Subchapter A. REGISTERED NURSES

§ 21.1. Definitions.

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

   Act—The Professional Nursing Law (63 P. S. § §  211—225.5), which establishes standards for nursing schools and the conduct of nursing programs.

   Approved—Approved by the Board.

   Board——The State Board of Nursing of the Commonwealth.

   Continuing education—An activity approved by the Board as a condition for renewal of licensure or certification for which proof of completion can be provided to the Board.

   Diagnosing—Identification of and discrimination between physical and psychosocial signs and symptoms essential to effective execution and management of the nursing regimen.

   Distance learning continuing education—Continuing education in which the individual participates in the educational activity by means of electronic media or through refereed journals, rather than in a classroom, laboratory or clinical setting where the faculty and participant are physically located in the same room.

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

   Human responses—Those signs, symptoms and processes which denote the interaction of the individual with an actual or potential health problem.

   Patient (includes residents and clients)—A person, other than a spouse or immediate family member, who receives professional services from a registered nurse, regardless of whether the nurse receives remuneration for the services.

   Practice of professional nursing—

     (i)   Diagnosing and treating human responses to actual or potential health problems through such services as case findings, health teaching, health counseling, provision of care supportive to or restorative of life and well-being, and executing medical regimens as prescribed by a licensed physician or dentist.

     (ii)   The term does not include acts of medical diagnosis or prescription of medical therapeutic or corrective measures, except as may be authorized by rules and regulations jointly promulgated by the State Board of Medicine and the Board, which rules and regulations will be implemented by the Board.

   Professional relationship—

     (i)   For a registered nurse not involved in providing mental health services, the relationship which shall be deemed to exist for a period of time beginning with the first professional contact or consultation between a registered nurse and a patient and ending with the patient’s discharge from or discontinuance of services by the nurse or by the nurse’s employer. The administration of emergency medical treatment or transitory trauma care will not be deemed to establish a professional relationship.

     (ii)   For a registered nurse involved in providing mental health services, the relationship which shall be deemed to exist for a period of time beginning with the first professional contact or consultation between the nurse and patient and ending 2 years after discharge from or discontinuance of services. For a patient who is a minor, a professional relationship shall be deemed to exist for 2 years or until 1 year after the age of majority, whichever is longer, after discharge from or discontinuance of services.

   Registered nurse—A nurse licensed under this subchapter to practice in this Commonwealth.

   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 a registered nurse 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 a 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 conduct that would constitute a sexual impropriety or sexual violation.

   Systematic evaluation plan—An organized, continuous analysis of all nursing education program components, such as curriculum, faculty, facilities, policies and outcome measures, that addresses standards or benchmarks to be achieved and establishes an action plan if those standards or benchmarks are not achieved.

   Treating—Selection and performance of those therapeutic measures essential to the effective execution and management of the nursing regimen and execution of the prescribed medical regimen.

   The provisions of this §  21.1 amended under section 2.1(k) of the Professional Nursing Law (63 P. S. §  212.1(k)).

 (a)  The Board administers the act by providing rules and regulations on standards for nursing schools and the conduct of the programs.

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

 (c)  The Board has the right to establish rules and regulations for the practice of nursing.

 (d)  The Board may suspend or revoke licenses for cause.

 (e)  The Board will approve basic nursing programs conducted in hospitals, colleges, universities; approve foreign exchange visitor programs; and promulgate a list of approved programs.

 (f)  The Board will approve applications for inactive status.

 (g)  The Board will regulate the practice of nursing.

 The Board will insure safe nursing services for the citizens of this Commonwealth. Embodied in this purpose are the following responsibilities:

   (1)  To establish safe standards for the preparation of registered and practical nurses in approved educational programs.

   (2)  To assure safe standards of nursing practice through examination and licensure of graduates of approved educational programs, through endorsement of registered and practical nurses from other jurisdictions, and through the regulation of the practice of nursing in this Commonwealth.

 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 and proceedings before the Board.

 (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 §  21.18(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 any 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.

   The provisions of this §  21.4a issued under section 2.1(k) of the Professional Nursing Law (63 P. S. §  212.1(k)).

 (a)  The following fees are charged by the Board:

 (b)  In addition to the examination and licensure fee of $35 prescribed in subsection (a), which is payable directly to the Board, a candidate for the registered nurse licensing examination shall also pay a fee of $40 to the National Council of the State Boards of Nursing to cover costs associated with the preparation and administration of the registered nurse licensing examination. Effective April 1994, or upon implementation of the computer adaptive examination, the fee paid directly to the National Council of the State Boards of Nursing or its designated agent is $88.

   The provisions of this §  21.5 issued under section 11.2(a) and (d) of The Professional Nursing Law (63 P. S. §  221.2(a) and (d)); amended under section 812 of The Administrative Code of 1929 (71 P. S. §  279.3a); section 11.2 of The Professional Nursing Law (63 P. S. §  221.2); sections 13.1 and 17.5 of the Practical Nurse Law (63 P. S. § §  663.1 and 667.5); and section 12 of The Professional Nursing Law (63 P. S. §  212).

   The provisions of this §  21.5 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 July 11, 2008, effective July 12, 2008, 38 Pa.B. 3796. Immediately preceding text appears at serial page (319560) to (319561).

 A registered nurse may form a professional corporation with other registered nurses or other health care practitioners who treat human ailments and conditions, and who are licensed to provide health care services in this Commonwealth without receiving a referral or supervision from another health care practitioner.

 (a)  A graduate registered nurse may only practice professional nursing under supervision and if the graduate registered 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 registered nurse is practicing. The Board may grant a temporary practice permit to a graduate registered nurse as follows:

   (1)  An individual who wishes to practice as a graduate registered nurse during the period from the date of completion of the educational program to the notification of the results of the licensing examination shall submit an application for a temporary practice permit for a graduate registered nurse on a form provided by the Board and remit the fee specified in §  21.5 (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 registered nurse shall:

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

     (ii)   Remit the fee specified in §  21.5.

     (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 registered 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 §  21.5.

     (iii)   Provide a detailed, written explanation of the reason 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 registered nurse license issued by another state, territory or possession of the United States or Canada (a currently-licensed registered 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 period in cases of illness or extreme hardship, as set forth in paragraph (5).

