy.

1.A permanent advanced practice registered nurse license with the addition of prescriptive

authority shall be issued upon meeting all requirements.

2.The advanced practice registered nurse with prescriptive authority may prescribe drugs as defined by chapter 43-15-01 pursuant to applicable state and federal laws.

3.A prescriptive authority advanced practice registered nurse license does not include drug enforcement administration authority for prescribing controlled substances. Each licensee must apply for and receive a drug enforcement administration number before writing prescriptions for controlled substances.

4.An advanced practice registered nurse with prescriptive authority who prescribes controlled substances has access to the North Dakota prescription drug monitoring program and shall utilize the prescription drug monitoring program in the following manner:

a.Shall evaluate a prescription drug monitoring program report for a client in the following situations:

(1)New or unestablished client requiring prescription for controlled substance;

(2)Every six months during treatment of client with a controlled substance;

(3)Client requests early refills or engages in a pattern of taking more than prescribed dosage; and (4)Upon suspicion or known drug overuse, diversion, or abuse by client.

b.Shall document evaluation of the prescription drug monitoring program reports made under this rule.

c.May evaluate the prescription drug monitoring program report in the following situations:

(1)Long-term care settings;

(2)Controlled settings in which controlled substances are locked and administered to client;

(3)Treatment of client with terminal illness, cancer, or cancer-related disorders; and (4)Hospice or palliative care settings.

5.The licensee may prescribe, administer, sign for, dispense over-the-counter, legend, and controlled substances, and procure pharmaceuticals, including samples following state and federal regulations.

6.The signature on documents related to prescriptive practices must clearly indicate that the licensee is an advanced practice registered nurse.

7.The advanced practice registered nurse with prescriptive authority may not prescribe, sell, administer, distribute, or give to oneself or to one's spouse or child any drug legally classified as a controlled substance or recognized as an addictive or dangerous drug.

8.Notwithstanding any other provision, a practitioner who diagnoses a sexually transmitted disease, such as chlamydia, gonorrhea, or any other sexually transmitted infection, in an individual patient may prescribe or dispense, and a pharmacist may dispense, prescription antibiotic drugs to that patient's sexual partner or partners, without there having been an examination of that patient's sexual partner or partners.

History: Effective March 1, 1992; amended effective November 1, 1996; April 1, 2004; January 1, 2009; April 1, 2011; April 1, 2014; October 1, 2016. 54-05-03.1-11. Prescriptive authority renewal.

Prescriptive authority is valid for the same period of time as the applicant's advanced practice registered nurse and registered nurse license. The applicant for renewal must:

1.Renew the applicant's registered nurse license.

2.Submit verification of current certification by a national nursing certification body in the specific area of nursing practice.

3.Submit a completed advanced practice registered nurse with prescriptive authority renewal application.

4.Pay the advanced practice registered nurse renewal fee of eighty dollars and the seventy-five dollar renewal fee for prescriptive authority.

5.Provide evidence of completion of fifteen contact hours of education during the previous two years in pharmacotherapy related to the scope of practice. These contact hours may fulfill the registered nurse renewal continuing education requirement. The education or its equivalent as approved by the board may include academic credits, attendance at approved seminars and courses, or participation in approved correspondence or home study continuing education courses.

History: Effective March 1, 1992; amended effective November 1, 1996; June 1, 2001; April 1, 2004;

March 24, 2004; April 1, 2011; July 1, 2020. 54-05-03.1-12. Change in physician collaboration regarding prescriptive authority.

Repealed effective October 1, 2011. 54-05-03.1-13. Suspension or enjoining of prescriptive authority.

The prescriptive authority granted to an advanced practice registered nurse may be temporarily suspended or enjoined according to provisions of North Dakota Century Code chapters 28-32 and 32-06, when the advanced practice registered nurse has:

1.Failed to maintain current licensure as an advanced practice registered nurse or failed to meet prescriptive authority requirements;

2.Prescribed outside the scope of practice or for other than therapeutic purposes;

3.Violated any state or federal law or regulation applicable to prescriptions; or Following final board action notice of suspension or injunctive action regarding prescriptive authority will be forwarded to the board of pharmacy.

History: Effective March 1, 1992; amended effective November 1, 1996; October 1, 2011. 54-05-03.1-14. Encumbered license. 54-05-03.1-15. Recognition at effective date.

Any registered nurse with an advanced license as a nurse practitioner, clinical nurse specialist, nurse midwife, or certified registered nurse anesthetist on November 1, 1996, must continue to be recognized as an advanced practice registered nurse, and is eligible for renewal of the advanced practice registered nurse license under the provision of this title. These rules may not be construed to limit or restrict the advanced practice registered nurse's scope of practice statement previously approved by the board.

History: Effective March 1, 1992; amended effective November 1, 1996; April 1, 2014.

