SPRING 2017Edition 51KBN
CONNECTIONCONTINUING
COMPETENCY FAQSPage 8
NURSING INCENTIVE
SCHOLARSHIP FUND
Page 18
ACUTE vs PRIMARY
CARE NURSE PRACTITIONER
Page 20
UPDATE ON COMPREHENSIVE
ADDICTION AND RECOVERY ACT (CARA)
Page 22
Official Publication of the Kentucky Board of Nursing
Statistics CornerAs of April 2, 2017 KBN records show:
ContentsSpring 2017 Edition 51
Published by the Kentucky Board of Nursing312 Whittington Pky., Ste 300
Louisville 40222-5172Phone: 800-305-2042 or 502-429-3300
Fax: 502-429-3311Web Address: http://kbn.ky.gov
EXECUTIVE DIRECTOR:Paula S. Schenk, MPH, RN
BOARD MEMBERS:Jimmy T. Isenberg, RN - President
Lewis Perkins, APRN – Vice PresidentNatalie Tate, LPN – Secretary
Anita Simmons – Citizen-at-Large –
Sally Baxter, RNMary Bennett, APRN
Dina Byers, APRNChristie Coe, APRN
Michelle Dunn, Citizen-at-LargeKelly R. Jenkins, RNLucy McDowell, LPN John Nordgauer, LPNSonia Rudolph, APRN
Patricia Spurr, RNAnne H. Veno, RN
Gail Wise, RN
EDITORIAL PANEL:Anita Simmons, Citizen-at-Large
Lucy McDowell, LPNPatricia Spurr, RN
PRODUCTION COORDINATOR:Eric Velazquez
CONSULTANT:Bernadette Sutherland, MSN, RNKBN does not necessarily endorse
advertisements contained herein. The publisher reserves the right to accept or reject advertisements for the KBN Connection.
Information published in the KBN Connection is not copyrighted and may be reproduced. KBN would appreciate credit for the material
used. Direct questions or comments to KBN ([email protected]).
KBN MISSIONThe Kentucky Board of Nursing protects the well-being of the public by development and enforcement of state laws governing the safe practice of nursing, nursing education, and
credentialing.
22 Update On Comprehensive Addiction and Recovery Act (CARA)
23 APRNS Seeking Data 2000 Waiver Notification of Intent
24 SCOPE OF PRACTICE: The Similarities and Differences of Family Nurse Practitioner and Psychiatric Mental Health Nurse Practitioner Practice
26 HIghlights of Board Actions
28 Disciplinary Actions
RN Active: 69,391
LPN Active: 14,353
Advanced Practice Registered Nurses: 7,157
Dialysis Technicians Active: 589
SANE Active: 238
5 President’s Message
6 Executive Director’s Message
KBN Connection is funded by advertisements. No licensure
fees or state tax dollarsfund this publication. KBN Connection is provided free
of charge to its readers.KBN receives no funding
from this publication. pcipublishing.com
Created by Publishing Concepts, Inc.David Brown, President • [email protected]
For Advertising info contact Michele Forinash • 800.561.4686 ext 112
ThinkNurse.com
KBN Connection circulation includes over 90,000 licensed nurses and nursing students
in Kentucky.
KBNCONNECTION 3
8 Continuing Competency FAQS
12 KNB Approved CE Providers
14 New CDC Opioid Prescribing Guideline Resources for Providers – Mobile App, COCA Webinar, and Videos
16 Celebrating National Nurses Week May 6-12, 2017
18 Nursing Incentive Scholarship Fund
20 Certified Nurse Practitioner: Acute Care or Primary Care Is My Practice Setting Specific to My Role
We are currently recruiting RNs in all areas of UK Chandler, UK Good Samaritan and Kentucky Children’s hospitals.
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president’s message
Jimmy Isenberg, PhD, RNPresident, Kentucky Board of Nursing
Nursing is the leading profession when it comes to ethics and honesty, according to a well-known national poll. Among professions surveyed by the annual Gallup honesty and ethics poll, nurses have been at the top of the list since they were added to the poll in 1999, and remain there after the latest survey conducted in December 2016. In that survey, 84% of respondents rated nurses as being very high or high as professionals who are honest and ethical. Nurses ranked at the top among 22 professions listed in the most recent survey. The only year that nurses were not ranked number one was in 2001 when fire fighters and first responders topped the list following the 911 event.