   (1)  A currently-licensed registered nurse who wishes to practice professional 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:

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

     (iii)   Remit the fee specified in §  21.5.

   (2)  An individual applying for a temporary practice permit for a currently-licensed registered 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. A list of Board-approved English proficiency examinations is available upon request to the Board. This information must 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 registered 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 the 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 must be submitted to the Board in English directly from the appropriate educational authorities. The applicant shall retain documentation of the submission of the request to provide to the Board upon request.

     (iii)   Submit the Commission on Graduates of Foreign Nursing Schools (CGFNS) application if the applicant is required to meet CGFNS requirements in § §  21.23(c) and 21.28(c) (relating to qualifications of applicant for examination; and licensure by endorsement) and retain documentation of the submission of the CGFNS application 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 registered nurse shall ensure that all documentation in support of the application for licensure is received by the Board no later than 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 registered nurse and who has complied with paragraphs (2)—(4) may request an extension of the individual’s temporary practice permit because of illness or extreme hardship by:

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

     (ii)   Remitting the fee specified in §  21.5.

     (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 must be submitted to the Board no less than 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).

   The provisions of this §  21.7 issued under section 2.1(k) of the Professional Nursing Law (63 P. S. §  212.1(k)).

   The provisions of this §  21.7 adopted May 19, 2006, effective May 20, 2006, 36 Pa.B. 2402.

RESPONSIBILITIES OF THE REGISTERED NURSE

§ 21.11. General functions.

 (a)  The registered nurse assesses human responses and plans, implements and evaluates nursing care for individuals or families for whom the nurse is responsible. In carrying out this responsibility, the nurse performs all of the following functions:

   (1)  Collects complete and ongoing data to determine nursing care needs.

   (2)  Analyzes the health status of the individuals and families and compares the data with the norm when possible in determining nursing care needs.

   (3)  Identifies goals and plans for nursing care.

   (4)  Carries out nursing care actions which promote, maintain and restore the well-being of individuals.

   (5)  Involves individuals and their families in their health promotion, maintenance and restoration.

   (6)  Evaluates the effectiveness of the quality of nursing care provided.

 (b)  The registered nurse is fully responsible for all actions as a licensed nurse and is accountable to clients for the quality of care delivered.

 (c)  The registered nurse may not engage in areas of highly specialized practice without adequate knowledge of and skills in the practice areas involved.

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

   The provisions of this §  21.11 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677. Immediately preceding text appears at serial page (9690).

   Nursing Care Actions

   Where nurse had disconnected patient from respirator to perform unauthorized evaluation of spontaneous respiration, failed to perform external cardiac resuscitation, etc., subsection (a)(2) and (4) was not unconstitutionally vague with respect to nurse’s conduct since nurse’s actions were ‘‘unauthorized, contra-indicated and a serious deviation from acceptable nursing practice.’’ Rafferty v. State Board of Nurse Examiners, 505 A.2d 357 (Pa. Cmwlth. 1986).

   A nurse violated subsection (a)(4) by leaving patient experiencing rare premature ventricular contractions failing to call code team when so instructed and failing to attach cardiac monitor strip to patient’s chart, but such actions did not constitute violations of 49 Pa. Code §  21.13 which merely establishes limitations on who may perform resuscitation and respiration and circumstances under which those procedures may be performed. State Board of Nurse Examiners v. Rafferty, 499 A.2d 289 (Pa. 1985).

   Nurse violated subsection (a)(4) by disconnecting comatose patient from respirator to check for spontaneous respirations, leaving patient without oxygen for 30 seconds, when there had been no special circumstances such as patient displaying signs of becoming conscious. State Board of Nurse Examiners v. Rafferty, 499 A.2d 289 (Pa. 1985).

   A nurse did not wilfully violate subsection (a)(4) in lightly slapping the hand of a patient who had a grip on her arm, since the nurse had to have the use of her arm in order to keep the patient from falling and other attempts to make the patient loosen his grip had failed. Leukhardt v. State Board of Nurse Examiners, 403 A.2d 645 (Pa. Cmwlth. 1979).

   Vagueness

   Where the Board of Nurse Examiners found no willful, repeated, deliberate or knowing violation, but merely acts which were deemed to deviate from accepted practice and errors of judgment, the court held that there was no violation of subsection (a) (1) and (4). Rafferty v. State Board of Nurse Examiners, 471 A.2d 1339 (Pa. Cmwlth. 1984).

   Willful Violations

   Board of Nurse Examiners need not prove specific intent to violate the statute or regulations in order to establish a ‘‘willful’’ violation. State Board of Nurse Examiners v. Rafferty, 499 A.2d 289 (Pa. 1985).

 Performing of venipuncture and administering and withdrawing intravenous fluids are functions regulated by this section, and these functions may not be performed unless:

   (1)  The procedure has been ordered in writing for the patient by a licensed doctor of the healing arts.

   (2)  The registered nurse who performs venipunctures has had instruction and supervised practice in performing venipunctures.

   (3)  The registered nurse who administers parenteral fluids, drugs or blood has had instruction and supervised practice in administering parenteral fluids, blood or medications into the vein.

   (4)  A list of medications which may be administered by the registered nurse is established and maintained by a committee of physicians, pharmacists and nurses from the employing agency or the agency within whose jurisdiction the procedure is being performed if no employing agency is involved.

   (5)  The intravenous fluid or medication to be administered is the fluid or medication specified in the written order.

   (6)  The blood is identified as the blood ordered for the patient.

   (7)  An accurate record is made concerning the following:

     (i)   The time of the injection.

     (ii)   The medication or fluid injected.

     (iii)   The amount of medication or fluid injected.

     (iv)   Reactions to the fluid.

   The provisions of this §  21.12 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829. Immediately preceding text appears at serial pages (47492) and (44732).

 External cardiac resuscitation and artificial respiration, mouth-to-mouth, are procedures regulated by this section, and these functions may not be performed unless both of the following provisions are met:

   (1)  External cardiac resuscitation and artificial respiration, mouth-to-mouth, shall only be performed by a nurse on an individual when respiration or pulse, or both, cease unexpectedly.

   (2)  A nurse may not perform external cardiac resuscitation and artificial respiration, mouth-to-mouth, unless the nurse has had instruction and supervised practice in performing the procedures.

   The provisions of this §  21.13 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677. Immediately preceding text appears at serial page (9691).

