CHAPTER Nur 100 ORGANIZATIONAL RULES
Statutory
Authority: RSA 326-B:2, RSA 326-B:3
REVISION
NOTE #1:
Document
#5887, effective 8-26-94, made extensive changes to the wording, format,
structure, and the sections in these chapters.
The prior filings for former rules included the following documents:
#2848,
eff 9-21-84 |
#4944,
eff 9-28-90 |
#4277,
eff 6-30-87 |
#5031,
eff 12-24-90 |
#4346,
eff 12-22-87 |
#5032,
eff 12-24-90 |
#4731,
eff 1-19-90 |
|
REVISION
NOTE #2:
Document #13003, effective 3-16-20, adopted
Nur 101.04 as an emergency rule defining “clinical experience.” The adoption necessitated the renumbering of
the existing definitions in Nur 101.04 through Nur 101.22 as Nur 101.05 through
Nur 101.23. However, the emergency rules
expired 9-14-20. Pursuant to RSA
541-A:18, V, the rules numbered Nur 101.05 though Nur 101.23 reverted to their
original numbering as Nur 101.04 through Nur 101.22.
Exhibit U of the Governor’s
Emergency Order #29, effective October 15, 2020, adopted again Nur 101.04
defining “clinical experience”, and renumbered the existing definitions in Nur
101.04 through Nur 101.22 as Nur 101.05 through Nur 101.23, pursuant to the
State of Emergency declared in Executive Order 2020-04, which was effective
3-13-20. Nur 101.04 remained in effect
during the duration of the State of Emergency until the State of Emergency
terminated at midnight on 6-11-21. The
rules numbered Nur 101.05 through Nur 101.23 also reverted to their original
numbering as Nur 101.04 through Nur 101.22.
PART Nur 101 DEFINITIONS
Nur 101.01 “Advanced Practice Registered Nurse (APRN)”
means a registered nurse currently licensed by the board under RSA 326-B:18.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #7736, eff 8-6-02; ss by #8777, eff 12-23-06;
ss by #10296, eff 3-22-13; ss by #10569, eff 4-17-14 (from Nur 101.01);
renumbered by #13672 (formerly Nur 101.02)
Nur 101.02 “Board” means “board” as defined in RSA
326-B:2, II, namely “the New Hampshire board of nursing established in RSA
326-B:3.”
Source. (See Revision Note at chapter heading for Nur
100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #7736, eff 8-6-02; ss by
#8777, eff 12-23-06; ss by #10296, eff 3-22-13; ss by #10569, eff 4-17-14
(from Nur 101.02); renumbered by #13672 (formerly Nur 101.03)
Nur 101.03 “Competency” means having
the integration of knowledge, judgment and skills necessary to provide safe
nursing care or safely to perform nursing related activities.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #7736, eff 8-6-02; ss by #8777, eff 12-23-06; ss by #10296, eff
3-22-13; ss by #10569, eff 4-17-14 (from Nur 101.03)
(see Revision Note #2 at chapter heading for Nur 100); renumbered by #13672 (formerly
Nur 101.04)
Nur 101.04 “Contact hour” means a minimum of 60 minutes
of organized learning.
Source. (See Revision Note #1 at chapter heading for Nur
100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #7736, eff 8-6-02; ss by #8777, eff 12-23-06; ss by #10296, eff 3-22-13; ss by #10569, eff 4-17-14 (from Nur 101.04) (see Revision Note #2 at
chapter heading for Nur 100); renumbered by #13672 (formerly Nur 101.05)
Nur 101.05 “Continuing competence” means “continuing
competency” as defined by RSA 326-B:2, III, namely, “integrated learning by
which a licensee gains, maintains, or refines practice knowledge, skills, and
abilities through a formal education program, continuing education, or clinical
practice. This development may occur
through a formal education program, continuing education, and clinical
practice, and is expected to continue throughout the practitioners’ career.”
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #7736, eff 8-6-02; ss by #8777, eff 12-23-06; ss by #10296, eff 3-22-13; ss by #10569, eff 4-17-14 (from Nur 101.05) (see Revision Note #2 at
chapter heading for Nur 100); renumbered by #13672 (formerly Nur 101.06)
Nur 101.06 “Delegatee” means
the person to whom a licensed nurse delegates a task of client care.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #7736, eff 8-6-02; ss by #8777, eff 12-23-06; ss by #10296, eff 3-22-13; ss by #10569, eff 4-17-14 (from Nur 101.06) (see Revision Note #2 at
chapter heading for Nur 100); renumbered by #13672 (formerly Nur 101.07)
Nur 101.07 “Delegation” means the transfer, at the
discretion of the nurse, of authority for the performance of a task of client
care from the licensed nurse with authority to perform the task to someone who
does not otherwise have such authority.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #7736, eff 8-6-02; ss by #8777, eff 12-23-06;
ss by #10296, eff 3-22-13; ss by #10569, eff 4-17-14 (from Nur 101.07) (see Revision Note #2 at
chapter heading for Nur 100); renumbered by #13672 (formerly Nur 101.08)
Nur 101.08 “Executive director” means the person given
authority by the board to perform administrative functions for the board.
Source.
#8777, eff 12-23-06; ss by #10296, eff 3-22-13; ss by
#10569, eff 4-17-14 (from Nur 101.08) (see Revision Note #2 at chapter
heading for Nur 100); renumbered by #13672 (formerly Nur 101.09)
Nur 101.09 “Licensed nursing assistant (LNA)” means
“licensed nursing assistant” as defined in RSA 326-B:2, IV, namely, “an
individual who holds a current license to provide client care under the
direction of a registered nurse or licensed practical nurse.”
Source.
#8777, eff 12-23-06; ss by #10296, eff 3-22-13; ss by #10569, eff
4-17-14 (from Nur 101.09) (see Revision Note #2 at chapter heading for Nur
100); renumbered by #13672 (formerly Nur 101.10)
Nur 101.10 “Licensed practical nurse (LPN)” means
“licensed practical nurse” as defined in RSA 326-B:2, V, namely, “an individual
who holds a current license to practice practical nursing as defined in RSA
326-B:2, IX.”
Source.
#8777, eff 12-23-06; ss by #10296, eff 3-22-13; ss by #10569, eff 4-17-14 (from Nur 101.10)
(see Revision Note #2 at chapter heading for Nur 100); renumbered by #13672 (formerly
Nur 101.11)
Nur 101.11 “Medication nursing assistant” means a
licensed nursing assistant who holds a currently valid certificate authorizing
the delegation to the nursing assistant of tasks of medication administration.
Source.
#8777, eff 12-23-06; ss by #10296, eff 3-22-13 (from Nur 101.11); ss by #10569, eff 4-17-14 (from Nur
101.11) (see Revision Note #2 at chapter heading for Nur 100); renumbered by #13672
(formerly Nur 101.12)
Nur 101.12 “Medication nurse-reviewer” means a
registered nurse approved by the board to administer a medication
administration education program meeting the requirements of Nur 800.
Source.
#8777, eff 12-23-06; ss by #10296, eff 3-22-13
(from Nur 101.12); ss by #10569, eff 4-17-14 (see Revision Note #2
at chapter heading for Nur 100); renumbered by #13672 (formerly Nur
101.13)
Nur101.13 “Medication skills instructor” means a
registered nurse approved by the board to teach in a medication administration
education program meeting the requirements of Nur 900.
Source.
#8777, eff 12-23-06; ss by #10296, eff 3-22-13 (from Nur 101.13); #ss by 10569, eff 4-17-14 (see Revision Note #2 at chapter heading for Nur
100); renumbered by #13672 (formerly Nur 101.14)
Nur 101.14 “National Council Licensure Examination
(NCLEX)” means the assessment instrument developed by the National Council of
State Boards of Nursing to determine the professional competency of a candidate
for licensure.
Source.
#8777, eff 12-23-06; ss by #10296, eff 3-22-13 (from Nur 101.14); ss by #10569, eff 4-17-14 (from Nur 101.12) (see Revision Note
#2 at chapter heading for Nur 100); renumbered by #13672 (formerly Nur
101.15)
Nur 101.15 “Nursing-related activities” means
“nursing-related activities” as defined by RSA 326-B:2, VIII, namely, “client
care provided by a licensed nursing assistant directed by an APRN, an RN, or an
LPN.”
Source.
#8777, eff 12-23-06; ss by #10296, eff 3-22-13
(from Nur 101.15); ss by #10569, eff
4-17-14 (from Nur 101.15) (see Revision Note #2 at chapter heading for Nur
100); renumbered by #13672 (formerly Nur 101.16)
Nur 101.16 “Practical nursing” means “practical nursing”
as defined in RSA 326-B:2, IX, namely, “the practice of nursing as defined in RSA 326-B:2,
VII by a person who:
(a)
Uses sound nursing judgment based on preparation, knowledge, skills,
understanding, and past nursing experience.
(b)
Works under the direction of a registered nurse, advanced registered
nurse practitioner, dentist, or physician.
(c)
Functions as a member of a health care team and contributes to the
assessment, planning, implementation, and evaluation of client care.”
Source.
#8777, eff 12-23-06; ss by #10296, eff 3-22-13 (from Nur 101.16); ss by #10569, eff 4-17-14
(from Nur 101.16) (see Revision Note #2 at chapter heading for Nur 100);
renumbered by #13672 (formerly Nur 101.17)
Nur 101.17 “Registered nurse (RN)” means “registered
nurse” as defined in RSA 326-B:2, X, namely, “an individual who holds a current
license to practice registered nursing as defined in XI.”
Source.
#8777, eff 12-23-06; ss by #10296, eff 3-22-13 (from Nur 101.17); ss by #10569, eff 4-17-14 (from Nur 101.17) (see Revision Note #2 at
chapter heading for Nur 100); renumbered by #13672 (formerly Nur 101.18)
Nur 101.18 “Registered nursing” means “registered
nursing” as defined in RSA 326-B:2, XI, namely, “the application of nursing
knowledge, judgment, and skill drawn from broad in-depth education in the
biological, psychological, social, and physical sciences in assessing and
diagnosing the health status of a client, and in planning, implementing, and
evaluating client care which promotes the optimum health, wellness, and
independence of the individual, the family, and the community.”
Source.
#8777, eff 12-23-06; ss by #10296, eff 3-22-13 (from Nur 101.18); ss by #10569, eff 4-17-14 (from Nur 101.18) (see Revision Note #2 at
chapter heading for Nur 100); renumbered by #13672 (formerly Nur 101.19)
Nur 101.19 “Sponsoring institution” means an educational
institution, public agency, non-profit organization or for-profit business
offering a board-approved program in medication administration education.
Source.
#8777, eff 12-23-06; ss by #10296, eff 3-22-13 (from Nur 101.19); ss by #10569, eff 4-17-14 (from Nur 101.19) (see Revision Note #2 at
chapter heading for Nur 100); renumbered by #13672 (formerly Nur 101.20)
Nur 101.20 “Stable client” means a client whose overall
health status, as assessed by a licensed nurse, is at the expected baseline or
with predictable or expected responses that can occur with known chronic or
long term medical conditions.
Source. #10296,
eff 3-22-13 (from Nur 101.20); ss by
#10569, eff 4-17-14 (from Nur 101.20)
(see Revision Note #2 at chapter heading for Nur 100); renumbered by #13672 (formerly
Nur 101.21)
Nur 101.21 “Unlicensed assistive personnel” means an
unlicensed individual who functions in a complementary role to the licensed RN
or LPN in providing patient care.
Source. #10296,
eff 3-22-13; ss by #10569, eff 4-17-14 (from Nur 101.21)
(see Revision Note #2 at chapter heading for Nur 100); renumbered by #13672 (formerly
Nur 101.22)
PART Nur 102 DESCRIPTION OF THE BOARD
Nur 102.01 Composition and Functions.
(a)
The board of nursing consists of 11 members appointed by the governor and
council, pursuant to RSA 326-B:3.
(b)
The board is empowered to:
(1) Establish standards for nursing practice;
(2) Approve nursing education programs;
(3) License, and renew and reinstate the licenses
of, registered and practical nurses, advanced registered nurse practitioners
and nursing assistants;
(4) Certify licensed nursing assistants to
administer medication;
(5) Establish and collect fees as authorized by
RSA 329-B:8 and by RSA 91-A:4, IV;
(6) Investigate
allegations of misconduct by licensees and applicants for licenses and take
disciplinary action if misconduct has been found; and
(7) Implement the nurse licensure compact set
forth in RSA 326-B:46.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #7736, eff 8-6-02; ss by #8777, eff 12-23-06; ss by #10296, eff
3-22-13; ss by #10569, eff 4-17-14
Nur 102.02 Organization.
(a)
The board is comprised of 11 members who meet the applicable eligibility
requirements of RSA 326-B:3, II to VI, and are appointed pursuant to RSA
326-B:3, VIII.
(b)
As required by RSA 326-B:3, I, membership of the board shall include:
(1) Registered nurses, of whom there are 5,
including one advanced registered nurse practitioner;
(2) Licensed practical nurses, of whom there are
2;
(3) Licensed nursing assistants, of whom there
are 2, including a medication licensed nursing assistant, if possible; and
(4) Public members, of whom there are 2.
(c)
The board assigns duties to the executive director, and forms standing
or ad hoc committees to accomplish the board’s function.
(b)
The board assigns duties to the executive director, and forms standing
or ad hoc committees to accomplish the board’s function.
Source. (See Revision Note #1 at chapter heading for Nur
100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #7736, eff 8-6-02; ss by
#8777, eff 12-23-06; ss by #10296, eff 3-22-13; ss by #10569, eff 4-17-14; amd by #11144, eff 7-28-16
Nur 102.03 Meetings. The board meets each month, if a quorum is
present, or at such additional times as called for by the chairperson or by
majority vote of the board.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #7736, eff 8-6-02; ss by #8777, eff 12-23-06; ss by #10296, eff 3-22-13; ss by #10569, eff 4-17-14; ss by #12567, eff 6-29-18
Nur 102.04 Quorum. Pursuant to RSA 91-A:2, I and RSA 21:15, II,
a quorum for a meeting or hearing shall consist of a majority of members
approved by the governor and council.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #7736, eff 8-6-02; ss by #8777, eff 12-23-06; ss by #10296, eff
3-22-13; ss
by #10569, eff 4-17-14; ss by #12567, eff 6-29-18
Nur 102.05 Committees.
(a)
The liaison committee and the practice and education committee are
permanent subcommittees of the board.
(b)
These committees meet as directed by the board.
(c)
These committees shall have the following responsibilities:
(c)
These committees shall have the following responsibilities:
(1) The liaison committee shall:
a. Make recommendations to the board related to
practice and education issues concerning APRN practice; and
b. Offer consultation to the board regarding
standards of practice in relation to a complaint or investigation into an APRN
licensee’s practice; and
(2) The practice and education committee shall
make recommendations to the board related to practice and education issues.
(d)
Committees additional to the liaison committee and the practice and
education committee, if any, shall consist of one or more board members who
have been directed by the board to investigate and make recommendations on
matters to be decided by the full board.
(e)
When expressly authorized by the board, the authority of a committee
described in (d) above shall include:
(1) The retention of voluntary assistance from
qualified persons to serve as
advisors to the
committee; or
(2) The retention of paid advisors or
consultants.
(f)
A member of the board shall act as liaison to each committee described
in (d) above.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #7736, eff 8-6-02; ss by #8777, eff 12-23-06; ss by #10296, eff 3-22-13;
ss by #10569, eff 4-17-14; amd by #12567, eff 6-29-18
Nur 102.06 Attendance at Meetings By Members of the
Public. Pursuant to RSA 91-A:2, II, members
of the public may attend and record board meetings except for those parts of
the meetings which are nonpublic sessions pursuant to RSA 91-A:3.
Source. (See Revision Note at #1 chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #7736, eff 8-6-02; ss by #8777, eff 12-23-06; ss by #10296, eff 3-22-13;
ss by #10569, eff 4-17-14
Nur 102.07 Notice of Meetings.
(a)
Notice of the time and place of board meetings, excluding emergency
meetings, is given in accordance with RSA 91-A:2, II.
(b)
Information about the time and place of board meetings is also
available:
(1) On the board’s website at http://www.nh.gov/nursing/about-us/index.htm;
(2) By telephone
at the number stated in Nur 103.01(b); and
(3) By TTY/TDD through the number stated in Nur
103.01(c).
Source. #7736,
eff 8-6-02; ss by #8777, eff 12-23-06; ss
by #10296, eff 3-22-13; ss by #10569, eff 4-17-14
Nur 102.08 Record of Board Actions.
(a)
Minutes shall be kept of board meetings and of official actions taken by
the board.
(b)
These minutes shall record those members who participate in each vote
and separately record the position of members who choose to dissent, recuse
themselves or concur.
(c)
The board reports annually on its activities and makes such reports
available to the public through its minutes.
Source. #7736,
eff 8-6-02; ss by #8777, eff 12-23-06; ss
by #10296, eff 3-22-13; ss by #10569, eff 4-17-14; amd by #11144, eff 7-28-16
PART Nur 103 PUBLIC REQUESTS FOR INFORMATION
Nur 103.01 Office Location, Mailing Address,
Telephone Numbers and TTY/TDD Number.
(a)
The board’s office and mailing address is:
New Hampshire
Board of Nursing
121 S. Fruit St.
Concord,
(b)
The telephone number for the office is 603-271-2323.
(c)
Access for in-state TTY/TDD users is through Relay New Hampshire by
dialing 711 or by dialing 1-800-735-2964.
(d) The board’s website is at www.state.nh.us/nursing.
(e) The board’s email address is boardquestions@nursing.state.nh.us.
Source. #6778, eff 6-26-98; ss by #7099, eff 9-20-99;
ss by #7736, eff 8-6-02; ss by #8777, eff 12-23-06; ss by #10296, eff 3-22-13;
ss by #10569, eff 4-17-14
Nur 103.02 Communication with the Board.
(a)
Persons wishing to make submissions to or requests of the board may mail
a letter to the address stated in Nur 103.01(a), call the number stated in Nur
103.01(b), send an email to the address in Nur 103.01(e), or communicate
by TTY/TDD using the number stated in Nur 103.01 (c).
(b)
Persons seeking information from the board may do so by mail, email, by
telephone using the numbers stated in paragraph Nur 103.01(b) or by TTY/TDD
using the number stated in Nur 103.01
(c)
Inquiries regarding clinical practice may be submitted via mail or email
by completing and submitting Form Clinical Practice Inquiry, amended 11-2013.
Source. #6778, eff 6-26-98; ss by #7736, eff 8-6-02; ss by #8777, eff 12-23-06; ss by #10296, eff 3-22-13;
ss by #10569, eff 4-17-14
Nur 103.03 Custodian of Records. The Office of Professional Licensure and
Certification is the custodian of the board’s records and responds to requests
to examine those portions of the board’s records which are public records.
