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COMMONWEALTH OF PENNSYLVANIA

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Pennsylvania Code



Subchapter B. PRACTICAL NURSES


GENERAL PROVISIONS

Sec.


21.141.    Definitions.
21.142.    Scope.
21.143.    Surveys; list of approved programs.
21.144.    [Reserved].
21.145.    Functions of the LPN.
21.145a.    Prohibited acts.
21.145b.    IV therapy curriculum requirements.
21.146.    Applicability of general rules.
21.146a.    Procedural matters.
21.147.    Fees.
21.148.    Standards of nursing conduct.
21.148a.    Impaired professional program.
21.149.    Temporary practice permits.

LICENSURE


21.150.    Licensure by examination.
21.151.    Application for examination.
21.152.    Passage of the examination.
21.153.    Re-examination.
21.154.    [Reserved].
21.155.    Licensure by endorsement.
21.156.    Renewal of license.
21.156a.    Continued competency.
21.156b.    Reporting of crimes and disciplinary action.
21.156c.    Reporting of address changes.
21.157.    Employment of practical nurses licensed outside of the United States, its territories or Canada.
21.158.    Qualifications of application for examination.
21.159.    [Reserved].

APPROVAL OF PRACTICAL NURSING PROGRAMS


21.161.    Objectives.
21.162.    Types of approval.
21.162a.    Failure to comply with standards.
21.162b.    Minimum rate for graduates of nursing education programs to pass the National licensure examination.
21.163.    [Reserved].
21.164.    [Reserved].
21.165.    [Reserved].
21.166.    Removal from approved list.

APPROVED PROGRAMS OF PRACTICAL NURSING


21.171.    [Reserved].
21.172.    Establishment.
21.173.    Discontinuance or interruption of a program of practical nursing.

ORGANIZATION AND ADMINISTRATION OF PRACTICAL NURSING PROGRAMS


21.181.    Administrative authority.
21.182.    Advisory committee.
21.183.    Budget.
21.184.    Cooperating agencies.

ADMINISTRATIVE AND INSTRUCTIONAL PERSONNEL


21.191.    Faculty and staff complement.
21.192.    Faculty qualifications.
21.193.    Faculty policies.
21.194.    Faculty organization.

CURRICULUM


21.201.    Philosophy, purposes and objectives.
21.202.    General curriculum requirements for practical nursing programs.
21.203.    Specific curriculum requirements for practical nursing programs.
21.204.    Changes in curriculum.

FACILITIES FOR ADMINISTRATION AND TEACHING


21.211.    Facility and resource requirements.

STUDENTS


21.221.    Selection and admission.
21.222.    Student services.
21.223.    Student’s rights.

RECORDS


21.231.    Program records and record maintenance.
21.232.    Records required to be filed in the Board office.
21.233.    Custody of records.
21.234.    Access and use of records.

Authority

   The provisions of this Subchapter B issued under the Practical Nurse Law (63 P.S. § §  651—667.8), unless otherwise noted.

Source

   The provisions of this Subchapter B adopted January 20, 1967; amended March 26, 1976, effective March 27, 1976, 6 Pa.B. 610, unless otherwise noted.

Cross References

   This subchapter cited in 28 Pa. Code §  201.3 (relating to definitions).

GENERAL PROVISIONS


§ 21.141. Definitions.

 The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise:

   Act—The Practical Nurse Law (63 P.S. §  §  651—667) which establishes standards for the education of practical nurses and the practice of practical nursing.

   Approved—Approved by the Board.

   Board—The State Board of Nursing of the Commonwealth.

   Bolus—A concentrated medication or solution given rapidly over a short period of time.

   Central venous catheter—An intravenous (IV) catheter, the tip of which terminates beyond the peripheral vasculature and may be either tunneled, implanted or percutaneously inserted.

   Examination year—The period beginning on October 1st of a year through September 30th of the following year.

   Focused assessment—Appraisal of an individual’s current status and situation, which contributes to comprehensive assessment by the licensed professional nurse and supports ongoing data collection.

   Graduate practical nurse—An individual who has graduated from an approved program of practical nursing in this Commonwealth or a comparable program in another state.

   IV access device—A centrally or peripherally inserted catheter used for the purpose of intravenous infusion therapy, including peripheral short catheters, peripheral midline catheters, peripherally inserted central catheters and central catheters, including tunneled, nontunneled catheters and implanted ports.

   IV therapy—The administration of fluids, electrolytes, nutrients or medications by the venous route.

   LPN—Licensed practical nurse. A nurse licensed under this subchapter to practice in this Commonwealth.

   Oral order—A spoken order issued by a practitioner authorized by law and by facility policy to issue orders for medical and therapeutic measures.

   PICC—Peripherally inserted central catheter—An IV catheter, the tip of which terminates in the superior vena cava and is confirmed by chest x-ray.

   Patient (includes residents and clients)—A person, other than a spouse or immediate family member, who receives professional services from a licensed practical nurse, regardless of whether or not the nurse receives remuneration for the services.

   Peripheral midline catheter—A peripherally inserted catheter, the tip of which terminates no further than the axilla and is between 3 inches and 8 inches (7.5 cm and 20 cm) in length.

   Peripheral short catheter—A venous access device less than 3 inches (7.5 cm) in length.

   Practice of practical nursing—The performance of selected nursing acts in the care of the ill, injured or infirm under the direction of a licensed professional nurse, a licensed physician or a licensed dentist which do not require the specialized skill, judgment and knowledge required in professional nursing.

   Professional relationship—The relationship which shall be deemed to exist for a period of time beginning with the first professional contact or consultation between a licensed practical nurse and a patient and ending with the final professional contact between them. The administration of emergency medical treatment or transitory trauma care will not be deemed to establish a professional relationship.

   Sexual impropriety—The term includes the following offenses:

     (i)   Making sexually demeaning or sexually suggestive comments about or to a patient, including comments about a patient’s body or undergarments.

     (ii)   Unnecessarily exposing a patient’s body or watching a patient dress or undress, unless for therapeutic purposes or the patient specifically requests assistance.

     (iii)   Examining or touching genitals without the use of gloves when performing an otherwise appropriate examination.

     (iv)   Discussing or commenting on a patient’s potential sexual performance or requesting details of a patient’s sexual history or preferences during an examination or consultation, except when the examination or consultation is pertinent to the issue of sexual function or dysfunction or reproductive health care. Discussion of a patient’s sexual practices and preferences shall be fully documented in the patient’s chart.

     (v)   Soliciting a date from a patient.

     (vi)   Volunteering information to a patient about one’s sexual problems, preferences or fantasies.

   Sexual violation—The term includes the following offenses:

     (i)   Sexual intercourse between an LPN and a patient during the professional relationship.

     (ii)   Genital to genital contact between a nurse and a patient during the professional relationship.

     (iii)   Oral to genital contact between a nurse and a patient during the professional relationship.

     (iv)   Touching breasts, genitals or any other body part for any purpose other than appropriate examination or treatment, or using prolonged or improper examination techniques, or after the patient has refused or withdrawn consent.

     (v)   Encouraging a patient to masturbate in the presence of the nurse or masturbating while the patient is present.

     (vi)   Providing or offering to provide drugs or treatment in exchange for sexual favors.

     (vii)   Using or causing the use of anesthesia or any other drug affecting consciousness for the purpose of engaging in any conduct that would constitute a sexual impropriety or sexual violation.

   Titration of IV medications—A process by which medication is administered and dosages are adjusted through a continuous medication-containing intravenous infusion (such as vasoactive drugs, anticoagulants, psychotropic drugs, neuromuscular drugs, hormones, and the like) to effect a desired state based upon patient assessment data and prescribed parameters.

Authority

   The provisions of this §  21.141 amended under section 2.1(k) of The Professional Nursing Law (63 P.S. §  212.1(k)); and section 17.6 of the Practical Nurse Law (63 P.S. §  667.6); and amended under sections 2.1(k) and 6.1 of The Professional Nursing Law (63 P.S. § §  212.1(k) and 216.1); and sections 9 and 17.6 of the Practical Nurse Law (63 P.S. § §  659 and 667.6).

Source

   The provisions of this §  21.141 amended July 1, 1983, effective July 2, 1983, 13 Pa.B. 2061; amended September 8, 2000, effective September 9, 2000, 30 Pa.B. 4730; amended December 19, 2003, effective December 20, 2003, 33 Pa.B. 6219; amended May 19, 2006, effective May 20, 2006, 36 Pa.B. 2402; amended April 24, 2009, effective April 25, 2009, 39 Pa.B. 2103; amended August 24, 2012, effective August 25, 2012, 42 Pa.B. 5486. Immediately preceding text appears at serial pages (342920) to (342922).

§ 21.142. Scope.

 (a)  The Board administers the act by promulgating rules and regulations which establish standards for practical nursing programs and the conduct of programs.

 (b)  The Board provides for licensure of graduate practical nurses from approved programs by examination, by endorsement and by programs renewal of licenses.

 (c)  The Board may impose disciplinary sanctions and assess civil penalties for cause.

 (d)  The Board may approve practical nursing education programs conducted in hospitals and accredited community colleges, universities and postsecondary institutions that award academic degrees and public school districts and vocational education programs under the Department of Education, and will make available a list of approved practical nursing education programs on its web site.

 (e)  The Board will regulate the practice of practical nursing.

Authority

   The provisions of this §  21.142 amended under section 506 of The Administrative Code of 1929 (71 P.S. §  186); and sections 8 and 17.6 of the Practical Nurse Law (63 P.S. § §  658 and 667.6).

Source

   The provisions of this §  21.142 amended July 1, 1983, effective July 2, 1983, 13 Pa.B. 2061; amended December 16, 2016, effective December 17, 2016, 46 Pa.B. 7822. Immediately preceding text appears at serial pages (363471) to (363472).

§ 21.143. Surveys; list of approved programs.

 (a)  Survey visits will be made of basic practical nursing programs conducted in hospitals, community colleges, universities and public school districts and vocational education programs under the Department of Education. The survey report will be presented to the Board and a written report of recommendations or requirements or both will be sent to the school, community college, university, hospital or vocational education program.

 (b)  A classified list of approved programs of practical nursing will be compiled and published annually and made available for distribution.

Authority

   The provisions of this §  21.143 amended under section 506 of The Administrative Code of 1929 (71 P.S. §  186); and section 8 of the Practical Nurse Law (63 P.S. §  658).

Source

   The provisions of this §  21.143 amended July 1, 1983, effective July 2, 1983, 13 Pa.B. 2061. Immediately preceding text appears at serial page (26485).

§ 21.144. [Reserved].


Authority

   The provisions of this §  21.144 amended under section 506 of The Administrative Code of 1929 (71 P.S. §  186); and section 8 of the Practical Nurse Law (63 P.S. §  658); reserved under section 17.6 of the Practical Nurse Law (63 P.S. §  667.6).

Source

   The provisions of this §  21.144 amended July 1, 1983, effective July 2, 1983, 13 Pa.B. 2061; reserved December 16, 2016, effective December 17, 2016, 46 Pa.B. 7822. Immediately preceding text appears at serial pages (363472) to (363473).

§ 21.145. Functions of the LPN.

