Links to Nurse Practice Acts and State Regulations

Boards of Nursing in the US and its Territories State or Territory Alabama Diagnosis Language Forensic Nursing Language

Diagnosis is not mentioned

Sexual Assault Nurse Examiner (SANE): A registered nurse who, through additional education and supervised clinical practice, has acquired knowledge, skills, and judgment specific to providing health services to sexual assault or rape victims including a forensics examination. 610-X-7-.05 Sexual Assault Nurse Examiner (SANE). (1) A registered nurse may practice as a sexual assault nurse examiner with appropriate additional education, including supervised clinical practice and demonstrated clinical competence. (a) The educational program for a sexual assault nurse examiner shall comply with the education standards of the International Association of Forensic Nurses. The educationalNursing program shall be specific to the population examined by the sexual assault nurse examiner: adult/adolescent or pediatric. (b) Supervised clinical practice shall occur with one of the following: (i) A physician licensed to practice medicine in Alabama (ii) An advanced practice nurse with experience as a sexual assault nurse examiner. (iii) Another registered nurse with experience as a sexual assault nurse examiner. (c) The registered nurse shall demonstrate clinical competence with all aspects of the examination. (2) A registered nurse who practices as a sexual assault nurse examiner shall:

Links to Nurse Practice Acts and State Regulations

(a) Practice according to a written protocol signed by a physician licensed in Alabama or an advanced practice nurse with prescriptive authority prior to administering medications for prophylaxis of sexually transmitted dise ases or pregnancy. (b) Conduct examinations of sexual assault or rape victims in accordance with accepted principles of forensic nursing, including, but not limited to, chain of custody, photodocumentation, colposcopy, documentation, confidentiality, and evidence integrity. (c) Maintain documentation of appropriate initial and continuing education, supervised clinical practice, and demonstrated clinical competence. Alaska (9) *P+ractice of registered nursing means the performance for compensation or personal profit of acts of professional service that requires substantial specialized knowledge, judgment, and skill based on the principles of biological, physiological, behavioral, and sociological sciences in assessing and responding to the health needs of individuals, families, or communities through services that include (A) assessment of problems, counseling, and teaching (i) clients to maintain health or prevent illness; and (ii) in the care of the ill, injured, or infirm; (B) administration, supervision, delegation, and evaluation of nursing practice; (C) teaching others the skills of nursing; (D) execution of a medical regimen as prescribed by a person authorized by the state to practice medicine; (E) performance of other acts that require education and training that are recognized by the nursing profession as properly performed by registered nurses; (F) performance of acts of medical diagnosis and the prescription of medical therapeutic or corrective

Links to Nurse Practice Acts and State Regulations

measures under regulations adopted by the board. American Samoa Arizona Registered nursing includes the following: (a) Diagnosing and treating human responses to actual or potential health problems. (p. 7) Board of Nursing has a test for nurses to take on the Nurse Practice Act: https://www.azbn.gov/MyServices/NursePracticeActEx am.asp

Arkansas

California

Not specifically within the Nurse Practice Act, but within the Board of Nursings Position Statement on Scopes of Practice it states: The delivery of healthcare services which require assessment, diagnosis, intervention, and evaluation fall within the professional nurse scope of practice. (p.2) The Medical Practice Act authorizes physicians to diagnose mental and physical conditions, to use drugs in or upon human beings, to sever or penetrate the tissues of human beings and to use other methods in the treatment of diseases, injuries, deformities or other physical or mental conditions. As a general guide, the performance of any of these by a registered nurse requires a standardized procedure; however, activities within each of these categories have already become common nursing practice and therefore do not require standardized procedures; for example, the administration of medication by injection requires penetration of human tissue, and registered nurses have performed this function through the years. In Section 2725(a), the Legislature referred to the dynamic quality of the nursing profession. This means, among other things, that some functions which today