 (a)  A licensed registered nurse may administer a drug ordered for a patient in the dosage and manner prescribed.

 (b)  A licensed registered nurse, responsible for administering a drug, may supervise a graduate nurse or a nursing student in an approved nursing education program in the administration of the drug. In this section, ‘‘supervise’’ means the licensed registered nurse is physically present in the area or unit where the student or unlicensed graduate is practicing. This definition is not intended to limit in any way the practice of practical nursing as defined in the Practical Nurse Law (63 P. S. § §  651—667).

   The provisions of this §  21.14 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).

   The provisions of this §  21.14 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended November 4, 1977, effective November 5, 1977, 7 Pa.B. 3263; amended December 19, 2003, effective December 20, 2003, 33 Pa.B. 6219. Immediately preceding text appears at serial pages (261719) to (261720).

 The use of monitoring, defibrillating or resuscitating equipment, or a combination of the three, hereinafter called ‘‘therapy,’’ is a proper function of a registered nurse and is a function regulated by this section; the function may not be performed unless all of the following provisions are met:

   (1)  The employer, through written policy, has agreed that the registered nurse may administer the therapy.

   (2)  A committee of licensed physicians and nurses within the employing agency has established written criteria prescribing when the therapy shall be administered by a registered nurse either in the presence or absence of the attending physician.

   (3)  The techniques for administering the therapy have been established by a committee of licensed physicians and registered nurses within the employing agency.

   (4)  The registered nurse has had instruction and supervised practice in administering the therapy.

   (5)  The registered nurse has demonstrated competency in administering the therapy to the satisfaction of the employer.

   (6)  The registered nurse shall have employed the prescribed techniques in administering the therapy in accordance with the established criteria.

   The provisions of this §  21.15 amended November 19, 1970, effective November 20, 1970, 1 Pa.B. 804; amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677. Immediately preceding text appears at serial pages (9691) to (9692).

 (a)  Immunization and skin testing is a proper function of a registered nurse and is a function regulated by this section, and the function may not be performed unless all of the following conditions are met:

   (1)  A written order has been issued by a licensed physician. The order may be a standing order applicable to individuals or groups.

   (2)  The policies and procedures under which the registered nurse 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. These written policies and procedures shall be available to the nurse. The committee shall also perform the following functions:

     (i)   Identify the immunizing and skin testing agents which the nurse may administer.

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

     (iii)   Outline medical principles governing the treatment of possible anaphylactic reactions.

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

 (b)  Following skin testing, the size of the induration or its absence may be observed and recorded by the properly instructed registered nurse.

 The administration of anesthesia is a proper function of a registered nurse and is a function regulated by this section; this function may not be performed unless:

   (1)  The registered nurse has successfully completed the educational program of a school for nurse anesthetists accredited by the Council on Accreditation of Education Programs of Nurse Anesthesia of the American Association of Nurse Anesthetists.

   (2)  The registered nurse is certified as a Registered Nurse Anesthetist by the Council on Certification or on Recertification of Nurse Anesthetists of the American Association of Nurse Anesthetists.

   (3)  The certified nurse anesthetist is authorized to administer anesthesia in cooperation with a surgeon or dentist. The nurse anesthetist’s performance shall be under the overall direction of the chief or director of anesthesia services. In situations or health care delivery facilities where these services are not mandatory, the nurse anesthetist’s performance shall be under the overall direction of the surgeon or dentist responsible for the patient’s care.

   (4)  Except as otherwise provided in 28 Pa. Code §  123.7(c) (relating to dental anesthetist and nurse anesthetist qualifications), when the operating/anesthesia team consists entirely of nonphysicians, such as a dentist and a certified registered nurse anesthetist, the registered nurse anesthetist shall have available to her by physical presence or electronic communication an anesthesiologist or consulting physician of her choice.

   (5)  A noncertified registered nurse who has completed an approved anesthesia program may administer anesthesia under the direction of and in the presence of the chief or director anesthesia services or a Board certified anesthesiologist until the announcement of results of the first examination given for certification for which she is eligible. If a person fails to take or fails to pass the examination, the person shall immediately cease practicing as a nurse anesthetist. If the applicant, due to extenuating circumstances, cannot take the first scheduled examination following completion of the program, the applicant shall appeal to the Board for authority to continue practicing.

 (b)  For purposes of this section, ‘‘cooperation’’ means a process in which the nurse anesthetist and the surgeon work together with each contributing an area of expertise, at their individual and respective levels of education and training.

   The provisions of this §  21.17 adopted October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2827. Immediately preceding text appears at serial page (81100).

   Willful Violation

 (a)  A registered nurse shall:

   (1)  Undertake a specific practice only if the registered 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 registered 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 registered 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)  A registered nurse who fails to comply with an obligation or prohibition under this section is subject to disciplinary and corrective measures under section 14 of the act (63 P. S. §  224).

 (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 13(b) of the act (63 P. S. §  223(b)) upon a nurse found to have engaged in conduct constituting a sexual impropriety or sexual violation.

   The provisions of this §  21.18 amended under section 2.1(k) of the Professional Nursing Law (63 P. S. §  212.1(k)).

   The provisions of this §  21.18 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 (261722) and (209951).

 When the Board is empowered to take disciplinary or corrective action against a 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 14.1 of the act (63 P. S. §  224.1).

   The provisions of this §  21.18a issued under section 2.1(k) of the Professional Nursing Law (63 P. S. §  212.1(k)).

   The provisions of this §  21.18a adopted September 8, 2000, effective September 9, 2000, 30 Pa.B. 4730.

LICENSES

§ 21.21. Application for examination.

 (a)  An application for the licensing examination without transcript may be submitted during the last term of the nursing program. The applicant will be scheduled for the subsequent examination.

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

 (c)  A copy of the transcript validating program completion shall be filed at least 2 weeks prior to the testing dates.

 (d)  The Board will not proctor an applicant for another state board. The Board will not permit an applicant for Commonwealth licensure to be proctored by another state board.

   The provisions of this §  21.21 issued under: section 506 of The Administrative Code of 1929 (71 P. S. §  186); and section 1 of The Professional Nursing Law (63 P. S. §  212.1); amended under section 812.1 of The Administrative Code of 1929 (71 P. S. §  279.3a).

 (a)  The Board conducts licensing examinations at least twice a year.