 (a)  The LPN is prepared to function as a member of the health-care team by exercising sound nursing judgment based on preparation, knowledge, experience in nursing and competency. The LPN participates in the planning, implementation and evaluation of nursing care using focused assessment in settings where nursing takes place.

   (1)  An LPN shall communicate with a licensed professional nurse and the patient’s health care team members to seek guidance when:

     (i)   The patient’s care needs exceed the licensed practical nursing scope of practice.

     (ii)   The patient’s care needs surpass the LPN’s knowledge, skill or ability.

     (iii)   The patient’s condition deteriorates or there is a significant change in condition, the patient is not responding to therapy, the patient becomes unstable or the patient needs immediate assistance.

   (2)  An LPN shall obtain instruction and supervision if implementing new or unfamiliar nursing practices or procedures.

   (3)  An LPN shall follow the written, established policies and procedures of the facility that are consistent with the act.

 (b)  The LPN administers medication and carries out the therapeutic treatment ordered for the patient in accordance with the following:

   (1)  The LPN may accept a written order for medication and therapeutic treatment from a practitioner authorized by law and by facility policy to issue orders for medical and therapeutic measures.

   (2)  The LPN may accept an oral order if the following conditions are met:

     (i)   The practitioner issuing the oral order is authorized by law and by facility policy to issue oral orders for medical and therapeutic measures.

     (ii)   The LPN has received instruction and training in accepting an oral order in an approved nursing education program or has received instruction and training in accepting an oral order in accordance with the established policies and protocols of the facility.

     (iii)   The policy of the facility permits an LPN to accept an oral order.

     (iv)   The regulations governing the facility permit an LPN to accept an oral order.

   (3)  The LPN shall question any order which is perceived as unsafe or contraindicated for the patient or which is not clear and shall raise the issue with the ordering practitioner. If the ordering practitioner is not available, the LPN shall raise the issue with a registered nurse or other responsible person in a manner consistent with the protocols or policies of the facility.

   (4)  The LPN may not accept an oral order which is not within the scope of functions permitted by this section or which the LPN does not understand.

   (5)  An oral order accepted by the LPN shall be immediately transcribed by the LPN in the proper place on the medical record of the patient. The transcription shall include the prescriber’s name, the date, the time of acceptance of the oral order and the full signature of the LPN accepting the oral order. The countersignature of the ordering practitioner shall be obtained in accordance with applicable regulations of the Department of Health governing the licensed facility.

 (c)  The LPN participates in the development, revision and implementation of policies and procedures designed to insure comfort and safety of patients in collaboration with other health care personnel.

 (d)  The Board recognizes codes of behavior as developed by appropriate practical nursing associations as the criteria for assuring safe and effective practice.

 (e)  The LPN may administer immunizing agents and do skin testing only if the following conditions are met:

   (1)  The LPN has received and satisfactorily completed a Board approved educational program which requires study and supervised clinical practice intended to provide training necessary for administering immunizing agents and for performing skin testings.

   (2)  A written order has been issued by a licensed physician pertaining to an individual patient or group of patients.

   (3)  Written policies and procedures under which the LPN may administer immunizing agents and do skin testing have been established by a committee representing the nurses, the physicians and the administration of the agency or institution employing or having jurisdiction over the LPN. A current copy of the policies and procedures shall be provided to the LPN at least once every 12 months. The policies and procedures shall provide for:

     (i)   Identification of the immunizing and skin testing agents which the LPN may administer.

     (ii)   Determination of contraindications for the administration of specific immunizing and skin testing agents.

     (iii)   The listing, identification, description and explanation of principles, including technical and clinical indications, necessary for the identification and treatment of possible adverse reactions.

     (iv)   Instruction and supervised practice required to insure competency in administering immunizing and skin testing agents.

 (f)  An LPN may perform only the IV therapy functions for which the LPN possesses the knowledge, skill and ability to perform in a safe manner, except as limited under §  21.145a (relating to prohibited acts), and only under supervision as required under paragraph (1).

   (1)  An LPN may initiate and maintain IV therapy only under the direction and supervision of a licensed professional nurse or health care provider authorized to issue orders for medical therapeutic or corrective measures (such as a CRNP, physician, physician assistant, podiatrist or dentist).

   (2)  Prior to the initiation of IV therapy, an LPN shall:

     (i)   Verify the order and identity of the patient.

     (ii)   Identify allergies, fluid and medication compatibilities.

     (iii)   Monitor the patient’s circulatory system and infusion site.

     (iv)   Inspect all equipment.

     (v)   Instruct the patient regarding the risk and complication of therapy.

   (3)  Maintenance of IV therapy by an LPN shall include ongoing observation and focused assessment of the patient, monitoring the IV site and maintaining the equipment.

   (4)  For a patient whose condition is determined by the LPN’s supervisor to be stable and predictable, and rapid change is not anticipated, the supervisor may supervise the LPN’s provision of IV therapy by physical presence or electronic communication. If supervision is provided by electronic communication, the LPN shall have access to assistance readily available.

   (5)  In the following cases, an LPN may provide IV therapy only when the LPN’s supervisor is physically present in the immediate vicinity of the LPN and immediately available to intervene in the care of the patient:

     (i)   When a patient’s condition is critical, fluctuating, unstable or unpredictable.

     (ii)   When a patient has developed signs and symptoms of an IV catheter-related infection, venous thrombosis or central line catheter occlusion.

     (iii)   When a patient is receiving hemodialysis.

 (g)  An LPN who has met the education and training requirements of §  21.145b (relating to IV therapy curriculum requirements) may perform the following IV therapy functions, except as limited under §  21.145a and only under supervision as required under subsection (f):

   (1)  Adjustment of the flow rate on IV infusions.

   (2)  Observation and reporting of subjective and objective signs of adverse reactions to any IV administration and initiation of appropriate interventions.

   (3)  Administration of IV fluids and medications.

   (4)  Observation of the IV insertion site and performance of insertion site care.

   (5)  Performance of maintenance. Maintenance includes dressing changes, IV tubing changes, and saline or heparin flushes.

   (6)  Discontinuance of a medication or fluid infusion, including infusion devices.

   (7)  Conversion of a continuous infusion to an intermittent infusion.

   (8)  Insertion or removal of a peripheral short catheter.

   (9)  Maintenance, monitoring and discontinuance of blood, blood components and plasma volume expanders.

   (10)  Administration of solutions to maintain patency of an IV access device via direct push or bolus route.

   (11)  Maintenance and discontinuance of IV medications and fluids given via a patient-controlled administration system.

   (12)  Administration, maintenance and discontinuance of parenteral nutrition and fat emulsion solutions.

   (13)  Collection of blood specimens from an IV access device.

Authority

   The provisions of this §  21.145 amended under section 506 of The Administrative Code of 1929 (71 P.S. §  186); sections 8 and 17.6 of the Practical Nurse Law (63 P.S. § §  658 and 667.6); and section 2.1(k) of The Professional Nursing Law (63 P.S. §  212.1(k)).

Source

   The provisions of this §  21.145 amended July 1, 1983, effective July 2, 1983, 13 Pa.B. 2061; amended August 4, 1989, effective August 5, 1989, 19 Pa.B. 3281; amended December 19, 2003, effective December 20, 2003, 33 Pa.B. 6219; amended August 24, 2012, effective August 25, 2012, 42 Pa.B. 5486. Immediately preceding text appears at serial pages (302267) to (302270).

Cross References

   This section cited in 49 Pa. Code §  21.414 (relating to interpretations regarding the functions of Licensed Practical Nurses (LPN)—statement of policy).

§ 21.145a. Prohibited acts.

 An LPN may not perform the following IV therapy functions:

   (1)  Initiate administration of blood, blood components and plasma volume expanders.

   (2)  Administer tissue plasminogen activators, immunoglobulins, antineoplastic agents or investigational drugs.

   (3)  Access a central venous route access device used for hemodynamic monitoring.

   (4)  Administer medications or fluids via arterial lines.

   (5)  Administer medications via push or bolus route.

   (6)  Administer fibrinolytic or thrombolytic agents to declot any IV access device.

   (7)  Administer medications requiring titration.

   (8)  Insert or remove any IV access device, except a peripheral short catheter.

   (9)  Access or program an implanted IV infusion pump.

   (10)  Administer IV medications for the purpose of procedural sedation or anesthesia.

   (11)  Administer fluids or medications via an epidural, intrathecal, intraosseous or umbilical route, or via a ventricular reservoir.

   (12)  Administer medications or fluids via an arteriovenous fistula or graft, except for dialysis.

   (13)  Perform repair of a central venous route access device or PICC.

   (14)  Perform therapeutic phlebotomy.

   (15)  Direct access of implantable devices.

Authority

   The provisions of this §  21.145a issued under section 17.6 of the Practical Nurse Law (63 P.S. §  667.6).

Source

   The provisions of this §  21.145a adopted August 24, 2012, effective August 25, 2012, 42 Pa.B. 5484.

§ 21.145b. IV therapy curriculum requirements.

 (a)  An IV therapy course provided as part of the LPN education curriculum in §  21.203 (relating to specific curriculum requirements for practical nursing programs) or as a stand-alone course offered by a provider shall include instruction of the topics in §  21.203(d)(8). An instructor of a stand-alone course shall have knowledge and skill in the aspect of the course content taught.

 (b)  Providers of stand-alone courses shall apply for approval from the Board before offering an IV therapy course. The request for approval must include the following:

   (1)  A course outline that includes the components of the IV therapy course required under §  21.203(d)(8).

   (2)  A description of the methods of instruction and the clinical learning experiences provided.

   (3)  A description of specific methodologies and tools that evaluate the learner’s achievement of the objectives.

   (4)  A list of faculty membership and verification that the instructors have knowledge and skill in the aspect of the content taught.

Authority

   The provisions of this §  21.145b issued under section 17.6 of the Practical Nurse Law (63 P.S. §  667.6).

Source

   The provisions of this §  21.145b adopted August 24, 2012, effective August 25, 2012, 42 Pa.B. 5484.

Cross References

   This section cited in 49 Pa. Code §  21.147 (relating to fees).

§ 21.146. Applicability of general rules.

 Under 1 Pa. Code §  31.1 (relating to scope of part) 1 Pa. Code Part II (relating to general rules of administrative practice and procedure) is applicable to the activities of the proceedings before the Board.

Authority

   The provisions of this §  21.146 issued under section 506 of The Administrative Code of 1929 (71 P.S. §  186); and section 8 of the Practical Nurse Law (63 P.S. §  658).

Source

   The provisions of this §  21.146 adopted July 1, 1983, effective July 2, 1983, 13 Pa.B. 2061.

§ 21.146a. Procedural matters.

 (a)  The consent of the patient to any sexual impropriety or violation is not a defense to any disciplinary charge for violation of the act or this subchapter.

 (b)  Evidence of specific instances, opinion evidence, or reputation evidence of a patient’s past sexual conduct is not admissible in proceedings brought under §  21.148(b)(9) (relating to standards of nursing conduct). The Board may consider sexual relationships between the nurse and the patient occurring prior to the professional relationship.