Law Implemented: NDCC 43-12.1-08

Chapter 54-05-03.2 Specialty Practice Registered Nurse

N.D. Admin. Code 54-05-03.2 Specialty Practice Registered Nurse

CHAPTER 54-05-03.2

SPECIALTY PRACTICE REGISTERED NURSE

Section 54-05-03.2-01Statement of Intent 54-05-03.2-02Board Authority - Title - Abbreviation 54-05-03.2-03Standards of Practice for the Specialty Practice Registered Nurse 54-05-03.2-04Initial Requirements for Specialty Practice Registered Nurse Licensure 54-05-03.2-05Requirements for Specialty Practice Registered Nurse Licensure Renewal 54-05-03.2-05.1Reactivation of a License 54-05-03.2-06Disciplinary Action Against Specialty Practice Registered Nurse Licensee 54-05-03.2-07Encumbered License 54-05-03.2-08Change in Scope of Practice 54-05-03.2-01. Statement of intent.

The 1977 legislative assembly enacted legislation that recognized the performance of additional acts to be performed by registered nurses practicing in expanded roles and gave the board of nursing the power to set standards for nurses practicing in specialized roles. The 2001 legislative assembly defined the education requirements for the specialty practice registered nurse.

The scope of practice for a registered nurse with specialty licensure is based upon an understanding that a broad range of health care services can be appropriately and competently provided by a registered nurse with validated knowledge, skills, and abilities in specific practice areas.

The health care needs of citizens in North Dakota require that nurses in specialty practice roles provide care to the fullest extent of their scope of practice. The specialty practice registered nurse retains the responsibility and accountability for that scope of practice and is ultimately accountable to the client within the Nurse Practices Act. 54-05-03.2-02. Board authority - Title - Abbreviation.

The board may authorize specialty nursing practice to a registered nurse who has submitted evidence of knowledge, skills, and abilities in a defined area of nursing practice. Each specialty practice registered nurse may use the applicable category designation for purposes of identification and documentation. No person may use the specialty practice registered nurse title without the express

authority of the board to do so. 54-05-03.2-03. Standards of practice for the specialty practice registered nurse.

1.The standards of practice for the registered nurse found in chapter 54-05-02 are the core standards of practice for all categories of specialty practice registered nurses.

2.In addition to the core registered nurse standards of practice, each specialty practice registered nurse shall practice according to national standards acceptable to the board for specialty practice registered nurses. 54-05-03.2-04. Initial requirements for specialty practice registered nurse licensure.

The board of nursing shall restrict the issuance of the specialty license to the registered nurse who has submitted evidence of specialization within a defined area of nursing practice.

Applicants for specialty practice registered nurse licensure must:

1.Possess a current license to practice as a registered nurse in North Dakota or a compact state;

2.Submit evidence of experiential expertise gained through the clinical aspect of coursework or employment or submit evidence of additional educational preparation in continuing education programs or formal education in a board-approved program;

3.Submit evidence of current certification by a national certifying body in the specific area of nursing practice;

4.Submit a completed notarized application and pay the fee of one hundred twenty-five dollars;

5.Submit a scope of practice statement for review and approval by the board; and

6.Submit other activities as approved by the board.

History: Effective June 1, 2002; amended effective July 1, 2008; July 1, 2020. 54-05-03.2-05. Requirements for specialty practice registered nurse licensure renewal.

The specialty license is valid for the same period of time as the applicant's registered nurse license.

Applicants for renewal of the license must:

1.Renew the registered nurse license;

2.Complete the specialty practice registered nurse license renewal application;

3.Pay the licensure renewal fee of eighty dollars;

4.Submit evidence of current certification; and

5.Meet the requirements in section 54-05-03.2-08.

History: Effective June 1, 2002; amended effective April 1, 2011; July 1, 2020. 54-05-03.2-05.1. Reactivation of a license.

A specialty practice registered nurse previously licensed in North Dakota who applies for reactivation must meet board requirements, including the following:

1.Complete the application and submit to a criminal history record check according to section 54-02-12-01;

2.Pay the nonrefundable renewal fee and fifty dollar reactivation fee; and

3.Meet the requirements in section 54-02-05-05.1 regarding practice requirements for license renewal, section 54-02-05-08 regarding continuing education requirements for license renewal, section 54-05-03.2-05 regarding requirements for specialty practice registered nurse licensure renewal, and section 54-05-03.2-08 regarding change in scope of practice; or

4.Submit other evidence the applicant wishes to submit which would provide proof of nursing competence acceptable to the board.

History: Effective July 1, 2008; amended effective April 1, 2011; July 1, 2020.

General Authority: NDCC 12-60-24(2)(o), 43-12.1-08

Law Implemented: NDCC 43-12.1-09.1, 43-12.1-10(1) 54-05-03.2-06. Disciplinary action against specialty practice registered nurse licensee.