Source. #6778, eff 6-26-98; ss by #7736, eff 8-6-02; ss by #8777, eff 12-23-06; ss by #10296, eff 3-22-13;
ss by #10569, eff 4-17-14; amd by #11144, eff
7-28-16
Nur 103.04 Inspection and Copies of Records.
(a)
Pursuant to RSA 91-A:4 members of the public may inspect and copy those
records of the board, including meeting minutes, which are public records and
not exempt from disclosure under RSA 91-A:5 or other applicable law.
(b)
Persons desiring copies of board records shall describe as particularly
as possible the information being sought and pay a copying fee of $.25 per
page.
(c)
If records are requested that contain both public information and
information exempt from disclosure pursuant to RSA 91-A or other law, the board
shall redact the exempt information and provide the remaining information.
Source. #6778, eff 6-26-98; ss by #7736, eff 8-6-02; ss by #8777, eff 12-23-06; ss by #10296, eff 3-22-13;
ss by #10569, eff 4-17-14
Nur 103.05 Access to Board Administrative Rules. The public may:
(a)
Inspect and copy the official version of the board’s administrative
rules at the board’s office;
(b)
Receive a copy of the rules by calling or writing the board; and
(c)
Access the rules on the board’s website.
Source. #7736,
eff 8-6-02; ss by #8777, eff 12-23-06; ss by #10296, eff 3-22-13;
ss by #10569, eff 4-17-14
Nur
103.06 Computerized Lists
Distribution.
A
computerized list of licensees who have agreed to share their name, email and
physical address shall be furnished upon request. The fee shall be $100.00.
Source. #11144,
eff 7-28-16
CHAPTER
Nur 200 PRACTICE
Statutory
Authority: RSA 326-B:12, RSA 326-B:13,
RSA 326-B:14
PART Nur 201 PURPOSE
Nur 201.01 Purpose. The board shall conduct proceedings for the
purpose of acquiring sufficient information to make fair and reasonable
decisions on matters within its statutory jurisdiction, including decisions on
applications and complaints filed against licensees. These proceedings shall
secure a just, efficient and accurate resolution.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8778
eff 12-23-06; ss by 10297, eff
3-22-13
PART Nur 202 DEFINITIONS
Nur 202.01 Definitions.
(a) “Adjudicative proceeding” means “adjudicative
proceeding” as defined in RSA 541-A:1,
(b) “Appearance” means a written notification to
the board that a party, an intervenor or the representative of a party or
intervenor intends to actively participate in an adjudicative proceeding.
(c) “Complaint” means an allegation of misconduct
by a licensee, and which has been submitted in writing to the board.
(d) “Contested case” means “contested case” as
defined in RSA 541-A:1, IV, namely, “a proceeding in which the legal rights,
duties, or privileges of a part are required by law to be determined by an
agency after notice and an opportunity for hearing.”
(e) “Declaratory ruling” means, pursuant to RSA
541-A:1, V, a ruling by the board as to the specific applicability of any
statutory provision or of any rule or order of the board.
(f) “Hearing” means the process by which the
board receives and considers evidence, argument, or both, by methods
appropriate to the circumstances, and includes:
(1) Conducting trial-type evidentiary
proceedings;
(2) Directing the filing of exhibits, affidavits,
memoranda, briefs, or oral arguments; or
(3) Any combination of these or similar methods.
(g) “Intervenor” means a person without the
status of a party but participating in an adjudicative proceeding to the extent
permitted by the presiding officer acting pursuant to RSA 541-A:32.
(h) “Motion” means a request to the presiding
officer for an order or ruling directing some act to be done in favor of the
proponent of the motion, including a statement of justification or reasons for
the request.
(i) “Order” means a
document issued by the board:
(1) Establishing procedures to be followed in an
adjudicatory or non-adjudicatory proceeding;
(2) Granting or denying a petition or motion;
(3) Requiring a person to do, or to abstain from
doing something; or
(4) Determining a person’s rights to a license or
other privilege established by RSA 326-B or rules of this chapter.
(j) “Party” means “party” as defined by RSA
541-A:1, XII, namely, “each person or agency named or admitted as a party, or
properly seeking and entitled as a right to be admitted as a party.”
(k) “Person” means
any individual, partnership, corporation, association, governmental subdivision
or public or private organization of any character other than the board.
(l) “Presiding officer” means, pursuant to RSA
541-A:1, XIV, that individual to whom the board has delegated the authority to
preside over a proceeding, if any.
Otherwise it means the chair of the board provided that, pursuant to RSA
326-B:38, VIII, the case is not a misconduct case and the chair of the board is
not a public member.
(m) “Proof by preponderance of the evidence”
means a demonstration by admissible evidence that a fact or legal conclusion is
more probably true than not.
(n) “Public comment hearing” means a proceeding
held pursuant to RSA 541-A:11.
(o) “Record” means, in a contested case, the
materials set forth in RSA 541-A:31, VI.
(p) “Rulemaking petition” means a petition made
pursuant to RSA 541-A:4,I.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8778,
eff 12-23-06; ss by #10297, eff 3-22-13
PART Nur 203 APPEARANCE BEFORE THE BOARD
Nur 203.01 Representatives.
(a) A natural person appearing before the board
may choose to be represented by an individual who:
(1) Is a
(2) Is not a
a. His or her daytime address;
b. His or her daytime telephone number, cellular
phone number, or both, if he or she has one or both;
c. His or her electronic email address, if he or
she has one;
d. A statement that he or she does not have any
criminal convictions that have not been annulled, or, if he or she has any
criminal convictions that have not been annulled, a description of all material
facts relating to each such conviction;
e. If his or her occupation is regulated by any
state or federal entity, a statement that he or she has not been found to have
committed misconduct, or if he or she has been found to have committed
misconduct, a description of all material facts relating to each finding;
f. A statement identifying each instance in
which he or she has represented any other person in any other forum for the 3
years previous to the filing of the appearance;
g. A statement that he or she has never had
sanctions imposed upon him or her for his or her conduct in his or her
representation, or, if any such sanction has been imposed, a description of all
material facts relating to the imposition of every such sanction;
h. A statement as to whether there are any
criminal or misconduct proceedings pending against him or her, and if there
are, a description of all material facts regarding such charges; and
i. The signatures of the representative and the
party or intervenor to be so represented.
(b) Corporations, partnerships and other legal
entities that are not natural persons shall be represented only by:
(1) An attorney licensed in
(2) An officer, director, or any other person who
has express and written authority to act on behalf of the entity concerning the
matter in question and has filed a motion for leave to appear as a
representative.
(c) Nothing in this section shall be construed to
permit the unauthorized practice of law.
(d) The representative submitting an appearance
pursuant to (a)(2) above shall, pursuant to RSA 311:1, be presumed to be of
good character unless the appearance discloses one or more of the following:
(1) He or she has been convicted of any
misdemeanor or felony involving dishonesty within the 3 years immediately
preceding the filing of the appearance;
(2) He or she has been found to have committed
misconduct by an occupational regulatory body of this or any other state or the
federal government;
(3) He or she has been sanctioned for his or her
actions as a representative in any other forum within the 3 years immediately
preceding the filing of the appearance; or
(4) There is any pending criminal or misconduct
charges against the representative and such charges relate to honesty.
(e) If an appearance filed pursuant to (a)(2)
above discloses any of the circumstances listed in (d) above, the board shall
prohibit the person from continuing as a representative in the proceeding and
shall notify the person .
(f) The board shall, after providing notice and
opportunity for hearing, restrict an individual from acting as a representative
before the board when the representative’s behavior obstructs the process.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8778,
eff 12-23-06; ss by #10297, eff
3-22-13
PART Nur 204 TIME PERIODS
Nur 204.01 Computation of Time. Any time period specified in an order shall
begin with the day following the act, event, or default, and shall include the
last day of the period, unless it is Saturday, Sunday, or state legal holiday,
in which event the period shall run until the end of the next day which is not
a Saturday, Sunday, or state legal holiday. When the period prescribed or
allowed is less than 7 days, intermediate Saturdays, Sundays, and state legal
holidays shall be excluded from the computation.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8778,
eff 12-23-06; ss by #10297, eff
3-22-13
Nur 204.02 Change in Allowed Times. A motion for a change of time shall be granted
upon concurrence of all parties.
Source. (See Revision Note at #1 chapter heading for Nur
100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM, eff
6-24-06, EXPIRED: 12-21-06
New.. #8778,
eff 12-23-06; ss by #10297, eff
3-22-13
Nur 204.03 Limitations. A motion to change time shall be filed at
least 3 business days prior to the event in question.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8778,
eff 12-23-06; ss by #10297, eff
3-22-13
PART Nur 205 FILING
Nur 205.01 Filing of Documents with the Board.
(a) A document shall be considered filed when it
is actually received at the board’s office in
(b) All documents filed shall be filed with an
original and a copy for each board member who will hear the case. However, only a single copy of
correspondence, applications and complaints against licensees shall be filed.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8778, eff 12-23-06; ss by #10297, eff 3-22-13
Nur 205.02 Subscription and Veracity of Documents.
(a) All complaints, petitions, motions, and
replies filed with the board shall be signed by the proponent of the document
or, if the party appears by representative, by the representative.
(b) The applicant’s signature on a document filed
with the board shall be certification that:
(1) The applicant has read the document;
(2) The applicant is authorized to file it;
(3) To the best of the applicant’s knowledge,
information, and belief, there are good grounds to support it; and
(4) The document has not been filed for purposes
of delay or harassment.
(c) A willful violation of (b), above, shall
cause the board to issue an order adverse to the party committing the
violation.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8778,
eff 12-23-06; ss by #10297, eff
3-22-13
Nur 205.03 Service of Documents.
(a) Complaints against licensees shall be filed
with the board.
(b) Petitions for rulemaking and petitions for
declaratory rulings shall be filed with the board by the petitioner without
service upon other persons.
(c) All motions, replies, exhibits, memoranda, or
other documents filed in an adjudicatory proceeding shall be served by the
proponent upon all parties to the proceeding by:
(1) Depositing a copy of the document in the
United States Postal Service, first class postage prepaid, addressed to the
last address given to the board by the party being served, no later than the
day the document is filed with the board; or
(2) Delivering a copy of the document in hand on
or before the date it is filed with the board.
(d) All notices, orders, decisions, or other
documents issued by the board in the course of an adjudicatory proceeding shall
be served by the board upon all parties to the proceeding by either:
(1) Depositing a copy of the document, first
class postage prepaid, in the United States Postal Service, addressed to the
last address given to the board by the party being served; or
(2) If a party is not represented, delivering a
copy of the document in hand to the party.
(e) When a party authorizes a representative,
service shall be upon the representative.
(f) Except for exhibits distributed at a
prehearing conference or hearing, every document filed with the board, and
required to be served upon the parties to an adjudicatory proceeding, shall be
accompanied by a certificate of service, signed by the person making service,
attesting to the method and date of service, and the persons served.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8778,
eff 12-28-06; ss by #10297, eff
3-22-13
Nur 205.04 Failure to Comply with Rules.
(a) Failure to comply with the rules of this
chapter shall result in:
(1) Refusal of a noncompliant document for
filing;
(2) Denial or conditional denial of a
noncompliant application, petition, or motion; or
(3) Issuance of an order adverse to noncompliant
person.
Source. #8778,
eff 12-28-06; ss by #10297, eff
3-22-13
PART Nur 206
FILING OF PLEADINGS, COMPLAINTS,
Nur 206.01 Pleadings.
(a) The only pleadings permitted shall be petitions,
other than for rulemaking, and replies to petitions. Complaints against
licensees shall be a particular type of petition and shall be governed
exclusively by Nur 206.02. Applications
for licensure or program approval shall not be considered pleadings.
(b) All petitions shall contain:
(1) The name and address of the petitioner;
(2) The name and address of the petitioner’s
representative, if any;
(3) A concise statement of the facts that caused
the petitioner to request the board to act;
(4) The action that the petitioner wishes the
board to take; and
(5) The identification of any statutes, rules,
orders, or other authority that entitles the petitioner to request the board to
act.
(c) Board replies to petitions shall contain:
(1) The name and address of the petitioner;
(2) The name and address of the representative of
the petitioner, if any;
(3) A statement addressing each fact alleged in
the petition pursuant to Nur 206.01(b)(3);
(4) A statement
addressing the authority identified by the petitioner pursuant to Nur
206.01(b)(5);
(5) A concise response to each statement noted in
Nur 206.01(b)(3);
(6) The
identification of any statutes, rules, orders, or other authority, not
identified in the petition, having a bearing upon the subject matter of the
petition; and
(7) The action the board took.
(d) Replies shall be filed within 90 days from
the date of the petition.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8778, eff 12-23-06; ss by #10297, eff
3-22-13
Nur 206.02 Filing of Complaints of Licensee
Misconduct.
(a) Complaints alleging misconduct
by licensees noting violations of RSA 326-B:37, II, shall be in writing and
filed at the board’s offices in
(b) A complaint shall contain the following
information:
(1) The name, address, home and work telephone
number, cellular telephone number, and electronic mail address as applicable of
the complainant;
(2) The name address, home and work telephone
number, cellular telephone number, and electronic mail address as applicable of
the licensee against whom the complaint is directed;
(3) Date, time, place and summary of alleged
violation(s);
(4) Name, address, home and work telephone number,
cellular telephone number, and electronic mail address as applicable of those
having knowledge of the alleged violations;
(5) Specific provision of RSA 326-B: 37 and Nur
402.02 on which the complaint is based; and
(6) Other data pertinent to the complaint.
(c) A complaint that alleges acts of misconduct
that occurred more than 6 years before the filing date shall not be accepted unless it also alleges that these acts could not have
reasonably been discovered during all or some substantial part of the
intervening 6 year period.
(d) Pursuant to RSA 326-B:38, IV, a complaint
shall be treated as a petition to the board for the commencement of a
disciplinary hearing which shall be conducted pursuant to Nur 207.
(e) The licensee shall respond in writing to
stated misconduct allegations by addressing each allegation. The licensee shall, within 15 days so respond
or submit a written request for more time to respond. Failure to respond or request more time shall
result in an order of default, including disciplinary sanctions, against the
licensee.
(f) The board shall automatically grant one
written request for more time to respond to allegations of misconduct pursuant
to (e) above. Such extension shall be
for the amount of time requested, but shall not exceed 30 days from the date
the response was due.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8779, eff 12-23-06; ss by #10297, eff 3-22-13
Nur 206.03 Motions, Petitions and Objections Thereto.
(a) Unless presented during an oral session of a
proceeding, all motions, petitions and objections shall be in writing.
(b) Each motion, petition, and objection shall
state clearly and concisely:
(1) The purpose;
(2) The relief sought;
(3) The statutes, rules, orders, or other
authority authorizing the relief sought; and
(4) The facts claimed to constitute grounds for
the relief.
(c) Each objection to a motion or petition shall
state clearly and concisely:
(1) The defense of the party or intervenor filing
the reply;
(2) The action which the party or intervenor
filing the reply wishes the board to take;
(3) The statutes, rules, orders, or other
authoritative relief in defense of the motion; and
(4) Any facts that are additional to, or
different from, the facts stated in the motion or petition.
(d) An objection to a petition or motion shall
specifically admit or deny each fact contained in the motion. Failure to deny a fact contained in the
motion shall constitute the admission of that fact for the purpose of the
objection. In the event a party or
intervenor filing an objection to a motion lacks sufficient information to
either admit or deny a fact contained in the motion, the party or intervenor
shall so state, specifically identifying such fact.
(e) Petitions or motions shall be decided upon
the writings submitted and oral argument, if the board determines that oral
argument would assist the board in reaching a decision regarding a petition or
motion. Repetitious motions or petitions shall not be submitted.
(f) Board replies to petitions or motions shall
be filed within 90 days after the filing of the motion. Failure to address a
motion within the time allowed shall constitute acceptance of the motion.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by ##8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8778,
eff 12-23-06; ss by #10297, eff
3-22-13
PART Nur 207 DISCIPLINARY
Nur 207.01 Applicability. This part shall govern all proceedings
conducted by the board except rulemaking and declaratory rulings.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRES: 12-21-06
New. #8778,
eff 12-23-06; ss by #10297, eff
3-22-13
Nur 207.02 Commencement.
(a) The board shall commence an adjudicatory
proceeding by issuing a notice to each party and to each complainant, if any,
at least 15 days before the first scheduled hearing date or first prehearing
conference.
(b) The notice commencing an adjudicatory
proceeding shall:
(1) Identify the parties to the proceeding as of
the date of the order, inform each complainant of their right to intervene, and
specify a deadline for the submission of petitions to intervene or statements
by complainants that they intend to intervene;
(2) Briefly summarize the subject matter of the
proceeding, and identify the issues to be resolved;
(3) Attach any complaint against the licensee
that forms, in whole or in part, the basis of the issues to be resolved;
(4) Specify the statutory authority for the
proposed action, and identify any applicable board rules;
(5) Specify the type of procedures to be
followed;
(6) Specify the date by which, and the address
where, appearances or motions by representatives shall be filed;
(7) Specify the date, time, and location of an
initial prehearing conference or dates for an oral hearing;
(8) Identify the presiding officer for the
proceeding if other than the chairperson of the board;
(9) Identify any confidentiality requirements
applicable to the proceeding;
(10) Indicate that each party or intervenor has
the right to be represented by an attorney but that such representation shall
not be at the expense of the board;
(11) Indicate that each party or intervenor has
the right to have the board arrange to have a certified shorthand court
reporter present, at the requestor’s expense, provided that such request is
submitted at least 10 days prior to the proceeding; and
(12) Contain such other information as the
circumstances of the case may warrant including, but not limited to, orders
consolidating or severing issues in the proceeding with other proceedings or
orders directing the production of documents.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8778,
eff 12-23-06; ss by #10297, eff
3-22-13
Nur 207.03 Docketing, Service of Notice, Public
Notice.
(a) The board shall assign each adjudicatory proceeding
a docket number, and serve the hearing notice upon all parties to the
proceeding. The hearing notice shall be
served upon the respondent by means of certified mail.
(b) Service of all subsequent orders, decisions
and notices issued by the board, including any amendments to the hearing
notice, shall be served upon the parties and any intervenors, by regular mail.
(c) Orders, notices, and decisions of the board,
and motions, memoranda, exhibits, and other documents and data submitted to the
board in a docketed case shall be kept in a docket file and made available for
public inspection in the board’s office except to the extent that
confidentiality has been provided for under the provisions of law.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8778,
eff 12-23-06; ss by #10297, eff
3-22-13
Nur 207.04 Intervention.