 (c)  A nurse who attempts to raise as a defense an argument that conduct prohibited as a sexual violation or sexual impropriety was necessary or appropriate to the treatment of a patient shall be required to demonstrate competency in practice which relates directly to the treatment of sexual function or dysfunction. This competence may be demonstrated through educational training and supervised clinical experience. Appropriate discussions of sexual matters between a nurse and a patient shall be fully documented in patient records.

Authority

   The provisions of this §  21.146a issued under section 17.6 of the Practical Nurse Law (63 P.S. §  667.6).

Source

   The provisions of this §  21.146a adopted September 8, 2000, effective September 9, 2000, 30 Pa.B. 4730.

§ 21.147. Fees.

 (a)  The following application fees are charged by the Board for services to licensees and applicants:

 Licensure by examination—Board-approved nursing education program graduates… $95

 Reexamination … $75

 Licensure by endorsement … $120

 Licensure by endorsement with examination … $145

 Temporary practice permit… $70

 Extension of temporary practice permit… $85

 Fee for review and challenge of PN exam… $435

 Licensure by examination—Graduates of out-of-State nursing education programs… $115

 Verification of licensure… $45

 Reactivation of inactive or lapsed license (5 years or longer)… $130

 Restoration after suspension or revocation… $60

 Certification of scores… $25

 Verification of licensure with history… $50

 (b)  The following renewal fees are charged by the Board to support its operations:

 Biennial renewal of license … $76

 (c)  The following fees are charged by the Board for services to nursing education programs:

 Application for approval of new nursing education program … $2,195

 Review of curriculum revisions fee… $585

 Review of annual compliance report fee… $430

 New nursing education program survey visit fee… $1,525

 (d)  The following fee is charged for evaluations of curricula and programs requiring Board approval under § §  21.145b(b) and 21.156a(2) (relating to IV therapy curriculum requirements; and continued competency)… $285

 (e)  In addition to the fees prescribed in subsection (a), which are payable directly to the Board, a candidate for the practical nurse licensing examination shall also pay a fee to the National Council of the State Boards of Nursing (www.ncsbn.org) to cover costs associated with the preparation and administration of the practical nurse licensing examination.

Authority

   The provisions of this §  21.147 issued under section 17.6 of the Practical Nurse Law (63 P.S. §  667.6); and 11.2(a) and (d) of The Professional Nursing Law (63 P.S. §  11.2(a) and (d)); amended under sections 810(a)(3) and (7) and 812.1 of The Administrative Code of 1929 (71 P.S. § §  279(a)(3) and (7) and 279.3a); sections 13.1 and 17.5 of the Practical Nurse Law (63 P.S. § §  663.1 and 667.5); sections 11(b) and 11.2 of The Professional Nursing Law (63 P.S. § §  221(b) and 221.2); and section 22.1 of the Podiatry Practice Act (63 P.S. §  42.21c).

Source

   The provisions of this §  21.147 adopted December 25, 1987, effective December 26, 1987, 17 Pa.B. 5329; amended June 8, 1990, effective June 9, 1990, 20 Pa.B. 3078; amended July 27, 1990, effective July 28, 1990, 20 Pa.B. 4086; amended November 29, 1991, effective November 30, 1991, 21 Pa.B. 5521; amended June 12, 1992, effective immediately and applies to biennial renewals commencing May 1, 1992, 22 Pa.B. 2976; amended June 18, 1993, effective June 19, 1993, 23 Pa.B. 2827; amended November 26, 1993, effective November 27, 1993, 23 Pa.B. 5634; amended June 16, 2000, effective June 17, 2000, 30 Pa.B. 3040; amended November 17, 2000, effective November 18, 2000, 30 Pa.B. 5952; amended June 2, 2006, effective June 3, 2006, 36 Pa.B. 2673; amended August 20, 2010, effective August 21, 2010, 40 Pa.B. 4755; amended July 26, 2019, effective July 27, 2019, 49 Pa.B. 3891. Immediately preceding text appears at serial pages (385168) to (385169).

Cross References

   This section cited in 49 Pa. Code §  21.149 (relating to temporary practice permits); 49 Pa. Code §  21.156 (relating to renewal of license); 49 Pa. Code §  21.156a (relating to continued competency); and 49 Pa. Code §  21.605 (relating to biennial renewal).

§ 21.148. Standards of nursing conduct.

 (a)  A licensed practical nurse shall:

   (1)  Undertake a specific practice only if the licensed practical nurse has the necessary knowledge, preparation, experience and competency to properly execute the practice.

   (2)  Respect and consider, while providing nursing care, the individual’s right to freedom from psychological and physical abuse.

   (3)  Act to safeguard the patient from the incompetent, abusive or illegal practice of any individual.

   (4)  Safeguard the patient’s dignity, the right to privacy and the confidentiality of patient information. This standard does not prohibit or affect reporting responsibilities under 23 Pa.C.S. Chapter 63 (relating to the Child Protective Services Law), the Older Adults Protective Services Act (35 P.S. § §  10211—10224) and other statutes which may mandate reporting of this information.

   (5)  Document and maintain accurate records.

 (b)  A licensed practical nurse may not:

   (1)  Knowingly aid, abet or assist another person to violate or circumvent a law or Board regulation.

   (2)  Discriminate, while providing nursing services, on the basis of age, marital status, sex, sexual preference, race, religion, diagnosis, socioeconomic status or disability.

   (3)  Knowingly permit another individual to use his license or temporary permit for any purpose or knowingly permit the unlicensed person under the licensed practical nurse’s jurisdiction or supervision to misrepresent that the individual is a licensed nurse.

   (4)  Misappropriate equipment, materials, property, drugs or money from an employer or patient.

   (5)  Solicit, borrow or misappropriate money, materials or property from a patient or the patient’s family.

   (6)  Leave a nursing assignment prior to the proper reporting and notification to the appropriate department head or personnel of such an action.

   (7)  Knowingly abandon a patient in need of nursing care. Abandonment is defined as the intentional deserting of a patient for whom the nurse is responsible.

   (8)  Falsify or knowingly make incorrect entries into the patient’s record or other related documents.

   (9)  Engage in conduct defined as a sexual violation or sexual impropriety in the course of a professional relationship.

 (c)  Failure to comply with an obligation or prohibition imposed by this section is subject to disciplinary and corrective measures under section 16 of the act (63 P.S. §  666).

 (d)  The Board may, in addition to any other disciplinary or corrective measure set forth in this section, levy appropriate civil penalties as authorized by section 15 of the act (63 P.S. §  665) upon a nurse found to have engaged in conduct constituting a sexual impropriety or sexual violation.

Authority

   The provisions of this §  21.148 amended under section 17.6 of the Practical Nurse Law (63 P.S. §  667.6).

Source

   The provisions of this §  21.148 adopted April 30, 1993, effective May 1, 1993, 23 Pa.B. 2115; amended September 8, 2000, effective September 9, 2000, 30 Pa.B. 4730. Immediately preceding text appears at serial pages (267600) to (267601) and (214445).

Notes of Decisions

   Nursing Standards

   The standard of nursing conduct promulgated by these regulations provides a definite warning to a licensee, in addition to the provisions of the law as interpreted by the Board of Nursing, of what may constitute unprofessional conduct by setting forth an ascertainable standard against which conduct can be measured. Stephens v. State Board of Nursing, 657 A.2d 71 (Pa. Cmwlth.), appeal denied, 664 A.2d 978 (Pa. 1995).

   Unprofessional Conduct Established

   These standards of nursing conduct provide a definite warning to a licensee, in addition to the provisions of the law as interpreted by the State Board of Nursing, of what may constitute unprofessional conduct by setting forth an ascertainable standard against which conduct can be measured. Thus, a licensed practical nurse could be assessed a civil penalty and formally reprimanded based on allowing a nurse’s aide to ingest patient medication and provoke patients into agitation. Stephens v. State Board of Nursing, 657 A.2d 71 (Pa. Cmwlth.), appeal denied, 664 A.2d 978 (Pa. 1995).

Cross References

   This section cited in 49 Pa. Code §  21.146a (relating to procedural matters).

§ 21.148a. Impaired professional program.

 When the Board is empowered to take disciplinary or corrective action against a practical nurse for conduct defined as a sexual violation or sexual impropriety, the nurse will not be eligible for placement into an impaired professional program under section 16.2 of the act (63 P.S. §  666.2).

Authority

   The provisions of this §  21.148a issued under section 17.6 of the Practical Nurse Law (63 P.S. §  667.6).

Source

   The provisions of this §  21.148a adopted September 8, 2000, effective September 9, 2000, 30 Pa.B. 4730.

§ 21.149. Temporary practice permits.

 (a)  A graduate practical nurse may only practice practical nursing under supervision and if the graduate practical nurse holds a current temporary practice permit. ‘‘Supervision’’ means that a licensed registered nurse is physically present in the area or unit where the graduate practical nurse is practicing. The Board may grant a temporary practice permit to a graduate practical nurse as follows:

   (1)  An individual who wishes to practice as a graduate practical nurse during the period from the date of completion of the Board-approved educational program to the notification of the results of the licensing examination shall submit an application for temporary practice permit for a graduate practical nurse on a form provided by the Board and remit the fee specified in §  21.147 (relating to fees). A temporary practice permit granted under this section is valid for up to 1 year from the date of issuance unless extended under paragraphs (3) and (4), and immediately expires if the applicant fails the licensing examination.

   (2)  At least 90 days prior to the expiration date of the temporary practice permit, the graduate practical nurse shall:

     (i)   Submit an application for licensure by examination as a practical nurse.

     (ii)   Remit the fee specified in §  21.147.

     (iii)   Submit the licensure examination registration form and fee required to the professional testing organization.

   (3)  At least 60 days prior to the expiration date of the temporary practice permit, the graduate practical nurse who wishes to extend the expiration date of the temporary practice permit because of illness or extreme hardship shall:

     (i)   Submit an application for temporary practice permit extension on a form provided by the Board.

     (ii)   Remit the fee specified in §  21.147.

     (iii)   Provide a detailed, written explanation of the reasons the extension is requested. If requesting an extension due to illness, the applicant shall provide certification of the illness from the applicant’s treating physician.

   (4)  The Board will not grant an extension to an individual who fails to meet the requirements of paragraphs (2) and (3).

 (b)  The Board may grant a temporary practice permit to an individual who holds a current practical nurse license issued by another state, territory or possession of the United States or Canada (a currently-licensed practical nurse). The temporary practice permit will expire in 1 year, unless the individual fails the licensure examination, in which case the temporary practice permit will immediately expire. The Board may extend the temporary practice permit in cases of illness or extreme hardship, as set forth in paragraph (5).

   (1)  A currently-licensed practical nurse who wishes to practice practical nursing during the period from the date of submission of the Applicant Data Sheet of the application for licensure until the Board makes a determination on the application for licensure or 1 year, whichever comes first, shall:

     (i)   Submit an application for temporary practice permit for a currently-licensed practical nurse on a form provided by the Board.

     (ii)   Remit the fee specified in §  21.147.