The specialty practice registered nurse licensee may be subject to discipline by the board when the licensee has:

1.Been found in violation of any provision of North Dakota Century Code section 43-12.1-14; or

2.Failed to maintain national nursing certification. 54-05-03.2-07. Encumbered license.

Encumbrances placed on the specialty practice registered nurse license will also be placed on the registered nurse license. 54-05-03.2-08. Change in scope of practice.

The specialty practice registered nurse must notify the board in writing of a change in scope of practice within five working days and submit completed scope of practice statement within sixty days of the change.

History: Effective April 1, 2011.

Chapter 54-05-04 Standards for Delegation [Repealed]

N.D. Admin. Code 54-05-04 Standards for Delegation [Repealed]

CHAPTER 54-05-04

STANDARDS FOR DELEGATION [Repealed effective April 1, 2014]

Article 54-07 Unlicensed Assistive Person

Chapter 54-07-01 General Provisions

N.D. Admin. Code 54-07-01-01 Statement of intent

The 1991 legislative assembly enacted legislation declaring that it is the policy of this state to regulate through the board of nursing the practice of nursing, those engaged in licensed nursing practice, and those persons who assist in the practice of nursing. Other governmental agencies, through implementation of federal standards and regulations, may also be charged with the regulation of those who assist in the practice of nursing. It is the intent of the board to recognize other state registries that may exist, rather than duplicating those services. These rules govern the provision, administration, and management of nursing interventions by licensed nurses and nursing interventions delegated to unlicensed assistive persons. Licensed nurses are accountable and responsible to clients for the nature and quality of nursing interventions. In organizations where direct nursing care is not provided as a specific service, the provisions of this article do not apply.

History

• History: Effective November 1, 1992; amended effective February 1, 1998; June 1, 2002.

N.D. Admin. Code 54-07-01-02 Definitions

Repealed effective June 1, 2002.

N.D. Admin. Code 54-07-01-03 Recognition of other state registries

The board will acknowledge placement on other state registries in lieu of the unlicensed assistive person registry. Criteria for recognition of other state registries is as follows:

1.The registry is open to the public during normal business hours.

2.The registry contains information about the individual that meets or exceeds the requirements for the unlicensed assistive person registry.

3.The registry provides a mechanism for removal of the individual for cause, or marking of the registry of disciplinary action by the board.

4.The agency operating the registry has submitted sufficient documentation to the board of nursing to verify compliance with these requirements.

June 1, 2002.

History

• History: Effective November 1, 1992; amended effective September 1, 1994; December 1, 1995;

N.D. Admin. Code 54-07-01-04 Medicaid waiver recipient service providers

A person who provides services authorized by North Dakota Century Code section 50-24.1-18.1 to individuals found eligible by the department of human services to direct their own care or to individuals who have designated a legally responsible person to make health care decisions on their behalf shall be required to register as an unlicensed assistive person on a registry recognized by the board and the North Dakota department of human services.

History

• History: Effective April 1, 2007; amended effective July 1, 2008.

N.D. Admin. Code 54-07-01-05 Consumer-directed service providers

A nurse licensed under North Dakota Century Code chapter 43-12.1 may verify the competence of an unlicensed assistive person to perform nursing interventions for individuals directing their own care or for individuals who have a legally responsible person acting on their behalf, when the licensed nurse is requested to train the unlicensed assistive person to provide services authorized by North Dakota Century Code section 50-24.1-18.1 to individuals found eligible by the department of human services to direct their own care or who have designated a legally responsible person to make health care decisions on their behalf.

History

• History: Effective April 1, 2014.
• General Authority: NDCC 43-12.1-02(5)
• Law Implemented: NDCC 43-12.1-08(1), 50-24.1-18.1

Chapter 54-07-02 Unlicensed Assistive Person Registry

N.D. Admin. Code 54-07-02-01 Application and fee for unlicensed assistive person registration

Applicants for registration as an unlicensed assistive person must meet board requirements, including the following:

1.Submit a completed application;

2.Submit to a criminal history record check according to chapter 54-07-02.1;

3.Pay a nonrefundable fee of forty dollars; and

4.Submit verification of completion of a recognized formal training program or hold a current registration or certification by a recognized national body.

June 1, 2002; April 1, 2004; July 1, 2008; April 1, 2014; July 1, 2020. 54-07-02-01.1. Renewal of registration.

Initial registration will be subject to renewal on or before June thirtieth of the second year following and every two years thereafter. Failure to receive the renewal notification does not relieve the registrant of the obligation to renew the registration by the expiration date.

1.An applicant must submit a completed application form.

2.An applicant must pay the nonrefundable renewal fee of forty dollars.

3.An applicant shall submit verification of competency or verification of current certification or registration by board-recognized national bodies.

4.The registration fee for any practicing unlicensed assistive person will be doubled for any renewal application received in the board office after the expiration date.