Links to Nurse Practice Acts and State Regulations

are considered medical practice will become common nursing practice and no longer require standardized procedures. Examples of medical functions which have evolved into common nursing functions are the measurement of cardiac output pressures, and the insertion of PICC lines. (p. 2) (5) "Diagnosing", within the terms of this article, means the use of professional nursing knowledge and skills in the identification of, and discrimination between, physical and psychological signs or symptoms to arrive at a conclusion that a condition exists for which nursing care is indicated or for which referral to appropriate medical or community resources is required. (p. 1) Section 20-87a. Definition of "nursing", "advanced nursing practice" and "practical nursing". (a) The practice of nursing by a registered nurse is defined as the process of diagnosing human responses to actual or potential health problems, providing supportive and restorative care, health counseling and teaching, case finding and referral, collaborating in the implementation of the total health care regimen and executing the medical regimen under the direction of a licensed physician, dentist or advanced practice registered nurse. (p. 1) Standards of Nursing Practice are those standards adopted by the Board that interpret the legal definitions of nursing, as well as provide criteria against which violations of the law can be determined. Such standards shall not be assumed the only evidence in civil malpractice litigation, nor shall they be given a different weight than any other evidence Nursing Process includes assessment, diagnosis, outcome identification, planning, implementation and evaluation.

Colorado

Connecticut

Delaware

Links to Nurse Practice Acts and State Regulations

District of Columbia 5414.1 The practice of registered nursing means the performance of acts requiring substantial specialized knowledge, judgment, and skill based upon the principles of the biological, physical, behavioral, and social sciences in the following: a) The observation, comprehensive assessment, evaluation and recording of physiological and behavioral signs and symptoms of health, disease, and injury, including the performance of examinations and testing and their evaluation for the purpose of identifying the needs of the client and family; (b) The development of a comprehensive nursing plan that establishes nursing diagnoses, sets goals to meet identified health care needs, and prescribes and implements nursing interventions of a therapeutic, preventive, and restorative nature in response to an assessment of the clients requirements; (3)(a) "Practice of professional nursing" means the performance of those acts requiring substantial specialized knowledge, judgment, and nursing skill based upon applied principles of psychological, biological, physical, and social sciences which shall include, but not be limited to: 1. The observation, assessment, nursing diagnosis, planning, intervention, and evaluation of care; health teaching and counseling of the ill, injured, or infirm; and the promotion of wellness, maintenance of health, and prevention of illness of others. AND (d) "Nursing diagnosis" means the observation and evaluation of physical or mental conditions, behaviors, signs and symptoms of illness, and reactions to treatment and the determination as to whether such conditions, signs, symptoms, and reactions represent a

Florida

Declaratory Statement: Registered Nurses as SANEs http://www.doh.state.fl.us/mqa/declaratory/nursing/fo _DOH-04-0039.pdf

Links to Nurse Practice Acts and State Regulations

deviation from normal. (6) "Practice nursing" or "practice of nursing" means to perform for compensation or the performance for compensation of any act in the care and counsel of the ill, injured, or infirm, and in the promotion and maintenance of health with individuals, groups, or both throughout the life span. It requires substantial specialized knowledge of the humanities, natural sciences, social sciences, and nursing theory as a basis for assessment, nursing diagnosis, planning, intervention, and evaluation. It includes, but is not limited to, provision of nursing care; administration, supervision, evaluation, or any combination thereof, of nursing practice; teaching; counseling; the administration of medications and treatments as prescribed by a physician practicing medicine in accordance with Article 2 of Chapter 34 of this title, or a dentist practicing dentistry in accordance with Chapter 11 of this title, or a podiatrist practicing podiatry in accordance with Chapter 35 of this title. (2) Establish and document nursing diagnosis (evaluation/problem) which serves as the basis for the strategy of care. (3) Develop the strategy of care based on assessment and nursing diagnosis (evaluation/problem). This includes: (A) Identifying priorities in the strategy of care. (B) Setting realistic and measurable goals to implement the strategy of care. (C) Prescribing nursing intervention(s) based on the nursing diagnosis (evaluation/problem). (D) Identifying measures to maintain comfort, to support human functions and responses, to maintain an environment conducive to well-being, and to provide