 (b)  A list of examination dates and locations are published annually.

   The provisions of this §  121.22 issued under section 506 of The Administrative Code of 1929 (71 P. S. §  186); and section 1 of The Professional Nursing Law (63 P. S. §  212.1).

 (a)  An applicant shall pass a written examination as provided by the Board.

 (b)  Additional applicant qualifications are contained in sections 5 and 6 of the act (63 P. S. § §  215 and 216).

 (c)  Nurses educated in schools of nursing outside of the United States or Canada shall have successfully completed the English language and nursing practice proficiency examination of the Commission on Graduates of Foreign Nursing Schools. A school of nursing located outside of the United States or Canada will be considered a foreign nursing school.

   The provisions of this §  21.23 issued under section 506 of The Administrative Code of 1929 (71 P. S. §  186); and section 1 of The Professional Nursing Law (63 P. S. §  212.1).

   The provisions of this §  21.23 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended May 22, 1981, effective May 23, 1981, 11 Pa.B. 1802; amended April 29, 1983, effective April 30, 1983, 13 Pa.B. 1439. Immediately preceding text appears at serial pages (60509) and (61942).

 The candidate for licensure shall achieve a minimum score as mandated by the Board.

   The provisions of this §  21.24 issued under section 506 of The Administrative Code of 1929 (71 P. S. §  186); and section 1 of The Professional Nursing Law (63 P. S. §  212.1).

 (a)  A candidate shall submit the required fee in the form of a check for reexamination.

 (b)  [Reserved].

 (c)  The candidate may take the licensing examination as many times as necessary to complete licensure process.

 (d)  A request to retake an examination for the purpose of elevating a passing score will not be granted.

   The provisions of this §  21.25 issued under section 506 of The Administrative Code of 1929 (71 P. S. §  186); and section 1 of The Professional Nursing Law (63 P. S. §  212.1).

 If 40% or more of the first-time examinees of a school of nursing writing the examination in this Commonwealth fail the examination, the school will be placed on provisional approval status. The Board may consider additional documented statistics concerning the examination scores received in other states by Commonwealth graduates in determining the status of the school.

 The candidate may practice as a graduate nurse until the licensing examination is passed subject to the following:

   (1)  Unless licensed, the candidate may be employed as a graduate nurse for 1 year only from the date of completion of a nursing program except in the case where special permission is granted by the Board due to extenuating circumstances. In such a case the candidate shall present validating documentation.

   (2)  The candidate shall practice under the supervision of an experienced registered nurse. ‘‘Supervision,’’ as used in this paragraph, means that the registered nurse is physically present in the area or unit where the unlicensed candidate is practicing.

 (a)  A registered nurse who has graduated from an approved nursing program in another state or territory of the United States or Canada and who is licensed by writing the National Council Licensure Examination in another jurisdiction of the United States or Canada may be granted licensure in this Commonwealth by endorsement of the original licensing board.

 (b)  An applicant for licensure in this Commonwealth by endorsement shall meet the requirements as stated in the act.

 (c)  A registered nurse who has graduated from a nursing program in a country or territory outside of the United States or Canada and who is licensed by completing the National Council Licensure Examination in another jurisdiction of the United States or Canada may be granted licensure in this Commonwealth without examination if the applicant’s program of study is deemed equivalent to the program of study required in this Commonwealth at the time the program was completed. The Board will base equivalency upon an evaluation performed by the Commission on Graduates of Foreign Nursing Schools (CGFNS) as to the foreign nursing program.

 (d)  An applicant for 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 §  21.30a(1) or (2) (relating to continued competency).

   The provisions of this §  21.28 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829; amended March 22, 1991, effective March 23, 1991, 21 Pa.B. 1165; amended June 18, 1993, effective June 19, 1993, 23 Pa.B. 2827; amended November 28, 1997, effective November 29, 1997, 27 Pa.B. 6210. Immediately preceding text appears at serial page (209954).

 (a)  The Board will assign registered nurses to one of the following license expiration dates:

   (1)  April 30 in the even-numbered years.

   (2)  October 31 in the even-numbered years.

   (3)  April 30 in the odd-numbered years.

   (4)  October 31 in the odd-numbered years.

 (b)  Notice of the renewal period of a license will be sent to each active licensee prior to the expiration date of the licensee’s license.

 (c)  The applicant for license renewal may complete and submit an application online or may mail a completed application form to the Board’s administrative office. When applying for licensure renewal, a professional nurse shall:

   (1)  Complete and submit the renewal application form, including disclosing any license to practice nursing or any allied health profession in any other state, territory, possession or country.

   (2)  Pay the biennial renewal of licensure fee in §  21.5 (relating to fees).

   (3)  Beginning with the license period commencing on July 12, 2010, verify that the professional nurse has complied with the continuing education requirements mandated by section 12 of the act (63 P. S. §  222) during the biennial period immediately preceding the application for renewal in accordance with § §  21.131—21.134 (relating to continuing education). School nurses, who as certified education specialists are required to obtain continuing professional education under the Public School Code of 1949 (24 P. S. § §  1-100—27-2702), shall verify by signed statement that the school nurse has complied with the continuing education requirements for certification by the Department of Education.

   (4)  Disclose any discipline imposed by a state licensing board on any nursing or allied health profession license or certificate in the previous biennial period and any 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.

 (d)  When communicating with the Board, licensees shall identify themselves by full name, current address and license number.

   The provisions of this §  21.29 amended under sections 2.1 and 11 of The Professional Nursing Law (63 P. S. § §  212.1 and 221).

   The provisions of this §  21.29 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829; amended March 22, 1985, effective March 23, 1985, 15 Pa.B. 1082; amended July 11, 2008, effective July 12, 2008, 38 Pa.B. 3796. Immediately preceding text appears at serial pages (319571) to (319572).

 (a)  A nurse educated and licensed in another country other than Canada may not be employed as a nurse in this Commonwealth until the requirements for Commonwealth licensure have been met.

 (b)  A graduate nurse licensed in another country may participate in an approved exchange-visitor program or in an accreditation graduate program in nursing for a period of 2 years without licensure and compensation in this Commonwealth.

 (c)  An applicant coming from a country outside of the United States or Canada who is from a nondegree granting institution shall obtain a Certificate of Preliminary Education through the Department of Education.