Students may provide limited nursing interventions consistent with their education.

1.In order to meet the requirement for the registry, the nursing student must:

a.Submit evidence of current enrollment in a board-approved nursing education program;

b.Be in good academic standing in the nursing education program; and

c.Provide satisfactory evidence of completion of a course in the fundamentals of nursing.

2.In order to meet the requirement for the registry, the technician student must:

a.Submit evidence of current enrollment in a board-recognized formal training program;

b.Be in good standing in the formal training program; and

c.Provide satisfactory evidence of completion of the theory component of the program.

3.Medical assistant student administering medications must adhere to the requirements in sections 54-07-05-09, 54-07-05-10, and 54-07-05-11.

Upon receipt of an application for unlicensed assistive person registration, payment of the fee as set by the board, and evidence that the applicant will meet all of the requirements for registration in North Dakota, the board may issue a temporary permit to practice as an unlicensed assistive person in this state. The temporary permit expires at the end of ninety days.

History

• History: Effective November 1, 1992; amended effective September 1, 1994; February 1, 1998;
• History: Effective April 1, 2004; amended effective July 1, 2008; April 1, 2014; July 1, 2020.
• Law Implemented: NDCC 43-12.1-10(2) 54-07-02-01.2. Unlicensed assistive person registration for students.
• History: Effective April 1, 2014.
• Law Implemented: NDCC 43-12.1-09 54-07-02-01.3. Temporary permit.
• History: Effective April 1, 2014.

N.D. Admin. Code 54-07-02-02 Disciplinary action of registry listing

Repealed effective December 1, 1995. 54-07-02-02.1. Unlicensed assistive person registry status.

Unlicensed assistive persons who carry out delegated nursing interventions must hold current registry status either on the board registry or on another state registry recognized by the board.

April 1, 2014.

An unlicensed assistive person previously registered in North Dakota who applies for reactivation must meet board requirements and includes the following:

1.Submit a completed application;

2.Submit to a criminal history record check according to chapter 54-07-02.1;

3.Pay the nonrefundable registry fee and thirty dollar reactivation fee; and

4.Submit documentation of competency or evidence of current certification or registration by board-recognized national bodies acceptable to the board.

History

• History: Effective February 1, 1998; amended effective June 1, 2002; April 1, 2004; July 1, 2008;
• Law Implemented: NDCC 43-12.1-08 54-07-02-02.2. Reactivation of a registration.
• History: Effective July 1, 2008; amended effective April 1, 2014.
• General Authority: NDCC 12-60-24(2)(o), 43-12.1-08
• Law Implemented: NDCC 43-12.1-10(2)

N.D. Admin. Code 54-07-02-03 Limited registration

The board may initiate the issuance of a limited registration when good cause exists to do so.

History

• History: Effective July 1, 2008.

Chapter 54-07-02.1 Criminal History Record Checks for Registration

N.D. Admin. Code 54-07-02.1 Criminal History Record Checks for Registration

CHAPTER 54-07-02.1

CRIMINAL HISTORY RECORD CHECKS FOR REGISTRATION

Section 54-07-02.1-01Criminal History Record Checks 54-07-02.1-01. Criminal history record checks.

Individuals must submit a set of fingerprints to the board or its agent for the purpose of obtaining a state and federal criminal history record check in the manner provided by North Dakota Century Code

section 12-60-24 and as set forth by the board. An authorization and release form must be signed by the applicant authorizing the release of the criminal history record information to the board. The fingerprint card, authorization and release form, and fee for the criminal history record check must be submitted with the application.

1.The following individuals for registration must submit to a criminal history record check:

a.Applicants for initial unlicensed assistive person registration.

b.Applicants for reactivation or reinstatement of unlicensed assistive person or medication assistant III registration.

2.The following individuals for registration may be required to submit to a criminal history record check:

a.Applicants for renewal of unlicensed assistive person.

b.Applicants for medication assistant registration.

c.An individual who is under investigation for violation of North Dakota Century Code

chapter 43-12.1. If a criminal history record check is required as part of a disciplinary investigation or proceeding, the fingerprint card, authorization and release form, and fee for the criminal history record check must be submitted within twenty days of the request.

History: Effective July 1, 2008; amended effective October 1, 2011; April 1, 2014.