Georgia

Guam

Links to Nurse Practice Acts and State Regulations

health teaching and counseling. (p. 4-5) Diagnosis is not mentioned Diagnosis is not mentioned A registered professional nurse provides holistic nursing care through the nursing process to individuals, groups, families, or communities, that includes but is not limited to: (1) the assessment of healthcare needs, nursing diagnosis, planning, implementation, and nursing evaluation; ALSO: Within that same section: The foregoing shall not be deemed to include those acts of medical diagnosis or prescription of therapeutic or corrective measures. As used in this chapter, "registered nursing" means performance of services which include but are not limited to:(2) deriving a nursing diagnosis; (p. 5) ALSO: (e) As used in this chapter, "nursing diagnosis" means the identification of needs which are amenable to nursing regimen. (p. 5) As used in this section, nursing diagnosis means to identify and use discriminatory judgment concerning physical and psychosocial signs and symptoms essential to determining effective nursing intervention. (p. 11) ALSO: The practice of the profession of a registered nurse means the practice of a natural person who is licensed by the board to do all of the following: a. Formulate nursing diagnosis and conduct nursing treatment of human responses to actual or potential health problems through services, such as case finding, referral, health teaching, health counseling, and care provision which is supportive to or restorative of life and well-being. (p. 12) Diagnosis in the context of nursing practice means that identification of and discrimination between

Hawaii Idaho Illinois

Illinois General Assembly is the only place where there is statutory language about the role: (c) In this Section, "sexual assault nurse examiner" means a registered nurse who has completed a sexual assault nurse examiner (SANE) training program that meets the Forensic Sexual Assault Nurse Examiner Education Guidelines established by the International Association of Forensic Nurses. http://www.ilga.gov/legislation/ilcs/fulltext.asp?DocNa me=041000700K6.4

Indiana

Iowa

Kansas

Links to Nurse Practice Acts and State Regulations

physical and psychosocial signs and symptoms essential to effective execution and management of the nursing regimen and shall be construed as distinct from a medical diagnosis. (p. 4) "Nursing process" means the investigative approach to nursing practice utilizing a method of problem-solving by means of: (a) Nursing diagnosis, a systematic investigation of a health concern, and an analysis of the data collected in order to arrive at an identifiable problem; and (b) Planning, implementation, and evaluation based on nationally accepted standards of nursing practice;

Kentucky

"Sexual assault nurse examiner" means a registered nurse who has completed the required education and clinical experience and maintains a current credential from the board as provided under KRS 314.142 to conduct forensic examinations of victims of sexual offenses under the medical protocol issued by the Justice and Public Safety Cabinet in consultation with the Sexual Assault Response Team Advisory Committee pursuant to KRS 216B.400(4); 314.142 Sexual Assault Nurse Examiner Program -Advisory council. (1) The Kentucky Board of Nursing shall promulgate administrative regulations pursuant to KRS Chapter 13A to create a Sexual Assault Nurse Examiner Program. These administrative regulations shall address, at a minimum: (a) Educational requirements for sexual assault nurse examiners and statewide standards for provision of the education; (b) The application process through which registered nurses who submit documentation of required education and clinical experience and who remit the designated application fee may apply to the board to be credentialed as a "Sexual Assault Nurse Examiner"; (c) Continuing education requirements for maintenance of the sexual assault nurse examiner credential; (d) Methods of monitoring overall program implementation; and (e) Procedures for obtaining input from the Sexual

Links to Nurse Practice Acts and State Regulations

Assault Response Team Advisory Committee established under KRS Chapter 403 prior to proposing amendments to any provision of the administrative regulations promulgated under this section or KRS 314.131. (2) Any person in this state who holds a credential as a Sexual Assault Nurse Examiner as defined in KRS 314.011(14) shall have the right to use the title "Sexual Assault Nurse Examiner" and the abbreviation "SANE". No other person shall assume the title or use the abbreviation or any other words, letters, signs, or figures to indicate that the person using the same is a Sexual Assault Nurse Examiner. http://www.lrc.ky.gov/krs/314-00/142.PDF Obtaining the SANE credential: http://kbn.ky.gov/apply/sane.htm Board of Nursing motion to recognize SANE function under the scope of RN practice: http://www.lsbn.state.la.us/Portals/1/Documents/agen das/pracmin071503.pdf

Louisiana

Maine

"Nursing diagnosis" means the identification of actual or potential responses to health needs or problems based on collecting, analyzing, and comparing data with appropriate nursing standards to serve as the basis for indicating nursing care or for which referral to appropriate medical or community resources is necessary. "Practice of nursing" means the performance, with or without compensation, by an individual licensed by the board as a registered nurse, of functions requiring specialized knowledge and skills derived from the biological, physical, and behavioral sciences. The practice of nursing or registered nursing shall not be deemed to include acts of medical diagnosis or medical prescriptions of therapeutic or corrective nature. 2. Professional nursing. The practice of "professional nursing" means the performance by a registered professional nurse for compensation of professional