 A nurse whose license has lapsed for 5 years or longer or whose license has been placed on inactive status for 5 years or longer, as permitted in section 11(b) of the act (63 P. S. §  221(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 as set forth in §  21.5 (relating to fees).

   (2)  Successfully completing a Board-approved reactivation program, which includes as a prerequisite to completion the passing of a Board-approved nursing achievement examination.

   (3)  Providing evidence to the Board that the applicant has practiced nursing in another jurisdiction at some period of time within the last 5 years under a current license during that time.

   The provisions of this §  21.30a adopted June 18, 1993, effective June 19, 1993, 23 Pa.B. 2827.

   This section cited in 49 Pa. Code §  21.28 (relating to licensure by endorsement); and 49 Pa. Code §  21.602 (relating to volunteer license).

APPROVAL OF SCHOOLS OF NURSING

§ 21.31. Surveys; list of approved schools.

 (a)  Survey visits are made of basic nursing programs conducted in hospitals, colleges or universities of exchange visitor programs and of cooperating agencies. In this section, ‘‘cooperating agency’’ means an educational institution or health care delivery system which cooperates with the controlling institution. The survey report is presented to the Board and a written report of recommendations or requirements, or both, is sent to the school, college or university.

 (b)  Classified lists of approved schools of nursing and of exchange visitor programs are compiled and published annually and are made available for distribution.

 (c)  A list of approved cooperating agencies that provide educational programs for schools of nursing is compiled and published annually and is made available for distribution.

 Nursing schools in this Commonwealth are approved to effectuate the following:

   (1)  Safeguard the preparation of nurses and assure safe standards of nursing practice in this Commonwealth.

   (2)  Stimulate and maintain continued growth and improvement of nursing education in this Commonwealth.

   (3)  Guide prospective students in the selection of approved schools which offer adequate resources for sound basic nursing education.

   (4)  Assure the graduates of nursing programs of eligibility for admission to examination for licensure.

   (5)  Assist graduates of schools of nursing in this Commonwealth to qualify for licensure by endorsement in other jurisdictions.

 (a)  Initial. The Board may grant initial approval to new schools, with evidence that acceptable standards are being met, for a period of time necessary to evaluate the results of the licensing examination taken by the first graduates.

 (b)  Full. The Board will place on full approval those schools which attain and maintain the acceptable standards and adhere to the policies and regulations of the Board considered essential for a sound program of nursing education.

 (c)  Provisional. The Board may place on provisional approval a school not meeting the acceptable standards. A period of 2 years will be the maximum time allowed for the correction of deficiencies resulting in provisional approval. If the standards are not met within this designated time, the school will be removed from the approved list.

   The provisions of this §  21.33 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829. Immediately preceding text appears at serial page (30245).

 The Board will give sufficient notification of intent of removal from the approved list and provide an opportunity for school officials to show cause as to why approval should not be withdrawn.

   The provisions of this §  21.34 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829. Immediately preceding text appears at serial pages (30245) to (30246).

DISCONTINUANCE OF A SCHOOL OF NURSING

§ 21.41. Notification; completion of program; records.

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

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

 (c)  If a program is discontinued, it is the responsibility of the controlling institution 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 classes until completion. If the program is continued until completion, approved and qualified instruction shall be assured. A controlling institution is a university, college or hospital which conducts programs of education in nursing.

 (d)  The controlling institution has the legal responsibility to make provision for permanent retention of student and graduate records in conformity of §  21.125 (relating to custody of records).

   The provisions of this §  21.41 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829. Immediately preceding text appears at serial page (30246).

   This section cited in 49 Pa. Code §  21.364 (relating to removal from approved list; discontinuance of CRNP program).

APPROVED PROGRAMS OF NURSING

§ 21.51. Establishment.

 (a)  A nursing education program shall be developed under the leadership of a registered nurse as follows:

   (1)  A nursing education program may be developed under the authority of a regionally accredited university or college and will be known as a degree-granting nursing education program.

   (2)  A nursing education program may be developed under the authority of a hospital approved by the Joint Commission on Accreditation of Hospitals and will be known as a diploma nursing education program.

   (3)  A Board-approved diploma nursing education program may transition to a degree-granting nursing education program under the authority of a university or college pursuing regional accreditation and will be known as a program in transition.

 (b)  A nursing education program may be developed only if there is an adequate faculty and adequate clinical facilities and the philosophy of the parent institution encompasses dual programs of education.

 (c)  Prior to establishment or transition, a nursing education program shall:

   (1)  Complete a feasibility study which includes:

     (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 recourses for program implementation based on the projected enrollment and faculty. In viewing the clinical resources, the study must speak to other nursing education programs that share the teaching facilities identified in the study.

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

     (iv)   Actual cost of the program including faculty needed, clinical teaching resources, education supplies, office supplies, and the like, and sufficient evidence of stable financial support.

   (2)  Submit 18 copies of the feasibility study to the Board for approval.

   (3)  Employ the nurse administrator of the educational unit at least 12 months prior to the intended admission date of students. Board approval of the nurse administrator’s credentials shall be obtained prior to the appointment. For a program in transition, the nurse administrator may serve as administrator of both the degree-granting and diploma nursing education program during the transition period.

   (4)  Submit 18 copies of the tentative planned education program to the Board. For degree-granting and diploma nursing education programs, the submission shall be made at least 8 months prior to the intended admission date of students. For a program in transition, the submission shall be made at least 3 months prior to the intended admission date of students.

   (5)  Employ the teaching faculty at least 1 semester before the initiation of their teaching responsibilities.

 (d)  Change of ownership shall be processed as the establishment of a new program.

 (e)  The planned educational program must include:

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

   (2)  Administrative structure and functions of the nursing school.

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

   (4)  Statement of the philosophy, purposes and objectives of the program.

   (5)  Proposed curriculum design based on sound educational concepts and including detailed course descriptions and identification of clinical practice.

   (6)  Admission policies.

   (7)  Educational standards.

   (8)  Copy of proposed budget projected for a minimum of 5 years.

   (9)  Copies of written agreements with cooperating agencies and facilities to be used in the program.

 (f)  A program in transition shall submit the following to the Board with the program’s feasibility study:

   (1)  A copy of the certificate of authority to operate a degree-granting institution from the Department of Education.

   (2)  Documentation of the university or college’s pursuit of regional accreditation.