General Authority: NDCC 12-60-24.2(o), 43-12.1-08(1)

Law Implemented: NDCC 43-12.1-09.1

Chapter 54-07-03 Nursing Tasks and Nursing Functions [Repealed]

N.D. Admin. Code 54-07-03 Nursing Tasks and Nursing Functions [Repealed]

CHAPTER 54-07-03

NURSING TASKS AND NURSING FUNCTIONS [Repealed effective February 1, 1998]

Chapter 54-07-03.1 Role of the Unlicensed Assistive Person and Technician

N.D. Admin. Code 54-07-03.1 Role of the Unlicensed Assistive Person and Technician

CHAPTER 54-07-03.1

ROLE OF THE UNLICENSED ASSISTIVE PERSON AND TECHNICIAN

Section 54-07-03.1-01Minimum Competence Requirements for Unlicensed Assistive Persons 54-07-03.1-02Process for Teaching Nursing Interventions [Repealed] 54-07-03.1-03Licensed Nurse Delegation to Unlicensed Assistive Persons 54-07-03.1-03.1Licensed Nurse Interventions that May Not Be Delegated 54-07-03.1-04Unlicensed Assistive Person's Contribution to the Nursing Process [Repealed] 54-07-03.1-05Requirements for Unlicensed Assistive Person and Technician 54-07-03.1-01. Minimum competence requirements for unlicensed assistive persons.

Unlicensed assistive person competence means having the required knowledge, skills, and ability to perform delegated nursing interventions safely, accurately, and according to standard procedures.

The unlicensed assistive person shall meet the criteria or requirements for their specific roles.

History: Effective February 1, 1998; amended effective June 1, 2002; April 1, 2004; April 1, 2014. 54-07-03.1-02. Process for teaching nursing interventions.

Repealed effective April 1, 2014. 54-07-03.1-03. Licensed nurse delegation to unlicensed assistive persons.

A licensed nurse may delegate a nursing intervention to an unlicensed assistive person only if all the conditions for delegation set forth in chapters 54-05-01, 54-05-02, and 54-05-03.1 and this article are met.

History: Effective February 1, 1998; amended effective June 1, 2002; April 1, 2014. 54-07-03.1-03.1. Licensed nurse interventions that may not be delegated.

Interventions that require nursing knowledge, skill, and judgment may not be delegated by the licensed nurse to an unlicensed assistive person. These interventions include, but are not limited to:

1.Physical, psychological, and social assessment which requires professional nursing judgment, intervention, referral, or followup.

2.Development of nursing diagnosis and care goals.

3.Formulation of the plan of nursing care.

4.Evaluation of the effectiveness of the nursing care provided.

5.Teaching except for that related to promoting independence in activities of daily living.

6.Counseling, except that the unlicensed assistive person may be instructed to recognize and report basic deviations from healthy behavior and communication patterns, and may provide listening, empathy, and support.

7.Coordination and management of care, including collaborating, consulting, and referring.

8.Triage.

9.Medication administration may not be delegated unless the unlicensed assistive person has met the requirements of chapters 54-07-02 and 54-07-05 or has met the requirements of

section 54-07-01-03. The exception is when a licensed nurse specifically delegates to a specific unlicensed assistive person the administration of a specific medication for a specific client according to chapter 54-07-08.

10.Receiving or transmitting verbal or telephone orders.

History: Effective April 1, 2014. 54-07-03.1-04. Unlicensed assistive person's contribution to the nursing process.

Repealed effective April 1, 2014. 54-07-03.1-05. Requirements for unlicensed assistive person and technician.

The unlicensed assistive person and technician shall meet the following requirements:

1.Competently performs nursing interventions and functions as delegated by the nurse and as authorized by the board.

2.Demonstrates honesty and integrity.

3.Performs nursing interventions based on education, training, and the direction of the supervising nurse.

4.Accepts accountability for one's behavior and actions while assisting the nurse and providing services to clients.

5.Assists in observing clients and identifying client needs.

6.Communicates progress toward completing delegated nursing interventions, as well as any problems or changes in a client's status.

7.Seeks clarification if unsure of expectations.

8.Uses educational and training opportunities as available.

9.Takes preventive measures to protect clients, others, and self.

10.Respects client's rights, concerns, decisions, and dignity.

11.Functions as a member of the health care team, contributing to the implementation of an integrated health care plan.

12.Respects patient property and the property of others.

13.Protects confidential information unless obligated by law to disclose the information.

History: Effective April 1, 2014.

Chapter 54-07-04 Nurse Assistant Disciplinary Action [Repealed]

N.D. Admin. Code 54-07-04 Nurse Assistant Disciplinary Action [Repealed]

CHAPTER 54-07-04

NURSE ASSISTANT DISCIPLINARY ACTION [Repealed effective December 1, 1995]

Chapter 54-07-05 Medication Administration by a Medication Assistant III

N.D. Admin. Code 54-07-05-01 Statement of intent

North Dakota Century Code chapter 43-12.1 allows the licensed nurse to delegate and supervise nursing interventions to individuals authorized by the board to perform those functions. Medication administration is a nursing intervention. Medication administration is the responsibility of licensed nurses and requires the knowledge, skills, and abilities of the licensed nurse to ensure public safety and accountability. The medication assistant III may perform the intervention of administering medications to the client in an ambulatory health care setting. The licensed nurse must be available to monitor the client's progress and effectiveness of the prescribed medication regimen. Delegation of medication administration for individuals with unstable or changing nursing care needs is specifically precluded by these rules.