Links to Nurse Practice Acts and State Regulations

services defined as follows: A. Diagnosis and treatment of human responses to actual or potential physical and emotional health problems through such services as case finding, health teaching, health counseling and provision of care supportive to or restorative of life and well-being and execution of the medical regimen as prescribed by a licensed physician, podiatrist or dentist or otherwise legally authorized individual acting under the delegated authority of a physician, podiatrist or dentist: (1) "Diagnosis" in the context of nursing practice means that identification of and discrimination between physical and psychosocial signs and symptoms essential to effective execution and management of the nursing regimen. This diagnostic privilege is distinct from medical diagnosis; (p. 3) "Practice registered nursing" means the performance of acts requiring substantial specialized knowledge, judgment, and skill based on the biological, physiological, behavioral, or sociological sciences as the basis for assessment, nursing diagnosis, planning, implementation, and evaluation of the practice of nursing in order to: (i) Maintain health; (ii) Prevent illness; or (iii) Care for or rehabilitate the ill, injured, or infirm. Diagnosis is not mentioned Diagnosis is not mentioned Diagnosis is not mentioned The practice of nursing by a registered nurse means the performance for compensation of services which requires substantial knowledge of the biological, physical, behavioral, psychological and sociological sciences and of nursing theory as the basis for

Maryland

Forensic Nurse Examiner regulatory language: http://www.dsd.state.md.us/comar/SubtitleSearch.asp x?search=10.27.21.* Forensic Nurse Examiner certification via the Maryland Board of Nursing: http://www.mbon.org/main.php?v=norm&p=0&c=adv_ prac/rn-fne_instructions.html

Massachusetts Michigan Minnesota Mississippi

Links to Nurse Practice Acts and State Regulations

assessment, diagnosis, planning, intervention and evaluation in the promotion and maintenance of health; management of individuals' responses to illness, injury or infirmity; the restoration of optimum function; or the achievement of a dignified death. Nursing practice includes, but is not limited to, administration, teaching, counseling, delegation and supervision of nursing, and execution of the medical regimen, including the administration of medications and treatments prescribed by any licensed or legally authorized physician or dentist. The foregoing shall not be deemed to include acts of medical diagnosis or prescriptions of medical, therapeutic or corrective measures, except as may be set forth by rules and regulations promulgated and implemented by the Mississippi Board of Nursing. (p. 3) (I) Nothing in these rules shall be construed to permit medical diagnosis of any condition by an RN pursuant to a collaborative practice arrangement. (p. 18) Diagnosis is not mentioned Practice of nursing by a registered nurse, defined. (1) The practice of nursing by a registered nurse means assuming responsibility and accountability for nursing actions. (2) Nursing actions include, but are not limited to: (a) Assessing human responses to actual or potential health conditions; (b) Establishing nursing diagnoses; (p. 2) Practice of nursing defined. Practice of nursing means the general observation, diagnosis and treatment of changes in a persons health. The term does not include acts of medical diagnosis or prescription of therapeutic or corrective measures, except as authorized by specific statute.

Missouri

Montana Nebraska

Nevada

SANE practice decision pursuant to RNs: http://nevadanursingboard.org/wpcontent/uploads/2011/10/Sexual-assault-nurseexaminer.pdf

Links to Nurse Practice Acts and State Regulations

New Hampshire "Registered nursing'' means the application of nursing knowledge, judgment, and skill drawn from broad indepth education in the biological, psychological, social, and physical sciences in assessing and diagnosing the health status of a client, and in planning, implementing, and evaluating client care which promotes the optimum health, wellness, and independence of the individual, the family, and the community. The practice of nursing as a registered professional nurse is defined as diagnosing and treating human responses to actual or potential physical and emotional health problems, through such services as casefinding, health teaching, health counseling, and provision of care supportive to or restorative of life and well-being, and executing medical regimens as prescribed by a licensed or otherwise legally authorized physician or dentist. Diagnosing in the context of nursing practice means that identification of and discrimination between physical and psychosocial signs and symptoms essential to effective execution and management of the nursing regimen. Such diagnostic privilege is distinct from a medical diagnosis. (p. 20) "professional registered nursing" means the practice of the full scope of nursing requiring substantial knowledge of the biological, physical, social and behavioral sciences and of nursing theory and may include advanced practice pursuant to the Nursing Practice Act. This practice includes but is not limited to: (2) establishing a nursing diagnosis; "[N]ursing diagnosis" means a clinical judgment about individual, family or community responses to actual or potential health problems or life processes, which judgment provides a basis for the selection of nursing