(a) Petitions for intervention may be filed any
time after the issuance of a notice pursuant to Nur 207.03(a), and state:
(1) How the petitioner’s rights, duties,
privileges, immunities or other substantial interests may be affected by the
hearing, or how the petitioner qualifies for intervention under any provision
of law;
(2) Why the interests of the parties and the
orderly and prompt conduct of the proceeding would not be impaired; and
(3) Any other reasons why the petitioner should
be permitted to intervene.
(b) Petitions for intervention shall be granted if
the petitioner has an interest in the proceeding and has clearly stated this
interest or if the petitioner qualifies for intervention under any provision of
law.
(c) Orders granting intervention shall be subject
to modifications.
(d) As provided in (a) above, a person filing a
complaint that becomes the subject of a disciplinary hearing shall be served
with the hearing notice and notified of the right to intervene in the
proceeding.
(e) Unless the complainant’s petition for
intervention is granted or the complainant is called as a witness in the
proceeding, the complainant shall have no role in the proceeding.
(f) Once granted leave to intervene and
participate in the proceeding, an intervenor shall take the proceeding as they
find it and no portion of the proceeding shall be repeated because of the fact
of intervention.
Source. #8778,
eff 12-23-06; ss by #10297, eff
3-22-13
Nur 207.05 Rights to Representation.
(a) Any party in an adjudicatory proceeding may
be represented by counsel or lay representation, but such person appearing on
behalf of a party shall first file an appropriate appearance pursuant to Nur
203.01 at the earliest date practicable.
(b) Requests to the board to appoint counsel or
otherwise arrange for representation shall be denied and the board shall assume
no responsibility for expenses of any party.
Source. #8778,
eff 12-23-06; ss by #10297, eff
3-22-13
Nur 207.06 Prehearing Conferences.
(a) At any time following the commencement of an
adjudicatory proceeding, the board shall, upon motion, or upon its own
initiative, encourage all parties to attend one or more prehearing
conference(s) to aid in the disposition of the proceeding.
(b) The following shall be considered at a
prehearing conference:
(1) Opportunities and procedures for settlement;
(2) Opportunities and procedures for
simplification of the issues;
(3) Possible amendments to the pleadings;
(4) Possible admissions of facts and of documents
to avoid unnecessary proof;
(5) Possible limitations on the number of
witnesses;
(6) Possible changes to the standard procedures
which would otherwise govern proceeding;
(7) The distribution of written testimony, if
any, and exhibits to the parties;
(8) Possible consolidation of the examination of
witnesses by the parties; and
(9) Any other
matters which might contribute to the prompt and orderly conduct of the
proceedings.
(c) The board shall cause prehearing conferences
to be recorded unless all parties wish to discuss possible settlement off the
record. Matters decided at a prehearing conference shall be reflected in an
appropriate order.
Source. #8778,
eff 12-23-06; ss by #10297, eff
3-22-13
Nur 207.07 Discovery and Disclosure. Upon the written request of a party or
intervenor, the board shall disclose to the each party and intervenor any
information, not privileged, in the possession of the board, that is pertinent
to the subject matter of the proceeding.
Neither the board nor any officer or employee thereof, shall be subject
to further discovery. At least 5 days before the hearings, the
parties shall exchange a list of all witnesses and exhibits to be offered as
evidence at the hearing and a copy of each document or exhibit.
Source. #8778,
eff 12-23-06; ss by #10297, eff
3-22-13
Nur 207.08 Subpoena.
(a) A subpoena for the attendance of witnesses or
the production of evidence in disciplinary proceedings shall be issued only
upon the order of the board.
(b) A subpoena shall be issued on the initiative
of the board or in response to the motion of a party or intervenor.
(c) A party or intervenor who moves for a
subpoena shall attach a copy of the proposed subpoena to its motion. If the
motion is granted, the requesting party or intervenor shall be responsible for
the service of the subpoena and payment of any witness fee and mileage expenses
that may be required.
(d) Pursuant to RSA 326-B:38, IV(c) and V, a
licensee shall not be entitled to any witness or mileage fee for compliance
with any subpoena issued by the board.
(e) The person to whom the subpoena is directed
may, within 10 days after service of the subpoena, or before the date specified
by the board in the subpoena for compliance therewith, whichever is earlier,
file a motion to quash or modify the subpoena.
(f) If the motion to quash or modify the subpoena
fails to refute the rationale for the subpoena and the motion is denied, in
whole or in part, the person to whom the subpoena is directed shall comply with
the subpoena, within the time prescribed in the subpoena, unless the board
expressly provides additional time to comply.
(g) A subpoena shall be served by any person who
is 18 years of age or older, and in the manner authorized for service of
subpoenas in the
(h) Should any person fail to comply with a
subpoena issued pursuant to this section, the board shall either enter an order
adverse to the party or intervenor who fails to comply, or seek judicial
enforcement against any other person.
Source. #8778,
eff 12-23-06; ss by #10297, eff
3-22-13
Nur 207.09 Evidence.
(a) Proceedings shall not be conducted under the
rules of evidence, but the evidentiary privileges recognized by the law of
(b) All data that will reasonably assist the
board to arrive at the truth shall be admissible, except that irrelevant,
immaterial or unduly repetitious evidence shall be excluded.
(c) Evidence shall be submitted in written or oral
form to assure the full and fair disclosure of the facts.
(d) If the board takes administrative notice of a
fact, it shall so state, and permit any party or intervenor the opportunity to
show the contrary.
(e) Witnesses appearing before the board shall
testify under oath or affirmation administered by the presiding officer.
(f) The board shall cause a tape recording or
stenographic record to be made of hearings and prehearing conferences but in a
disciplinary hearing the record shall be made by a certified shorthand court
reporter at the request and expense of a party or intervenor. This record shall not be transcribed unless a
request is made by a party or intervenor who agrees to pay the cost of the
transcription, or unless the board elects to transcribe the record on its own
initiative, in which case any party or intervenor who requests a copy of the
transcript shall pay copying costs, only.
Source. #8778,
eff 12-23-06; ss by #10297, eff
3-22-13
Nur 207.10 Burden of Proof. The party or intervenor asserting the affirmative
of a proposition and each movant shall have the burden of proving the truth of
that proposition by a preponderance of the evidence.
Source. #8778,
eff 12-23-06; ss by #10297, eff
3-22-13
Nur 207.11 Methods of Proceeding.
(a)
Where there are no disputes as to the material facts involved in the
subject matter of the proceeding, offers of settlement shall be entertained.
(b)
Where facts material to the subject matter of the proceedings are in
dispute, the proceeding shall consist of a trial-type evidentiary hearing with
the subsequent submission of memoranda as appropriate.
(c)
Oral argument and brief opening and closing statements, shall be
permitted when requested in a written motion that includes the proposed
arguments. Written arguments in the form of legal briefs or memoranda shall be
permitted subject to such filing schedules that allow for timely hearing,
adequate preparation time for parties’ response.
(d)
The board shall schedule a hearing or require the submission of
additional evidence at any time, including the ordering of supplemental
hearings if the board determines that such are necessary for a full and true
disclosure of the facts of the case.
Source. #8778,
eff 12-23-06; ss by #10297, eff
3-22-13
Nur 207.12 Continuances.
(a)
Any party to or intervenor in a hearing may make an oral or written
motion that a hearing be postponed to a later date or time.
(b)
If a continuance is requested by a party or intervenor, it shall be
granted if the presiding officer determines that good cause has been
demonstrated. Good cause shall include
the unavailability of any party or intervenor, witness or attorney or other
representative necessary to conduct the hearing, the likelihood that a hearing
will not be necessary because the parties have reached a settlement or any
other circumstances that demonstrate that a continuance would assist resolving
the case fairly.
(c)
If the later date, time and place are known at the time of the hearing
that is being postponed, the date, time and place shall be stated on the
record. If the later date, time and
place are not known at the time of the hearing that is being postponed, the
presiding officer shall issue a written scheduling order stating the date, time
and place of the postponed hearing as soon as practicable.
Source. #8778,
eff 12-23-06; ss by #10297, eff
3-22-13
Nur 207.13 Inquiry By Board Members. Except as provided by RSA 326-B:38 and subject
to the direction of the presiding officer who shall regulate the time and
manner of speaking in an orderly fashion, board members present during and
participating in an adjudicative proceeding shall question witnesses and make
such inquiry of witnesses, as they believe appropriate for a full and true
disclosure of the facts of the case.
Source. #8778,
eff 12-23-06; ss by #10297, eff
3-22-13
Nur 207.14 Proposed Findings of Fact and Conclusions
of Law. Each party or intervenor may
submit written proposed findings of fact and conclusions of law. The board shall include individual rulings
upon each such proposed finding or conclusion as part of its final decision.
Source. #8778,
eff 12-23-06; ss by #10297, eff
3-22-13
Nur 207.15 Decisions and Orders.
(a) The board shall issue a decision and order
based on:
(1) A hearing attended by a quorum of the board;
or
(2) A written proposed settlement agreement.
(b) The decision and order shall be in writing
and dated.
(c) A board member shall not participate in
rendering a decision if he or she has not personally heard all of the testimony
in the case, unless the disposition does not depend on the credibility of any
witness and the record provides a reasonable basis for evaluating all testimony
and other evidence.
(d) If a presiding officer has been delegated the
authority to draft a proposed decision and order, the presiding officer shall
submit to the board a written proposed decision and order containing:
(1) The disposition proposed by the presiding
officer;
(2) A statement of the reasons for the proposed
disposition;
(3) Findings of fact and rulings of law necessary
to the proposed disposition; and
(4) Any order necessary to effectuate the
disposition.
(e) If a proposed disposition submitted pursuant
to paragraph (d) is adverse to any party or intervenor, the board shall:
(1) Serve a copy of it on each party and
intervenor; and
(2) Provide an opportunity to file objections and
present briefs and oral arguments to the board.
(f) The board shall keep a final decision in its
records for at least 5 years following their dates of issuance, unless the
director of the division of records management and archives of the department
of state sets a different retention period pursuant to rules adopted under RSA
5:40.
Source. #8778,
eff 12-23-06; ss by #10297, eff
3-22-13
Nur 207.16 Ex Parte
Communications. Once a notice of
hearing has been issued in an adjudicative proceeding, no party or intervenor
shall communicate with any member of the board or the presiding officer who
will render a decision in the case concerning the merits of the case except
upon notice to such other parties and intervenors and granting an opportunity
for such party or parties to participate.
In accordance with the rules of this chapter, no party shall cause
another person to make such communications or otherwise engage in conduct
prohibited by RSA 541-A:36.
Source. #8778, eff 12-23-06; ss by #10297, eff 3-22-13
PART Nur 208 PRESIDING OFFICER
Nur 208.01 Designation.
(a) Adjudicatory proceedings commenced by the
board shall be conducted by a presiding officer.
(b) The board shall appoint a board member or
members of the board’s staff to serve as presiding officer.
(c) The presiding officer shall serve in a
conscientious and truthful manner or shall be removed by the board without
notice or hearing.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8778,
eff 12-23-06; ss by #10297, eff
3-22-13
Nur 208.02 Authority of Presiding Officer.
(a) The presiding officer shall possess all
authority with respect to the procedural aspects of adjudicatory proceedings
that would be possessed by the board itself, including, but not limited to, the
power to administer oaths and affirmations, direct the course of the
proceedings, and decide procedural and discovery issues.
(b) The presiding officer shall receive no
evidence or oral argument on the merits of the case unless at least 6 board
members, including the presiding officer if the presiding officer is a board
member, are present.
(c) Except in proceedings conducted pursuant to Nur
208.02(d), the presiding officer shall, to the extent consistent with the fair
and orderly conduct of the proceeding pursuant to Nur 207.13, permit board
members who are present during any stage of an adjudicatory proceeding to query
the witnesses.
(d) The presiding officer shall not accept final
offers of settlement or impose consent decrees, but shall assist the parties
and intervenors in reaching proposed settlements. When a settlement has been proposed in
writing, the presiding officer shall refer it to the board for decision, but
shall not stay the proceeding while the board is deliberating the settlement
proposal.
(e)
The presiding officer shall not decide motions or enter orders which
finally resolve the proceeding or stay the proceeding for more than 30 days.
Potentially dispositive motions shall be referred to the board or deferred
until the close of the record.
(f)
If the presiding officer believes that a default or similar final order
should enter against a party, the presiding officer shall issue a written
recommendation to the board, with service on each party and intervenor, and the
board shall take appropriate action after allowing the parties and intervenors
10 days to file objections thereto.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8778,
eff 12-23-06; ss by #10297, eff
3-22-13
Nur 208.03 Exceptions to Rulings By the Presiding
Officer.
(a)
There shall be no interlocutory appeal to the board of procedural or
discovery orders made by the presiding officer.
(b)
After the close of the record, the parties and intervenors shall be
provided 10 days to submit written exceptions to rulings of the presiding
officer. The board shall rule upon any such exceptions and shall reopen or
modify the record, if necessary or appropriate to effect relief.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8778,
eff 12-23-06; ss by #10297, eff
3-22-13
Nur 208.04 Withdrawal of Presiding Officer.
(a) Upon his or her own initiative or upon the
motion of any party or intervenor, the presiding officer shall withdraw from
any adjudicative proceeding for good cause.
(b) Good cause shall exist if the presiding
officer:
(1) Has a direct interest in the outcome of the
matter, including but not limited to, a financial or family relationship with
any party or intervenor;
(2) Has made statements or engaged in behavior which
objectively demonstrates that he or she has prejudged the facts of the case; or
(3) Personally believes that he or she cannot
fairly judge the facts of the case.
(c) Mere knowledge of the issues or acquaintance
with any party, intervenor or witness shall not constitute good cause for
withdrawal.
Source. #8778,
eff 12-23-06; ss by #10297, eff
3-22-13
PART Nur 209 RECONSIDERATION
Nur 209.01 Motion for Reconsideration.
(a)
An adjudicative order of the board shall not be final until the date it
is served upon the parties pursuant to Nur 205.03(d).
(b)
Within 30 days after service of a final adjudicative order of the board,
any party or intervenor may file a motion for reconsideration. No distinction
shall be made between the terms “reconsideration” and “rehearing” for purposes
of RSA 326-B: 39.
(c)
A motion for reconsideration of a proposed board order shall be filed
pursuant to RSA 326-B:39 and comply with Nur 206.03(a) and (b).
(d)
A motion for reconsideration shall be filed within 30 days of the date
of an agency decision or order.
(e)
A motion for reconsideration shall:
(1) Identify each error of fact, error of
reasoning, or error of law which the moving party wishes to have reconsidered;
(2) Set forth fully every ground upon which it is
claimed that the decision or order is unlawful or unreasonable, or based upon a
mistake of fact or law;
(3) State concisely the factual findings,
reasoning or legal conclusion proposed by the moving party; and
(4) Include any argument or memorandum of law the
moving party wishes to file.
(f)
A motion for reconsideration shall be granted if it demonstrates that
the board’s decision or order is unlawful or unreasonable, or based upon a
mistake of fact or law.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8778,
eff 12-23-06; ss by #10297, eff
3-22-13
Nur 209.02 Reconsideration on the Board’s Own Motion.
(a)
Within the time frame specified in Nur 209.01(b), the board shall
reconsider, revise, reverse or affirm any final action on its own motion.
(b)
If reconsideration is based upon the existing record, prior notice shall
not be given to the parties. If the board believes further argument or evidence
should be considered to eliminate a possible mistake of fact or conclusion of
law, an appropriate order providing the parties and intervenors with notice and
opportunity to be heard shall be issued before any revision is made in the
board’s previous action.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8778,
eff 12-23-06; ss by #10297, eff
3-22-13
Nur 209.03 Stay of Board Orders.
(a) A stay of board action shall be
specifically requested. The mere filing of a motion for reconsideration shall
not operate as a stay of any order, but a motion for stay may be combined with
a motion for reconsideration.
(b)
A motion for stay shall be granted only if it
is filed with a motion for reconsideration and within the time period specified
by Nur 209.01(b). Such a motion for stay
shall be granted automatically and shall remain in effect unless and until the
board denies the motion for reconsideration.
(c)
The board, acting on its own motion, shall stay the effect of any board
order to allow submission of additional exhibits or testimony within the time
period specified in Nur 209.01(b).
Source. #8778,
eff 12-23-06; ss by #10297, eff
3-22-13
PART Nur 210 CONSOLIDATION
Nur 210.01 Consolidation. Whenever it shall appear to the board, upon
motion or its own initiative, that 2 or more proceedings involve substantially
similar or substantially related issues, the board shall, as fairness and
efficiency permit, consolidate those proceedings for hearing, or decision, or
both.
Source. (See Revision Note at #1 chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8778,
eff 12-23-06; ss by #10297, eff
3-22-13
Nur 210.02
Severance. Whenever it
shall appear to the board, upon motion or its own initiative, that injury to
the substantial rights of a party or undue delay may be thereby avoided, the
board shall, as fairness and efficiency permit, sever one or more issues from a
proceeding, and dispose of those issues in another proceeding.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8778,
eff 12-23-06; ss by #10297, eff
3-22-13
PART Nur 211 PROCESSING OF COMPLAINTS, INVESTIGATIONS
Nur 211.01 Initiation of Disciplinary Proceedings. The board shall undertake investigations and
disciplinary hearings, in response to a written complaint filed in accordance
with Nur 206.02 or in response to other information that comes to the board’s
attention.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8779, eff 12-23-06; ss by #10297, eff 3-22-13
Nur 211.02
Processing of Complaints and Complainant Participation.
(a)
Upon receipt of a complaint, the board shall commence an investigation
pursuant to Nur 211.03.
(b)
The board shall dismiss a complaint at any time for failure to state a
cause of action, failure to respond to a request for information, or failure to
participate in any investigation or hearing ordered by the board. However, the board shall independently pursue
allegations of misconduct alleged against a licensee under their jurisdiction
upon receipt of information alleging such misconduct. Such complaint shall
adhere to Nur 206.02.
(c)
At any stage of the board’s investigation of the allegations in a
complaint, the board shall, with the consent of the licensee, enter a
settlement agreement that imposes discipline upon the licensee and terminates
further disciplinary action in whole or part.
(d)
Action under (c) above, shall not be taken unless:
(1) The complainant receives notice and an
opportunity to submit written comments concerning the proposed settlement or
consent decree; and
(2) There are no material facts in dispute
between the licensee, the complainant, and intervenor and the proposed
discipline would not be greater than foreseen discipline imposed by the board
after notice and opportunity for hearing pursuant to Nur 200.
(e)
At any time during the board’s investigation of the allegations in a
complaint, the board shall encourage the licensee and the complainant to
participate in mediation on a timely and good faith basis with a non-board
member designated and who agrees to act as a mediator.
