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HF 1124

1st Engrossment - 88th Legislature (2013 - 2014) Posted on 03/13/2013 08:20pm

KEY: stricken = removed, old language. underscored = added, new language.

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1.1A bill for an act
1.2relating to nursing; modifying definitions in the Minnesota Nurse Practice Act;
1.3amending Minnesota Statutes 2012, sections 148.171, subdivisions 14, 15,
1.4by adding subdivisions; 148.271; repealing Minnesota Statutes 2012, section
1.5148.171, subdivision 12; Minnesota Rules, part 6321.0100.
1.6BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.7    Section 1. Minnesota Statutes 2012, section 148.171, is amended by adding a
1.8subdivision to read:
1.9    Subd. 3a. Assignment. "Assignment" means the designation of nursing tasks or
1.10activities to be performed by another nurse or unlicensed assistive person.

1.11    Sec. 2. Minnesota Statutes 2012, section 148.171, is amended by adding a subdivision
1.12to read:
1.13    Subd. 7a. Delegation. "Delegation" means the transfer of authority to another nurse
1.14or competent, unlicensed assistive person to perform a specific nursing task or activity in
1.15a specific situation.

1.16    Sec. 3. Minnesota Statutes 2012, section 148.171, is amended by adding a subdivision
1.17to read:
1.18    Subd. 7b. Intervention. "Intervention" means any act or action, based upon clinical
1.19judgment and knowledge that a nurse performs to enhance the health outcome of a patient.

1.20    Sec. 4. Minnesota Statutes 2012, section 148.171, is amended by adding a subdivision
1.21to read:
2.1    Subd. 8a. Monitoring. "Monitoring" means the periodic inspection by a registered
2.2nurse or licensed practical nurse of a delegated or assigned nursing task or activity and
2.3includes: (1) watching during the performance of the task or activity; (2) periodic
2.4checking and tracking of the progress of the task or activity being performed; (3) updating
2.5a supervisor on the progress or completion of the task or activity performed; and (4)
2.6contacting a supervisor as needed for direction and consultation.

2.7    Sec. 5. Minnesota Statutes 2012, section 148.171, is amended by adding a subdivision
2.8to read:
2.9    Subd. 12a. Patient. "Patient" means a recipient of nursing care, including an
2.10individual, family, group, or community.

2.11    Sec. 6. Minnesota Statutes 2012, section 148.171, subdivision 14, is amended to read:
2.12    Subd. 14. Practice of practical nursing. The "practice of practical nursing"
2.13means the performance for, with or without compensation or personal profit of any of
2.14those services in observing and caring for the ill, injured, or infirm, in applying counsel
2.15and procedure to safeguard life and health, in administering medication and treatment
2.16prescribed by a licensed health professional, which are commonly performed by licensed
2.17practical nurses and which require specialized knowledge and skill such as are taught
2.18or acquired in an approved school of practical nursing, but which do not require the
2.19specialized education, knowledge, and skill of a registered nurse. that incorporate caring
2.20for individual patients in all settings through nursing standards recognized by the board at
2.21the direction of a registered nurse, advanced practice registered nurse, or other licensed
2.22health care provider and includes, but is not limited to:
2.23(1) conducting a focused assessment of the health status of an individual patient
2.24through the collection and comparison of data to normal findings and the individual
2.25patient's current health status, and reporting changes and responses to interventions in an
2.26ongoing manner to a registered nurse or the appropriate licensed health care provider for
2.27delegated or assigned tasks or activities;
2.28(2) participating with other health care providers in the development and
2.29modification of a plan of care;
2.30(3) determining and implementing appropriate interventions within a nursing plan of
2.31care or when delegated or assigned by a registered nurse;
2.32(4) implementing interventions that are delegated, ordered, or prescribed by a
2.33licensed health care provider;
2.34(5) assigning nursing activities or tasks to other licensed practical nurses (LPNs);
3.1(6) assigning and monitoring nursing tasks or activities to unlicensed assistive
3.2personnel;
3.3(7) providing safe and effective nursing care delivery;
3.4(8) promoting a safe and therapeutic environment;
3.5(9) advocating for the best interests of individual patients;
3.6(10) assisting in the evaluation of responses to interventions;
3.7(11) collaborating and communicating with other health care providers;
3.8(12) providing health care information to individual patients;
3.9(13) providing input into the development of policies and procedures; and
3.10(14) accountability for the quality of care delivered, recognizing the limits of
3.11knowledge and experience; addressing situations beyond the nurse's competency; and
3.12performing to the level of education, knowledge, and skill ordinarily expected of an
3.13individual who has completed an approved practical nursing education program described
3.14in section 148.211, subdivision 1.