New Jersey

Forensic Nurse-Certified Sexual Assault application packet: http://www.njconsumeraffairs.gov/nursing/ForensicNu rse.pdf

New Mexico

Links to Nurse Practice Acts and State Regulations

interventions to achieve outcomes for which the person making the judgment is accountable; "Diagnosing" in the context of nursing practice means that identification of and discrimination between physical and psychosocial signs and symptoms essential to effective execution and management of the nursing regimen. Such diagnostic privilege is distinct from a medical diagnosis. The practice of the profession of nursing as a registered professional nurse is defined as diagnosing and treating human responses to actual or potential health problems through such services as casefinding, health teaching, health counseling, and provision of care supportive to or restorative of life and well-being, and executing medical regimens prescribed by a licensed physician, dentist or other licensed health care provider legally authorized under this title and in accordance with the commissioner's regulations. A nursing regimen shall be consistent with and shall not vary any existing medical regimen. Formulation of a nursing diagnosis includes: (A) describing actual or potential responses to health conditions. Such responses are those for which nursing care is indicated, or for which referral to medical or community resources is appropriate; and (B) developing a statement of a client problem identified through interpretation of collected data. (p. 1) "Nursing" means the performance of acts utilizing specialized knowledge, skills, and abilities for people in a variety of settings. The term includes the following acts, which may not be deemed to include acts of medical diagnosis or treatment or the practice of

New York

Department of Health SAFE Examiner Standards: http://www.health.ny.gov/professionals/safe/docs/safe _examiner_standards.pdf

Northern Mariana Islands North Carolina

SANE laws and regulations: http://www.ncbon.com/content.aspx?id=34

North Dakota

Links to Nurse Practice Acts and State Regulations

medicine as defined in chapter 43-17: a. The maintenance of health and prevention of illness. b. Diagnosing human responses to actual or potential health problems. c. Providing supportive and restorative care and nursing treatment, medication administration, health counseling and teaching, case finding and referral of individuals who are ill, injured, or experiencing changes in the normal health processes. d. Administration, teaching, supervision, delegation, and evaluation of health and nursing practices. e. Collaboration with other health care professionals in the implementation of the total health care regimen and execution of the health care regimen prescribed by a health care practitioner licensed under the laws of this state. (p. 1) 4723.151 Unlicensed practice. (A) Medical diagnosis, prescription of medical measures, and the practice of medicine or surgery or any of its branches by a nurse are prohibited. "The practice of nursing" means the performance of services provided for purposes of nursing diagnosis and treatment of human responses to actual or potential health problems consistent with educational preparation. Knowledge and skill are the basis for assessment, analysis, planning, intervention, and evaluation used in the promotion and maintenance of health and nursing management of illness, injury, infirmity, restoration or optimal function, or death with dignity. Practice is based on understanding the human condition across the human lifespan and understanding the relationship of the individual within the environment. This practice includes execution of the medical regime including the administration of

Ohio

Oklahoma

Board of Nursing declaration to recognize SANE role within the scope of RN practice: http://www.ok.gov/nursing/rnsassualt.pdf

Links to Nurse Practice Acts and State Regulations

medications and treatments prescribed by any person authorized by state law to so prescribe; (p. 3) Nursing Diagnostic Statements means the nursing diagnoses or reasoned conclusions which are developed as a result of nursing assessment. They describe a clients actual or potential health problems which are amenable to resolution by means of nursing strategies, interventions or actions; "Nursing process" means the systematic problem solving method licensed nurses use when they provide nursing care. The nursing process includes assessing, making nursing diagnoses, planning, intervening, and evaluating. The steps of the nursing process are interrelated and together form the basis for the practice of nursing; (1) The Practice of Professional Nursing means diagnosing and treating human responses to actual or potential health problems through such services as casefinding, health teaching, health counseling, and provision of care supportive to or restorative of life and well-being, and executing medical regimens as prescribed by a licensed physician or dentist. The foregoing shall not be deemed to include acts of medical diagnosis or prescription of medical therapeutic or corrective measures, except as performed by a certified registered nurse practitioner acting in accordance with rules and regulations promulgated by the Board (4)Diagnosing means that identification of and discrimination between physical and psychosocial signs and symptoms essential to effective execution and management of the nursing regimen. (p. 2) Diagnosis is not mentioned