What an awesome accolade that we all enjoy. With this recognition comes professional responsibilities. One area that has been written about extensively is the topic of Professional Boundaries. Professional Boundaries are the spaces between the nurse’s power and the client’s vulnerability. The power of the nurse comes from the professional position and the access to private knowledge about the client. Further enhancing this power is the continued view from the public about the ethics and honesty of nurses as proven by the continued ranking in the Gallup Poll annually.
One of the more extreme forms of boundary violation is professional sexual misconduct. It is a breach of trust as well as an extremely serious violation of the nurse’s professional responsibility to the client, and a violation of the Kentucky Nursing Laws. All states have laws that are in place to protect the public from those that violate this trust. There are many other ways to violate this professional boundary that might not be so apparent. One of the more recent types of violations involves the use of social media and smart phones with video and camera capabilities. There have been instances where confidential personal information was shared with the nurse by the client. The nurse then posted it on a social media outlet where it was available for all to read. This violation may be exacerbated by an accompanying photo or by the use of the check-in feature that identifies the location of a facility. Such conduct can cause an erosion in the public’s perception of nurses’ ethical behavior.
The National Council of State Boards of Nursing (NCSBN) provides extensive information regarding these violations on its website at www.ncsbn.org. In addition, two NCSBN brochures are available as follows:• A Nurse’s Guide to the Use of Social Media• A Nurse’s Guide to Professional Boundaries
As we begin the new year, let’s us all strive to adhere to the professional qualities that have propelled us to the number one ranking among all professions as the most trusted.
6 KBNCONNECTION Spring 2017
executive director’s message
House Bill 304, the Enhanced Nurse Licensure Compact was signed by Governor Bevin on March 21, 2017. Representative (Rep.) Addia Wuchner graciously agreed to sponsor HB 304, the Enhanced Nurse Licensure Compact (ENLC) legislation, along with two former registered nurses in the KY House of Representatives, Rep. Mary Lou Marzian and Rep. Kim Moser. Other stakeholder organizations took on this legislative initiative as a priority including, but not limited to, the KY Nurses Association, the KY Coalition of Nurse Practitioners and Nurse Midwives, KY Association of Nurse Anesthetists, the KY Hospital Association, KentuckyOne Health, Baptist Health, American Association of Retired Persons and the National Military Family Foundation. On behalf of the Board, appreciation is expressed to these legislators and organizations for supporting the ENLC legislation and recognizing that continued participation in the Compact benefits not only nurses and employers of nurses, but most importantly, the citizens of the Commonwealth.
In early March, the Board initiated a project to evaluate its customer service. The Board is sending an email to a randomly selected group of licensees and dialysis technicians which will contain an embedded link to a Customer Satisfaction Survey. This survey should take no more than five (5) minutes to complete. All responses are confidential. By responding to this survey, the licensee is assisting the Board in evaluating its services and how we may improve those services. Each licensee’s participation is critical to the success of the endeavor.
It is a pleasure to share information from the National Council of State Boards of Nursing (NCSBN) and its new program, the Transition to Practice (TTP) online e-learning program for newly licensed nurses. This program is based upon the NCSBN’s Transition
to Practice multi-state, randomized and controlled study which found that transition programs increase new nurse competence, satisfaction and retention in addition to decreasing stress and self-reported errors. The TTP contains important concepts, integral to patient safety and critical thinking, and is designed to help new graduates apply nursing knowledge, new skills and critically think as they make the transition from newly licensed nurses to clinically competent and proficient nursing professionals. The new graduate coursework includes 5 sections (Communication and Teamwork; Patient and Family-Centered Care; Evidence Based Practice; Quality Improvement; and Informatics) which can be purchased separately or as a package through the NCSBN learning website (www.learningext.com). There is also a course designed for preceptors of new graduates, entitled Helping New Nurses Transition to Practice. These resources are ideal for any type institution onboarding new nurses but particularly so for those institutions with limited resources.