(f)
When mediation is agreed to be undertaken pursuant to (e), above, the
mediator shall attempt resolution of the dispute between the complainant and
the licensee, and, within 60 days of agreement to mediate, shall submit a
written report to the board.
(g)
The report noted under (f), above, shall contain:
(1) A written settlement agreed by the parties;
or
(2) A report that indicates only that settlement
of the issues between the complainant and the licensee could not be reached.
(h)
Upon receiving the mediator’s report, the board shall proceed with
further disciplinary proceedings or, with consent of complainant, discontinue
its investigation.
(i) Misconduct issues alleged by the complainant
and disclosed to the mediator during good faith mediation shall be negotiated
by the complainant and the licensee.
(j)
Unless previously settled, a complaint that raises issues of misconduct
shall be incorporated into a notice of hearing that commences a disciplinary
hearing pursuant to Nur 210.04.
(k)
When a complaint is the subject of a disciplinary hearing, the notice of
hearing shall provide the complainant the opportunity to intervene in the
proceeding. A complainant shall have no rights to participate in a disciplinary
hearing unless an affirmative election to intervene is made in writing to the
board.
(l)
Information provided during an evidentiary hearing shall be considered
public information.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8779, eff 12-23-06; ss by #10297, eff 3-22-13
Nur 211.03
Investigations.
(a)
The board shall conduct such investigations as are necessary to examine
acts of possible misconduct that come to its attention through complaints or
other means.
(b)
The board shall issue subpoenas in investigations whenever it determines
that it needs access to documents, persons, or things that would not otherwise
be made available to it in the absence of a subpoena.
(c)
The board shall conduct an investigation of any person licensed by the
board who has been the subject of 3 different medical injury actions reported
under RSA 326-B:37.
(d)
The board shall appoint a member of its staff, or one or more of its
members, or other knowledgeable person to conduct the investigation. Each board
member who participates in an investigation shall not participate in any
further actions of the board concerning the subject matter of that
investigation.
(e) The type, form and extent of an
investigation shall be determined pursuant to the following:
(1) The statutory or regulatory authority for the
investigation;
(2) Any statutes or rules believed to have been,
or about to be, violated;]
(3) The identity of the persons, or class of
persons, that are subject of the investigation;
(4) The general nature of the conduct being
investigated;
(5) The date upon which the investigating officer
shall report his or her findings and recommendations to the board;
(6) Any special authority conferred upon the
investigating officer.
(f)
Investigations shall not commence a disciplinary hearing and shall not
constitute an allegation of misconduct against a licensee.
(g)
When an investigation occurs, an investigator designated by the board
shall contact such persons and examine such records and other documents as are
reasonably necessary to make a recommendation to the board as to whether there
is reasonable basis to conduct disciplinary proceedings.
(h)
Investigations, including those based upon allegations in a complaint,
shall be conducted on an ex parte basis.
(i) Following the investigation, the investigator
shall make a recommendation as to whether there is reasonable basis to conduct
disciplinary proceedings.
(j)
Investigatory reports and all information gathered by an investigator
shall be confidential, provided that:
(1) The investigator’s report shall be made
available to the parties in any adjudicatory proceeding resulting therefrom;
and
(2) The board shall provide information gathered
in disciplinary investigations to:
a. Law enforcement agencies;
b. Health licensing boards or agencies,
including those in other jurisdictions;
c. Board investigators or prosecutors;
d. Expert witnesses or assistants retained by board
prosecutor or investigators in the same or related disciplinary matters; or
e. Persons to whom the licensee has given a
release.
(k) Information gathered during investigations
shall not be released to the public until an evidentiary hearing is held or a
final settlement or other disposition of such a proceeding is reached.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8779, eff 12-23-06; ss by #10297,
eff 3-22-13
Nur 211.04 Disciplinary Hearings.
(a)
Adjudications in disciplinary matters shall be conducted in accordance
with Nur 207. The presiding officer
shall set forth in writing all orders which shall be served upon the parties
and intervenors.
(b)
A hearing notice shall be amended at any time prior to the issuance of a
final order. The parties shall receive
at least 15 days’ notice and an opportunity to be heard on any amended issues.
(c) The decision to appoint a prosecuting and /or
investigatory attorney shall not be the subject of a motion by any party. The board shall appoint an attorney to
represent the board at any time during the course of a disciplinary hearing, if
such expertise is required upon the advise and
consent of the attorney general office.
(d)
Prehearing conferences in disciplinary proceedings shall not be open to
the public.
(e)
The parties shall submit written memoranda of law or fact, proposed
findings of fact and conclusions of law, or present oral argument on some or
all aspects of the proceeding when requested to do so by the presiding officer.
(f)
The parties shall, as ordered by the presiding officer, participate in
one or more supplementary hearings for the purpose of receiving additional
evidence relevant to the disciplinary proceeding. An order scheduling a supplemental hearing
shall be issued by the presiding officer at any time prior to the issuance of a
final order in the proceeding.
Source. #8778,
eff 12-23-06; ss by #10297, eff
3-22-13
PART Nur 212 RULEMAKING
Nur 212.01 How Adopted. A board rule, or any amendment or repeal
thereof, shall be proposed, adopted, and filed in accordance with RSA 541-A:5
through RSA 541-A:16 for 10-year and non-expiring rules, RSA 541-A:18 for
emergency rules, RSA 541-A:19-a for expedited repeal of rules, RSA 541-A:19-c
for expedited revision of forms and RSA 541-A:19 for interim rules.
Source. (See Revision Note #1 at chapter heading for Nur
100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM, eff
6-24-06, EXPIRED: 12-21-06
New. #8778,
eff 12-23-06; ss by #10297, eff
3-22-13
Nur 212.02
Petition for Rulemaking.
(a)
Any person may request the board to commence a proceeding for the
purpose of adopting, amending, or repealing a rule by filing a written petition
that contains:
(1) A statement of the petitioner’s request for
the proposed rule;
(2) The text of the proposed rule or a statement
of the particular results intended by the petitioner’s interest in the subject
matter of the proposed rule;
(3) An identification of the particular rule
sought to be amended or repealed;
(4) Any data or argument the petitioner believes
would be useful to the board in deciding whether to commence a rulemaking
proceeding; and
(5) Name, address, signature of petitioner and
date.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8778,
eff 12-23-06; ss by #10297, eff 3-22-13
Nur 212.03 Disposition of Petitions for Rulemaking.
(a) The board shall request additional
information or argument from the petitioner for rulemaking or from others if such
additional information or argument is required to reach a reasoned decision.
(b) The board shall grant the petition for
rulemaking unless the adoption, amendment or repeal sought would result in:
(1) A rule that is not within the rulemaking
authority of the board;
(2) Duplication of a rule or of a statutory
provision;
(3) Inconsistency between the existing rules and
the statutory mandate of the board;
(4) Inconsistency of administrative rules one
with another; or
(5) Excessive burden upon the board in terms of
cost or a reduction in efficiency or effectiveness.
(c) Within 30 days of receipt of a sufficient petition
the board shall dispose of it in the following manner:
(1) By notifying the petitioner that the petition
is granted and beginning rulemaking proceedings as required by RSA 541-A:4; or
(2) By notifying the petitioner in writing that
the petition is denied and the reasons for its denial.
(d) The denial of a petition for rulemaking shall
not entitle the petitioner to a hearing.
Source. #8778,
eff 12-23-06; ss by #10297, eff 3-22-13
PART Nur 213 EXPLANATION OF ADOPTED RULES
Nur 213.01 Requests for Explanation of Adopted Rules. Any interested person may, within 30 days of
the final adoption of a rule, request a written explanation of that rule by
making a written request to the board including:
(a) The name and address of the individual making
the request; or
(b) If the request is that of an organization or other
entity, the name and address of such organization or entity and the name and
address of the representative authorized by the organization or entity to make
the request.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8779, eff 12-23-06; ss by #10297, eff 3-22-13
Nur 213.02 Contents of Explanation. The board shall, within 90 days of receiving
a request in accordance with Nur 213.01, provide a written response which:
(a) Concisely states the meaning of the rule
adopted;
(b) Concisely states the principal reasons for
and against the adoption of the rule in its final form; and
(c) States, if the board did so, why the board
overruled any arguments and considerations presented against the rule.
Source. #8779, eff 12-23-06; ss by #10297, eff 3-22-13
PART Nur 214 DECLARATORY RULINGS
Nur 214.01 Petitions.
(a)
Any person may request a declaratory ruling from the board on matters
within its jurisdiction by filing an original and 11 copies of a petition
pursuant to Nur 206.01(b).
(b)
Such a petition shall also set forth the following information:
(1) The exact ruling being requested;
(2) The statutory and factual basis for ruling,
including any supporting affidavits or memoranda of a law; and
(3) A statement as to how and why the issuance of
a ruling on this subject would benefit the petitioner.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8778,
eff 12-23-06; ss by #10297, eff 3-22-13
Nur 214.02 Action on Petitions.
(a)
The petitioner shall provide such further information or participate in such
evidentiary or other proceedings as the board shall direct after reviewing the
petition and any replies received.
(b)
Upon review and consideration, the board shall within 90 days respond to
the petition giving its decision in writing.
(c)
The decision shall be in accordance with Nur 206.01(c).
Source. #8778,
eff 12-23-06; ss by #10297, eff 3-22-13
CHAPTER Nur 300 LICENSING REQUIREMENTS
Statutory
Authority: RSA 326-B:4, III
REVISION
NOTE:
The Governor declared a State of
Emergency in Executive Order 2020-04, which was effective 3-13-20. The declaration and subsequent Emergency
Orders issued pursuant to Executive Order 2020-04 affected various rules and
statutes governing licensing under Chapter Nur 300, such as Exhibit H to
Emergency Order #29, effective 5-19-20, which modified Nur 303.05 titled “RN
and LPN Licensure through Comparable Education” and RSA 326-B:24. The State of Emergency terminated at midnight
on 6-11-21, and rules or statutes amended during the State of Emergency were restored. To determine what rules in Nur 300 were applicable
during the State of Emergency, the user should check not only the source notes
of the rules but also the Emergency Orders in effect at the time in question.
Document #13012, effective 3-16-20,
amended paragraph (d) in Nur 303.02 titled “Registered and Practical Nurse
Examinations” as an emergency rule.
Pursuant to RSA 541-A:18, V, the emergency rule expired 9-23-20, and Nur
303.02(d) was effective again in its original form in Document #12753,
effective 4-4-19.
Document #13219, effective 6-25-21,
readopted with amendment Nur 301.02 titled “Temporary Registered and Practical
Nurse Licensure” as an emergency rule.
Pursuant to RSA 541-A:18, V, the emergency rule expired 12-22-21, and
Nur 301.02 was effective again in its original form in Document #12753,
effective 4-4-19.
Document #13300, effective 12-3-21,
readopted with amendment Nur 301.05 titled “Licensed Nursing Assistant” as an
emergency rule. Pursuant to RSA
541-A:18, V, the emergency rule expired 6-1-22, and Nur 301.05 was effective
again in its original form.
Document
#13301, effective 12-3-21, adopted Nur 302.015 titled “Restricted Licensure
Pending Criminal Records Check” as an emergency rule. Pursuant to RSA 541-A:18, V, the emergency
rule expired 6-1-22.
Document
#13424, effective 8-2-22, readopted with amendment Nur 301.05 titled “Licensed
Nursing Assistant” as a regular rule and adopted Nur 302.07 titled “Restricted
Licensure Pending Criminal Records Check” as a regular rule.
PART Nur
301 APPLICATION PROCEDURE
Nur
301.01 Registered Nurse and Licensed
Practical Nurse Licensure by Examination.
(a)
This section shall apply to those who seek licensure by examination as a
registered nurse or practical nurse in New Hampshire under RSA 326-B:17.
(b)
Each person seeking licensure as a registered nurse or practical nurse
by examination who was educated in the United States or Canada, except for
Quebec Province shall:
(1) Complete and submit to the board a forms
packet containing the following forms listed below, including all required
explanations as attachments:
a. “Application Process for
Licensing by Examination (NCLEX),” as amended 12/2018, including verification
that the individual has pre-registered with Pearson VUE and paid the required
fee;
b. “NH Board of Nursing License
by Examination (NCLEX) Application,” as amended 12/2018;
c. “Declaration of Primary
State of Residency Form,” as amended 12/2018;
d. “LPN Comparable Education
Verification Form,” as amended 12/2018;
e. “RN Comparable Education
Verification Form,” as amended 12/2018;
f. “NH Board of Nursing
Temporary License Application,” as amended 12/2018; and
g. “Optional Information
Question Regarding Military Experience and/or Relationship to Military
Personnel Transferred to New Hampshire,” as amended 12/2018; and
(2) Have the following documents submitted to the
board:
a. “New
Hampshire Board of Nursing Record Information Authorization” form, also known
as form DSSP from the department of safety, available at https://www.oplc.nh.gov/nursing/documents/criminal-background.pdf;
b. A
completed fingerprint card or submission of Live Scan documentation. A fingerprint card may be obtained by
contacting the board offices. Livescan
site locations are listed on the department of safety’s website at https://www.nh.gov/safety/divisions/nhsp/ssb/crimrecords/index.html;
c. The fee, as required by the
department of safety;
d. Final official transcript showing completion of the nursing
educational program requirements, the type of degree conferred, and the date of
graduation; and
e. If requesting American with
Disabilities Act (ADA) Accommodations when taking the NCLEX, a “Request for
NCLEX Accommodations under the Americans with Disabilities Act” form, as
amended 2/28/18.
(c) Each person seeking licensure as a registered
nurse or practical nurse by examination who was educated outside of the United States or educated in Quebec
Province shall:
(1) Complete and submit to the board a forms
packet containing the following forms listed below, including all required
explanations as attachments:
a. “Application Process for
Licensing by Examination (NCLEX),” as amended 12/2018, including verification
that the individual has pre-registered with Pearson VUE and paid the required
fee;
b. “License by Examination
(NCLEX) Application,” as amended 12/2018;
c. “Declaration of Primary
State of Residency Form,” as amended 12/2018; and
d. A notarized Criminal Record Release
Authorization, available at https://www.oplc.nh.gov/nursing/criminal-background-
check.htm/, and completed fingerprint card along with any required
fee, with the New Hampshire board of nursing identified as the recipient of the
record or records; and
(2) Have the following documents submitted to the
board:
a. All foreign educated nurses
shall provide evidence of educational evaluations by an organization recognized
by National Council State Board of Nursing, which includes a certificate of a
passing grade from an examination pursuant to Nur 302.(c);
b. For applicants whose program
was not in English or English is not the applicant’s native language, the
credentialing shall also include an English proficiency exam that includes the
components of reading, speaking, writing and listening as required by RSA
326-B:46, Article III(c)(3); and
c. If requesting American with
Disabilities Act (ADA) Accommodations when taking the NCLEX, a “Request for
NCLEX Accommodations under the Americans with Disabilities Act” form, as
amended 2/28/18.
(d)
New Hampshire school of nursing students and military personnel applying
pursuant to Nur 303.05 shall submit evidence, by means of an official stamped transcript,
of educational experiences comparable to Nur 602.12 and Nur 602.13.
(e)
All applicants for initial licensure shall submit the application fee of
$120.
(f)
All applicants for initial licensing shall comply with the Nurse
Licensure Compact (NLC) Model Rules and Regulations developed by the Nurse
Licensure Compact Administrators (NLCA) as amended January 19, 2018 and as
referenced in Appendix 2.
(g)
An applicant who has satisfactorily met the requirements of this section
shall:
(1) Receive a registered nurse license or a
practical nurse license, as appropriate; and
(2) Be authorized to use the title RN or LPN, as
appropriate.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; amd
by #7101, eff 9-20-99; ss by #8664, INTERIM, eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #10298, eff
3-22-13; ss by #10996, eff 12-19-15; ss by #12753, eff 4-4-19
Nur 301.02 Temporary Registered and Practical Nurse
Licensure.
(a) This
section shall apply to each registered or practical nurse applicant who has met
the requirements for licensure except passage of the required examination and
seeks a once-per-lifetime temporary registered or practical nurse
license pursuant to RSA 326-B:24 while awaiting a decision on full licensure
pursuant to Nur 301.01.
(b) Each applicant for a temporary registered or
practical nurse license shall:
(1) Submit a completed
“Application for New Hampshire Temporary Nurse Licensure”, as amended 7-2015;
(2)
Demonstrate proficiency in English as outlined in Nur 302.01(a), if
currently foreign educated; and
(3) Pay the application fee of
$20.
(c) Each temporary license shall expire at the
earlier of the following:
(1) A final licensure determination
is made after receipt of initial examination results; or
(2) The passage of 120 days
from the date of issuance.
(d) A temporary licensee shall, pursuant to RSA
326-B:24, III, practice only under the supervision of an RN currently licensed
in New Hampshire or working under a compact license, pursuant to RSA 326-B:46.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #10298, eff
3-22-13; ss by #10996, eff 12-19-15; ss by #12753, eff 4-4-19; ss by #13219,
EMERGENCY RULE, eff 6-25-21, EXPIRED: 12-22-21 (see Revision Note at chapter
heading for Nur 300)
Nur
301.03 Advance Practice Registered
Nurse (APRN) Licensure.
(a) This section shall apply to each registered
nurse licensed in New Hampshire and to each nurse who holds a current,
unencumbered registered nurse license from a compact state pursuant to RSA
326-B:46, who seeks licensure in New Hampshire as an APRN.
(b) Each applicant seeking licensure as an APRN
under this section shall submit:
(1)
Evidence of completion of an accredited advanced
nursing education program that includes:
a. At least 225 hours of theoretical nursing
content; and
b. At least
480 hours of clinical nursing practice, including precepted experience and
pharmacological interventions;
(2) A final, official transcript from a nurse
practitioner program, accredited by a national accrediting body, that
demonstrates that the applicant earned a:
a. Graduate or post-masters graduate degree; or
b. Certificate prior to July 1, 2004;
(3) Documentation from the director of the
program identified pursuant to (2) above for each pharmacology course taken but
not reflected on the transcript, verifying integration of pharmacological
interventions;
(4) Evidence of competence to practice, as a
result of participation in and completion of the nurse practitioner
program.