   (2)  An individual applying for a temporary practice permit for a currently-licensed practical nurse shall demonstrate proficiency in English by submitting proof that the individual’s nursing education program was conducted in English or that the individual has received a passing score on a Board-approved English proficiency examination. The Board will make available a list of Board-approved English proficiency examinations on its web site. This information shall be submitted with the Applicant Data Sheet of the application for licensure.

   (3)  Within 45 days of the date the temporary practice permit is issued, an individual who has been granted a temporary practice permit for a currently-licensed practical nurse shall submit the Verification of Licensure Form of the application for licensure and shall:

     (i)   Request verification of licensure from the foreign jurisdiction and retain documentation of submission of the request to provide to the Board upon request.

     (ii)   Request certification of the applicant’s nursing education program from the licensing board or appropriate educational authorities. The certification of nursing education shall be submitted to the Board in English directly from the appropriate educational authorities. The applicant shall retain documentation of submission of the request to submit to the Board upon request.

     (iii)   Submit an application for an education evaluation to a Board-approved foreign credentials evaluator if required under §  21.155(d) (relating to licensure by endorsement) and retain documentation of the application submitted to the evaluator to provide to the Board upon request.

     (iv)   If the applicant is required to take the licensure examination, submit the licensure examination registration form and fee required to the professional testing organization and retain documentation of the submission of the application to take the examination to provide to the Board upon request.

   (4)  An individual who has been granted a temporary practice permit for a currently-licensed practical nurse shall ensure that all documentation in support of the application for licensure is received by the Board at least 90 days prior to the expiration date of the temporary practice permit. An individual whose supporting documentation has not been received by the Board at least 90 days prior to the expiration date of the temporary practice permit shall submit, within 10 days of receiving notice of the deficiency from the Board, a detailed written explanation of why the supporting documentation has not been supplied to the Board in a timely manner.

   (5)  An individual who has been granted a temporary practice permit for a currently-licensed practical nurse and who has complied with paragraphs (2)—(4) may request an extension of the temporary practice permit because of illness or extreme hardship by:

     (i)   Submitting a temporary practice permit extension application on a form provided by the Board.

     (ii)   Remitting the fee specified in §  21.147.

     (iii)   Submitting a written, detailed explanation of the reasons the extension is requested. If requesting an extension due to illness, the applicant shall provide certification of the illness from the applicant’s treating physician.

     (iv)   Providing proof of the timely request for verification of licensure referenced in paragraph (3)(i).

   (6)  The request for temporary practice permit extension shall be submitted to the Board at least 60 days prior to the expiration date of the temporary practice permit.

   (7)  The Board will not grant an extension to an individual who fails to meet the requirements of paragraphs (2)—(6).

Authority

   The provisions of this §  21.149 issued under sections 3.1 and 17.6 of the Practical Nurse Law (63 P.S. § §  653.1 and 667.6); amended under section 17.6 of the Practical Nurse Law (63 P.S. §  667.6).

Source

   The provisions of this §  21.149 adopted May 19, 2006, effective May 20, 2006, 36 Pa.B. 2402; amended December 16, 2016, effective December 17, 2016, 46 Pa.B. 7822. Immediately preceding text appears at serial pages (363482) to (363484).

Cross References

   This section cited in 49 Pa. Code §  21.151 (relating to application for examination); and 49 Pa. Code §  21.155 (relating to licensure by endorsement).

LICENSURE


§ 21.150. Licensure by examination.

 An applicant for licensure by examination shall comply with the requirements of §  21.151 (relating to application for examination), pass the examination and complete at least 3 hours of training in child abuse recognition and reporting in accordance with §  21.508(a) (relating to child abuse recognition and reporting—mandatory training requirement).

Authority

   The provisions of this §  21.150 added under section 2.1(k) of The Professional Nursing Law (63 P.S. §  222.1(k)); section 17.6 of the Practical Nurse Law (63 P.S. §  667.6); and 23 Pa.C.S. §  6383(b)(2).

Source

   The provisions of this §  21.150 added March 25, 2022, effective March 26, 2022, 52 Pa.B. 1916.

§ 21.151. Application for examination.

 (a)  A candidate for the licensing examination may submit an application together with the required fee no sooner than 90 days prior to completing a practical nursing education program.

 (b)  A candidate will not be authorized to take the examination unless the candidate has satisfied the requirements of the act necessary for eligibility, including confirmation of completion of an approved practical nursing educational program.

 (c)  Graduates of practical nursing education programs outside of this Commonwealth shall file an official transcript validating program completion with the application.

 (d)  An applicant shall demonstrate proficiency in English by submitting proof that the applicant’s nursing education program was conducted in English or that the applicant has, prior to being approved to take the licensure examination, received a passing score on a Board-approved English proficiency examination unless the applicant has already met this requirement in satisfaction of §  21.149(b)(2) (relating to temporary practice permits). The Board will make available a list of Board-approved English proficiency examinations on its web site.

 (e)  An applicant who graduated from a practical nursing education program outside of the United States or Canada shall have the applicant’s education evaluated by a Board-approved foreign credentials evaluator to determine whether the education obtained is equivalent to the program of study required in this Commonwealth at the time the program was completed.

 (f)  A candidate shall take the examination for the first time within 1 year of completing the practical nursing education program unless prevented by emergency, illness, military service or other good cause shown, or the candidate holds a license to practice nursing in another state or country.

Authority

   The provisions of this §  21.151 amended under sections 506 and 812.1 of The Administrative Code of 1929 (71 P.S. § §  186 and 279.3a); and sections 8 and 17.6 of the Practical Nurse Law (63 P.S. § §  658 and 667.6).

Source

   The provisions of this §  21.151 amended July 1, 1983, effective July 2, 1983, 13 Pa.B. 2061; amended June 8, 1990, effective June 9, 1990, 20 Pa.B. 3078; amended December 16, 2016, effective December 17, 2016, 46 Pa.B. 7822. Immediately preceding text appears at serial pages (363484) to (363485).

Cross References

   This section cited in 49 Pa. Code §  21.150 (relating to licensure by examination).

§ 21.152. Passage of the examination.

 Candidates for practical nursing licensure shall pass the licensure examination approved by the Board.

Authority

   The provisions of this §  21.152 amended under section 506 of The Administrative Code of 1929 (71 P.S. §  186); and sections 8 and 17.6 of the Practical Nurse Law (63 P.S. § §  658 and 667.6).

Source

   The provisions of this §  21.152 amended July 1, 1983, effective July 2, 1983, 13 Pa.B. 2061; amended December 16, 2016, effective December 17, 2016, 46 Pa.B. 7822. Immediately preceding text appears at serial page (363485).

§ 21.153. Re-examination.

 (a)  A candidate shall submit a re-examination application, including the required fee for re-examination.

 (b)  The candidate may take the licensing examination as many times as necessary to pass the licensure examination.

 (c)  Candidates who reapply for examination 2 years or more after initial examination shall satisfy the administrative and education requirements prevailing at the time of reapplication.

Authority

   The provisions of this §  21.153 amended under section 506 of The Administrative Code of 1929 (71 P.S. §  186); and sections 8 and 17.6 of the Practical Nurse Law (63 P.S. § §  658 and 667.6).

Source

   The provisions of this §  21.153 amended March 25, 1977, effective March 26, 1977, 7 Pa.B. 841; amended July 1, 1983, effective July 2, 1983, 13 Pa.B. 2061; amended December 16, 2016, effective December 17, 2016, 46 Pa.B. 7822. Immediately preceding text appears at serial page (363485).

§ 21.154. [Reserved].


Authority

   The provisions of this §  21.154 amended under section 506 of The Administrative Code of 1929 (71 P.S. §  186); and section 8 of the Practical Nurse Law (63 P.S. §  658); reserved under section 17.6 of the Practical Nurse Law (63 P.S. §  667.6).

Source

   The provisions of this §  21.154 amended March 11, 1977, effective March 12, 1977, 7 Pa.B. 704; amended March 25, 1977, effective March 26, 1977, 7 Pa.B. 841; amended July 1, 1983, effective July 2, 1983, 13 Pa.B. 2061; reserved December 16, 2016, effective December 17, 2016, 46 Pa.B. 7822. Immediately preceding text appears at serial pages (363485) to (363486).

§ 21.155. Licensure by endorsement.

 (a)  A practical nurse who has graduated from an approved practical nursing program in the United States or Canada and who obtained licensure in another jurisdiction of the United States or Canada upon having passed an examination considered by the Board to be equivalent to the examination required for licensure in this Commonwealth may be granted licensure by endorsement.

 (b)  An applicant for licensure by endorsement shall meet the requirements regarding age, good moral character, preliminary education and practical nursing education as outlined in the act.

 (c)  An applicant for licensure by endorsement whose license in the other jurisdiction is not current for 5 years or longer shall, prior to receiving a license in this Commonwealth, satisfy the requirements of §  21.156a(a)(1) or (2) (relating to continued competency).

 (d)  A practical nurse who has graduated from a practical nursing education program in a country or territory outside of the United States or Canada deemed equivalent to the program of study required in this Commonwealth at the time the program was completed and who obtained licensure in that country or territory upon having passed an examination considered by the Board to be equivalent to the examination required for licensure in this Commonwealth may be granted licensure by endorsement without examination. The Board will base educational equivalency upon an evaluation administered by a Board-approved foreign credentials evaluator.

 (e)  An applicant for licensure by endorsement shall demonstrate proficiency in English by submitting proof that the applicant’s nursing education program was conducted in English or that the applicant has received a passing score on a Board-approved English proficiency examination unless the applicant has previously met this requirement in satisfaction of §  21.149(b)(2) (relating to temporary practice permits). The Board will make available a list of Board-approved English proficiency examinations on its web site.

 (f)  An applicant for licensure by endorsement shall complete at least 3 hours of approved training in child abuse recognition and reporting in accordance with §  21.508(a) (relating to child abuse recognition and reporting—mandatory training requirement).

Authority

   The provisions of this §  21.155 amended under section 506 of The Administrative Code of 1929 (71 P.S. §  186); sections 8 and 17.6 of the Practical Nurse Law (63 P.S. § §  658 and 667.6); section 2.1(k) of The Professional Nursing Law (73 P.S. §  222.1(k)); and 23 Pa.C.S. §  6383(b)(2).

Source

   The provisions of this §  21.155 amended July 1, 1983, effective July 2, 1983, 13 Pa.B. 2061; amended June 18, 1993, effective June 19, 1993, 23 Pa.B. 2827; amended November 28, 1997, effective November 29, 1997, 27 Pa.B. 6210; amended December 16, 2016, effective December 17, 2016, 46 Pa.B. 7822; amended March 25, 2022, effective March 26, 2022, 52 Pa.B. 1916. Immediately preceding text appears at serial pages (385175) to (385176).

Cross References

   This section cited in 49 Pa. Code §  21.149 (relating to temporary practice permits).

§ 21.156. Renewal of license.

 (a)  Licenses for practical nurses expire on June 30 of each biennium in the even-numbered years.

 (b)  When applying for licensure renewal, a licensed practical nurse shall:

   (1)  Submit the renewal application, including disclosing a license to practice nursing or an allied health profession in any other state, territory, possession or country.

   (2)  Pay the biennial renewal of license fee in §  21.147(b) (relating to fees).