History

• History: Effective September 1, 1994; amended effective February 1, 1998; May 1, 1999; April 1, 2004;

N.D. Admin. Code 54-07-05-02 Definitions

Repealed effective April 1, 2004.

N.D. Admin. Code 54-07-05-03 Medication management regimen

When the licensed nurse is responsible for the management of the medication regimen, then any delegation must conform to the provisions of this chapter.

History

• History: Effective September 1, 1994; amended effective February 1, 1998.

N.D. Admin. Code 54-07-05-04 Requirements for supervision

A licensed nurse who delegates medication administration to a medication assistant III must provide supervision as follows:

1.In a licensed nursing facility or acute care setting, the licensed nurse must be on the unit and available for immediate direction.

2.In an ambulatory health care setting where the licensed nurse delegates the intervention of giving medications to another individual, the licensed nurse must be available for direction.

3.In any other setting where the licensed nurse delegates the intervention of giving medications to another individual, the licensed nurse must follow facility policy for providing the supervision in order to provide the recipient of the medication appropriate safeguards.

History

• History: Effective September 1, 1994; amended effective February 1, 1998; May 1, 1999; April 1, 2004;

N.D. Admin. Code 54-07-05-05 Eligibility for medication assistant III registration

An application for registration as a medication assistant III and a forty dollar fee must be submitted by the applicant to the board office. The applicant for medication assistant III registration must have registration on the unlicensed assistive person registry. Upon receipt of the required materials, a medication assistant III registration will be issued to correspond with the applicant's registration as an unlicensed assistive person. Unlicensed assistive persons may obtain initial medication assistant III registration by:

1.Submitting evidence of successful completion of a course which includes medication administration from an approved nursing education program, which must have included a clinical nursing component. The course must have included basic clinical skills, basic pharmacology, principles of medication administration, and mathematics competency; or

2.Submitting evidence of:

a.Successful completion of a board-recognized medical assistant program; and

b.Submit verification of current certification from one of the following examinations:

(1)Certified medical assistant examination through the American association of medical (2)Registered medical assistant certification examination through the American medical technologists;

(3)Clinical medical assistant certification examination through the national health career association;

(4)National certified medical assistant examination through the national center for competency testing; or (5)The successor organization.

History

• History: Effective September 1, 1994; amended effective February 1, 1998; May 1, 1999; April 1, 2004;
• Law Implemented: NDCC 43-12.1-09(2)(e)

N.D. Admin. Code 54-07-05-06 Medication assistant III registration renewal

The medication assistant III registration expiration date must correspond to the individual's unlicensed assistive person registration expiration date and must be renewable at the same time that the unlicensed assistive person registration is renewed. The applicant for renewal must:

1.Submit a completed medication assistant Ill renewal application that includes the unlicensed assistant person registration.

2.Pay the unlicensed assistive person registry renewal fee of thirty dollars and the forty dollar renewal fee for medication assistant Ill.

3.Submit verification of current certification from one of the following examinations:

a.Certified medical assistant examination through the American association of medical

b.Registered medical assistant certification examination through the American medical technologists;

c.Clinical medical assistant certification examination through the national health career association;

d.National certified medical assistant examination through the national center for competency testing;

e.The successor organization; or

f.Provide evidence of the clinical practice hours in a nursing education program within the past two years.

History

• History: Effective September 1, 1994; amended effective February 1, 1998; May 1, 1999; April 1, 2004;
• Law Implemented: NDCC 43-12.1-10(2)

N.D. Admin. Code 54-07-05-07 Reactivation of a medication assistant III registration

A medication assistant III previously registered in North Dakota who applies for reactivation must meet board requirements, including the following:

1.Complete the application and submit to a criminal history record check according to section 54-02.1-01.

2.Pay the nonrefundable renewal fee and thirty dollar reactivation fee.

3.Submit verification of current certification from one of the following examinations:

a.Certified medical assistant examination through the American association of medical

b.Registered medical assistant certification examination through the American medical technologists;

c.Clinical medical assistant certification examination through the national health career association;

d.National certified medical assistant examination through the national center for competency testing; or

e.The successor organization.

July 1, 2008; October 1, 2011; April 1, 2014.

History

• History: Effective September 1, 1994; amended effective May 1, 1999; April 1, 2004; August 1, 2005;
• Law Implemented: NDCC 43-12.1-10(2)

N.D. Admin. Code 54-07-05-08 Medication assistant III registration disciplinary action

The registration issued to an unlicensed assistive person, including the medication assistant III registration, may be revoked, suspended, encumbered, or denied based upon the provisions of chapter 54-02-07.

