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Patient Safety and Nursing Regulation in the United States

Patient Safety and Nursing Regulation in the United States. Faith A. Fields, MSN, RN President National Council of State Boards of Nursing United States of America.

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Patient Safety and Nursing Regulation in the United States

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  1. Patient Safety and Nursing Regulation in the United States Faith A. Fields, MSN, RN President National Council of State Boards of Nursing United States of America

  2. Topics:1. Importance of patient safety with regard to nursing regulation in the U.S. 2. How regulation ensures public protection 3. Share practice cases which resulted in disciplinary action 4. US perspective on public protection

  3. By the Profession By the Government Regulation

  4. What is the NCSBN? National Council of State Boards of Nursing www.ncsbn.org

  5. U.S.A. Authority to Regulate • 10th Amendment of the US Constitution • Gives to states all powers not delegated to federal government • States have power to enact laws to protect its citizens • Regulatory authority derived from legislative authority • State legislatures delegate enforcement activities to state administrative agencies (e.g. Boards of Nursing)

  6. Why do we regulate professions? • Potential for harm • Forum for complaints • Patient safety • Protection of the public

  7. Need for Regulation • Information Asymmetry • Bundling of Services • Forum for Complaints Patient Safety Public Protection

  8. Why license nurses? • Because nursing requires specialized knowledge, skill and independent decision making. • Because harm could result • Because it matters

  9. We protect the public safety by: • Regulating nursing education • Carrying out laws governing nursing • Setting licensing requirements • Taking disciplinary action on the license

  10. Board Authority • Fraud or deceit in procuring a license • Guilty of a crime or gross immorality • Is unfit or incompetent • Is habitually intemperate or is addicted • Is mentally incompetent • Guilty of unprofessional conduct • Action in other jurisdictions • Willfully or repeatedly violated NPA

  11. Importance of Patient Safety with regard to Nursing Regulation in the U.S.A. • Case studies/Examples

  12. Disciplinary Authority • Reprimand • Probation • Suspension • Revocation • Voluntary Surrender

  13. Case Review – Practice Issue • Nurse Did What? • Terminated from employment due to patient abuse • Attempted to use force to cause a patient to swallow their medication • Witness statements • Review of work history • License revoked

  14. Most discipline issues involve drugdiversion and abuse.

  15. Discipline has also been issued for: • Theft of patient’s property • Fraudulent billing for services • Sexual, physical or verbal abuse • Failure to follow a prescriber’s order

  16. Avoiding Disciplinary Action • Know and follow the Laws and Rules • Know your scope of practice and limit actions to scope of practice • Know and follow the facility policies and procedures • Check and double check when action/inaction may cause harm to a patient. www.learningext.com

  17. Scope of Practice Decision Making Model www.arsbn.org

  18. Importance of Patient Safety with regard to Nursing Regulation in the U.S.A. Just Culture

  19. CORE Commitment to Ongoing Regulatory Excellence • Education • Practice • Discipline

  20. Trends • Shortage of qualified nurses • Continued competence • Unlicensed assistive personnel • Advanced certification • Disaster preparedness • Mobility of nurses www.ncsbn.org

  21. Questions?

  22. Compact States

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