   (3)  Disclose discipline imposed by a state licensing board in the previous biennial period and criminal charges pending or criminal conviction, plea of guilty or nolo contendere, or admission into a probation without verdict or accelerated rehabilitative disposition during the previous biennial period, unless prior notification has been made under §  21.156b (relating to reporting of crimes and disciplinary actions).

 (b.1)  Licensed practical nurses applying for renewal shall complete at least 2 hours of approved training in child abuse recognition and reporting in accordance with §  21.508(b) (relating to child abuse recognition and reporting—mandatory training requirement).

 (c)  When communicating with the Board, licensed practical nurses shall identify themselves by their full name, current address and license number.

Authority

   The provisions of this §  21.156 amended under section 17.6 of the Practical Nurse Law (63 P.S. §  667.6); section 2.1(k) of The Professional Nursing Law (63 P.S. §  222.1(k)); and 23 Pa.C.S. §  6383(b)(2).

Source

   The provisions of this §  21.156 amended October 16, 2015, effective October 17, 2015, 45 Pa.B. 6196; amended December 16, 2016, effective December 17, 2016, 46 Pa.B. 7822; amended March 25, 2022, effective March 26, 2022, 52 Pa.B. 1916. Immediately preceding text appears at serial pages (385176) and (396897).

Cross References

   This section cited in 49 Pa. Code §  21.156b (relating to reporting of crimes and disciplinary action).

§ 21.156a. Continued competency.

 (a)  A licensed practical nurse whose license has lapsed for 5 years or longer or has been placed on inactive status for 5 years or longer, as permitted in section 13.1(b) of the act (63 P.S. §  663.1(b)), may reactivate the license by doing one of the following:

   (1)  Successfully completing the initial licensing examination approved by the Board and submitting the examination fee in §  21.147 (relating to fees).

   (2)  Successfully completing a Board-approved reactivation program which requires passage of a nursing achievement examination.

   (3)  Providing evidence to the Board that the applicant has a current license and has practiced as a practical nurse in another jurisdiction at sometime within the last 5 years.

 (b)  A licensed practical nurse whose license has been suspended for 5 years or longer may reactivate the license after complying with the terms of the suspension Order by doing either of the following:

   (1)  Successfully completing the initial licensing examination approved by the Board and submitting the examination fee in §  21.147.

   (2)  Successfully completing a Board-approved reactivation program which requires passage of a nursing achievement examination.

Authority

   The provisions of this §  21.156a amended under section 17.6 of the Practical Nurse Law (63 P.S. §  667.6).

Source

   The provisions of this §  21.156a adopted June 18, 1993, effective June 19, 1993, 23 Pa.B. 2827; amended December 16, 2016, effective December 17, 2016, 46 Pa.B. 7822. Immediately preceding text appears at serial page (378858).

Cross References

   This section cited in 49 Pa. Code §  21.147 (relating to fees); 49 Pa. Code §  21.155 (relating to licensure by endorsement); and 49 Pa. Code §  21.602 (relating to volunteer license).

§ 21.156b. Reporting of crimes and disciplinary action.

 (a)  An LPN shall notify the Board of pending criminal charges within 30 days of the filing of the criminal charges or on the biennial renewal application under §  21.156 (relating to renewal of license), whichever is sooner.

 (b)  An LPN shall notify the Board of a criminal conviction, plea of guilty or nolo contendere, or admission into a probation without verdict or accelerated rehabilitative disposition program within 30 days of the disposition or on the biennial renewal application under §  21.156, whichever is sooner.

 (c)  An LPN shall notify the Board of disciplinary action in the nature of a final order taken against the LPN by the licensing authority of another state, territory or country within 90 days of receiving notice of the disciplinary action or on the biennial renewal application under §  21.156, whichever is sooner.

Authority

   The provisions of this §  21.156b issued under section 17.6 of the Practical Nurse Law (63 P.S. §  667.6).

Source

   The provisions of this §  21.156b adopted October 16, 2015, effective October 17, 2015, 45 Pa.B. 6196.

Cross References

   This section cited in 49 Pa. Code §  21.156 (relating to renewal of license).

§ 21.156c. Reporting of address changes.

 A licensed practical nurse shall notify the Board within 14 days of a change of address.

Authority

   The provisions of this §  21.156c issued under section 17.6 of the Practical Nurse Law (63 P.S. §  667.6).

Source

   The provisions of this §  21.156c adopted December 16, 2016, effective December 17, 2016, 46 Pa.B. 7822.

§ 21.157. Employment of practical nurses licensed outside of the United States, its territories or Canada.

 A person who holds a current and valid license or other evidence of the right to practice practical nursing issued by another country other than Canada may not be employed as a practical nurse in this Commonwealth until licensed by the Board.

Authority

   The provisions of this §  21.157 amended under section 506 of The Administrative Code of 1929 (71 P.S. §  186); and section 8 of the Practical Nurse Law (63 P.S. §  658).

Source

   The provisions of this §  21.157 amended July 1, 1983, effective July 2, 1983, 13 Pa.B. 2061. Immediately preceding text appears at serial page (78865).

§ 21.158. Qualifications of application for examination.

 Additional applicant qualifications are contained in section 5 of the act (63 P.S. §  655). Every applicant for examination as a licensed practical nurse shall furnish evidence satisfactory to the Board that the applicant is 18 years of age or older, is of good moral character, has completed at least 12 years of education with diploma in public, parochial or private school, or its equivalent as evaluated by the Department of Education; and has satisfactorily completed a course in practical nursing prescribed and approved by the Board in a school, hospital or other institution of not less than 1,500 hours and within a period of not less than 12 months.

Authority

   The provisions of this §  21.158 issued under section 506 of The Administrative Code of 1929 (71 P.S. §  186); and section 8 of the Practical Nurse Law (63 P.S. §  658).

Source

   The provisions of this §  21.158 adopted July 1, 1983, effective July 2, 1983, 13 Pa.B. 2061.

§ 21.159. [Reserved].


Source

   The provisions of this §  21.159 adopted December 10, 1982, effective December 11, 1982, 12 Pa.B. 4236; amended September 20, 1985, effective September 21, 1985, 15 Pa.B. 3345; reserved December 25, 1987, effective December 26, 1987, 17 Pa.B. 5329. Immediately preceding text appears at serial page (101303).

APPROVAL OF PRACTICAL NURSING PROGRAMS


§ 21.161. Objectives.

 Practical nurse programs require approval for the following reasons:

   (1)  To safeguard the preparation of practical nurses, and to assure safe standards of nursing practice in this Commonwealth.

   (2)  To guide prospective students in the selection of approved programs which offer adequate resources for sound basic practical nursing education.

   (3)  To insure the graduates of practical nursing programs of eligibility for admission to examination for licensure.

   (4)  To assist graduates of programs of practical nursing in this Commonwealth to qualify for licensure by endorsement in other jurisdictions.

   (5)  To stimulate and maintain continued growth and improvement of practical nursing education in this Commonwealth.

§ 21.162. Types of approval.

 (a)  The Board grants the following types of approval to nursing education programs:

   (1)  Initial. The Board may grant initial approval to a new nursing education program, with evidence that the standards of this subchapter are being met, for a period of time necessary to evaluate the results of the licensing examination by the first cohort of graduates. A program will not be placed on full approval status until it has graduated its first class and the class has achieved an acceptable rate of passing the National licensure examination, as set forth in §  21.162b (relating to minimum rate for graduates of nursing education programs to pass the national licensure examination). A program on initial approval status that fails to achieve an acceptable rate of passing the National licensure examination upon graduation of its first class will be placed on provisional approval status.

   (2)  Full. The Board will place those nursing education programs on full approval status which attain and maintain the standards of this subchapter.

   (3)  Provisional. The Board may place on provisional approval a nursing education program not meeting the standards of this subchapter. A nursing education program on full approval status will be placed on provisional approval status if the program fails to meet the provisions of §  21.162b.

 (b)  A nursing education program shall notify applicants for admission of the program’s approval status and, within 30 days of a change of status, shall notify applicants and students by electronic mail or first class mail that the program’s approval status has changed. The program shall provide the Board a copy of the notice sent to applicants and students. A program shall provide additional notice to applicants and students at the direction of the Board.

 (c)  For purposes of activities relating to the approval and status of nursing education programs, the term ‘‘Board’’ as used in this subchapter may mean the Board’s educational advisors appointed under section 2.1(i) of the act (63 P.S. §  212.2(i)). Only the Board may, by a majority vote, confer initial approval status on a proposed nursing education program, extend the maximum 2-year period for correction of deficiencies or remove a program from the approved list.

Authority

   The provisions of this §  21.162 amended under section 506 of The Administrative Code of 1929 (71 P.S. §  186); and section 8 of the Practical Nurse Law (63 P.S. §  658); amended under sections 2.1(k) and 6.1 of The Professional Nursing Law (63 P.S. § §  212.1(k) and 216.1); and sections 9 and 17.6 of the Practical Nurse Law (63 P.S. § §  659 and 667.6).

Source

   The provisions of this §  21.162 amended July 1, 1983, effective July 2, 1983, 13 Pa.B. 2061; amended April 24, 2009, effective April 25, 2009, 39 Pa.B. 2103. Immediately preceding text appears at serial page (238278).

§ 21.162a. Failure to comply with standards.

 (a)  If the Board receives information suggesting that a nursing education program has not maintained the standards of this subchapter, the Board will validate the information and notify the program, in writing, of the alleged deficiency. The Board may request information from the program or conduct an announced or unannounced site visit before notifying the program of the alleged deficiency. The Board may informally resolve any deficiency.

 (b)  The Board will notify a program, in writing, that the program will be placed on provisional approval status.

 (c)  If the Board places a nursing education program on provisional approval status, the Board will notify the program, in writing, of the deficiencies and the amount of time that will be allowed for correction of the deficiencies that resulted in the program’s placement on provisional approval status. The Board may extend the time period for correction of deficiencies at its discretion if the program is making demonstrable progress toward the correction of deficiencies. If additional deficiencies are identified, the existing provisional period may be extended at the discretion of the Board.

 (d)  The Board may place restrictions on a nursing education program on provisional approval status as deemed necessary by the Board to bring the program into compliance with this subchapter and will notify the program, in writing, of the restrictions.

 (e)  The Board may require that a nursing education program on provisional approval status prepare and submit additional reports and will notify the program, in writing, of the reports required.

 (f)  The Board may make announced or unannounced site visits to a nursing education program on provisional approval status.

 (g)  A period of 2 years will be the maximum time period allowed for the correction of deficiencies that returns the program to compliance with the Board’s regulations. A program may petition the Board for extension of the maximum period and the Board may, by majority vote, extend the period for good cause demonstrated by the program.

 (h)  If the standards of this subchapter are met within the designated time, the nursing education program will be removed from provisional approval status. The Board will notify the program in writing of this action.

 (i)  If the standards of this subchapter are not met within the designated time, the nursing education program will be removed from the approved list as provided in §  21.166 (relating to removal from approved list).

 (j)  Within 10 days of service of a request under subsection (a) or (e) or notice of the imposition of a restriction under subsection (d), a nursing education program may appeal the action of the staff as provided in 1 Pa. Code §  35.20 (relating to appeals from actions of the staff).