3.15    Sec. 7. Minnesota Statutes 2012, section 148.171, subdivision 15, is amended to read:
3.16    Subd. 15. Practice of professional nursing. The "practice of professional nursing"
3.17means the performance for, with or without compensation or personal profit of the
3.18professional interpersonal service of: (1) providing a nursing assessment of the actual or
3.19potential health needs of individuals, families, or communities; (2) providing nursing care
3.20supportive to or restorative of life by functions such as skilled ministration of nursing care,
3.21supervising and teaching nursing personnel, health teaching and counseling, case finding,
3.22and referral to other health resources; and (3) evaluating these actions. The practice of
3.23professional nursing includes both independent nursing functions and delegated medical
3.24functions which may be performed in collaboration with other health team members, or
3.25may be delegated by the professional nurse to other nursing personnel. Independent
3.26nursing function may also be performed autonomously. The practice of professional
3.27nursing requires that level of special education, knowledge, and skill ordinarily expected
3.28of an individual who has completed an approved professional nursing education program
3.29as described in section 148.211, subdivision 1. of those services that incorporate caring
3.30for all patients in all settings through nursing standards recognized by the board and
3.31includes, but is not limited to:
3.32(1) providing a comprehensive assessment of the health status of a patient through
3.33the collection, analysis, and synthesis of data used to establish a health status baseline and
3.34plan of care, and address changes in a patient's condition;
4.1(2) collaborating with the health care team to develop and coordinate an integrated
4.2plan of care;
4.3(3) developing nursing interventions to be integrated with the plan of care;
4.4(4) implementing nursing care through the execution of independent nursing
4.5interventions;
4.6(5) implementing interventions that are delegated, ordered, or prescribed by a
4.7licensed health care provider;
4.8(6) delegating nursing tasks or assigning nursing activities to implement the plan of
4.9care;
4.10(7) providing safe and effective nursing care;
4.11(8) promoting a safe and therapeutic environment;
4.12(9) advocating for the best interests of individual patients;
4.13(10) evaluating responses to interventions and the effectiveness of the plan of care;
4.14(11) collaborating and coordinating with other health care professionals in the
4.15management and implementation of care within and across care settings and communities;
4.16(12) providing health promotion, disease prevention, care coordination, and case
4.17finding;
4.18(13) designing and implementing teaching plans based on patient need, and
4.19evaluating their effectiveness;
4.20(14) participating in the development of health care policies, procedures, and systems;
4.21(15) managing, supervising, and evaluating the practice of nursing;
4.22(16) teaching the theory and practice of nursing; and
4.23(17) accountability for the quality of care delivered, recognizing the limits of
4.24knowledge and experience; addressing situations beyond the nurse's competency; and
4.25performing to the level of education, knowledge, and skill ordinarily expected of an
4.26individual who has completed an approved professional nursing education program as
4.27described in section 148.211, subdivision 1.

4.28    Sec. 8. Minnesota Statutes 2012, section 148.171, is amended by adding a subdivision
4.29to read:
4.30    Subd. 23. Supervision. "Supervision" means the guidance by a registered nurse
4.31in the accomplishment of a nursing task or activity. Supervision consists of monitoring,
4.32as well as establishing, the initial direction, delegating, setting expectations, directing
4.33activities and courses of action, evaluating, and changing a course of action.

5.1    Sec. 9. Minnesota Statutes 2012, section 148.171, is amended by adding a subdivision
5.2to read:
5.3    Subd. 24. Unlicensed assistive personnel. "Unlicensed assistive personnel" (UAP)
5.4means any unlicensed person to whom nursing tasks or activities may be delegated or
5.5assigned, as approved by the board.

5.6    Sec. 10. Minnesota Statutes 2012, section 148.271, is amended to read:
5.7148.271 EXEMPTIONS.
5.8The provisions of sections 148.171 to 148.285 shall not prohibit:
5.9(1) The furnishing of nursing assistance in an emergency.
5.10(2) The practice of professional or practical nursing by any legally qualified
5.11registered or licensed practical nurse of another state who is employed by the United
5.12States government or any bureau, division, or agency thereof while in the discharge of
5.13official duties.
5.14(3) The practice of any profession or occupation licensed by the state, other than
5.15professional or practical nursing, by any person duly licensed to practice the profession or
5.16occupation, or the performance by a person of any acts properly coming within the scope
5.17of the profession, occupation, or license.
5.18(4) The provision of a nursing or nursing-related service by a nursing assistant an
5.19unlicensed assistive person who has been delegated or assigned the specific function and
5.20is supervised by a registered nurse or monitored by a licensed practical nurse.
5.21(5) The care of the sick with or without compensation when done in a nursing home
5.22covered by the provisions of section 144A.09, subdivision 1.
5.23(6) Professional nursing practice or advanced practice registered nursing practice by
5.24a registered nurse or practical nursing practice by a licensed practical nurse licensed in
5.25another state or territory who is in Minnesota as a student enrolled in a formal, structured
5.26course of study, such as a course leading to a higher degree, certification in a nursing
5.27specialty, or to enhance skills in a clinical field, while the student is practicing in the course.
5.28(7) Professional or practical nursing practice by a student practicing under the
5.29supervision of an instructor while the student is enrolled in a nursing program approved by
5.30the board under section 148.251.
5.31(8) Advanced practice registered nursing as defined in section 148.171, subdivisions
5.325, 10, 11, 13, and 21
, by a registered nurse who is licensed and currently registered in
5.33Minnesota or another United States jurisdiction and who is enrolled as a student in a
5.34formal education program leading to eligibility for certification as an advanced practice
5.35registered nurse; or by a registered nurse licensed and currently registered in Minnesota
6.1who has completed an advanced practice registered nurse course of study and is awaiting
6.2certification, the period not to exceed six months.

6.3    Sec. 11. REPEALER.
6.4(a) Minnesota Statutes 2012, section 148.171, subdivision 12, is repealed.
6.5(b) Minnesota Rules, part 6321.0100, is repealed.

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