History

• History: Effective September 1, 1994; amended effective February 1, 1998; April 1, 2004; October 1, 2011.
• Law Implemented: NDCC 43-12.1-14

N.D. Admin. Code 54-07-05-09 Routes or types of medication administration

1.Administration of the initial dose of a medication that has not been previously administered to the client must be administered according to organization policy.

2.Conversion or calculation of a medication dosage must be verified with a licensed nurse.

3.Medication assistants III may administer medications by the following routes to individuals or groups of individuals with stable, predictable conditions according to organization policy:

a.Oral, sublingual, and buccal medications;

b.Eye medications;

c.Ear medications;

d.Nasal medications;

e.Rectal medications and enemas;

f.Vaginal medications;

g.Skin ointments, topical medications, including patches and transdermal medications;

h.Metered hand-held inhalants;

i.Unit dose nebulizers;

j.Intramuscular injections;

k.Subcutaneous injections;

l.Intradermal injections;

m.Gastrostomy;

n.Jejunostomy;

o.Nasogastric tube;

p.Nonmetered inhaler; and

q.Non-unit dose aerosol or nebulizer.

4.Medication assistants III may not administer medications by the following routes:

a.Central lines;

b.Colostomy;

c.Intravenous;

d.Intravenous lock; or

e.Urethral catheter.

5.Medication assistants III may not administer the following kinds of medications:

a.Barium and other diagnostic contrast media;

b.Chemotherapeutic agents except oral maintenance chemotherapy; or

c.Through any medication pumps, nor assume responsibility for medication pumps, including client-controlled analgesia.

October 1, 2011; April 1, 2014.

History

• History: Effective May 1, 1999; amended effective April 1, 2004; August 1, 2005; July 1, 2008;

N.D. Admin. Code 54-07-05-10 Pro re nata medications

1.The decision to administer pro re nata medications cannot be delegated in situations where an onsite assessment of the client is required prior to administration.

2.Some situations allow the administering of pro re nata medications without directly involving the licensed nurse prior to each administration.

a.The decision regarding whether an onsite assessment is required is at the discretion of the licensed nurse.

b.Written parameters specific to an individual client's care must be written by the licensed nurse for use by the medication assistant III when an onsite assessment is not required prior to administration of a medication. These written parameters:

(1)Supplement the physician's pro re nata order; and (2)Provide the medication assistant III with guidelines that are specific regarding the pro re nata medication.

History

• History: Effective May 1, 1999; amended effective October 1, 2011.

N.D. Admin. Code 54-07-05-11 Medication interventions that may not be delegated

The following acts shall not be delegated to a medication assistant III:

1.Assessment of client need for or response to medication. See section 54-07-03.1-05.

Accountability and responsibility within the delegation process; and

2.Nursing judgment regarding the administration of PRN medication.

History

• History: Effective July 1, 2008; amended effective October 1, 2011; April 1, 2014.

Chapter 54-07-06 Medication Assistant Program Requirements [Repealed]

N.D. Admin. Code 54-07-06 Medication Assistant Program Requirements [Repealed]

CHAPTER 54-07-06

MEDICATION ASSISTANT PROGRAM REQUIREMENTS [Repealed effective May 1, 1999]

Chapter 54-07-06.1 Medication Assistant Program I Requirements [Repealed]

N.D. Admin. Code 54-07-06.1 Medication Assistant Program I Requirements [Repealed]

CHAPTER 54-07-06.1

MEDICATION ASSISTANT PROGRAM I REQUIREMENTS [Repealed effective October 1, 2011]

Chapter 54-07-07 Medication Assistant Program II Requirements [Repealed]

N.D. Admin. Code 54-07-07 Medication Assistant Program II Requirements [Repealed]

CHAPTER 54-07-07

MEDICATION ASSISTANT PROGRAM II REQUIREMENTS [Repealed effective October 1, 2011]

Chapter 54-07-08 Specific Delegation of Medication Administration

N.D. Admin. Code 54-07-08-01 Specific delegation

A licensed nurse who delegates the delivery of specific medication for a specific client to an unlicensed assistive person shall:

1.Supply organization procedural guidelines for the unlicensed assistive person to follow in the administration of medication by specific delegation.

2.Teach each unlicensed assistive person for each specific client's medication administration which includes verbal and written instruction for the specific client's individual medications:

a.The trade name and generic name;

b.The purpose of the medication;

c.Signs and symptoms of common side effects, warnings, and precautions;

d.Route of administration; and

e.Instructions under which circumstances to contact the licensed nurse or licensed practitioner.

3.Observe the unlicensed assistive person administering the medication to the specific client until competency is demonstrated.

4.Verify the unlicensed assistive person's competency through a variety of methods, including oral quizzes, written tests, and observation. The nurse verifies that the unlicensed assistive person:

a.Knows the six rights for each medication for the specific client:

(1)Right client;

(2)Right medication;

(3)Right dosage;

(4)Right route;

(5)Right time; and (6)Right documentation.

b.Knows the name of the medication and common dosage;

c.Knows the signs and symptoms of side effects for each medication;

d.Knows when to contact the licensed nurse;

e.Can administer the medication properly to the client; and

f.Documents medication administration according to organization policy.

