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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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A bill for an act
relating to nursing; modifying definitions in the Minnesota Nurse Practice Act;
amending Minnesota Statutes 2012, sections 148.171, subdivisions 14, 15,
by adding subdivisions; 148.271; repealing Minnesota Statutes 2012, section
148.171, subdivision 12; Minnesota Rules, part 6321.0100.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2012, section 148.171, is amended by adding a
subdivision to read:


Subd. 3a.

Assignment.

"Assignment" means the designation of nursing tasks or
activities to be performed by another nurse or unlicensed assistive person.

Sec. 2.

Minnesota Statutes 2012, section 148.171, is amended by adding a subdivision
to read:


Subd. 7a.

Delegation.

"Delegation" means the transfer of authority to another nurse
or competent, unlicensed assistive person to perform a specific nursing task or activity in
a specific situation.

Sec. 3.

Minnesota Statutes 2012, section 148.171, is amended by adding a subdivision
to read:


Subd. 7b.

Intervention.

"Intervention" means any act or action, based upon clinical
judgment and knowledge that a nurse performs to enhance the health outcome of a patient.

Sec. 4.

Minnesota Statutes 2012, section 148.171, is amended by adding a subdivision
to read:


Subd. 8a.

Monitoring.

"Monitoring" means the periodic inspection by a registered
nurse or licensed practical nurse of a delegated or assigned nursing task or activity and
includes: (1) watching during the performance of the task or activity; (2) periodic
checking and tracking of the progress of the task or activity being performed; (3) updating
a supervisor on the progress or completion of the task or activity performed; and (4)
contacting a supervisor as needed for direction and consultation.

Sec. 5.

Minnesota Statutes 2012, section 148.171, is amended by adding a subdivision
to read:


Subd. 12a.

Patient.

"Patient" means a recipient of nursing care, including an
individual, family, group, or community.

Sec. 6.

Minnesota Statutes 2012, section 148.171, subdivision 14, is amended to read:


Subd. 14.

Practice of practical nursing.

The "practice of practical nursing"
means the performance for, with or without compensation or personal profit of any of
those services in observing and caring for the ill, injured, or infirm, in applying counsel
and procedure to safeguard life and health, in administering medication and treatment
prescribed by a licensed health professional, which are commonly performed by licensed
practical nurses and which require specialized knowledge and skill such as are taught
or acquired in an approved school of practical nursing, but which do not require the
specialized education, knowledge, and skill of a registered nurse.
that incorporate caring
for individual patients in all settings through nursing standards recognized by the board at
the direction of a registered nurse, advanced practice registered nurse, or other licensed
health care provider and includes, but is not limited to:

(1) conducting a focused assessment of the health status of an individual patient
through the collection and comparison of data to normal findings and the individual
patient's current health status, and reporting changes and responses to interventions in an
ongoing manner to a registered nurse or the appropriate licensed health care provider for
delegated or assigned tasks or activities;

(2) participating with other health care providers in the development and
modification of a plan of care;

(3) determining and implementing appropriate interventions within a nursing plan of
care or when delegated or assigned by a registered nurse;

(4) implementing interventions that are delegated, ordered, or prescribed by a
licensed health care provider;

(5) assigning nursing activities or tasks to other licensed practical nurses (LPNs);

(6) assigning and monitoring nursing tasks or activities to unlicensed assistive
personnel;

(7) providing safe and effective nursing care delivery;

(8) promoting a safe and therapeutic environment;

(9) advocating for the best interests of individual patients;

(10) assisting in the evaluation of responses to interventions;

(11) collaborating and communicating with other health care providers;

(12) providing health care information to individual patients;

(13) providing input into the development of policies and procedures; and

(14) accountability for the quality of care delivered, recognizing the limits of
knowledge and experience; addressing situations beyond the nurse's competency; and
performing to the level of education, knowledge, and skill ordinarily expected of an
individual who has completed an approved practical nursing education program described
in section 148.211, subdivision 1.

Sec. 7.

Minnesota Statutes 2012, section 148.171, subdivision 15, is amended to read:


Subd. 15.

Practice of professional nursing.