Oregon

Registered Nurse Scope of Practice as A Sexual Assault Nurse Examiner Board of Nursing policy statement: http://www.oregon.gov/osbn/pdfs/policies/sane.pdf

Pennsylvania

Puerto Rico Rhode Island

Links to Nurse Practice Acts and State Regulations

South Carolina "Nursing diagnosis" means a clinical judgment about a person, family, or community that is derived through a nursing assessment and the standard nursing taxonomy. "Nursing diagnosis," the identification of and discrimination between physical and psychological signs or symptoms essential to the effective execution and management of a nursing regimen. Scope of registered nursing practice. As used in this chapter, the practice of nursing by a registered nurse means the: (1) Nursing diagnosis of human responses to actual or potential health problems of individuals or groups, providing preventative, restorative and supportive care, health teaching and counseling, case finding and referral; The practice of professional nursing does not include acts of medical diagnosis or the development of a medical plan of care and therapeutics for a patient, except to the extent such acts may be authorized by 63-1-132, 63-7-123 and 63-7-207. The registered nurse shall assist in the determination of healthcare needs of clients and shall: (A) Utilize a systematic approach to provide individualized, goal-directed, nursing care by: (i) performing comprehensive nursing assessments regarding the health status of the client; (ii) making nursing diagnoses that serve as the basis for the strategy of care; (iii) developing a plan of care based on the assessment and nursing diagnosis; Diagnosis is not mentioned "Registered nursing" means the practice of nursing which includes: Advisory opinion on the use of the colposcope by RNs functioning as SANEs: http://www.llr.state.sc.us/POL/Nursing/AdvisoryOp/AO 36.pdf Board of Nursing advisory opinion on SANE role within the scope of RN practice: http://doh.sd.gov/boards/nursing/titleopinion.aspx#SART

South Dakota

Tennessee

Texas

Forensic evidence collection provision: http://www.bne.state.tx.us/practice/faqforensicevidence.html SANE Certification through the Texas Attorney Generals Office: https://www.oag.state.tx.us/victims/sapcs.shtml#certifi cation

Utah Vermont

SANE Board (via Department of Health and Human Services) Regulation of Sexual Assault Nurse Examiners:

Links to Nurse Practice Acts and State Regulations

(A) Assessing the health status of individuals and groups. (B) Establishing a nursing diagnosis Virgin Islands Virginia Washington Diagnosis is not mentioned Nursing Diagnosis/Problem Identification: The registered nurse uses client data and nursing scientific principles to develop nursing diagnosis and to identify client problems in order to deliver effective nursing care; Diagnosis is not mentioned Diagnosis is not mentioned "Nursing process" means the investigative approach to nursing practice utilizing a method of problem identification by means of: (A)Assessment: A systematic and continuous collection of objective and subjective data about the health status of individuals and groups derived from observations, health assessment including physical assessment, interviews, written records and reports; (B) Nursing Diagnosis: The identification of actual or potential responses to health needs or problems based on collecting, analyzing and comparing data with appropriate nursing standards to serve as the basis for providing nursing care or for which referral to appropriate medical or community resources is required; (C) Planning: Development of a plan of care which includes measurable goals derived from the nursing diagnosis and identified priorities to maintain comfort, support of human functions and responses, and an environment conducive to wellness; (D)Intervention: Actions in nursing practice which implement the plan of care to maximize health http://www.vtnetwork.org/wp-content/uploads/SANEFinal-Rule-as-Adopted-04-30-10.pdf

West Virginia Wisconsin Wyoming

Links to Nurse Practice Acts and State Regulations

capabilities of individuals and groups; (E)Evaluation: The continuous appraisal of the effectiveness of goal attainment in the plan of care by means of reassessing health status, and if necessary, modifying nursing diagnosis, plan of care and interventions. .