 (k)  The failure of a program to cooperate with the Board by failing to provide requested information or reports, by refusing or limiting a site visit, or by refusing to adhere to restrictions mandated by the Board will be considered a violation of the standards for nursing education programs and may result in immediate referral of the program to the prosecution division to consider formal action to remove the program from the approved list as provided in §  21.166 (relating to removal from approved list).

Authority

   The provisions of this §  21.162a adopted under sections 2.1(k) and 6.1 of The Professional Nursing Law (63 P.S. § §  212.1(k) and 216.1); and sections 9 and 17.6 of the Practical Nurse Law (63 P.S. § §  659 and 667.6).

Source

   The provisions of this §  21.162a adopted April 24, 2009, effective April 25, 2009, 39 Pa.B. 2103.

§ 21.162b. Minimum rate for graduates of nursing education programs to pass the National licensure examination.

 A nursing education program shall prepare its graduates to pass the National licensure examination at a rate at least equal to the minimum rate set by the Board. The minimum rate for graduates to pass the National licensure examination are as follows:

   (1)  A nursing education program shall achieve and maintain a minimum pass rate of 60% or more of its first-time examinees during an examination year.

   (2)  Beginning on October 1, 2009, a nursing education program shall achieve and maintain a minimum pass rate of 70% or more of its first-time examinees during an examination year.

   (3)  Beginning on October 1, 2010, a nursing education program shall achieve and maintain a minimum pass rate of 80% or more of its first-time examinees during an examination year.

Authority

   The provisions of this §  21.162b adopted under sections 2.1(k) and 6.1 of The Professional Nursing Law (63 P.S. § §  212.1(k) and 216.1); and sections 9 and 17.6 of the Practical Nurse Law (63 P.S. § §  659 and 667.6).

Source

   The provisions of this §  21.162b adopted April 24, 2009, effective April 25, 2009, 39 Pa.B. 2103.

Cross References

   The provisions of this section cited in 49 Pa. Code §  21.162 (relating to types of approval).

§ 21.163. [Reserved].


Source

   The provisions of this §  21.163 reserved July 1, 1983, effective July 2, 1983, 13 Pa.B. 2061. Immediately preceding text appears at serial page (26491).

§ 21.164. [Reserved].


Source

   The provisions of this §  21.164 amended July 1, 1983, effective July 2, 1983, 13 Pa.B. 2061. Immediately preceding text appears at serial page (26492).

§ 21.165. [Reserved].


Source

   The provisions of this §  21.165 reserved July 1, 1983, effective July 2, 1983, 13 Pa.B. 2061. Immediately preceding text appears at serial page (26492).

§ 21.166. Removal from approved list.

 (a)  The Board may remove a nursing education program from the approved list in accordance with the following procedures if the program fails to meet and maintain minimum standards, including the minimum passing rates on the National licensure examination, as established by this subchapter.

   (1)  The Board will give a nursing education program notice of its intent to remove the program from the approved list.

   (2)  The notice of intent to remove a program from the approved list will set forth the alleged violations of the standards for nursing education programs.

   (3)  A program served with notice of intent to remove will be given 45 days in which to file a written answer to the notice.

   (4)  The nursing education program will be provided an opportunity to appear at a hearing to demonstrate why approval should not be withdrawn.

   (5)  The nursing education program and the Commonwealth will be provided an opportunity to file posthearing briefs.

   (6)  The Board will issue a written decision which will set forth findings of fact and conclusions of law.

   (7)  The Board’s written decision will be a final decision of a governmental agency subject to review under 2 Pa.C.S. §  702 (relating to appeals).

 (b)  If a nursing education program is removed from the approved list, the controlling institution shall provide for the completion of the program for students currently enrolled by placing the students in an approved program.

 (c)  If a nursing education program is removed from the approved list, the controlling institution shall make provision for permanent retention of student and graduate records in conformity with § §  21.233 and 21.234 (relating to custody of records; and access and use of records).

Authority

   The provisions of this §  21.166 adopted under sections 2.1(k) and 6.1 of The Professional Nursing Law (63 P.S. § §  212.1(k) and 216.1); and sections 9 and 17.6 of the Practical Nurse Law (63 P.S. § §  659 and 667.6).

Source

   The provisions of this §  21.166 adopted April 24, 2009, effective April 25, 2009, 39 Pa.B. 2103.

Cross References

   This section cited in 49 Pa. Code §  21.162a (relating to failure to comply with standards).

APPROVED PROGRAM OF PRACTICAL NURSING


§ 21.171. [Reserved].


Source

   The provisions of this §  21.171 reserved July 1, 1983, effective July 2, 1983, 13 Pa.B. 2061. Immediately preceding text appears at serial page (26492).

§ 21.172. Establishment.

 (a)  A controlling agency may be a hospital, educational institution or combination thereof. The controlling agency desiring to establish or conduct an approved program of practical nursing shall submit a written proposal to the Board. If the practical nursing program is in the public school system, the proposal shall be submitted to the Board through the Department of Education, Bureau of Vocational Education.

 (b)  A controlling agency desiring to establish a program of practical nursing is required to:

   (1)  Employ the nurse administrator of the educational unit at least 6 months prior to the intended admission date of students. Board approval of the nurse administrator’s credentials shall be obtained prior to the appointment.

   (2)  Employ teaching faculty for the educational program at least 1 month prior to the initiation of their teaching responsibilities.

   (3)  Submit 15 copies of the tentative planned educational program to the Board at least 4 months prior to the intended admission date of students.

   (4)  Complete a feasibility study which shall include:

     (i)   Sufficient statistical data to support the need for a program within the community and to assure availability of an adequate supply and flow of interested candidates.

     (ii)   Identification of available clinical resources for program implementation based on the projected enrollment and faculty. In viewing the clinical resources, the study shall speak to other nursing programs that share the teaching facilities identified in the study.

     (iii)   Letters of intent from the cooperating agencies indicating positive commitment to the nursing program and the availability of sufficient clinical resources to meet the educational requirements of the program.

   (5)  Submit 15 copies of the feasibility study and the written decision of the health planning agency, if obtained, to the Board for approval.

 (c)  The planned educational program shall include the following:

   (1)  Organization and administrative policies of the controlling agency.

   (2)  Educational preparation and nursing experience of the faculty members employed.

   (3)  Statement of philosophy and objectives of the program.

   (4)  Proposed curriculum including detailed course descriptions and identification of clinical areas of practice.

   (5)  Admission policies.

   (6)  Educational standards.

   (7)  Advisory committee membership and functions if one is appointed.

   (8)  Copies of written agreements with cooperating agencies and facilities to be used in the program. A cooperating agency is any educational or health-care delivery system.

   (9)  A copy of the proposed budget projected.

   (10)  Administrative structure and functions of the practical nursing program.

 (d)  Following the review of the practical nursing program and before final Board action is taken to grant permission to recruit students, an initial facility survey will be made by a Board’s nursing education advisor.

Authority

   The provisions of this §  21.172 amended under section 506 of The Administrative Code of 1929 (71 P.S. §  186); and section 8 of the Practical Nurse Law (63 P.S. §  658).

Source

   The provisions of this §  21.172 amended July 1, 1983, effective July 2, 1983, 13 Pa.B. 2061. Immediately preceding text appears at serial pages (26492) and (26493).

§ 21.173. Discontinuance or interruption of a program of practical nursing.

 (a)  Written notification of intent to discontinue a program of practical nursing shall be submitted to the Board within a reasonable period of time, but not less than 6 months prior to a discontinuance.

 (b)  When a class is not admitted in a given year, the practical nursing program shall close unless approval has been granted by the Board based on the justification for continuation as submitted to the Board.

 (c)  If a practical nursing program is discontinued, it is the responsibility of the controlling agency to provide for the completion of the program for students currently enrolled either by placing the students in an approved program or continuing the enrolled class until completion. If the program is continued until graduation, approved and qualified instruction shall be assured.

 (d)  The controlling agency also has the legal responsibility to make provisions for permanent retention of student and graduate records in conformity with §  21.233 (relating to custody of records).

Authority

   The provisions of this §  21.173 amended under section 506 of The Administrative Code of 1929 (71 P.S. §  186); and section 8 of the Practical Nurse Law (63 P.S. §  658).

Source

   The provisions of this §  21.173 amended July 1, 1983, effective July 2, 1983, 13 Pa.B. 2061. Immediately preceding text appears at serial page (26493).

ORGANIZATION AND ADMINISTRATION OF PRACTICAL
NURSING PROGRAMS


§ 21.181. Administrative authority.

 (a)  The practical nursing program shall be established as an educational unit of the controlling agency.

 (b)  The authority and the administrative responsibility for the program shall be delegated by the governing body of the controlling agency to the registered professional nurse in charge of the program.

 (c)  The organizational plan for the program of practical nursing shall provide for relationships with the governing body of the controlling agency, individuals and cooperating agencies responsible for and participating in the program operation.

 (d)  Adequate funds shall be allocated and properly budgeted for sound and effective operation of the program.

 (e)  The faculty shall formulate policies which relate to the operation of the program.

 (f)  Approval by the Board shall be obtained before the educational unit in practical nursing may utilize a new clinical agency for learning experiences. An Agency Data form, provided by the Board, shall be submitted for each new clinical agency. A clinical agency is one in which clinical experience can be obtained.

Authority

   The provisions of this §  21.181 amended under section 506 of The Administrative Code of 1929 (71 P.S. §  186); and section 8 of the Practical Nurse Law (63 P.S. §  658).

Source

   The provisions of this §  21.181 amended July 1, 1983, effective July 2, 1983, 13 Pa.B. 2061. Immediately preceding text appears at serial page (26494).

§ 21.182. Advisory committee.

 (a)  If an advisory committee exists, the membership shall consist of representatives from practical nursing, professional nursing, general education and other community groups. The nurse in charge of the practical nursing program shall be a member of this committee.

 (b)  The function of this committee is to act in an advisory capacity to the faculty and as a liaison group between the faculty, the agency and the community.

Authority

   The provisions of this §  21.182 amended under section 506 of The Administrative Code of 1929 (71 P.S. §  186); and section 8 of the Practical Nurse Law (63 P.S. §  658).

Source

   The provisions of this §  21.182 amended July 1, 1983, effective July 2, 1983, 13 Pa.B. 2061. Immediately preceding text appears at serial page (26494).

§ 21.183. Budget.

 Budgetary funds shall be allocated by the controlling agency to administer the program effectively. The nurse in charge of the program and the administrative officers of the controlling agency shall prepare an annual budget based on desired needs for growth and change.

Authority

   The provisions of this §  21.183 amended under section 506 of The Administrative Code of 1929 (71 P.S. §  186); and section 8 of the Practical Nurse Law (63 P.S. §  658).

Source

   The provisions of this §  21.183 amended July 1, 1983, effective July 2, 1983, 13 Pa.B. 2061. Immediately preceding text appears at serial page (26494).

§ 21.184. Cooperating agencies.

 (a)  The agreement between the program and each of the cooperating agencies shall be written and signed by the administrators of the program and the cooperating agency and shall identify the responsibility and authority of each party. The agreement shall be reviewed annually and a copy of the current agreement shall be filed in the office of the Board.