   (3)  Documentation that the diploma program has maintained full approval status under §  21.33 (relating to types of approval) for at least 3 years prior to the intended date for admission of students.

 (g)  A program in transition shall:

   (1)  Submit an annual report detailing the progress of the transition to the Board. If requested by the Board’s educational advisor, a program in transition shall appear before the Board to respond to questions or concerns that arise from the annual progress report.

   (2)  Be subject to a site review by the Board’s education advisor after the first class has been awarded degrees and the results of the licensing examination taken by the first class are available.

   (3)  Continue on initial approval under §  21.33(a) until the university or college has obtained full regional accreditation.

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

   The provisions of this §  21.51 amended under sections 2.1(k) and 6.1 of the Professional Nursing Law (63 P. S. § §  212.1(k) and 216.1).

   The provisions of this §  21.51 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829; amended December 2, 2005, effective December 3, 2005, 35 Pa.B. 6527. Immediately preceding text appears at serial pages (209959) to (209960).

ORGANIZATION AND ADMINISTRATION OF NURSING PROGRAMS

§ 21.61. Baccalaureate and associate degree programs: organizational requirements.

 (a)  The educational unit in nursing shall be established as a department, division, school or college of the controlling institution in accordance with the structural plan of the institution.

 (b)  Relationships with central administrative officers, interrelationships among other disciplines and services of the institution and representation on institutional councils and committees for faculty of the educational unit in nursing shall be consistent with the interaction and responsibilities accorded to other faculty members of the institution.

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

 (d)  Policies in effect for faculty members of the educational unit in nursing shall be those in effect for faculty members throughout the controlling institution, except where specified otherwise in this chapter.

 (e)  The educational unit in nursing shall have administrative authority and responsibility consonant with the general policies of the controlling institution.

 (f)  The resources, facilities and services of the controlling institution shall be available to and used by the educational unit in nursing and shall be adequate to meet the needs of the faculty and the students.

 (g)  Cooperating agencies shall be subject to the following provisions:

   (1)  Agreements to utilize field agencies outside the structural control of the controlling institution shall be initiated by the educational unit in nursing.

   (2)  Cooperating agencies or services selected by the school shall be approved by the appropriate State and National bodies, if such exist.

   (3)  The agreement between the educational unit in nursing and the cooperating agency shall be developed jointly, recorded in writing, reviewed periodically by both parties, revised as occasion requires and consistently adhered to by those responsible for implementing the provisions.

   (4)  The agreement shall insure full control of student education by the faculty of the program; faculty shall have the freedom to teach and guide students and to select appropriate learning experiences in consultation with designated members of the agency staff.

   (5)  The field agencies selected for use shall have the quality and variety of resources for planned learning experiences needed for the program of the educational unit in nursing.

   (6)  Approval by the Board shall be obtained before the educational unit in nursing may utilize a new field agency for learning experiences. An Agency Data form, provided by the Board, shall be submitted for each new field agency used for the first time.

 (h)  The faculty of the educational unit in nursing shall conduct planned periodic evaluation of its organization and administration.

 (a)  The nursing school shall be established as an educational unit of the governing body.

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

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

 (d)  The authority and the administrative responsibility for the school shall be delegated by the governing body to the director of the school.

 (e)  The faculty shall formulate policies that relate to the operation of the school.

 (f)  Approval by the Board shall be obtained before the educational unit in nursing may utilize a cooperating agency or a new field agency for learning experiences. An Agency Data form, provided by the Board, shall be submitted for each new cooperating agency and field agency.

 (a)  Cooperating agencies within this Commonwealth shall be subject to the following:

   (1)  The agreement between the educational unit in nursing and the cooperating agency shall be developed jointly, recorded in writing, reviewed periodically by both parties, revised as occasion requires and consistently adhered to by those responsible for implementing the provisions.

   (2)  Cooperating agencies on the approved list shall submit changes on curriculum content to the Board for approval before schools are notified of the changes.

 (b)  Cooperating agencies outside of this Commonwealth shall be subject to the following:

   (1)  The state board of nursing of the state in which the cooperating agency is located shall be contacted to determine the approval status of that agency in that state. Only fully approved programs may be considered.

   (2)  The school wishing to establish agreements with a cooperating agency shall initiate meetings with the proposed cooperating agency to determine:

     (i)   Compatibility of the educational philosophy and objectives of the cooperating agency with those of the parent school.

     (ii)   Effectiveness with which the planned program of the cooperating agency can be utilized as a part of the total educational program of the school.

     (iii)   Quality of the faculty of the cooperating agency.

     (iv)   Ability of the cooperating agency to absorb an additional affiliating school.

   (3)  Following the exploratory meetings, the school shall submit written notification of intent to establish an affiliation with the cooperating agency for Board approval. The following shall accompany the letter of intent:

     (i)   A copy of the master curriculum plan of the school indicating the placement of the proposed program.

     (ii)   A copy of the course syllabus offered by the cooperating agency.

     (iii)   Faculty biographical forms on all faculty in the cooperating agency.

     (iv)   One copy of the annual report form required by the Board, completed by the cooperating agency.

     (v)   A copy of the agreement or contract between the cooperating agency and the affiliating school.

     (vi)   A list of affiliating schools utilizing the cooperating agency.

 (c)  A cooperating agency providing faculty and instruction for clinical nursing courses shall be responsible for submitting 15 copies of proposed curriculum changes to the Board prior to the announcement of change to the affiliating school.

 (d)  Diploma schools of nursing utilizing their own faculties shall be subject to the following provisions:

   (1)  Agreements to utilize field agencies outside the structural control of the controlling institution shall be initiated by the school of nursing.

   (2)  Cooperating agencies or services selected by the school shall be approved by the appropriate State and National bodies, if such exist.

   (3)  The agreement between the school of nursing and the cooperating agency shall be developed jointly, recorded in writing, reviewed periodically by both parties, revised as occasion requires and consistently adhered to by those responsible for implementing the provisions.

   (4)  The agreement shall insure full control of student education by the faculty of the program. The faculty shall have the freedom to teach and guide students and to select appropriate learning experiences in consultation with designated members of the agency staff.

   (5)  The field agencies selected for use shall have the quality and variety of resources for planned learning experiences needed for the purpose of the program of the school of nursing.

