Illinois implements changes to Nurse Practice Act.

Department of Financial and Professional Regulation

The Department of Financial and Professional Regulation recently amended section 1300 of the Nurse Practice Act, which lays out many of the regulations governing Advanced Practice Nurses (APNs), Registered Nurses (RNs), and Licensed Practical Nurses (LPNs). 68 Ill Adm Code 1300 et seq. Section 1300 is comprised of four subparts: general provisions and provisions governing LPNs, RNs, and APNs. Each subpart is examined in turn. Various changes to the rules and updated definitions and requirements are discussed, but as the changes are numerous, the regulations themselves should be consulted for a full understanding. The amended regulations became effective September 17, 2010.

The new general provisions include changes to the rules governing nursing delegation, mandatory reporting of impaired nurses, and continuing education. After defining "delegation" and "nursing activity," the regulations stipulate that APNs may delegate to RNs, LPNs, and other persons. 68 Ill Adm Code 1300.20(a)-(b). Additionally, RNs may not delegate any nursing activity requiring the specialized knowledge, judgment, and skill of a licensed nurse to an unlicensed person, but may delegate nursing activities to other RNs or LPNs. 68 Ill Adm Code 1300.20(c) (d). RNs may delegate other tasks to other licensed and unlicensed persons. 68 Ill Adm Code 1300.20(d). Finally, a LPN who has been delegated a nursing activity may not re-delegate that activity and both RPNs and APNs retain the right to refuse to delegate or to stop a previously authorized delegation. 68 Ill Adm Code 1300.20(d).

Furthermore, the department adopted new rules governing the mandatory reporting of impaired nurses. Any nurse who is an administrator or officer in any hospital, nursing home, other healthcare agency or facility or nurse agency who has knowledge of any action or condition which reasonably indicates that a LPN, RN, or APN is impaired due to drugs or alcohol to the extent that it affects the nurse's professional performance must report the individual. 68 Ill Adm Code 1300.110. Any such nurse who also has knowledge that a LPN, RN, or APN possesses, uses, distributes, or converts mood altering drugs must also report the individual. Id. If the individual participates in a course of remedial professional counseling or medical treatment for substance abuse and meets the other criteria in this subsection, then the nurse does not have to report the individual. Id.

A final general provision concerns continuing education (CE). The new requirements mandate that beginning with a nurse's January 31, 2013, license renewal, all LPNs must complete 20 hours of approved CE per two-year license renewal cycle. Beginning with the May 31, 2012, renewal, all RNs must complete 20 hours of approved CE per 2-year license renewal cycle; and all APNs must complete 50 hours of approved CE per 2-year license renewal cycle. 68 Ill Adm Code 1300.130. The regulations contain more specific guidelines on all nurses' required CE.

The LPN subpart explains the LPN scope of practice as "a scope of basic nursing practice, with or without compensation, as delegated by a registered professional nurse or an advanced practice nurse or as directed by a physician assistant, physician, dentist or podiatrist" and the scope includes eight activities listed in the regulations (such as implementing aspects of the plan of care as delegated), as well as "other activities requiring a like skill level for which the LPN is properly trained." 68 Ill Adm Code 1300.250. The subpart also contains the new standards for professional conduct for LPNs. 68 Ill Adm Code 1300.260.

The RN subpart contains a new provision regulating conscious sedation by RNs in ambulatory surgical treatment centers. 68 Ill Adm Code 1300.370. This section stipulates that in accordance with Section 6.7 of the Ambulatory Surgical Treatment Center Act (210 ILCS 5), "nothing in that Act precludes a registered nurse from administering medications for the delivery of local or minimal sedation ordered by a physician licensed to practice medicine in all of its branches, podiatrist or dentist." 68 Ill Adm Code 1300.370(a). The rules then stipulate the requirements a RN must follow in delivering moderate sedation. 68 Ill Adm Code 1300.370(b).

The final subpart contains rules governing APNs, and it includes, among other things, updated language addressing APNs practicing in hospitals or surgical treatment centers. 68 Ill Adm Code 1300.400. It also contains updated sections detailing the agreements between APNs and their collaboration physicians to reflect other changes in the Nurse Practice Act. 68 Ill Adm Code 1300.410.