Since the last issue of the KBN Connection, KBN bid a fond and bittersweet farewell to Diane Thomas, Executive Assistant, who, after ten (10) years of diligent and faithful service to the Board, retired to enjoy time with her family. In addition, KBN welcomed two Nurse Investigators, Bonnie Fenwick, RN, Investigation Branch and Anna Marling, RN, Compliance Branch to the agency.
Paula Schenk, MPH, RN Executive Director
KBNCONNECTION 7Spring 2017
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Q: What are the dates of the CE earning period for renewal of my nursing license?A: Nurses are required to earn 14 contact hours or the equivalent within the yearly earning period of November 1st through October 31st. You may wish to view the CE brochure available on the CE/Competency page of the KBN website (www.kbn. ky.gov) for additional information regarding the different ways to demonstrate continuing competency.
Q: I am an Advanced Practice Registered Nurse (APRN) in Kentucky. Are there any specific CE requirements for my APRN renewal?A: APRNs are required to earn five (5) contact hours of approved CE in pharmacology each licensure period. The licensure earning period is November 1st through October 31st. In 2008, the regulation was amended to reflect that pharmacology CE contact hours can be earned from any provider that is recognized by your APRN accrediting body. It is the responsibility of the individual APRN to contact the certifying body for a complete and up-to-date list of recognized providers for their organization.
APRNs with a CAPA-CS are required to earn 1.5 approved CE contact hours on the use of KASPER, pain management or addiction disorders. These hours may count as part of the required five (5) pharmacology contact hours.
Q: Are SANE-credentialed nurses required to earn specific CE contact hours in addition to the required 14 contact hours for RN renewal?A: SANE-credentialed nurses are required to earn five (5) contact hours of approved sexual assault CE (forensic medicine or domestic violence CE will meet this requirement). These hours count as part of the required 14 contact hours for RN renewal.
Q: If I am no longer employed as a nurse and do not plan to work as a nurse, but want to renew my nursing license do I need to complete nursing CE?A: Yes. If you plan to renew your nursing license you must complete the required 14 contact hours of continuing education or the equivalent on or before October 31st. Completion of CE is required each earning period in order to renew your nursing license; it is not based on the status of your employment.
Q: I am a relatively new graduate. I am required to renew my nursing license for the first time by
October 31st, 2017. Since this is my first renewal am I exempt from earning CE hours for this renewal?A: No. You are not exempt from earning CE hours for your first-time renewal. All nurses required to renew their license must also complete 14 approved CE contact hours or the equivalent within the earning period of Nov. 1st, 2016 through Oct. 31st, 2017. There is no exemption for first-time renewal.
Q: What will happen if I am audited, and I do not have the required contact hours?A: You will be asked to earn the required hours and submit copies of the CE certificates to KBN along with a letter of explanation as to why these hours were earned late. Once this documentation is received and accepted by KBN, you will be allowed to enter into a Consent Decree with KBN and pay the required fine. If you do not earn the late hours and/or pay the fine, your records and audit response will be forwarded to the Investigation Branch for initiation of disciplinary action.
Q: I understand Kentucky nurses are required to complete a CE course in Pediatric Abusive Head Trauma. Please give me information about this requirement.A: All nurses licensed as of July 15, 2010 must earn 1.5 CE contact hours in Pediatric Abusive Head Trauma (Shaken Baby Syndrome). Nurses must complete this earning within 3 years of their initial licensure date in the state of Kentucky. This one-time only requirement is included as part of the nursing curriculum for nurses graduating from a Kentucky Program of Nursing as of December 2011.
Q: I understand Kentucky nurses are required to complete a CE course in Domestic Violence. Please give me information about this requirement.A: All nurses licensed in the state of Kentucky must earn 3 CE contact hours in Domestic Violence within 3 years of their initial licensure date. This one-time only requirement is included as part of the nursing curriculum for nurses graduating from a Kentucky Program of Nursing as of May 1998.