   The provisions of this §  21.63 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829. Immediately preceding text appears at serial pages (30249) to (30250).

ADMINISTRATIVE AND INSTRUCTIONAL PERSONNEL

§ 21.71. Nurse administrator, faculty and staff requirements.

 (a)  A nursing education program shall employ a sufficient number of qualified faculty, faculty assistants, allied faculty and staff to accomplish the objectives of the curriculum and the systematic evaluation plan. The minimum faculty and staff requirements are as follows:

   (1)  Full-time nurse administrator.

   (2)  Full-time faculty members in the areas of practice encompassed within the curriculum.

   (3)  Additional faculty members as needed.

   (4)  Allied faculty members as needed.

   (5)  Adequate personnel to provide program support services, including administrative, clerical, library, admissions, financial aid and student services.

 (b)  The nurse administrator’s credentials shall be submitted to the Board for approval. The nurse administrator’s qualifications are as follows:

   (1)  The nurse administrator of a baccalaureate degree nursing education program shall hold at least one graduate degree in nursing. The nurse administrator shall hold an earned doctoral degree or have a specific plan for completing doctoral preparation within 5 years of appointment. The nurse administrator shall have experience in nursing practice, nursing education and administration. A professional nurse who does not hold at least one graduate degree in nursing, but who has experience in nursing practice, nursing education and administration may be considered on an individual basis.

   (2)  The nurse administrator of an associate degree or diploma program shall hold at least one graduate degree in nursing. The nurse administrator shall have experience in nursing practice, nursing education and administration. A professional nurse who does not hold at least one graduate degree in nursing, but who has experience in nursing practice, nursing education and administration may be considered on an individual basis.

   (3)  The length of appointment of an interim or acting nurse administrator of a nursing education program may not exceed 1 year.

   (4)  The nurse administrator shall hold either a temporary practice permit to practice professional nursing or be currently licensed as a professional nurse in this Commonwealth.

 (c)  Faculty qualifications are as follows:

   (1)  Faculty members teaching required nursing education courses shall hold at least one graduate degree in nursing, shall be currently licensed as professional nurses in this Commonwealth, and shall have expertise in their areas of instruction.

   (2)  Faculty members without a graduate degree in nursing shall be designated faculty assistants. Faculty assistants shall be currently licensed as professional nurses in this Commonwealth. Faculty assistants may teach required nursing education courses only when fully qualified faculty are not available and shall teach under the direct guidance of a faculty member qualified as set forth in paragraph (1). Faculty assistants shall have a baccalaureate degree in nursing and shall give evidence of a plan for obtaining a graduate degree in nursing. A person may teach as a faculty assistant in a nursing education program in this Commonwealth for a maximum cumulative period of 5 years.

   (3)  Faculty members without a degree in nursing, but who hold at least one graduate degree in a subject area pertinent to their area of teaching, shall be designated as allied faculty members. Allied faculty members may teach basic sciences or specialized areas of health care practice.

   (4)  Faculty employed to teach dietetics-nutrition shall be currently licensed to practice dietetics-nutrition in this Commonwealth.

   (5)  An individual who enhances faculty-directed clinical learning experiences by guiding selected clinical activities shall be designated as a clinical preceptor. A clinical preceptor shall hold a current license to practice professional nursing in the state of the clinical experience.

     (i)   Faculty shall have input into the selection of preceptors.

     (ii)   Faculty shall retain responsibility for planning and evaluating student learning experiences when students are engaged in clinical activities with a preceptor.

     (iii)   If a faculty member is not physically present in the area in which students are practicing, a faculty member shall be immediately available by telephone or other means of telecommunication when students are engaged in clinical activities with a preceptor.

 (d)  Program support personnel shall be qualified by education and experience to serve in the capacity in which they are employed.

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

 (b)  Policies, including personnel policies in effect for nursing faculty, must be those in effect for faculty members throughout the controlling institution except where specified otherwise in this chapter.

 (c)  Functions and responsibilities of each faculty member must be defined in writing.

 (d)  Teaching hours and additional duties of nurse faculty must be consistent with the policies of the controlling institution.

 (e)  The nurse administrator and nursing faculty shall be afforded the time and opportunity to engage in leadership activities within their profession commensurate with their responsibilities.

 (f)  There shall be a planned and active faculty development program designed to meet the needs of the faculty. Faculty members shall maintain a record of participation in continuing education, professional self-development and other activities that promote the maintenance of expertise in their respective areas of teaching.

 (g)  Faculty assistants shall maintain a record of their activities leading to the completion of a graduate degree in nursing which shall be submitted to the Board upon request.

 (a)  There shall be a nursing faculty organization appropriate to its size and in harmony with other educational units within the controlling institution.

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

 (c)  Members of the faculty shall participate in the activities of the faculty organization in ways consistent with their rank and responsibilities.

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

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

 (a)  Rules and regulations of the faculty organization shall be in writing and shall be revised by the faculty periodically.

 (b)  The committee structure shall be consistent with the size and needs of the faculty.

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

   The provisions of this §  21.77 reserved October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677. Immediately preceding text appears at serial page (9705).

CURRICULUM FOR BACCALAUREATE, ASSOCIATE DEGREE,
AND DIPLOMA PROGRAMS

§ 21.81. General curriculum requirements.

 (a)  The curriculum shall be developed, implemented and evaluated by the faculty and shall implement the philosophy and objectives of the school.

 (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)  Physical and biological sciences shall include content from the areas of anatomy and physiology, chemistry, microbiology, physics and nutrition, which may be integrated, combined or presented as separate courses; the scientific facts and principles drawn from these areas serve as a basis for planning and implementing nursing care. When the basic sciences are presented as distinct academic courses—that is, chemistry, anatomy and physiology and microbiology—there shall be a related laboratory experience. A related laboratory experience is defined as an assigned period of time during which students participate in the testing of scientific principles.

 (d)  Selected courses shall be included in the humanities and social and behavioral sciences that support the philosophy, purposes, educational concepts and terminal objectives of the program.

 (e)  The curriculum shall provide concurrent theory and clinical experience in the care of men, women and children in age groups and with the health problems characteristic of each group. Experiences shall be provided which include preventive aspects of nursing care during acute and chronic illness and rehabilitative care. Opportunities shall be provided for the student to participate in case findings, health teaching and health counseling for patients and their families. Evening and night assignments are considered part of the curriculum only in terms of the objectives to be achieved and if faculty supervision is provided.