5.Document the training of the unlicensed assistive person related to the specific delegation of medication administration for each client.

6.Evaluate the client when medication orders change and determine if further instruction for each unlicensed assistive person is necessary to implement the change.

History

• History: Effective May 1, 1999; amended effective April 1, 2004.
• General Authority: NDCC 43-12.1-08
• Law Implemented: NDCC 43-12.1-08(1)

Article 54-10 Alternative to Discipline Program

Chapter 54-10-01 Alternative to Discipline Program

N.D. Admin. Code 54-10-01-01 Organization

1.The board shall employ a program coordinator to organize and administer the alternative to discipline program.

2.The program coordinator shall:

a.Review, evaluate, and determine eligibility of nurses who request participation in or are recommended for the alternative to discipline program;

b.Review and designate treatment facilities and services to which nurses in the alternative to discipline program may be referred;

c.Receive and review information relating to the participation of nurses in the alternative to discipline program;

d.Prepare reports for the board; and

e.Other duties as deemed necessary by the board.

N.D. Admin. Code 54-10-01-02 Elgibility and participation

1.Referrals can be made for participation in the program by:

a.The licensed nurse themselves;

b.A friend or family member;

c.The employer;

d.The board of nursing; or

e.An alternative to discipline program or board of nursing from another state.

2.Participation in the program may be exempt if the nurse remains in compliance with the nurse's contract. To ensure public safety and to facilitate monitoring unless otherwise prohibited by law, the program contract authorizes the program to communicate directly with:

a.Current and prospective employers;

b.Health, mental health, and treatment providers;

c.Probation departments;

d.Drug court agencies;

e.Disciplinary, nondisciplinary, and regulatory agencies;

f.Recovery community programs and support individuals;

g.Drug test collection sites; and

h.Third-party monitoring and drug testing services.

3.Participants shall:

a.Be actively licensed as a nurse in North Dakota or be a nurse currently enrolled in an alternative to discipline program who is requesting endorsement from another state;

b.Have a physical, mental, or chemical dependency condition that is affecting, or may affect their nursing practice;

c.Agree to enter the program and provide consent voluntarily for appropriate medical, chemical dependency, or mental health evaluations;

d.Follow all recommendations of the evaluator; and

e.Agree to the terms set forth in the agreement.

4.Participants shall acknowledge that North Dakota is their home state for purposes of the nurse licensure compact and that during the term of the agreement their multistate licensure privilege to practice in all other party states will be deactivated until the contract is complete.

5.Participants may not practice nursing in any other state without prior written authorization from the North Dakota alternative to discipline program and the board of nursing and alternative to discipline program in the state in which the participant intends to practice.

N.D. Admin. Code 54-10-01-03 Noncompliance

1.Failure to comply with the program conditions may result in termination of participation and report to the North Dakota board of nursing for investigation and consideration of disciplinary action.

2.Participants who voluntarily terminate the program or who were required to terminate due to noncompliance, who request to re-enter the program must submit evidence of a minimum period of continuous sobriety as defined by the program.

Chapter 54-03

N.D. Admin. Code 54-03

ARTICLE 54-03

REQUIREMENTS FOR NURSING EDUCATION PROGRAMS [Repealed effective January 1, 1987]

Chapter 54-03.1

N.D. Admin. Code 54-03.1

ARTICLE 54-03.1

REQUIREMENTS FOR NURSING EDUCATION [Repealed effective November 1, 1996]

Chapter 54-04

N.D. Admin. Code 54-04

ARTICLE 54-04

NURSING SCHOLARSHIP-LOANS [Repealed effective October 1, 1987]

Chapter 54-04.1

N.D. Admin. Code 54-04.1

ARTICLE 54-04.1

NURSING EDUCATION LOANS [Repealed effective July 1, 2025]

Chapter 54-06

N.D. Admin. Code 54-06

ARTICLE 54-06

NURSE AIDE REGISTRY [Repealed effective February 1, 1998]

Chapter 54-08

N.D. Admin. Code 54-08

ARTICLE 54-08

STANDARD FOR LICENSED NURSE DELEGATION OF NURSING TASKS IN SETTINGS

WHERE LICENSED NURSES ARE NOT REGULARLY SCHEDULED [Repealed Effective February 1, 1998]

Chapter 54-09

N.D. Admin. Code 54-09

ARTICLE 54-09

WORKPLACE IMPAIRMENT PROGRAM [Repealed effective January 1, 2014]

Determined repealed by the Legislative Council because the statutory authority for the article was eliminated by S.L. 2013, ch. 321, § 5.