(5) The following, if the applicant graduated
from an APRN program 2 or more years prior to the submission of the
application:
a. A copy of current national certification
pursuant to Nur 302.04(a)(6);
b. Documentation
of meeting the advanced practice requirements set forth in Nur 302.04(a)(6);
and
c. Documentation of completion of the continuing
education required pursuant to Nur 302.04(a)(7) including at least 5 hour in
pharmacology, within the 2 years immediately preceding the application;
(6) The following forms:
a. A separate Form “Application Process for APRN
License”, as amended 4-2015; and
b. Declaration of Primary State of Residence, as
amended 1-2015; and
(7) To the department of safety, division of
state police, a notarized Criminal Record Release Authorization along with any
required fee, with the board identified as the recipient of the record or
records;
(c) An applicant who has satisfactorily met the
requirements of this section shall:
(1) Receive an Advanced Practice Registered Nurse
license; and
(2) Be authorized to use the title, APRN.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #10298, eff
3-22-13; ss by #10996, eff 12-19-15
Nur
301.04 Advanced Practice Registered
Nurse (APRN) Temporary Licensure.
(a)
Pursuant to RSA 326-B:24, a new graduate of an advanced nursing practice
educational program may seek a once-per-lifetime temporary licensure to
practice in the advanced role following verification of authorization from the
certifying agency to sit for the first national certifying examination in the
applicant’s specialty area.
(b)
Each temporary APRN license shall expire at the earlier of:
(1)
The passage of 120 days; or
(2)
The date on which the applicant receives either:
a.
A permanent APRN license, after having made timely application; or
b. Notice
that the applicant failed the national certifying examination.
(c)
An applicant seeking temporary APRN licensure shall, along with, or at
any time after, the submission of an “Application for License: Advanced
Practice Registered Nurse” submit:
(1)
A Form “Directions for Temporary APRN Licensure”, as amended 1-2015; and
(2)
The application fee of $20.
(d)
Notwithstanding (c) above, no applicant shall seek a temporary APRN
license after sitting for the national certifying examination.
(e)
As part of the application, the applicant shall provide a statement of
agreement from an APRN holding a currently unencumbered APRN license issued by
the board who agrees to oversee the applicant during the period of temporary
licensure.
(f)
Temporary APRN licensees shall use the designation “TAPRN” during the
period of temporary licensure.
(g)
Upon notification of the examination results by the national certifying
agency the licensee shall:
(1)
Complete the APRN licensing process within 15 business days if
successful in the examination specified above; or
(2)
Immediately cease APRN practice and notify the board within 15 business
days.
(h)
Failure to comply with (g) above, shall result in disciplinary action by
the board as specified in RSA 326-B: 37.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #10298, eff
3-22-13; ss by #10996, eff 12-19-15
Nur 301.05 Licensed Nursing Assistant.
(a) This section shall apply to those who seek
licensure as a nursing assistant (LNA) by competency examination or by having
received a comparable education.
(b) Each person seeking licensure as a nursing
assistant, regardless of method of qualification, shall:
(1)
Submit an “Application for Initial New Hampshire Nursing Assistant
License;” Nur 301.05 Form “Initial New Hampshire Nursing Assistant License”, as
amended 1/2015;
(2)
Submit to the department of safety, division of state police, a
notarized Criminal Record Release Authorization along with any required fee,
with the board identified as the recipient of the record or records; and
(3) Pay
the application fee of $35.
(c) Subject to (d), below, each applicant seeking
licensure as a nursing assistant by competency examination shall, in addition
to complying with (b) above:
(1)
Submit a copy of his or her LNA Education Program Certificate to
demonstrate successful completion of such program; and
(2)
Submit a copy of the final report for the Written and Clinical
Competency Testing results showing the applicant to be competent in all areas
tested.
(d) An applicant shall not be required to submit
the copies required by (c), above, if the program from which the applicant
graduated has already provided information to the board that the applicant has
successfully completed the program and passed the competency test.
(e) Each applicant seeking licensure as a nursing
assistant by comparable education shall, in addition to complying with (b)
above shall submit one of the following:
(1) His
or her nursing program transcript, showing successful completion of nursing
fundamentals coursework that contains content noted in Nur 704.09, within 5
years immediately prior to date of application;
(2) A
letter from the nursing program verifying successful completion of nursing fundamentals
coursework, that contains content noted in Nur 704.09, within 5 years
immediately prior to date of application; or
(3) A Challenge Examination Certificate and a
final report for the Written and Clinical Competency Evaluation Results showing
the applicant to be competent in all areas tested.
(f) An applicant who has satisfactorily met the
requirements of this section shall:
(1)
Receive a nursing assistant license; and
(2) Be
authorized to use the title LNA.
Source. #8873, eff 4-24-07; ss by #10298, eff
3-22-13; ss
by #10996, eff 12-19-15; ss by #13300, EMERGENCY RULE, eff 12-3-21, EXPIRED:
6-1-22; ss by #13424, eff 8-2-22 (see Revision Note at chapter heading for Nur
300)
Nur
301.06 Licensed Medication Nursing
Assistant.
(a) This section shall apply to licensed nursing
assistants who seek certification in New Hampshire as a medication nursing
assistant (MNA).
(b) Each LNA seeking certification as a MNA
shall:
(1) Submit a completed Form “Medication Nursing
Assistant Certification”, as amended
3-2014;
(2) Submit a copy of the completion certificate
from the MNA education program approved by the board;
(3) Submit a copy of the applicant’s current,
unrestricted LNA license issued by the board; and
(4) Pay the application fee of $10.
(c)
An applicant who has satisfactorily met the requirements of this section
shall receive a MNA certificate.
Source. #8873, eff 4-24-07; ss by #10298, eff
3-22-13; ss by #10996, eff 12-19-15
Nur 301.07 Fees.
(a)
Checks to pay fees shall be made out to “Treasurer, State of New
Hampshire.”
(b)
Applicants may pay by credit or debit card if using e-licensing through
the state’s online licensing website, https://nhlicenses.nh.gov/. The board’s requirements for obtaining a
license through the website shall be the same as for obtaining a license
through the submission of a traditional, paper application.
Source. #8873, eff 4-24-07; ss by #10298, eff 3-22-13
PART Nur 302
QUALIFICATIONS
Nur
302.01 General Qualifications for All
Applicants. Each applicant for any
license or certificate issued by the board shall, pursuant to RSA 326-B:16,
meet the following general requirements:
(a) The applicant shall have the ability to read
and write the English language, and demonstrate such proficiency through
either:
(1) Graduating from a school of nursing in which:
a. All classroom instruction was in English;
b. All nursing textbooks were in English; and
c. The majority of all clinical experience was
in English; or
(2) Passing the English proficiency evaluation of
a nationally accepted accrediting agency examination endorsed by the National
Council of State Boards of Nursing;
(b) The applicant shall have committed no acts or
omissions which are grounds for disciplinary actions as set forth in RSA 326-B,
unless the board determines that sufficient restitution has been made for such
acts or omissions;
(c) The applicant shall not have been convicted
of a crime constituting any of the following unless such conviction was
annulled by a court of competent jurisdiction:
(1) Murder or manslaughter;
(2) Robbery;
(3) Felonious theft;
(4) Felonious assault;
(5) Sexual crime involving a child;
(6) Kidnapping; or
(7) Endangering the welfare of a child or
incompetent person.
(d)
The applicant shall not have committed any act or engaged in any course
of conduct involving intentional deception by the applicant, whether in the
course of employment or as private conduct, that indicates the applicant cannot
be entrusted with the care of patients; and
(e)
The applicant shall submit a complete application for the specific
license or certificate sought, including the payment of all required
application and related fees.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #9395, eff 2-25-09;
ss by #10298, eff 3-22-13
Nur
302.02 Qualifications for Initial
Registered and Practical Nurses Licensure by Examination. Each applicant for an initial registered or
practical nurse license by examination shall:
(a) Meet the general requirements of Nur 302.01;
and
(b) Meet either education requirement:
(1) Graduated from a board approved nursing
education program in the United States or Canada that meets the requirements
set forth in Nur 600, including the NCLEX-RN or NCLEX-PN course requirements;
or
(2) Graduated from a nursing program outside the
United States or Canada;
(c) Take and pass either the:
(1) NCLEX exam if a graduate of a board approved
nursing education program in the United States or Canada; or
(2) A nationally accepted accrediting agency
examination endorsed by the National Council of State Boards of Nursing
examination and NCLEX if a graduate of a board approved nursing education
program outside the United States or Canada.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #10298, eff 3-22-13
Nur 302.03 Qualifications for Initial Registered and
Practical Nurses Licensure by Endorsement.
(a)
Each applicant for an initial registered or practical nurse license by
endorsement shall:
(1)
Meet the general requirements of Nur 302.01;
(2)
Hold a current, unencumbered license in any other jurisdiction; and
(3)
Submit verification of licensure status from the jurisdiction of
licensure by examination.
(b)
Graduates of a nursing program in the United States or Canada, except
Quebec, who have passed the NCLEX examination, shall also meet all of the
requirements of Nur 304.01.
(c)
Graduates of a nursing program in Canada who have not taken the NCLEX
examination shall also meet all of the requirements of Nur 304.02.
(d)
Graduates of a non-Canadian foreign nursing program who have taken the
NCLEX examination shall also meet all of the requirements of Nur 304.03.
(e)
Graduates of a non-Canadian foreign nursing program shall present
verification pursuant to Nur 301.01(b)(2)a.2 that the nursing educational
program required theoretical and clinical content that meets the minimum
requirements of Nur 601.15 and Nur 601.16.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; amd
by #7101, eff 9-20-99; ss by #7740, eff 8-13-02; ss by #8873, eff 4-24-07; ss by #10298, eff 3-22-13; ss by #10996,
eff 12-19-15; ss by #12753, eff 4-4-19
Nur 302.04 Qualifications for an Initial Advanced
Practice Registered Nurse (APRN) License.
(a)
Each applicant for an initial advanced registered nurse practitioner
license shall:
(1)
Meet the general requirements of Nur 302.01;
(2)
Hold a current and unencumbered RN license issued by the board or a
multi-state license issued by another compact state;
(3)
Have either:
a. Earned a graduate degree in an accredited
advanced registered nurse practitioner education program; or
b.
Graduated before July 1, 2004 from a APRN education program accredited
by a national accrediting body that meets the requirements of Nur 600;
(4)
Be competent to practice as a result of graduation from an educational
program that complies with (3) above that has been recognized by the National
Council of State Boards of Nursing in the specialty area of practice;
(5)
Hold current certification from a national certifying body, recognized
by the by National Council of State Boards of Nursing, that specializes in the
APRN area of practice;
(6)
Have used advanced practice nursing knowledge, judgment, and skills for
at least 400 hours within the 4 years immediately preceding the application;
and
(7)
If the applicant graduated from an advanced nurse practitioner program 2
or more years prior to the date of application, taken:
a.
At least 30 educational contact hours to satisfy the requirements of RN
continuing competence; and
b.
An additional 30 hours, at least 5 of which shall be training in
pharmacology appropriate to the specialty, within 2 years immediately prior to
date of application.
(b) Current certification as described in (a)(5)
above may be counted for 30 of the 60 contact hour requirement of (a)(7).
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #9395, eff 2-25-09;
ss by #10298, eff 3-22-13
Nur 302.05 Qualifications for an Initial Nursing
Assistant License. Each applicant
for an initial nursing assistant license shall:
(a)
Meet the general requirements of Nur 302.01; and
(b)
If seeking licensure by examination:
(1)
Successfully complete a board-approved nursing assistant education
program pursuant to Nur 700; and
(2)
Pass the examination required pursuant to Nur 700; or
(c) If seeking licensure by endorsement, hold a
current, unencumbered license in another jurisdiction and shall:
(1)
Have used nursing assistant knowledge and skills for a minimum of 200
hours in the 2 years immediately preceding the application; and
(2)
Either:
a. Provide documentation of at least 24
educational contact hours within 2 years
immediately preceding the application to satisfy the requirements of LNA continuing competence; or
b. Have taken and passed a competency evaluation
within the 2 years immediately preceding the application.
Source. #6778, eff 6-26-98; ss by #8664, INTERIM, eff
6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #10298, eff
3-22-13; amd by #11146, eff 7-28-16
Nur 302.06 Qualifications for a Medication Nursing
Assistant Certificate. Each
applicant for an initial medication nursing assistant certificate shall:
(a)
Possess a current unencumbered LNA license issued by the board;
(b)
Successfully complete a board-approved medication administration
education program described in Nur 800; and
(c) Pass the required the competency evaluation
described in Nur 800.
Source. #8873, eff 4-24-07; ss by #10298, eff 3-22-13
Nur 302.07 Restricted Licensure Pending Criminal
Records Check.
(a)
Notwithstanding Nur 302.01(c), an applicant who meets all other
qualifications shall be issued a restricted, single-state license pending
receipt of the results of the criminal records check.
(b)
Upon receipt of the results of the criminal records check demonstrating
that the requirement of Nur 302.01(c) has been met, the restricted license
shall be converted to a regular license without further action by the holder of
the restricted license, provided that for RNs and LPNs, the regular license
shall be multi-state license.
(c)
Upon receipt of the results of the criminal records check demonstrating
that the requirements of Nur 302.01(c) are not met, then:
(1) The restricted license shall be immediately
suspended under RSA 541-A:30, III; and
(2) The board shall commence an adjudicative
proceeding to determine whether to revoke the restricted license
Source. #13424, eff 8-3-22
PART Nur 303 EXAMINATION
Nur
303.01 Applicant Responsibility for
Examination. Each applicant for
licensure shall:
(a)
Contact the appropriate examining entity and obtaining all application
materials;
(b)
Submit all required application materials, including any required fee;
(c)
Arrange to sit for all portions of the required examination; and
(d) Actually sit for and pass all portions of the
required examination.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #10298, eff 3-22-13
Nur 303.02 Registered and Practical Nurse
Examinations.
(a)
Each person seeking licensure as an LPN and who graduated from a nursing
education program in the United States or Canada shall take and pass the
NCLEX-PN examination.
(b)
Each person seeking licensure as an RN and who graduated from a nursing
education program in the United States or Canada, except Quebec, shall take and
pass the NCLEX-RN examination, unless the applicant meets the requirement for
endorsement under Nur 304.02.
(c)
Each person seeking licensure as an RN or LPN and who graduated from a
nursing education program outside the United States or Canada or has graduated
from a nursing program in Quebec shall:
(1)
Provide a certificate of a passing grade from an examination endorsed by
the National Council of State Boards of Nursing, issued within the 2 years
prior to the date of the application;
(2)
Provide evidence the applicant has received educational credentials
review from an institution accredited by the National Council State Boards of
Nursing; and meets English language requirements pursuant to Nur 302.01(a); and
(3)
Provide verification of any existing nursing license from the issuing
jurisdiction.
(d)
For graduates of programs within the US or Canadian Provinces where the
NCLEX is required, the NCLEX shall be taken within 6 months of graduation from
an approved school of nursing.
(e)
Notwithstanding (d) above, the following individuals may take the NCLEX
examination at any time following graduation from an approved school of
nursing:
(1)
Graduates of foreign nursing schools that have:
a.
Practiced in the licensed role for a minimum of 400 hours within the
past 4 years before filing the application; and
b. Have
met the requirements of Nur 303.02 (c); and
(2)
Graduates of Canadian nursing schools that have:
a. Practiced in the licensed role for a minimum
of 400 hours within the past 4 years before filing the application; and
b. Are taking NCLEX for licensure.
(f)
An applicant required by this part to obtain a passing grade on the
NCLEX examination shall have a lifetime total of 5 opportunities within a
consecutive 3 year period to obtain a passing grade on the examination.
(g)
An applicant may take the examination 3 times without intervention by
the board.
(h)
Prior to a fourth attempt:
(1)
The applicant shall submit to the board a written plan of remediation
and propose measures the applicant
intends to implement in order to pass the exam;
(2)
Once the board receives a plan of remediation, it shall review the
proposed remediation plan, and:
a. Approve the plan if it addresses the
applicant’s barriers to passing the examination;
b. Deny the plan if it fails to adequately
address such barriers, and return it to the applicant with written findings of
the reason(s) for denial; and
c. The applicant may submit a revised plan of
remediation for consideration by the board; and
(3)
The remediation plan shall:
a. Be completed no more than one year prior to
taking the examination, and
b. The applicant shall submit evidence of
completion of the remediation plan prior to again sitting for the examination.
(i) Following a fourth failure to obtain a
passing grade on the required NCLEX examination, an applicant shall not be
permitted to retake the examination for the fifth and final time unless the
following occurs:
(1)
The applicant submits to the board a second and updated written plan of
remediation and proposes measures the applicant intends to implement in order
to pass the exam;
(2)
Once the board receives a plan of remediation, it shall review the
proposed remediation plan, and either:
a. Approve the plan if it addresses the
applicant’s barriers to passing the examination; or
b. Deny the plan if it fails to adequately
address such barriers. If the board does so, it shall return the plan to the
applicant with written findings of the reason(s) for denial.
(3)
The remediation plan shall:
a. Be completed no more than one year prior to
taking the examination, and
b.
The applicant shall submit evidence of completion of the remediation
plan prior to again sitting for the examination.
Source. #5925, INTERIM, eff 11-21-94; ss by #6010,
eff 3-25-95; ss by #6778, eff 6-26-98; ss by #8664, INTERIM, eff 6-24-06,
EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #9395, eff 2-25-09;
ss by #10298, eff 3-22-13; ss by #10996, eff 12-19-15; ss
by #12753, eff 4-4-19; amd by #13012, EMERGENCY
RULE, eff 3-27-20, EXPIRED: 9-23-20 (see
Revision Note at chapter heading for Nur 300)
Nur
303.03 Licensed Nursing Assistant
Competency Examinations.
(a) Each
person seeking licensure as a LNA who graduated from a nursing assistant
education program in the United States shall take and pass a competency
evaluation approved by the board and administered by an organization
approved by the board. Approval of such
examinations and organizations shall be determined by applying the criteria for
each as set forth in Nur 700.
(b) The following individuals may take the
examination:
(1) Graduates from an approved nursing assistant
program in New Hampshire;
(2) Graduates of nursing assistant schools in
other jurisdictions; and
(3) Students in board approved nursing programs
who have successfully completed the fundamentals of nursing curriculum.
Source. #8873, eff 4-24-07; ss by #10298, eff 3-22-13
Nur 303.04 Medication Nursing Assistant Examinations.
(a)
Each person seeking licensure as a MNA and who graduated from a
medication nursing assistant education program in New Hampshire shall take and
pass a competency evaluation approved by the board and administered by an
organization approved by the board.
Approval of such examinations and organizations shall be determined by
applying the criteria for each as set forth in Nur 800.
(b)
Only those who have completed a medication nursing assistant education
program in New Hampshire may take the examination.
Source. #8873, eff 4-24-07; ss by #10298, eff 3-22-13
Nur 303.05 RN and LPN Licensure through Comparable
Education.
(a)
Licensure as an LPN through comparable education shall be limited to:
(1)
Pre-licensure students attending approved state of New Hampshire nursing
programs; or
(2) Military personnel who meet New
Hampshire’s minimum educational practical nursing requirements pursuant to Nur.