 (f)  Content related to history, trends and professional responsibilities of nursing may be integrated, combined or taught as separate courses.

 (g)  The Board encourages curriculum experimentation designed to replicate or validate educational theories or to promote open-ended career development.

   The provisions of this §  21.81 issued under section 506 of The Administrative Code of 1929 (71 P. S. §  186).

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

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

   (2)  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 licensing examination.

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

   (6)  Evaluation of graduates by their employers.

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

 (a)  Major curriculum changes that require Board approval include:

   (1)  Alteration of the program philosophy, purposes and objectives which influences or affects the integration of material into the total curriculum, such as changes in course content or instruction, shifting content, changing course placement, adding or deleting courses, changing the length of a course or the program and changing the allotment.

   (2)  Reorganization of the entire curriculum.

   (3)  Changes in clinical facilities involving contractual agreements.

 (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)  The school bulletin and other pertinent information.

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

 (a)  A clear statement of philosophy and purposes of the baccalaureate nursing program, consistent with the philosophy and purposes of the controlling institution, shall be formulated and adopted.

 (b)  The philosophy, purposes and objectives of the educational unit in nursing shall be developed and clearly stated by the faculty and shall be reviewed and revised at stated time intervals by this group.

 (c)  The philosophy and purposes of the educational unit in nursing shall be consistent with currently accepted social, educational and nursing standards.

 (d)  The objectives of the nursing program shall be consistent with the purposes of the educational unit.

 (e)  The terminal objectives of the program shall identify behavioral changes that are expected to occur in the student.

 (a)  The educational policies of the educational unit in nursing shall be consistent with those of the controlling institution.

 (b)  The curriculum shall reflect the philosophy and purposes of the educational unit in nursing and shall implement the objectives of the program.

 (c)  There shall be an educational rationale for the selection and distribution of courses and for the selection of theoretical and clinical laboratory content in nursing courses.

 (d)  The rationale for the allocation of credit for nursing courses shall be consistent with the practice of the institution.

 (e)  The courses shall be planned on the academic term basis common to the institution.

 (f)  The learning experiences and methods of instruction shall provide opportunity for fulfilling the purposes of the educational unit in nursing and the objectives of the program.

 (g)  Learning experiences and methods that promote critical thinking and synthesis of learning shall be utilized in the teaching-learning process.

 (h)  Consideration shall be given to individual differences among students.

 (i)  The program shall build its professional education on a general education basis.

 (j)  Courses in general education shall be shared with students in other disciplines of the controlling institution.

 (k)  Provision shall be made for students to take electives in upper divisional general education courses.

 (l)  Nursing courses shall be organized to use and reinforce relevant learnings from preceding and concurrent nursing courses.

 (m)  Education in the nursing major shall be offered largely at the upper divisional level.

 (n)  Nursing courses and curriculum shall be organized to continue the development of values, understandings, knowledge and skills needed in all aspects of professional nursing.

 (o)  Preparation insuring professional nursing competencies shall be provided through selected and supervised learning experiences.

 (p)  The ratio of credits in nursing, that is, the major field of study, general education and elective credits shall be consistent with the nature, purposes and requirements of the parent institution.

 (q)  The ratio of students to faculty shall assure optimal learning opportunities in clinical laboratory sessions and shall be consistent with the objectives of the clinical nursing courses.

 (r)  The curriculum for baccalaureate nursing programs shall give evidence of providing learning experiences which will prepare graduates for professional nursing practice. The standards of practice are defined and delineated by the nursing profession.

 (s)  Course syllabi that identify all aspects of each course shall be developed and readily available.

 (a)  A clear statement of philosophy and purposes of the associate degree program in nursing, consistent with the philosophy and purposes of associate degree education and with the controlling institution, shall be formulated and adopted.

 (b)  The philosophy, purposes and objectives of the educational unit in nursing shall be developed and clearly stated by the faculty and shall be reviewed and revised at stated time intervals by this group.

 (c)  The philosophy and purposes of the educational unit in nursing shall be consistent with currently accepted social, associate degree education and nursing standards.

 (d)  The objective of the nursing program shall be consistent with the purposes of the educational unit.

 (e)  The terminal objectives of the program shall identify behavioral changes that are expected to occur in the student.

 (a)  The educational policies of the educational unit in nursing shall be consistent with those of the controlling institution.

 (b)  The curriculum shall reflect the philosophy and purposes of the educational unit in nursing and shall implement the objectives of the program.

 (c)  There shall be an education rationale for the selection and distribution of courses and for the selection of theoretical and clinical laboratory content in nursing courses.

 (d)  The rationale for the allocation of credit for nursing courses shall be consistent with the practice of the institution.

 (e)  The courses shall be planned on the academic term basis common to the institution.

 (f)  The learning experiences and methods of instruction shall provide opportunity for fulfilling the purposes of the educational unit in nursing and the objectives of the program.

 (g)  The nursing curriculum shall demonstrate the accepted pattern of development for associate degree education and be consistent with college policy.

 (h)  Courses in general education shall be shared with students in other programs of the controlling institution.

 (i)  Nursing courses shall be organized to use and reinforce relevant learnings from preceding and concurrent courses.

 (j)  Preparation insuring associate degree nursing competencies shall be provided through selected and supervised learning experiences.

 (k)  The ratio of credits in nursing to general education and elective credits shall be consistent with other associate degree programs in the college.

 (l)  The ratio of students to faculty shall assure optional learning opportunities in clinical laboratory sessions and shall be consistent with the objectives of the clinical nursing courses.

 (m)  The curriculum for associate degree nursing programs shall give evidence of providing learning experiences which will prepare graduates for associate degree nursing practice as defined and delineated by the nursing profession.

 (n)  Course syllabi that identify all aspects of each course shall be developed and readily available.

 (a)  A clear statement of philosophy, purposes and objectives consistent with the philosophy and objectives of the governing body shall be formulated and adopted.

 (b)  The philosophy, purposes and objectives of the school shall be developed by the faculty and reviewed at stated intervals.

 (c)  The philosophy of the school shall express beliefs about education, nursing and the responsibility of the school to the student.

 (d)  The terminal objectives of the school shall identify behavioral changes that are expected to occur in the student.

 (a)  The selection of learning ex