Q: I understand there have been some changes in the HIV/AIDS CE requirements. How many HIV/AIDS contact hours must I earn, and what is the earning period?
by Beth A. Tanner, Continuing Competency
Program CoordinatorCONTINUING COMPETENCY FAQS
KBNCONNECTION 9Spring 2017
A: Effective June 24, 2015, earning contact hours for HIV/AIDS content is no longer required.
Q: I understand that I can use my national nursing certification for the required 14 contact hours of CE. Is this correct?A: If you have a national nursing certification or recertification related to your practice role that is in effect the whole earning period or earned initially this period, it will count for the required 14 contact hours for Kentucky licensure. NOTE: In addition to the national nursing certification, APRNs are required to earn five approved contact hours in pharmacology each earning period. APRNs with a CAPA-CS are required to earn 1.5 approved CE contact hours on the use of KASPER, pain management, or addiction disorders.
These hours may count as part of the required pharmacology hours.
Q: Is it true that I can use an employment evaluation for part of my CE contact hours?A: Yes. A satisfactory employment evaluation for your position as a nurse, that covers at least six months of the earning period, can be used for seven contact hours towards your CE requirement. In order to meet the required 14 contact hours needed for renewal, you must also earn the other seven contact hours. Other acceptable ways to earn your CE contact hours can be found online (www. kbn.ky.gov/ce) under “Licensure Renewal Requirements.”
Q: Do college courses count as CE hours?A: Academic courses in nursing and health care, or social or physical sciences beyond the prelicensure curriculum of your license will count toward your CE requirement. One semester credit hour equals 15 contact hours. One quarter credit hour equals 12 contact hours. You must achieve a grade of “C” or better, or a‘pass’ on a pass-fail grading system. These courses count as CE for the earning period in which the course was completed.
Q: Can a nurse substitute CME credits for nursing contact hours?A: CME credits do not automatically transfer to contact hours. If you wish to earn contact hours for a course that awarded CME credit, you will need to go to the
KBN CE Web page (www.kbn.ky.gov/ce/) under “CE Forms and Publications,” and submit an “Individual Request for Review of CE Activities.” APRNs are allowed to use CME credits for pharmacology continuing education if the provider offering the course is recognized by their national certifying organization.
Q: I am required to take a class in CPR where I work. Will this CPR class count toward my CE requirement?A: No. CPR and BLS classes, as well as in-service education and nurse aide training, do not count as CE hours.
Q: Will ACLS and PALS courses count toward my CE requirement?A: If an approved provider offers the ACLS or PALS courses, the contact hours earned will be accepted by KBN. See the list of national nursing organizations recognized by KBN for continuing education offerings on the KBN website (www. kbn.ky.gov/ce).
Q: Where can I find a list of approved CE providers?A: You can print a copy of the KBN approved provider list from the KBN website (www.kbn.ky.gov) under “CE Forms and Publications.” In addition, a list of National Nursing Organizations recognized by KBN for continuing education is also provided on the KBN website. If a provider approved by one of these organizations offers a course you wish to take, that course will be accepted by KBN for the same number of contact hours.
Q: I was selected for the CE audit last year. I have friends that have been in nursing for many years but have never been selected. Why did I receive an audit letter and they did not?A: Nurses receiving CE audit letters are chosen by random selection. The number of years one has been in nursing has nothing to do with the selection process.
Q: My friend refers to the continuing education hours she earns as CEUs. I notice that you refer to them as contact hours. What is the difference between a CEU and a contact hour?A: Contact hours refer to the stated amount of time an individual was present during a course. One contact hour is equal to 50 minutes of clock time. Continuing Education Unit (CEU) is the term used as the unit of measurement by colleges and universities
10 KBNCONNECTION Spring 2017
to designate 10 contact hours. The terms contact hour and CEU cannot be used interchangeably. Kentucky and most nursing continuing education providers require offerings to be determined in contact hours.