 (b)  Approval of the cooperating agency shall be secured prior to the placement of students within the agency.

 (c)  Before an established program changes its clinical facilities through a new or additional cooperating agency, Board approval of the agency is required. A request shall be presented to the Board in writing. Upon receipt of the request, the Board will require information to be submitted on an Agency Data form and returned for review and action. Final approval of the cooperating agency will depend upon a survey of the facilities.

ADMINISTRATIVE AND INSTRUCTIONAL PERSONNEL


§ 21.191. Faculty and staff complement.

 The minimum faculty and clerical personnel required in each program is as follows:

   (1)  A full-time nurse director or nurse coordinator.

   (2)  Full-time nursing instructors must be adequate in number to provide a maximum student-teacher ratio of 15 to 1 in the clinical area.

   (3)  Additional instructors consistent with the size and needs of the programs.

   (4)  Adequate secretarial assistance.

Source

   The provisions of this §  21.191 amended March 25, 1977, effective March 26, 1977, 7 Pa.B. 841. Immediately preceding text appears at serial page (26495).

§ 21.192. Faculty qualifications.

 (a)  The qualifications of the nurse director or nurse coordinator shall be as follows:

   (1)  Graduation from an approved school of professional nursing.

   (2)  Current registration as a professional nurse in this Commonwealth.

   (3)  A baccalaureate degree, preferably in nursing, with experience in the areas of nursing, nursing education and educational administration. The nurse director or coordinator shall give evidence of ability to provide leadership and shall have a specific plan for completing work towards a master’s degree with evidence of consistent effort toward completion of the plan.

 (b)  The qualifications of the instructors shall be as follows:

   (1)  Graduation from an approved school of professional nursing.

   (2)  Current registration as a professional nurse in this Commonwealth.

   (3)  A baccalaureate degree, preferably in nursing, with additional preparation for teaching appropriate to the teaching of practical nursing.

   (4)  Experience and skill in the practice of nursing.

   (5)  Nursing experience involving direct patient care or teaching experience within 2 years of employment. Faculty and instructors shall give evidence of maintaining expertness in clinical and functional areas of responsibility.

 (c)  The employment of less qualified instructors. Faculty or instructors with less academic preparation may be employed if qualified personnel is not available provided that less qualified faculty and instructors shall function under the direct guidance of a fully qualified faculty member and shall give evidence of continuing their academic preparation.

§ 21.193. Faculty policies.

 (a)  The faculty shall be employed by and responsible to the educational institution.

 (b)  Faculty members shall meet the requirements of the parent institution for faculty appointments.

 (c)  Policies, including personnel policies, in effect for nursing faculty, shall be those in effect for faculty members throughout the educational institution, with adjustments for differences that may be required in education for practical nursing.

 (d)  Policies for selection, appointment and promotion of faculty shall be defined in writing.

 (e)  Functions and responsibilities of each faculty member shall be defined in writing.

 (f)  Full-time faculty of the nursing program may not carry responsibilities for administration, curriculum development or teaching for other types of educational programs, nor may the nursing faculty be responsible for student health services or first aid.

 (g)  Changes in status of faculty from full-time to part-time or vice versa shall be reported to the Board.

 (h)  The director or coordinator and nursing faculty of the program shall be afforded the time and opportunity to engage in leadership activities within their profession as are commensurate with their educational responsibilities.

 (i)  In determining teaching load of the faculty the following criteria shall be considered:

   (1)  Number of individual courses or units of study assigned with consideration of differences in scope and depth.

   (2)  Number and size of scheduled weekly classes, including laboratory and clinical teaching contact hours.

   (3)  Additional assignments relative to the functions and responsibilities of the faculty member; such as guidance of students, student evaluation, program revision, participation in activities of faculty organization.

 (j)  There shall be a planned and active faculty development program designed by the faculty to meet their perceived needs.

§ 21.194. Faculty organization.

 (a)  There shall be a nursing faculty organization appropriate to the size of the group.

 (b)  Policies and rules of procedure of the faculty organization shall be in written form and shall be reviewed periodically by the faculty.

 (c)  Members of the faculty shall participate in the activities of the faculty organization.

 (d)  Committees shall be established as needed to implement the functions of the faculty effectively, and the purposes and membership of each committee shall be defined clearly.

 (e)  Committee reports and faculty actions shall be recorded, filed systematically and kept available for reference.

CURRICULUM


§ 21.201. Philosophy, purposes and objectives.

 (a)  The philosophy and objectives of the program shall be formulated, agreed upon and implemented by the faculty and shall be in accordance with the philosophy and objectives of the controlling agency. The philosophy and objectives of the program shall reflect the following:

   (1)  The belief of the faculty about nursing, practical nursing education and education in general.

   (2)  The concept that practical nursing is an integral part of nursing.

   (3)  The fact that the educational needs of the students are being met.

   (4)  The concept of preparing a practitioner who shares in the giving of direct care to patients and who functions within the accepted roles of the L.P.N.

 (b)  The philosophy and objectives shall provide the basis for the development, the conduct and the evaluation of the total program.

 (c)  The expected changes in student behavior identified in the statement of objectives shall be realistic and attainable within the program of instruction.

Authority

   The provisions of this §  21.201 amended under section 506 of The Administrative Code of 1929 (71 P.S. §  186); and section 8 of the Practical Nurse Law (63 P.S. §  658).

Source

   The provisions of this §  21.201 amended July 1, 1983, effective July 2, 1983, 13 Pa.B. 2061. Immediately preceding text appears at serial pages (26499) and (26500).

§ 21.202. General curriculum requirements for practical nursing programs.

 (a)  The curriculum shall be designed to meet the stated objectives of the program.

 (b)  The program of study shall reflect sound principles of general education and practical nursing education.

 (c)  The curriculum shall be based on broad areas of learning but shall be limited in depth.

 (d)  The curriculum shall be flexible enough to permit adaptations according to individual student needs as well as to changing concepts relative to emerging roles.

 (e)  The curriculum shall provide for instruction and practice in the care of selected individuals with different degrees of illness, with various types of incapacities and from all age groups.

 (f)  Scientific facts and concepts selected to be taught shall be limited to those that are essential as a basis for nursing action and are applicable to patient care.

 (g)  Learning experiences shall be selected and arranged to provide opportunity for the student to learn how to function within the role of the LPN and for the personal growth of students.

 (h)  Learning experiences shall focus on direct nursing care, and effort shall be made to arrange experiences in a pattern of logical sequence that demonstrates continuity of care.

 (i)  The plan of instruction shall enable students to develop understanding of the functions of the LPN within different patterns of nursing service.

 (j)  Course outlines shall include specific behavioral objectives anticipated and shall contribute to the objectives of the total curriculum.

 (k)  Learning experiences selected shall focus on the needs of the student and may not be structured to render service to the cooperating agency.

§ 21.203. Specific curriculum requirements for practical nursing programs.

 (a)  The curriculum shall be based upon the philosophy and objectives of the program and shall be developed, implemented and evaluated by the faculty.

 (b)  The curriculum shall be organized and developed to include the knowledge, attitudes, skills and abilities necessary for the specific levels of student achievement.

 (c)  The curriculum shall be planned to promote measurable abilities, as contained in the Test Plan for the Practical Nurse Licensing Examination, published by Council of State Boards of Nursing, Inc.

 (d)  The curriculum shall provide instruction in the following areas:

   (1)  Physical and biological sciences, including appropriate content from basic human anatomy and physiology as well as elementary principles of chemistry, microbiology, physics and normal nutrition.

   (2)  Social and behavioral sciences including psycho-social facts and principles basic to personal adjustment and to nursing practice as well as appropriate content on the family and development stages from birth to senescence.

   (3)  Concurrent or sequential theory and clinical experience in:

     (i)   The care of patients with simple nursing needs.

     (ii)   The care of patients with short-term nursing needs.

     (iii)   The care of patients with long-term nursing needs.

   (4)  Clinical experience, as provided in paragraph (3), in the care of men, women and children in a variety of age groups with health problems characteristic of the age group involved.

   (5)  Theory, as required in paragraph (3), including appropriate knowledge from diet therapy and pharmacology, as well as scientific facts and selected clinical concepts which are essential as a basis for nursing action and are applicable to patient care.

   (6)  Learning experiences, as required in paragraph (3), providing opportunities for the student to:

     (i)   Develop an awareness of the needs of patients.

     (ii)   Learn to plan and give nursing care to selected individuals in various nursing situations that are relatively free of complexity.

     (iii)   Learn to plan and give nursing care to a group of selected patients.

     (iv)   Learn to assist the professional nurse in more complex nursing situations.

   (7)  Content, as required in paragraph (3), drawn from information about ethical, moral and legal responsibilities of the practical nurse, current trends in nursing and health delivery systems and vocational development.

   (8)  Technical and clinical aspects of immunization, skin testing, the performance of venipuncture and the administration and withdrawal of intravenous fluids to the extent each function is an authorized function of an LPN under this chapter. An IV therapy course must include instruction in the following topics:

     (i)   Definition of IV therapy and indications.

     (ii)   Types of vascular access delivery devices.

     (iii)   Age-related considerations.

     (iv)   Legal implications for IV therapy.

     (v)   Anatomy and physiology.

     (vi)   Fluid and electrolyte balance.

     (vii)   Infusion equipment used in IV therapy.

     (viii)   Parenteral solutions and indications.

     (ix)   Infection control and safety.

     (x)   Insertion of peripheral short catheters.

     (xi)   Administration, maintenance and monitoring of peripheral IV therapy.

     (xii)   Complications and nursing interventions.

     (xiii)   Central and peripheral vascular devices.

     (xiv)   Administration, maintenance and monitoring of central and peripheral IV therapy.

     (xv)   Documentation.

     (xvi)   Patient education.

 (e)  The total curriculum shall include a minimum of 1500 hours offered within a time period of not less than 12 months. The Board recommends that a minimum of 40% of the total curriculum be theoretical and the remaining 60% be in appropriate clinical experience.

 (f)  Evening and night assignments shall be considered part of the curriculum only in terms of the objectives to be achieved and if supervision is provided by the nursing faculty. Learning experiences during evening and night hours shall be planned only after the termination of the first 4 months of the program.

 (g)  Total hours of theory and clinical experience should be planned on a 35-hour week basis.

 (h)  The curriculum shall be evaluated according to a plan developed by the faculty and shall include the following:

   (1)  A careful review of aspects of the educational program based on the stated philosophy and objectives.

   (2)  A continuous evaluation of instructional procedures, learning experiences and student progress.

   (3)  Opportunities for students to participate in self-evaluation of their own learning experiences.

   (4)  Performance of graduates on the State Board Test Pool Examination.

   (5)  Opinions of graduates regarding the adequacy of their nursing program.

   (6)  Evaluation of graduates by their employers.

   (7)  A record system in operation which will assist in the evaluation of the educational program.

Authority

   The provisions of this §  21.203 amended under section 506 of The Administrative Code of 1929 (71 P.S. §  186); and sections 8 and 17.6 of the Practical Nurse Law (63 P.S. § §  658 and 667.6).