602.13 and Nur 602.12.
(b)
Applicants for licensure as an LPN through comparable education shall
submit:
(1)
Form “LPN Comparable Education Verification Form,” as amended
12/2018, referenced in Nur 301.01(b)(1)(d); and
(2)
Evidence of completion of a minimum of 600 course work hours of
instruction that meet the requirements of Nur 602.12 in:
a. Fundamentals of Nursing;
b. Medical/Surgical Nursing;
c. Mental Health Nursing;
d. Parent and Child Health; and
e. Any other applicable nursing courses required
under Nur.602.13.
(c)
In order to license as an LPN, a passing grade shall be obtained on the
NCLEX-PN examination, provided that no applicant for licensure by comparable
education shall be permitted to take the examination more than 2 times.
(d)
The NCLEX PN exam shall be taken within 6 months of leaving an RN
program or at any point during matriculation through an RN program. An applicant for licensure may take the
NCLEX-PN up to 2 times within a 2 year period.
(e)
Applicants for licensure as an RN through comparable education shall
submit:
(1)
Form “RN Comparable Education Verification Form,” as amended
12/2018, referenced in Nur 301.01(b)(1)(e);
(2)
Evidence of completion of a minimum of 1080 course work hours of
instruction that meet the requirements of Nur 602.13; and
(3)
A stamped official transcript that verifies completion of general
education requirements as required by Nur 302.02;
(f)
In order to license as an RN, a passing grade shall be obtained on the
NCLEX-RN examination, provided that no applicant for licensure by comparable
education shall be permitted to take the examination more than 5 times pursuant
to Nur 303.02(f).
Source. #10996, eff 12-19-15; ss by #12753, eff
4-4-19
PART Nur 304
ENDORSEMENT
Nur 304.01 Registered Nurse
and Licensed Practical Nurse Licensure by Endorsement with NCLEX.
(a) This section shall apply to
nurses who seek licensure in New Hampshire and who:
(1) Graduated from a nursing
school in the United States or Canada, except Quebec, and took the NCLEX in the
United States; or
(2) Have taken the NCLEX –RN
examination in Canada, except Quebec.
(b) Each person seeking
licensure as a registered nurse or practical nurse by endorsement shall:
(1) Complete and submit to the
board a forms packet containing the following forms listed below:
a. “Application Process for
LPN/RN License by Endorsement,” as amended 12/2018;
b. “LPN/RN License by
Endorsement Application,”, as amended 12/2018;
c. “Declaration of Primary
State of Residence Form,” as amended 12/2018;
d. “Request for LPN/RN
Verification of Original License,” as amended 12/2018; and
e. “Optional Information
Question Regarding Military Experience and/or Relationship to Military
Personnel Transferred to New Hampshire,” as amended 12/2018;
(2) Have the following
documents submitted to the board:
a. A completed “New
Hampshire Board of Nursing Record Information Authorization” form, also known
as form DSSP 387 from the department of safety, available at http://www.oplc.nh.gov/nursing/documents/criminal-background.pdf;
b. A completed fingerprint card
or submission of Live Scan documentation.
A fingerprint card may be obtained by contacting the board offices. Live Scan site locations shall be as listed
on the department of safety’s website at https://www.nh.gov/safety/divisions/nhsp/ssb/crimrecords/index.html;
c. The fee, as required by the
department of safety;
d. Final official transcript
showing completion of the nursing educational program requirements, the type of
degree conferred, and the date of graduation; and
e. If requesting American with
Disabilities Act (ADA) accommodations when taking the NCLEX, a “Request for
NCLEX Accommodations under the Americans with Disabilities Act” form, as
amended 2/28/18;
(3) Submit evidence of either
having:
a. Used nursing knowledge,
judgment, and skills for at least 400 hours in the 4 years immediately
preceding the application; or
b. Successfully completed the
NCLEX examination within the 2 years immediately preceding the application;
(4) Submit evidence of either
having:
a. Completed 30 contact hours
of continuing education within the 2 years immediately preceding the
application; or
b. Successfully completed the NCLEX examination within the 2 years
immediately preceding the application;
(5) If a graduate of a nursing
program in Canada who took the NCLEX in the United States or in a Canadian
Province that requires the NCLEX, submit one of the following:
a. A copy of the nursing school
transcript and course descriptions submitted to the original licensing body; or
b. Verification of having
worked in the United States or Canada as a nurse for at least 200 hours within
the 2 years immediately preceding the application; and
(6) Pay the application fee of
$120.
(c) An applicant who has
satisfactorily met the requirements of this section shall:
(1) Receive a registered nurse license
or a practical nurse license, as appropriate; and
(2) Be authorized to use the
title RN or LPN, as appropriate.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #10298, eff
3-22-13; ss by 10996, eff 12-19-15; ss by #12924, eff 11-26-19
Nur 304.02
Canadian Registered Nurse Licensure by Endorsement without NCLEX.
(a)
This section shall apply to registered nurses who graduated from a
nursing school in Canada and have not taken the NCLEX in the United States or
Canada and who seek licensure in New Hampshire.
(b)
Each applicant seeking licensure as a registered nurse by endorsement
under this section shall:
(1) Submit
evidence of graduation from nursing education program in Canada that has been
approved by the regulatory body of the province or territory where the program
is located;
(2) Submit
evidence of successful completion of one of the following examinations with at
least the scores indicated as follows:
a. The
English version of the Canadian Nurses’ Association Testing Service 5-part
examination between the years 1970 and 1980, achieving a score of at least 350
in each of the following areas:
1.
Medical nursing;
2.
Maternal-child nursing;
3.
Surgical nursing;
4.
Mental health nursing; and
5.
Pediatric nursing; and
b. The
English version of the Canadian Nurses’ Association Testing Service
Comprehensive Examination between 1980 and July 31, 1995, achieving a score of
at least 400;
(3) Submit
additional evidence that the applicant has:
a. An
educational credentials review from an institution accredited by a nationally
recognized accrediting body that is endorsed by the National Council of State
Boards of Nursing;
b. Proficiency
with the English language; and
c. Nurse
licensure in the country of origin;
(4) Submit
evidence of having been licensed by the province in which the examination in
(2) above was taken;
(5) Submit
evidence of use of nursing knowledge, judgment, and skills for at least 400
hours in the 4 years immediately preceding the application;
(6) Submit
evidence of completion of at least 30 contact hours of continuing education
within the 2 years immediately preceding the application;
(7) Complete
and submit to the board a forms packet containing the following forms listed
below:
a. “Application
Process for LPN/RN License by Endorsement,” as amended 12/2018;
b..
“LPN/RN License by Endorsement Application,” as amended 12/2018;
c. “Declaration
of Primary State of Residence Form,” as amended 12/2018;
d. “Request
for LPN/RN Verification of Original License,” as amended 12/2018; and
e. “Optional Information Question Regarding
Military Experience and/or Relationship to Military Personnel Transferred to
New Hampshire,” as amended 12/2018;
(8) Have
the following documents submitted to the board:
a. A completed “New Hampshire Board of
Nursing Record Information Authorization” form, also known as form DSSP 387
from the department of safety, available at http://www.oplc.nh.gov/nursing/documents/criminal-background.pdf;
b. A completed fingerprint card or
submission of Live Scan documentation. A
fingerprint card may be obtained by contacting the board offices. Live
Scan site locations are listed on the department of safety’s website at https://www.nh.gov/safety/divisions/nhsp/ssb/crimrecords/index.html;
c. The
fee, as required by the department of safety;
d.
Final
official transcript showing completion of the nursing educational program
requirements, the type of degree conferred, and the date of graduation; and
e. If
requesting American with Disabilities Act (ADA) accommodations when taking the
NCLEX, a “Request for NCLEX Accommodations under the Americans with
Disabilities Act” form, as amended 2/28/18; and
(9) Pay
an application fee of $120.
(c) An
applicant who has satisfactorily met the requirements of this section shall:
(1) Receive
a registered nurse license; and
(2) Be
authorized to use the title RN.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; amd
by #7101, eff 9-20-99; ss by #8664, INTERIM, eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #10298, eff
3-22-13; ss by 10996, eff 12-19-15; ss by #12924, eff 11-26-19
Nur
304.03 Quebec and Non-Canadian
Foreign Registered Nurse and Licensed Practical Nurse Licensure by Endorsement.
(a) This section shall apply to nurses who seek
licensure in New Hampshire and who have:
(1) Graduated from a nursing school outside the
United States and Canada; or
(2) Graduated from a non-English speaking nursing
program in Quebec, Canada and are already licensed in another state.
(b) Each person seeking licensure as a registered
nurse or practical nurse by endorsement and who does not qualify under Nur
302.01 or Nur 302.02 shall complete and submit, including all required
explanations as attachments:
(1) The following forms packet “Endorsement
(Reciprocity) Application for LPN/RN, Quebec and non-Canadian Foreign Educated
Nurses,” as amended 12/2018, including the following forms;
a. “LPN/RN License by Endorsement Application,” as amended 12/2018;
b. “Declaration of Primary State of Residency Form,” as amended 12/2018; and
c. “Request for LPN/RN Verification of Original License,” as amended 12/2018;
(2) To the department of safety, division of
state police, a notarized Criminal Record Release Authorization along with any
required fee, with the board identified as the recipient of the record or
records;
(3)
Evidence that the applicant has received educational credentials from
an institution recognized by a nationally recognized accrediting body that is
endorsed by the National Council of State Boards of Nursing, and verification
of English language proficiency pursuant to Nur 302.01(a) including:
a. Official transcript(s), translated into
English, from the applicant’s school of nursing; or
b. Certified copies of applicant’s school of
nursing curriculum as provided to the state board of nursing that originally
licensed the applicant;
(4) Evidence of a minimum of 400 hours of active
practice in the 4 years immediately prior to this application; and
(5) Payment of the application fee of $120.
(c) An applicant who has satisfactorily met the
requirements of this section shall:
(1) Receive a registered nurse license or a
practical nurse license, as appropriate; and
(2) Be authorized to use the title RN or LPN, as
appropriate.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #7740, eff
8-13-02; ss by #8873, eff 4-24-07; ss by #10298, eff 3-22-13; ss by 10996, eff
12-19-15; ss by #12753, eff 4-4-19
Nur
304.04 Licensed Nursing Assistant.
(a) This section shall apply to those who seek
licensure as a nursing assistant by endorsement.
(b) Each person seeking
licensure as a nursing assistant shall complete and submit:
(1) Form “Application for
Initial Endorsement Nursing Assistant License” packet as amended 4-28-2016;
(2) Evidence of having taken
24 contact hours of continuing education in the last 2 years immediately
preceding the application; and
(3) Evidence of having worked
as a licensed nursing assistant for at least 200 hours within the 2 years
immediately preceding the application;
(4) Payment of the application
fee of $35.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #10298, eff
3-22-13; ss by #10996, eff 12-19-15; amd by #11146,
eff 7-28-16
CHAPTER Nur
400 CONTINUED STATUS
REVISION NOTE:
The
Governor declared a State of Emergency in Executive Order 2020-04, which was
effective 3-13-20. The declaration and
subsequent Emergency Orders issued pursuant to Executive Order 2020-04 affected
various rules and statutes governing continued status of licensees under
Chapter Nur 400, including continuing education. The State of Emergency terminated at midnight
on 6-11-21, and rules or statutes which had been amended during the State of
Emergency were restored. To determine
what rules in Nur 400 were applicable during the State of Emergency, the user
should check not only the source notes of the rules but also the Emergency
Orders in effect at the time in question.
Document
#13347, effective 2-28-22, adopted and readopted with amendment various rules
in Chapter Nur 400 as emergency rules.
The rule adopted was Nur 401.015 defining “re-entry”, “reinstatement”,
and “renewal.” The rules Nur 401.02
through Nur 401.07 were readopted with amendment. Pursuant to RSA 541-A:18, V, the emergency
rules expired 8-27-22, including Nur 401.015, and the rules Nur 401.02 through
Nur 401.07 were effective again in their original form as indicated in the
source notes.
PART Nur 401 RENEWAL AND REINSTATEMENT
Nur 401.01 Licensure Renewal for All Licensees.
(a)
Each applicant seeking renewal of licensure shall, pursuant to RSA
326-B:22 and Nur 403:
(1)
By midnight on the applicant’s date of birth in the renewal year submit
a completed renewal application applicable to the type of license renewal
sought, as follows:
a.
An applicant for a license renewal to practice as a RN or LPN under RSA
326-B:22 shall complete and submit the “Application for License Renewal:
Registered (RN) and Practical Nurse (LPN)”, revised 6/2023;
b.
An applicant for license renewal to practice as an Advanced Practice
Registered Nurse under RSA 326-B:22 shall complete and submit the “Application
for License Renewal: Advanced Practice Registered Nurse (A.P.R.N.)”, revised
6-2023; and
c.
An applicant for license renewal to practice as an LNA under RSA-B: 22
shall complete and submit the “Application for License Renewal: Nursing
Assistant (LNA)”, revised 6-2023.
(2)
Pay the applicable renewal fee as set forth in (b), below;
(3)
Meet the applicable continuing competence requirements described in Nur
401;
(4)
Report any pending criminal charges, criminal convictions, or plea
arrangements in lieu of convictions;
(5)
Have committed no acts or omissions constituting grounds for
disciplinary actions as set forth in RSA 326-B or the rules adopted pursuant
thereto, unless the board has found, after investigation that sufficient restitution
has been made;
(6)
Meet the continuing competence requirements for the specific type of
license for which the applicant seeks renewal; and
(7)
Have complied with all special requirements ordered by the board as part
of disciplinary action against the applicant.
(b)
Pursuant to RSA 326-B 9, all applicants for renewal of license as
an RN or LPN shall comply with the Nurse Licensure Compact (NLC) Model Rules
and Regulations developed by the Nurse Licensure Compact Administrators (NLCA)
as amended January 19, 2018 and as referenced in Appendix 2;
(c)
Applicants for renewal shall pay the fee for the type of license renewal
sought as set forth in Plc 1002.33:
(d) The
license for which renewal is sought shall be renewed when the completed
application has been reviewed and approved.
The application shall be approved if it complies with the specific
procedural and substantive provisions of this part and all applicable
requirements of RSA 326-B.
(e)
Each license renewal shall be valid for the biennium commencing the day
after the license being renewed expired, except that reinstatement of a license
that has lapsed, was obtained after completion of a reentry program, or was the
subject of discipline shall be effective as of the date that the renewal
application was approved and shall expire at the end of the biennium.
(f)
Failure to renew the license shall result in forfeiture of the ability
to practice nursing or engage in nursing activities in New Hampshire. Failure to receive and complete the license
renewal application shall not relieve the licensee of the obligation to renew
the license prior to midnight on the licensee’s birthday of the renewal year.
(g)
Each person who practices as a nurse or as a nursing assistant after
their license or certification has lapsed, after notice and opportunity for a
hearing pursuant to Nur 402.04(a), shall be fined up to $50.00 for every
calendar month, or any part thereof, during which the individual so practices. The Board shall apply the factors described
in Nur 402.04(g) when determining the amount of the fine to be imposed.
(h)
Each nurse or as a nursing assistant who fails to notify the board of a
change of address shall, after notice and opportunity for a hearing pursuant to
Nur 402.04(a), be fined $10.00.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #7741, eff
8-13-02; ss by #8873, eff 4-24-07; ss by #9395, eff 2-25-09; ss by #9573, eff
10-21-09; ss by #10299, eff 3-22-13; ss by #10571, eff 4-17-14; amd by #10953, eff 10-22-15; amd
by #12789, eff 5-25-19; ss by #13706, eff 9-27-23
Nur 401.02 Re-entry
Requirement and Process for Re-entry for RN and LPN.
(a) Each nurse who has not
held an active RN or LPN license in any U.S. jurisdiction for 5 or more years
prior to their application for renewal or reinstatement shall successfully
complete a reentry program prior to being issued a license.
(b) An applicant for a
license renewal to practice as a RN or LPN under RSA 326-B:23 shall complete
and submit Form “Registered and Practical Nurse License Reinstatement”, 3-2014.
(c) An applicant for a
license renewal to practice as a registered and practical nurse under RSA
326-B:23 shall complete and submit the “Declaration of Primary State of
Residency Form”, revised 6/2023.
(d) Each re-entry applicant
shall also:
(1)
Obtain temporary licensure prior to the start of the re-entry program;
(2)
Be supervised by an RN; and
(3)
After completion of the reentry program, document successful completion
of the program.
(e) Each re-entry applicant
shall select and complete one of the following within 120 days of application:
(1)
A structured refresher course as described in (g) below; and
(2)
An individualized program of study as described in (h) and (i) below.
(f)
The board shall extend the time in (e) above for 90 days when the
reentry applicant:
(1)
Cannot meet the time requirement of (e) above; and
(2)
Requests that the board extend the time in a letter setting forth the
reason(s) for requesting extension.
(g)
Each applicant seeking re-entry through successful completion of a
structured refresher course shall complete a course of at least 120 hours that
includes theoretical and clinical experiences which:
(1)
Are pertinent to those activities set forth in RSA 326-B:12 for
practical nurses or RSA 326-B:13 for registered nurses; and
(2)
Comply with Nur 605.03.
(h)
Each applicant seeking re-entry through successful completion of an
individualized program of study shall submit the proposed program of study to
the board for approval.
(i) The board shall approve the proposed
individualized program of study if:
(1)
It includes theoretical and clinical components which:
a.
Include content described in Nur 602.13; and
b. Are consistent with RSA 326-B:12 for
practical nursing and RSA 326-B:13 for registered nursing; and
(2)
The clinical component of the individualized program shall be supervised
by an RN.
Source. #8873, eff 4-24-07; ss by #10299, eff
3-22-13; ss by #10571, eff 4-17-14; ss by #13347, EMERGENCY RULE, eff 2-28-22, EXPIRED: 8-27-22 (see Revision Note at chapter
heading for Nur 400);
ss by #13706, eff 9-27-23
Nur 401.03 Specific Renewal Requirements for APRN.
(a)
In addition to meeting the requirements of Nur 401.01, each applicant
for renewal or reinstatement of an APRN license shall:
(1)
Document at least 30 educational contact hours to satisfy the
requirements of RN continuing competence and an additional 30 hours, 5 of which
shall be education in pharmacology within 2 years immediately prior to date of
application;
(2)
Document current national certification if licensed after September
1984;
(3)
If holding lifetime certification, document continuing participation in
the certification process; and
(4)
Verify current licensure as an RN in NH or another compact state.
(b)
The national certification required by (a)(3) above may be counted as 30
of the 60 contact hours required by (a)(2) above.
(c)
Failure to provide all the requested information shall cause the
application to be refused.