The "practice of professional nursing"
means the performance for, with or without compensation or personal profit of the
professional interpersonal service of: (1) providing a nursing assessment of the actual or
potential health needs of individuals, families, or communities; (2) providing nursing care
supportive to or restorative of life by functions such as skilled ministration of nursing care,
supervising and teaching nursing personnel, health teaching and counseling, case finding,
and referral to other health resources; and (3) evaluating these actions. The practice of
professional nursing includes both independent nursing functions and delegated medical
functions which may be performed in collaboration with other health team members, or
may be delegated by the professional nurse to other nursing personnel. Independent
nursing function may also be performed autonomously. The practice of professional
nursing requires that level of special education, knowledge, and skill ordinarily expected
of an individual who has completed an approved professional nursing education program
as described in section 148.211, subdivision 1.
of those services that incorporate caring
for all patients in all settings through nursing standards recognized by the board and
includes, but is not limited to:

(1) providing a comprehensive assessment of the health status of a patient through
the collection, analysis, and synthesis of data used to establish a health status baseline and
plan of care, and address changes in a patient's condition;

(2) collaborating with the health care team to develop and coordinate an integrated
plan of care;

(3) developing nursing interventions to be integrated with the plan of care;

(4) implementing nursing care through the execution of independent nursing
interventions;

(5) implementing interventions that are delegated, ordered, or prescribed by a
licensed health care provider;

(6) delegating nursing tasks or assigning nursing activities to implement the plan of
care;

(7) providing safe and effective nursing care;

(8) promoting a safe and therapeutic environment;

(9) advocating for the best interests of individual patients;

(10) evaluating responses to interventions and the effectiveness of the plan of care;

(11) collaborating and coordinating with other health care professionals in the
management and implementation of care within and across care settings and communities;

(12) providing health promotion, disease prevention, care coordination, and case
finding;

(13) designing and implementing teaching plans based on patient need, and
evaluating their effectiveness;

(14) participating in the development of health care policies, procedures, and systems;

(15) managing, supervising, and evaluating the practice of nursing;

(16) teaching the theory and practice of nursing; and

(17) accountability for the quality of care delivered, recognizing the limits of
knowledge and experience; addressing situations beyond the nurse's competency; and
performing to the level of education, knowledge, and skill ordinarily expected of an
individual who has completed an approved professional nursing education program as
described in section 148.211, subdivision 1.

Sec. 8.

Minnesota Statutes 2012, section 148.171, is amended by adding a subdivision
to read:


Subd. 23.

Supervision.

"Supervision" means the guidance by a registered nurse
in the accomplishment of a nursing task or activity. Supervision consists of monitoring,
as well as establishing, the initial direction, delegating, setting expectations, directing
activities and courses of action, evaluating, and changing a course of action.

Sec. 9.

Minnesota Statutes 2012, section 148.171, is amended by adding a subdivision
to read:


Subd. 24.

Unlicensed assistive personnel.

"Unlicensed assistive personnel" (UAP)
means any unlicensed person to whom nursing tasks or activities may be delegated or
assigned, as approved by the board.

Sec. 10.

Minnesota Statutes 2012, section 148.271, is amended to read:


148.271 EXEMPTIONS.

The provisions of sections 148.171 to 148.285 shall not prohibit:

(1) The furnishing of nursing assistance in an emergency.

(2) The practice of professional or practical nursing by any legally qualified
registered or licensed practical nurse of another state who is employed by the United
States government or any bureau, division, or agency thereof while in the discharge of
official duties.

(3) The practice of any profession or occupation licensed by the state, other than
professional or practical nursing, by any person duly licensed to practice the profession or
occupation, or the performance by a person of any acts properly coming within the scope
of the profession, occupation, or license.

(4) The provision of a nursing or nursing-related service by a nursing assistant an
unlicensed assistive person
who has been delegated or assigned the specific function and
is supervised by a registered nurse or monitored by a licensed practical nurse.

(5) The care of the sick with or without compensation when done in a nursing home
covered by the provisions of section 144A.09, subdivision 1.

(6) Professional nursing practice or advanced practice registered nursing practice by
a registered nurse or practical nursing practice by a licensed practical nurse licensed in
another state or territory who is in Minnesota as a student enrolled in a formal, structured
course of study, such as a course leading to a higher degree, certification in a nursing
specialty, or to enhance skills in a clinical field, while the student is practicing in the course.

(7) Professional or practical nursing practice by a student practicing under the
supervision of an instructor while the student is enrolled in a nursing program approved by
the board under section 148.251.

(8) Advanced practice registered nursing as defined in section 148.171, subdivisions
5, 10, 11, 13, and 21
, by a registered nurse who is licensed and currently registered in
Minnesota or another United States jurisdiction and who is enrolled as a student in a
formal education program leading to eligibility for certification as an advanced practice
registered nurse; or by a registered nurse licensed and currently registered in Minnesota
who has completed an advanced practice registered nurse course of study and is awaiting
certification, the period not to exceed six months.

Sec. 11. REPEALER.

(a) Minnesota Statutes 2012, section 148.171, subdivision 12, is repealed.

(b) Minnesota Rules, part 6321.0100, is repealed.