Source

   The provisions of this §  21.203 amended July 1, 1983, effective July 2, 1983, 13 Pa.B. 2061; amended August 4, 1989, effective August 5, 1989, 19 Pa.B. 3281; amended August 24, 2012, effective August 25, 2012, 42 Pa.B. 5486. Immediately preceding text appears at serial pages (214458) to (214459).

§ 21.204. Changes in curriculum.

 (a)  Changes that are a departure from the requirements of the program and which shall be submitted to the Board for approval include the following:

   (1)  Changes in the objectives of the program which require alteration of the present curriculum or courses or which increase or decrease the length of the program.

   (2)  Reorganization of the entire curriculum.

   (3)  Changes in clinical facilities involving contractual agreements.

   (4)  Changes in administrative control.

 (b)  When a program change is contemplated, a plan shall be presented to the Board showing:

   (1)  Rationale for the change.

   (2)  Present program.

   (3)  Proposed changed program.

   (4)  Philosophy and objectives of the proposed program.

   (5)  Old and new master rotation or organizational curriculum plans.

   (6)  Program bulletin and any other pertinent information.

 (c)  Fifteen copies of the materials listed in subsection (b) shall be submitted at least 3 weeks prior to the Board meetings at which the matters are to be considered.

Authority

   The provisions of this §  21.204 issued under section 506 of The Administrative Code of 1929 (71 P.S. §  186); and section 8 of the Practical Nurse Law (63 P.S. §  658).

Source

   The provisions of this §  21.204 amended July 1, 1983, effective July 2, 1983, 13 Pa.B. 2061. Immediately preceding text appears at serial page (26504).

FACILITIES FOR ADMINISTRATION AND TEACHING


§ 21.211. Facility and resource requirements.

 (a)  The physical structures that serve the purpose of the practical nursing program and are available for student or faculty or both use include those that are provided in the immediate environment and also those that are off the school premises. Facilities and resources of the program shall include the following:

   (1)  Administrative and instructional and office personnel shall be provided with the appropriate and adequate space and equipment essential for attainment of the objectives of the program.

   (2)  The number and size of accessible classrooms, conference rooms and laboratories shall be sufficient to meet the needs of the program. The number and size of classrooms shall be determined by the maximum student enrollment.

     (i)   Educational facilities shall be attractive, adequately heated, lighted and ventilated.

     (ii)   Educational facilities shall be provided with the equipment and supplies necessary to meet the teaching and learning requirements of both students and teachers.

     (iii)   The curriculum outline and instructional methods utilized by the faculty shall be determinative in the selection and maintenance of the facilities needed in the individual practical nursing program.

 (b)  Concerning adequate storage space for general supplies and equipment. policies shall be in existence for the replacement of equipment, furnishings, and supplies.

 (c)  Library facilities and resources, which are planned and maintained to meet the specific needs of the student and the faculty shall be as follows.

   (1)  The physical equipment of the library shall include adequate lighting and ventilation, sufficient tables and comfortable chairs, space for proper display of library holdings and exhibits and appropriate work space for the librarian.

   (2)  Provision shall be made for adequate storage space to maintain the safety and security of the library materials and holdings.

   (3)  Library holdings shall include sufficient reference titles, periodicals and other educational materials, as well as supplementary aids to achieve the objectives of the program.

Source

   The provisions of this §  21.211 amended July 1, 1983, effective July 2, 1983, 13 Pa.B. 2061.

STUDENTS


§ 21.221. Selection and admission.

 (a)  Admission standards shall conform with the following:

   (1)  Policies and procedures related to the selection and admission of students are the responsibility of the individual program. Consideration shall be given to scholastic aptitude, academic achievement, personal qualities and physical and emotional health.

   (2)  Applicants shall have completed work equal to a standard high school course as evaluated by the Credentials Evaluation Division of the Pennsylvania Department of Education.

 (b)  The Board recommends that only one class be admitted per year. The number of candidates for each class shall be determined by the educational and clinical resources which the program can provide.

 (c)  Advanced standing shall conform with the following:

   (1)  The Board encourages practical nursing programs to thoughtfully review their respective curriculi to identify where opportunity can be provided for the recognition and validation of previous education and experience of prospective applicants. Advanced placement proposals developed may then be submitted for review and approval by the Board.

   (2)  Programs submitted shall be developed for either a specific, identified individual or for a theoretical group of individuals. The extent of the approval granted will be based on the nature and content of the program submitted.

§ 21.222. Student services.

 (a)  Health program. There shall be written objectives and policies for the health program.

 (b)  Program requirements. The health program shall include at least the following:

   (1)  Preentrance and periodic health examinations.

   (2)  Provisions for necessary immediate professional health care.

   (3)  An immunization policy.

   (4)  A policy addressing student absences due to illness which gives the student the opportunity to attain the learning objectives not achieved due to absences.

 (c)  Maintenance of health records. Appropriate cumulative student health records shall be maintained throughout the enrollment of the student.

 (d)  Student employment. When part-time student employment is permitted, written policies shall include the type of employment and conditions regulating the employment, such as health, academic load and scholastic progress and consideration of current Federal and State laws affecting employment. When students are employed in health agencies, they may not perform the functions normally assigned to a professional or practical nurse unless they are currently licensed. Students in this role cannot be assigned as charge nurse of a unit. Student employment shall be on a voluntary basis and not a requirement of the institution. Remuneration for employment shall be within the range of the salary scale for the position.

 (e)  Student housing. Policies concerning housing shall include the following:

   (1)  Adequate space, equipment and furnishings for each student, such as desk, chairs, proper lighting, ventilation and closet space.

   (2)  Safe and adequately maintained facilities directly related to personal hygiene and personal security measures which include appropriate supervision of housing facilities and periodic inspection of safety devices, such as fire extinguishers, housing exits and fire drills.

   (3)  Provision of facilities which promote recreational and social activities.

   (4)  Facilities for obtaining adequate, well-balanced meals.

 (f)  Counseling and guidance. The scope of the counseling program shall be clearly defined in accordance with the objectives of the program. A program shall includeacademic counseling, initiated by either faculty or students. Adequate provision shall be made for the student’s referral to or consultation with skilled counselors, psychiatrists, psychologists or religious advisors when profes-sional and personal assistance is needed for individual student problems.

 (g)  Financial aid. Policies and procedures relating to scholarships, loans and grants shall be developed within the framework of the philosophy of the controlling institution and defined in writing.

Authority

   The provisions of this §  21.222 issued under section 506 of The Administrative Code of 1929 (71 P.S. §  186); and section 8 of the Practical Nurse Law (63 P.S. §  658).

Source

   The provisions of this §  21.222 amended March 25, 1977, effective March 26, 1977, 7 Pa.B. 841; amended July 1, 1983, effective July 2, 1983, 13 Pa.B. 2061; amended November 15, 1991, effective November 16, 1991, 21 Pa.B. 5342; amended April 26, 1996, effective April 27, 1996, 26 Pa.B. 2005. Immediately preceding text appears at serial pages (210007) to (210008).

§ 21.223. Student’s rights.

 There shall be written specified policies relating to students’ rights and grievances with procedures for implementation.

Source

   The provisions of this §  21.223 adopted July 1, 1983, effective July 2, 1983, 13 Pa.B. 2061.

RECORDS


§ 21.231. Program records and record maintenance.

 A record system essential to the operation of the program shall be maintained. Records shall be kept in locked fire-proof files. A nursing faculty shall select record forms specifically for the practical nursing program which shall include the following:

   (1)  Student records. Student records shall conform with the following:

     (i)   Permanent record, on students admitted, including both clinical and theoretical experience and achievement shall be kept ad infinitum.

     (ii)   Health records shall be kept for 5 years following completion of the program.

   (2)  Faculty records. Faculty records shall conform with the following:

     (i)   ‘‘Display Portion’’ of current nursing license.

     (ii)   Records of preparation and experience, including college transcripts.

     (iii)   Current record of continuing education activities.

   (3)  Administrative records. Administrative records shall conform with the following:

     (i)   Affiliation agreements with cooperating agencies.

     (ii)   Minutes of meetings.

     (iii)   Annual reports.

     (iv)   Follow-up studies of graduates.

     (v)   Budgets.

     (vi)   Current written policies.

   (4)  Program bulletin. Program bulletins shall:

     (i)   Be comprehensive and current since they serve as contracts of agreement between the applicant or student and the program.

     (ii)   Include clearly defined refund policies governing all fees and tuition paid by the students.

Authority

   The provisions of this §  21.231 issued under section 506 of The Administrative Code of 1929 (71 P.S. §  186); and section 8 of the Practical Nurse Law (63 P.S. §  658).

Source

   The provisions of this §  21.231 amended July 1, 1983, effective July 2, 1983, 13 Pa.B. 2061. Immediately preceding text appears at serial pages (30278) to (30279).

§ 21.232. Records required to be filed in the Board office.

 (a)  An annual report of the practical nursing program shall be sent to the Board using the form supplied by the Board.

 (b)  Upon completion of the entire program a transcript or photocopy of the final record of the student shall be submitted along with the application for admission to the State Board Test Pool Examination. The transcript shall bear the impression of the school seal and signature of the nurse in charge of the program or authorized representative.

 (c)  A notarized list of nurses employed in the program shall be submitted by January 15 of each year. This list shall include the full name including maiden name, current address, license number and date of original employment in this Commonwealth.

Authority

   The provisions of this §  21.232 issued under section 506 of The Administrative Code of 1929 (71 P.S. §  186); and section 8 of the Practical Nurse Law (63 P.S. §  658).

Source

   The provisions of this §  21.232 amended July 1, 1983, effective July 2, 1983, 13 Pa.B. 2061. Immediately preceding text appears at serial page (30279).

§ 21.233. Custody of records.

 (a)  When a program closes, the controlling agency shall be responsible for the safekeeping of the records of its students; and official copies shall be made available upon request. If the controlling agency also closes, advice should be obtained from the Board concerning the permanent safekeeping and availability of the records of the practical nursing program.

 (b)  The Board shall be informed in writing concerning permanent placement of these records.

Authority

   The provisions of this §  21.233 issued under section 506 of The Administrative Code of 1929 (71 P.S. §  186); and section 8 of the Practical Nurse Law (63 P.S. §  658).

Source

   The provisions of this §  21.233 amended July 1, 1983, effective July 2, 1983, 13 Pa.B. 2061. Immediately preceding text appears at serial page (30279).

Cross References

   This section cited in 49 Pa. Code §  21.166 (relating to removal from approved list); and 49 Pa. Code §  21.173 (relating to discontinuance or interruption of a program of practical nursing).

§ 21.234. Access and use of records.

 (a)  Students shall have access to personal records as provided by Federal and State legislation.

 (b)  Information shall be released from a student’s record only in accordance with Federal and State law.

Authority

   The provisions of this §  21.234 issued under section 506 of The Administrative Code of 1929 (71 P.S. §  186); and section 8 of the Practical Nurse Law (63 P.S. §  658).

Source

   The provisions of this §  21.234 adopted July 1, 1983, effective July 2, 1983, 13 Pa.B. 2061.

Cross References

   This section cited in 49 Pa. Code §  21.166 (relating to removal from approved list).



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