(d)
APRN applicants for license renewal unable to comply with (a)(1) above
shall complete a board approved reentry program as described in Nur 401.05.
(e)
Pursuant to RSA 126-A:5, XVIII-a (a) and RSA 326-B:9-a, licensees may
complete and submit, as part of their renewal application, the New Hampshire
Division of Public Health Service’s “New Hampshire APRN Licensure Survey”
issued by the State Office of Rural Health and Primary Care, Department of
Health and Human Services.
(f)
The board shall provide licensees with the opportunity to opt out of the
survey. Written notice of the opt-out
opportunity shall be provided with the renewal application. The opt out form shall be available on the NH
State Office of Rural Health and Primary Care website, https://www.dhhs.nh.gov/programs-services/health-care/rural-health-primary-care/health-professions-data-center.
(g)
Licensees choosing to opt-out of the survey shall submit a completed NH
Department of Health and Human Services form, “New Hampshire Health Professions
Survey Opt-Out Form” pursuant to HB 322, Laws of 2017, Ch. 131, to the State
Office of Rural Health and Primary Care, Department of Health and Human
Services, via one of the following as specified on the form:
(1)
Mail;
(2)
Email; or
(3)
Fax.
(h)
Information contained in the opt-out forms shall be kept confidential in
the same accord with the survey form results, pursuant to RSA 126-A:5, XVIII-a
(c).
Source. #8873, eff 4-24-07; ss by #10299, eff
3-22-13; ss by #10571, eff 4-17-14; amd by #10953,
eff 10-22-15; ss by #13347, EMERGENCY RULE, eff 2-28-22, EXPIRED: 8-27-22 (see Revision Note at chapter
heading for Nur 400);
ss by #13706, eff 9-27-23
Nur
401.04 Re-entry Requirement and
Process for Re-entry for APRN.
(a) Each APRN who has not held an active APRN license
in any U.S. jurisdiction for 5 years or more prior to their application for
renewal or reinstatement shall successfully complete a re-entry program prior
to being issued a license.
(b) An applicant for license reinstatement to
practice as an APRN under RSA 326-B:23 shall complete and submit Form
“Application for Reinstatement: Advanced Practice Nurse (A.P.R.N.)”, revised
6/2023.
(c) An applicant for license reinstatement to
practice as an APRN under RSA 326-B:23 shall complete and submit the
“Declaration of Primary State of Residency Form”, revised 6/2023.
(d) APRN re-entry applicants shall hold a current
registered nurse license issued by the New Hampshire board of nursing or hold a
multi-state registered nurse license issued by a state that is a member of the
nurse licensure compact.
(e) Re-entry applicants shall, after completion
of the re-entry program, document successful completion of the program.
(f) Re-entry applicants shall complete one of the
following:
(1)
An established reentry program approved by the board pursuant to Nur 603
and designed and implemented by a New Hampshire, regional, or national nursing
specialty professional organization; or
(2)
A supervised re-entry program as described in (g) below and then comply
with (h) below.
(g) Each applicant seeking re-entry through
successful completion of a supervised reentry program shall complete the
following under the supervision of an education program that prepares APRN’s:
(1)
A minimum of 3 credit hours or minimum of 30 class hours in pharmacology
at the advanced nurse practitioner level; and
(2)
A minimum of 200 hours clinical practice supervised by an advanced
registered nurse practitioner practicing in the applicant’s specialty practice
area.
(h) After completion of the re-entry program
pursuant to (g) above, each applicant shall provide documentation from the
program director or designee that the applicant possesses competencies equal to
or greater than current program graduates.
Source. #8873, eff 4-24-07; ss by #10299, eff
3-22-13; ss by #10571, eff 4-17-14; amd by #12577,
eff 7-21-18; ss by #13347, EMERGENCY RULE, eff 2-28-22, EXPIRED: 8-27-22 (see Revision Note at chapter
heading for Nur 400);
ss by #13706, eff 9-27-23
Nur
401.05 Specific Renewal and
Reinstatement Requirements for LNA.
(a)
An applicant seeking licensure renewal as an LNA shall complete and
submit Form “Nursing Assistant License Renewal”, as amended, 5-2016.
(b) An applicant seeking licensure reinstatement
as an LNA shall complete and submit the “Application for License Reinstatement:
Nursing Assistant”, revised 6/2023.
(c)
Each re-entry nursing assistant applicant shall complete and submit an
application form for renewal or reinstatement, as applicable, and pay the
appropriate application fee.
(d) In addition to meeting the requirements of
Nur 401.01, each applicant for renewal or reinstatement of an LNA license shall
either:
(1)
Affirm use of nursing assistant knowledge, judgment, and skills within
their practice category for a minimum of 200 hours within 2 years immediately
prior to the date of application;
(2)
Affirm completion of at least 24 contact hours of continuing education
in the last 2 years immediately preceding the application; or
(3)
Present evidence of completion of a board-approved nursing assistant
education program pursuant to Nur 702 within 2 years immediately prior to the
date of application.
(e) Applicants shall have the option to fulfill
the requirements of (d) (1) above through:
(1)
Paid or unpaid work; or
(2)
Providing care to a family member if:
a.
Licensed expertise is required for such care;
b.
A nursing plan of care is implemented; and
c.
Care is provided under the supervision of a licensed nurse.
Source. #8873, eff 4-24-07; ss by #10299, eff
3-22-13; ss by #10571, eff 4-17-14; amd by #10953,
eff 10-22-15; ss by #13347, EMERGENCY RULE, eff 2-28-22, EXPIRED: 8-27-22 (see Revision Note at chapter
heading for Nur 400); ss by #13706, eff 9-27-23 (formerly Nur 401.06);
renumbered by #13706 (formerly Nur 401.05)
Nur
401.06 Specific Renewal Requirements
for Medication Nursing Assistant (MNA).
(a) In addition to meeting the requirements of
Nur 401.01, each applicant for renewal or reinstatement of a Medication Nursing
Assistant (MNA) certificate shall either:
(1)
Affirm use of medication nursing assistant knowledge, judgment and
skills within the applicant’s practice category for a minimum of 50 hours
within 2 years immediately prior to the date of application;
(2) Affirm
completion of at least 8 contact hours of continuing education in each of the
last 2 years immediately preceding the application for a minimum total of 8
hours for the 2-year period; or
(3)
Present evidence of completion of a board-approved medication nursing
assistant education program pursuant to Nur 806.03 within 2 years immediately
prior to the date of application.
(b) An applicant for license renewal as a MNA
shall complete and submit Form “MNA Renewal Application”, as amended, 5-2016.
(c) Applicants for renewal or reinstatement who fail to meet the
requirements of (a) shall have the option to take a board-approved medication
nursing assistant competency evaluation to meet the active in practice,
continuing education requirement, or both.
(d) An applicant who fails the medication nursing
assistant competency evaluation shall not retake the competency evaluation and
may reestablish eligibility only by meeting the requirements for and receiving
another initial certificate pursuant to Nur 801.01.
(e) A licensed nursing assistant whose medication
administration certification has expired and has not been renewed within one year from the certification expiration date shall be:
(1)
Ineligible to administer medication; and
(2) Able to reestablish eligibility only by
meeting the requirements for and receiving another initial certificate pursuant
to Nur 801.01.
(f) An applicant seeking reinstatement of MNA
Certification shall complete and submit Form “Medication Nursing Assistant
Certification Reinstatement”, as amended, 5-2016.
Source. #8873, eff 4-24-07; ss by #10299, eff
3-22-13; ss by #10571, eff 4-17-14; amd by #11132,
eff 7-1-16; ss by #13347, EMERGENCY RULE, eff 2-28-22, EXPIRED: 8-27-22 (see Revision Note at chapter
heading for Nur 400); renumbered by #13706, (formerly Nur 401.06)
Nur 401.07 Retired Status Designation.
(a)
A retired RN may use the title, “R.N. (Ret.).”
(b)
A retired LPN may use the title, “L.P.N. (Ret.).”
(c)
A retired APRN may use the title, “ A.P.R.N. (Ret.).”
(d)
A retired LNA may use the title, “L.N.A. (Ret.).”
Source. #9096, eff 2-23-08; ss by #10299, eff
3-22-13; ss by #10571, eff 4-17-14; renumbered by #13706 (formerly Nur 401.06)
PART Nur 402
REVOCATION, SUSPENSION AND OTHER SANCTIONS
Nur
402.01 Initiation of Disciplinary
Action. The board shall undertake
misconduct investigations, settlements of misconduct allegations, or
disciplinary hearings, when warranted, in response to any information which
reasonably suggests that a licensee has engaged in professional misconduct.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #7741, eff
8-13-02; ss by #8873, eff 4-24-07; ss by #10299, eff 3-22-13; ss by #10571, eff
4-17-14
Nur
402.02 License Surrender When
Misconduct Allegations Pending.
(a) A licensee may surrender the license at any
time.
(b) Surrender or nonrenewal of license shall not
preclude the board from investigating or completing a disciplinary proceeding
based upon the licensee’s conduct while the license was still in effect. Such investigations and proceedings shall be
handled in the same manner as other disciplinary investigations and
proceedings.
(c) A licensee who surrenders a license shall have
no right or privilege to practice in
(d) A licensee who surrenders the license as part
of a settlement of pending misconduct allegations shall make a written
settlement offer to the board before the close of the record in a disciplinary
hearing.
(e) Any settlement agreement reached under (d),
above, shall include the following concessions:
(1)
That license surrender has occurred in settlement of pending
disciplinary allegations;
(2)
That all or some specifically identified part of the material facts
pertaining to the allegations are true; and
(3)
That the pending allegations shall be issues to be resolved in any
future application the licensee submits to the board.
(f) The fact of license surrender pending
disciplinary action and the terms of any settlement agreement pertaining
thereto shall be distributed to all relevant licensing authorities and data
bank in the same manner as a final decision containing specific findings of
dishonesty or misconduct.
Source. (See Revision Note #1 at chapter heading for Nur
100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #7741, eff 8-13-02; ss
by #8873, eff 4-24-07; ss by #10299, eff 3-22-13; ss by #10571, eff 4-17-14
Nur
402.03 Immediate Suspension.
(a) When the board receives information
indicating that a licensee has engaged misconduct that poses an immediate
danger to public health, safety, or welfare, the board shall, pursuant to RSA
326-B:37, IV, immediately suspend such person’s license and commence an
adjudicative proceeding not later than 10 working days after the date of the
board order suspending the license.
(b) Suspension orders under this section shall
include a notice of hearing that sets forth all the information required by RSA
326-B: 38, IX, and RSA 541-A: 31, III.
(c) No hearing date established in a proceeding
conducted under this section shall be postponed at the request of the licensee
unless the licensee agrees in writing to waive the 10-working day requirement. If the licensee waives the 10-working day
requirement, the suspension shall remain in effect until the completion of the
hearing, pursuant to RSA 326-B: 37, IV.
(d) Pursuant to RSA 541-A: 31, III, a record of
the proceeding shall be made by a certified shorthand court reporter provided
by the board.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #7741, eff
8-13-02; ss by #8873, eff 4-24-07; ss by #10299, eff 3-22-13; ss by #10571, eff
4-17-14 (formerly Nur 401.02)
Nur
402.04 Disciplinary Sanctions.
(a) Other than immediate license suspensions
authorized by RSA 541-A: 30, III, and RSA 326-B: 37, IV, the board shall impose
disciplinary sanctions only:
(1)
After prior notice and an opportunity for a hearing; or
(2)
Pursuant to a mutually agreed upon settlement or consent decree.
(b)
In addition to the acts described in RSA 326-B: 37, II, the following
shall also be considered acts of misconduct or dishonesty for any person
licensed under RSA 326-B:
(1)
Accepting a nursing or nursing-related assignment when the licensee
knows or has reason to know he or she is unqualified to perform the assignment;
(2) Leaving an assignment from the acute care,
long term care, home care or community setting, without notifying the
appropriate authority, whereby such departure endangers the health, safety, and
welfare of those individuals entrusted to the licensee's care;
(3)
Violating care recipients' rights, confidentiality, privacy, or records;
(4)
Practicing in a manner that discriminates on the basis of age, race,
sex, handicap, national origin, sexual orientation, nature of illness or health
status, physical or mental infirmity;
(5)
Misappropriating human or material resources;
(6) Physical, mental and/or verbal abuse,
battery, exploitation, harassment, or neglect of individuals;
(7) Receiving, or agreeing to receive, fees or
other considerations for influencing the care, activities or records of
individuals;
(8)
Failure to maintain standards of practice or education pursuant to RSA
326-B: 2;
(9)
Claiming as their own another's license, or allowing others to use a
license not their own;
(10) Administering therapeutic agents,
treatments, or activities, or recording of same, in an inaccurate or negligent
manner;
(11) Failure to record or report in an
accurate manner without omission, falsification, or alteration any patient care
data, or health care, employment or board records;
(12)
Failure to take appropriate action to safeguard individuals from
incompetent health-care, nursing practices, nursing-providers, ancillary
personnel or others involved with care-recipients;
(13)
Performing nursing activities or interventions, or providing
nursing-related activities beyond the authorized scope of practice;
(14)
Practicing without a current license, or altering a license pocket-card
by changing dates, numbers, or any information appearing on a license
pocket-card;
(15)
Falsifying or not providing information requested by the board;
(16)
Being the subject of 3 different medical injury actions reported under
RSA 326-B: 37; and
(17)
Any pattern of behavior consisting of more than one incident of
professional misconduct that is incompatible with the standards of practice.
(c) Acts of misconduct for APRNs, RNs and LPNs
shall also include:
(1) Delegating
or directing activities or tasks to individuals when the licensee knows or has
reason to know that the individual(s) is not qualified to perform the activity
or task;
(2)
Failure of licensee to supervise individuals or groups required to
practice nursing or provide nursing-related activities under supervision;
(3)
Requiring a licensee to perform specific nursing interventions or
nursing related activities when the licensee clearly and cogently states their
inability, either through lack of education, practice or knowledge and skills,
to perform the delegated activity; and
(4)
Permitting the use or disclosure of program information under control of
the APRN’s by a person not authorized to receive it in violation of RSA 318 or
administrative rules of the board of pharmacy.
(d) When the board receives notice that a
licensee has been disciplined for acts related to professional conduct by the
licensing authority of another jurisdiction, the board shall issue an order
providing the opportunity for a hearing and directing the licensee to
demonstrate why reciprocal discipline should not be imposed in
(e) In a disciplinary proceeding brought on the
basis of discipline imposed in another jurisdiction, a licensee shall not be
subject to disciplinary sanctions which exceed those imposed by the other
jurisdiction unless the board first provides specific notice of an intention to
consider other sanctions. When such notice is provided, the licensee shall be
subject to any disciplinary sanction authorized by RSA 326-B: 37, III.
(f) Following opportunity for a hearing and after
a finding that misconduct or dishonesty has occurred by a licensee, the board
shall impose disciplinary sanctions, to the extent authorized by RSA 326-B: 37,
III, and the Omnibus Budget Reconciliation Act (OBRA) of 1987; Section 1819 and
1919 of the Social Security Act (42 U.S.C. 1395 & 1396).
(g) In imposing sanctions, the board shall apply
the following factors in determining the level or kind of disciplinary
sanction imposed:
(1) The
seriousness of the offense;
(2) The
licensee’s prior disciplinary record;
(3) The
licensee’s state of mind at the time of the offense;
(4) The
licensee’s acknowledgment of his or her wrongdoing;
(5) The
licensee’s willingness to cooperate with the board;
(6) The
purpose of the rule or statute violated;
(7) The
potential harm to public health and safety; and
(8) The
nature and extent of the enforcement activities required of the board as a
result of the offense.
(h) Discipline imposed upon a licensee under (b)
above shall be intended to be the minimum sanction or sanctions, both in type
and extent, that the board believes will, based upon the unique facts and
circumstances of each act of misconduct:
(1)
Protect the public; and
(2)
Deter both the licensee charged and any other licensee from engaging in
such misconduct in the future.
(i) The type of
disciplinary sanctions available to the board shall include the following,
listed in ascending order of severity:
(1)
Issuance of a public reprimand pursuant to RSA 326-B: 37, III(a);
(2) Imposing
conditions on the licensee’s scope of practice pursuant to RSA 326-B: 37,
III(a);
(3)
Imposing one or more limitations on the licensee’s scope of practice
pursuant to RSA 326-B:37, III(a);
(4) Placing
the licensee on probation for a specific period of time pursuant to RSA 326-B:
37, III(a);
(5)
Requiring the licensee to practice under the direct supervision of an RN
pursuant to RSA 326-B: 37, III(e);
(6)
Imposition of an administrative fine pursuant to RSA 326-B: 37, III(f);
(7) Requiring the licensee to submit to the
care, counseling, or treatment of a physician, counseling service, health care
facility, professional assistance program, or any comparable person or facility
pursuant to RSA 326-B:37, III(d);
(8)
Requiring continuing nursing education in the area or areas in which
they have been found deficient or incompetent pursuant to RSA 326-B:37, III(c);
(9)
Requiring participation in a rehabilitative program in the area or areas
in which they have been found deficient or incompetent pursuant to RSA 326-B:
37, III(c);
(10)
Imposition of a period of license suspension pursuant to RSA 326-B: 37,
III(a);
(11)
Declining to renew or reinstate a license pursuant to RSA 326-B: 37,
III; and
(12)
Revocation of a license pursuant to RSA 326-B: 37, III(b).
(j) Copies of board orders imposing disciplinary
sanctions and copies of all settlement agreements or consent decrees shall be
sent to the licensing body of each state in which the licensee is licensed and
to such other entities, organizations, associations, or boards as are required
to be notified under applicable state or federal law.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #7741, eff
8-13-02; ss by #8873, eff 4-24-07; ss by #10299, eff 3-22-13; ss by #10571, eff
4-17-14; amd by #10953, eff 10-22-15; amd by #11082, eff 4-26-16
PART Nur 403
CONTINUING EDUCATION
Nur
403.01 Continuing Education
Requirements for LPN, RN, and APRN.
(a) Each applicant for licensure by endorsement,
renewal or reinstatement for an RN or LPN license shall complete at least 30
contact hours of workshops, conferences, lectures or in-service educational
offerings that are designed to enhance nursing knowledge, judgment, and
skills. Current national certification
may be used to fulfill such continuing education requirement.
(b) Educational courses offering content in the
following shall fulfill the requirements of (a) above:
(1)
Nursing art and science;
(2)
Nursing education, practice, or research;
(3)
Research in health care;
(4)
Biological, physical, or behavioral sciences;
(5)
Management, administration or supervision of health-care delivery;
(6) Teaching
or learning principles;
(7)
Ethical or legal aspects of health-care;
(8) Content offered in basic nursing educational
programs appropriate to the licensure category; or
(9) Health-care
trends, issues or policies.