Q: I have attended a CE course that is not offered by an approved CE provider. How can I get credit for these hours?A: You may wish to submit an “Individual Request for Review of CE Activities,” (www.kbn.ky.gov/ce/) under “CE Forms and Publications,” to KBN requesting contact hours for this course. There is a non-refundable charge of $10 for the review. Once submitted, your application will be reviewed and, if approved, the appropriate number of contact hours will be awarded. Applications must be submitted no later than November 30th of the licensure year.
Q: Are CE hours earned on the internet acceptable for licensure in Kentucky? If so, how many of the required 14 hours can be earned on the internet?
A: Internet CE courses are acceptable if offered by an approved CE provider. All 14 contact hours or any combination of the contact hours may be from internet providers.
Q: I have earned more CE contact hours this earning period than I need. Can these contact hours be used for my next renewal?A: No. CE contact hours cannot be carried over to the next earning period. All 14 contact hours must be earned within the specified earning period (November 1st - October 31st).
Q: Does KBN have a record of the CE hours I have earned?A: No. KBN does not keep track of each nurse’s CE contact hours. Nurses must retain records of their CE/competency for at least five years following a licensure period. It is the responsibility of the CE provider to see that the nurse receives a certificate of completion, but the provider does not send a copy of the certificate of completion to the KBN. You are not required to submit CE certificates to KBN unless requested to do so.
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The purpose of mandatory continuing education (CE)/competency, as cited in the Kentucky Nursing Laws (KRS 314), is to require evidence of the nurse’s efforts to maintain and update nursing knowledge and skills needed to make competent judgments and deci-sions in nursing practice, nursing administration, nursing education, and/or nursing research.
One of the ways the Board assists nurses in meet-ing their annual continuing competency requirements is by approving nursing continuing education provid-ers. Currently, there are 211 KBN approved providers of nursing continuing education. These providers offer an array of educational opportunities to nurses both online and in person.
In order to remain in compliance, KBN approved nursing CE providers must follow guidelines set forth in Kentucky Administrative Regulation, specifically 201 KAR 20:215. Continuing competency requirements and 201 KAR 20:220 Nursing continuing education provider approval. KBN issues approvals of CE providerships for a two (2) year period of time.
To find the most up-to-date listing of KBN approved CE providers please visit the CE/Competency pages of the KBN website at www.KBN.Ky.gov. The CE/Competency pages can be found under the “Education” tab. A direct link to the CE/Competency pages is http://kbn.ky.gov/ce/Pages/default.aspx.
by Beth A. Tanner, Continuing Competency
Program CoordinatorKBN APPROVED CE PROVIDERS
12 KBNCONNECTION Spring 2017
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The mobile app is free, and available on both Android and Apple devices.
New VideosCDC has produced videos to help improve understanding about
prescription opioids and to spur communication between prescribers and patients on this important topic. These tools complement the CDC Guideline and to educate patients and providers about opioids and their risks. Videos can be easily used as a Public Service Announcements (PSA), shared on social media, or featured in trainings and presentations.
Even When Prescribed by a Doctor (video raises general awareness about opioids)
CDC shared new data published in the Morbidity and Mortality Weekly Report. Opioid overdose deaths increased significantly between 2014 and 2015, and more than 300,000 Americans have lost their lives to opioids—prescription and illicit—since 2000.
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The Kentucky Board of Nursing members and staff would like to recognize the American Nurses Association (ANA) celebration of National Nurses Week. It begins each year on May 6 and ends on May 12, Florence Nightingale’s birthday. ANA has designated 2017 as the “Year of the Healthy Nurse,” and established this year’s theme as, “Nursing: the Balance of Mind, Body and Spirit.”
We join with ANA, the Kentucky Nurses Association (KNA), and all other nursing organizations celebrating this
week. We congratulate and thank the licensed practical nurses, registered nurses, and advanced practice regis-tered nurses who strive to assure a culture of safety in
their practice and so capably serve the citizens of the Commonwealth. In addition, the other health care team members who are licensed/credentialed by the Board, such as Dialysis Technicians and RN Sexual Assault Nurse Examiners, are also thanked for their service. The Kentucky Board of Nursing seeks to promote safety by development and enforcement of state laws governing the safe practice of nursing, nursing education, and credentialing.
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