(c) One or more of the following educational
activities shall fulfill the requirements of (a) above:
(1)
Authorship of a published professional nursing article or book;
(2)
Preparation and initial delivery of a professional nursing paper;
(3)
Preparation and initial participation on a professional nursing panel;
(4)
Participation in quality assessment or risk management studies;
(5) Nursing
or nursing-related grant-writing or research; or
(6)
Completion of 2 or more credits in a school, college, or university that
enhances nursing knowledge, judgment and skills.
(d) Each APRN applicant for APRN license renewal
or reinstatement shall complete at least 30 contact hours of continuing
education in addition to the continuing education requirements to renew or
reinstate a RN license within the 2 years immediately preceding date of
application. At least 20 of the 30 hours
shall be specific to the specialty practice area, and 5 hours shall be
education in pharmacology appropriate to the specialty practice area.
Source. #6778, eff 6-26-98; ss by #7741, eff 8-13-02;
ss by #8873, eff 4-24-07; ss by #10299, eff 3-22-13; ss by #10571, eff 4-17-14
Nur 403.02
Continuing Education Requirements for LNA. Each applicant for renewal, reinstatement, or
endorsement of an LNA license shall complete at least 12 contact hours per year
of workshops, conferences, lectures, or in-service educational offerings that
are designed to enhance nursing assistant knowledge, judgment, and skills. Successful completion of a state nursing
assistant examination may be used to fulfill such continuing education
requirements.
Source. #7741, eff 8-13-02; ss by #8873, eff 4-24-07;
ss by #10299, eff 3-22-13; ss by #10571, eff 4-17-14
Nur 403.03 Continuing Education Requirements for MNA. Each applicant for renewal of an MNA license
shall complete at least 4 contact hours per year of workshops, conferences,
lectures, or in-service educational offerings that are designed to enhance
nursing assistant knowledge, judgment, and skills related to medications and/or
medication administration.
Source. #7741, eff 8-13-02; ss by #8873, eff 4-24-07;
ss by #10299, eff 3-22-13; ss by #10571, eff 4-17-14
Nur 403.04 Method of Calculation of Contact Hours for
Individualized Learning.
(a) Academic credit for courses shall
be converted to contact hours, with one credit being the equivalent of 15
contact hours.
(b) Individualized learning activities
shall count on an hour-for-hour basis towards fulfilling the requirements of
continuing education.
Source. #7741, eff 8-13-02; ss by #8873, eff 4-24-07;
ss by #10299, eff 3-22-13; ss by #10571, eff 4-17-14
Nur
403.05 Continuing Education
Validation.
(a) Licensees shall be responsible for
maintaining accurate records and upon request shall submit documentation
demonstrating compliance with all applicable continuing education requirements.
(b) All nurse licensees audited for continuing
education shall complete and submit Form “Continuing Education Contact Hour
Audit”, 1-2014.
(c) All nursing
assistant licensees audited for continuing education shall complete and submit
“Form Licensed Nursing Assistant Continuing Education Audit”, 11-2013.
(d) At least 45 days prior to the renewal date,
every 100th license application shall be selected for a continuing education
audit and the licensee shall submit a list of educational offerings, sponsor
and hours documenting compliance with continuing education requirements.
(e) A renewal under Nur 401 shall not be issued
if:
(1) The
licensee fails to submit documentation upon request before midnight of the
renewal date; or
(2)
Submitted documents fail to meet continuing education requirements.
(f) Licensees may request inactive status in lieu
of complying with the specific continuing education requirements of Nur 403
applicable to their license.
Source. #8873, eff 4-24-07 (formerly Nur 402.05); ss
by #10299, eff 3-22-13; ss by #10571, eff 4-17-14
PART Nur 404
ONGOING REQUIREMENTS
Nur 404.01 Purpose.
(a)
The purpose of Nur 404.01 to Nur 404.07 is to regulate the delegation of
tasks of client care by licensed nurses to licensed and unlicensed persons,
pursuant to RSA 326-B:28 and RSA 326-B:29.
(b)
The purpose of Nur 404.08 to Nur 404.11 is to regulate the delegation of
tasks of administration of medication tasks by licensed nurses to MNA, pursuant
to RSA 326-B:28 and RSA 326-B:29.
Source. #6778, eff 6-26-98; ss by #7741, eff 8-13-02;
ss by #8873, eff 4-24-07; ss by #9096, eff 2-23-08; ss by #9395, eff 2-25-09;
ss by #10299, eff 3-22-13; ss by #10571, eff 4-17-14; amd
by #11082, eff 4-26-16
Nur 404.02 Scope.
This part shall apply to the delegation of nursing tasks by all
licensees except for those persons exempted by RSA 326-B:43.
Source. #6778, eff 6-26-98; ss by #7741, eff 8-13-02;
ss by #8873, eff 4-24-07; ss by #10299, eff 3-22-13; ss by #10571, eff 4-17-14;
amd by #11082, eff 4-26-16
Nur 404.03
Definitions
(a) “Administration of medication” means an
action taken by a licensee or authorized delegate whereby a single does of the prescribed medication is instilled into or
applied to the body of a person for immediate consumption or use.
(b) “Assistance with administration of
medication” means an action taken by a licensee or authorized delegate whereby
a client with stable medical condition(s) and who is fully able to recognize
and accept prescribed medications is assisted with one or more of the following
steps in the process of instilling or
applying a single dose of prescribed medication:
(1)
Providing assistance, observation, and documentation to a a client;
(2)
Taking the medication to the client when the client is present to
receive medication;
(3)
Opening the medication container for the client when the client is
present;
(4)
Reminding or prompting the client to take the medication at the proper
time;
(5)
Reading a medication label to the client;
(6)
Physically assisting the client to self-administer medication utilizing
hand or hand technique; and
(7)
Providing food or liquids if the medication label instructs the client
to take the medication with food or liquids.
(c) “Nursing task” means a procedure that
requires nursing education and a license as a registered nurse or licensed
practical nurse to perform.
Source. #10953, eff 10-22-15; amd
by #11082, eff 4-26-16
Nur 404.04 Licensees with the Authority to Delegate Nursing
Related Activities.
(a)
The following licensees shall have the authority pursuant to RSA 326-B
to delegate nursing related activities:
(1) Any currently licensed RN or APRN when practicing
registered nursing; and
(2) Any currently licensed LPN when practicing practical
nursing directed by a licensed APRN, RN, dentist or physician.
(b) For nursing related tasks involving
assistance with or the administration of medication, the following persons
shall be eligible to be delegatees:
(1) Any
currently licensed RN and APRN;
(2) Any
currently licensed LPN, only when:
a. The
method of medication administration is not intravenous; or
b. The method
of medication administration is intravenous and the LPN is in compliance with
Nur 604.01 (b) and (c);
(3)
Unlicensed assistive personnel who have competency to perform the
specific task to be delegated; and
(4) Any
currently licensed LNA only when:
a. The
task is assistance with medication administration; or
b. The task is administration of medication in a
setting that involves administration of medication to stable clients, as
defined in Nur 101.21, and the LNA holds a certificate of medication
administration issued in accordance with the provisions of Nur 801; or
c. The LNA that does not hold a certificate of
medication administration is employed in the home care, residential care, adult
day care, or hospice care setting, where the number of delegations is limited
to the number of clients assigned to the LNA, and in accordance with Nur
404.07(h).
Source. #7741, eff 8-13-02; ss by #8873, eff 4-24-07;
ss by #10299, eff 3-22-13; ss by #10571, eff 4-17-14; amd
by #10953, eff 10-22-15 (from Nur 404.03); amd by
#11082, eff 4-26-16; amd by #12439, eff 12-22-17
Nur
404.05 Eligibility to be a Delegatee.
(a) Any individual shall be eligible to receive
the delegation of a task of client care not involving the administration of
medication only if such individual has competency to perform the specific task.
(b)
For nursing related activities involving the administration of
medication, the following persons shall be eligible to be delegatees:
(1) Any
currently licensed RN and APRN;
(2) Any
currently licensed LPN only when:
a. The
method of medication administration is not intravenous; or
b. The method
of medication administration is intravenous and the LPN is in compliance with
Nur 604.01 (b) and (c);
(3)
Unlicensed assistive personnel who have competency to perform the
specific task to be delegated; and
(4)
Currently licensed LNA when:
a. The LNA holds a certificate of medication
administration issued in accordance with the provisions of Nur 801 and in
compliance with this part; or
b. The LNA is in compliance with Nur 404.07(h).
Source. #7741, eff 8-13-02; ss by #8873, eff 4-24-07;
ss by #10299, eff 3-22-13; ss by #10571, eff 4-17-14; renumbered by #10953
(from Nur 404.04); amd by #12439, eff 12-22-17
Nur 404.06 Delegation of Nursing Tasks.
(a)
To delegate a nursing task, the delegating nurse shall:
(1) Assess the client to ensure the client’s
condition is stable and predictable pursuant to Nur 101.21;
(2) Ensure the task does not require nursing
assessment and consider:
a. The nature of the task, the complexity, and
the risks involved;
b. The delegate skills necessary to safely perform
the task within the care setting and without the direct supervision of the
delegating nurse; and
c. The willingness of the delegate to perform
the task;
(3) Teach the task to the prospective delegate;
(4) Observe the prospective delegate performing
the task to ensure that the task is performed safely and accurately;
(5) Upon finding the delegate competent at the task,
delegate the task and instruct the delegate that the delegation is specific to
the specified client only and not transferable to another client;
(6) Document the delegation and the delegation
process and leave written instructions with the delegate, as appropriate;
(7) Supervise the delegate and provide ongoing
evaluation at a frequency determined by consideration of the following:
a. The complexity of the delegated task of
client care;
b. The condition of the client;
c. The skill level of the delegate; and
d. The familiarity of the delegate with the
environment in which the task is to be performed; and
(8) Rescind the delegation if:
a. The client’s condition changes in a way that
renders the delegation no longer safe or appropriate;
b. The delegate proves unwilling or incompetent
to perform the delegated task;
c. The client objects to the delegation ; or
d. The delegating nurse is no longer able to supervise
the performance of the delegated task.
The delegating nurse shall notify the delegate and the delegatee’s supervisor of a rescission.
(b)
A licensed nurse shall report to the board an attempt to coerce the
delegation of a task of client”care in violation of
RSA 326-B: 29, II.
Source. #7741, eff 8-13-02; ss by #8873, eff 4-24-07;
ss by #10299, eff 3-22-13; ss by #10571, eff 4-17-14; renumbered by #10953
(from Nur 404.05); ss by #11082, eff 4-26-16
Nur
404.07 Delegation of Medication
Administration.
(a) In addition to the requirements of Nur
404.05, when delegating medication administration, the delegating nurse shall
specify:
(1) The
medication to be administered;
(2) The dosage,
route and time of the medication to be administered;
(3) The proper
method for administration;
(4) Required
documentation; and
(5) The duty to
report immediately to the delegating nurse any error in the administration.
(b) In addition to the requirements in paragraph
(a), and when relevant to the care of the client by the delegate, the
delegating nurse shall instruct the delegate on:
(1) The reasons
for the medication;
(2) The
potential side effects of the medication;
(3) Observation
of the client’s response; and
(4) Expected
actions if side effects are observed.
(c) A nurse may delegate medication
administration when medication is administered via the following routes:
(1) Topical;
(2) Oral;
(3) Nasal;
(4) Ocular;
(5) Auricular;
(6) Vaginal;
(7) Rectal;
(8) Enteral
tube; and
(9) Injection of
insulin or epinephrine in accordance with paragraph (f) and (g).
(d) A nurse
shall not delegate the
following:
(1) Medication
administered via a parenteral route, if not listed in paragraph (c);
(2) Medication
administered via a nasogastric tube;
(3) The initial
dose of a new medication or a previously prescribed medication with a dosage
change; or
(4) Medication
administration requiring a dosage calculation by the LNA.
(e) A nurse may delegate PRN medications subject to the following:
(1) The
delegating nurse provides written instructions; and
(2) The
administration is authorized by the supervising nurse on duty or on call.
(f) A nurse may delegate the administration of
insulin from a labeled and pre-set or pre-drawn Insulin delivery device.
(g) A nurse may delegate the administration of
epinephrine from a labeled and pre-set or pre-drawn delivery device.
(h) In addition to the requirements of this part,
when delegating medication administration to a currently licensed LNA that does
not hold a certificate of medication administration, the delegating nurse
shall:
(1) Ensure the
administration of medication is to stable clients, as defined in Nur 101.21 and
pursuant to Nur 404.06(a)(1);
(2) Identify a
routine medication regime with a clear process for the LNA to follow, such as
the use of:
a. A medication
planner or box that is prefilled by a licensed nurse;
b. Clearly marked medication bottles or
containers that provide direction for administration; or
c. Written
instructions on administration provided by the delegating nurse;
(3) Ensure the
LNA has, pursuant to Nur 404.06(a)(3), received instruction on requirements of
the task delegated and understands a client medication administration record;
and
(4) Ensure
delegation of medication administration does not, pursuant to Nur 404.06(a)(2),
require independent decision-making by the LNA and shall only be appropriate
when the client is unable to safely self-administer.
Source. #7741, eff 8-13-02; ss by #8873, eff 4-24-07;
ss by #10299, eff 3-22-13; ss by #10571, eff 4-17-14; renumbered by #10953
(from Nur 404.06); ss by #11082, eff 4-26-16; amd by
#12439, eff 12-22-17
Nur
404.08 Obligations of Licensees as Delegatees.
(a) A licensee to whom a specific task of client
care has been delegated shall perform that task in accordance with RSA 326-B
and these rules.
(b) A delegatee who is
a licensee shall wear a badge showing the delegatee’s
name and title when performing the delegated task of client care.
(c) A delegatee who is
a licensee shall report to the board the fact of any delegation which the delegatee believes to be beyond his or her competency.
Source. #7741, eff 8-13-02; ss by #8873, eff 4-24-07;
ss by #10299, eff 3-22-13; ss by #10571, eff 4-17-14; renumbered by #10953
(from Nur 404.07)
Nur
404.09 Circumstances Permitting the Performance by a MNA of Tasks Involving
the Administration of Medication. A
MNA shall perform a task involving the administration of medication only if:
(a) The task has been delegated to the MNA by a
licensed nurse in accordance with the provisions of Nur 404; and
(b) The delegation is not prohibited by Nur
404.04.
Source. #8873, eff 4-24-07; ss by #10299, eff
3-22-13; ss by #10571, eff 4-17-14; renumbered by #10953 (from Nur 404.08)
Nur 404.10 Circumstances Prohibiting the Performance
by an LNA of Tasks Involving Medication Administration. An MNA shall not perform a task involving the
administration of medication if:
(a)
The task requires the determination of the client's need for the
medication, the calculation of the dosage of the medication or the conversion
of dosage;
(b)
The delegating nurse is unavailable to monitor the progress of the
client and the effect on the client of the medication; or
(c)
The client is not stable or has changing nursing needs.
Source. #8873, eff 4-24-07; ss by #10299, eff
3-22-13; ss by #10571, eff 4-17-14; renumbered by #10953 (from Nur 404.09)
Nur
404.11 Obligations of Delegating
Licensee in Connection with the Delegation to a LNA of a Task Involving
Medication Administration.
(a) A licensee intending to delegate, or having
delegated, a task involving medication administration to a MNA shall comply
with the requirements of Nur 404.05 and Nur 404.06.
(b) A licensee who, having delegated a task
involving medication administration to a MNA, has any reason to believe that
the delegatee may have made an error in the
administration of medication shall:
(1)
Immediately ascertain whether the error occurred; and
(2) If
the error occurred or its occurrence cannot be ascertained immediately, take
the following steps:
a.
Inform the administrator of the facility, institution or agency in which
the error occurred;
b.
Document the error in the client's clinical record;
c.
Complete any report required by the policies or rules of the facility,
institution or agency within the required time period;
d.
Determine whether immediate action is required to be taken with respect
to the delegation of tasks to the MNA who made the error; and
e.
Maintain a record of errors in medication administration and actions
taken by the delegating licensee for medication nursing assistant program site
review.
Source. #8873, eff 4-24-07; ss by #10299, eff
3-22-13; ss by #10571, eff 4-17-14; renumbered by #10953 (from Nur 404.10)
Nur
404.12 Obligation of MNA to Report
Possible or Known Error in the Administration of Medication. An MNA who has any reason to believe that he
or she has made an error in the administration of medication shall:
(a) Immediately report to the following people a
possible or known error in the administration of medication:
(1) The
licensee who delegated the task involving the administration of medication; and
(2) The
MNA’s immediate supervisor in the facility, institution or agency in which the
possible or known error occurred, if such supervisor is someone other than the
delegating licensee; and
(b) Assist the delegating licensee and the
immediate supervisor in the setting in which the possible or known error
occurred in the completion of any document for reporting error which required
to be completed.
Source. #8873, eff 4-24-07; ss by #10299, eff
3-22-13; ss by #10571, eff 4-17-14; renumbered by #10953 (from Nur 404.11)
PART Nur 405 ONGOING REQUIREMENTS
Nur 405.01 Competence to Practice. All licensees shall, through education and
experience, maintain the ability to practice nursing or nursing related
activities competently.
Source. #9096, eff 2-23-08; ss by #10299, eff
3-22-13; ss by #10571, eff 4-17-14; renumbered by #10953 (from Nur 404.12); ss
by #11082, eff 4-26-16 (formerly Nur 404.13)
Nur 405.02 Change of Address.
(a) Each licensee shall notify the
board, in writing or electronically, within 30 days of a change of residential
or business address by completing and submitting Form “Address Name Change
Form”, 11-2013.
(b)
The notification required by (a) above shall include the licensee’s:
(1) Full name, license type and number;
(2) Complete current residential mailing and
physical address, even if unchanged; and
(3) Current business mailing and physical
address, even if unchanged.
(c)
As part of the notice required pursuant to (a) above, the licensee may
also provide his or her email address, even if unchanged.
(d)
Each person who fails to notify the board as required pursuant to (a)
above shall, after notice and opportunity for a hearing pursuant to Nur
402.04(a), be fined $10.00.
Source. #9395, eff 2-25-09; ss by #10299, eff
3-22-13; ss by #10571, eff 4-17-14; renumbered by #10953 (from Nur 404.13);
renumbered by #11082 (formerly Nur 404.14)
CHAPTER Nur
500 ETHICAL STANDARDS
PART Nur 501 ETHICAL CONDUCT STANDARDS AND GENERAL ETHICAL
STANDARDS
Nur
501.01 Obligation to Obey.
(a) The ethical standards set forth in this part shall
bind all licensees and, as applicable, applicants for a license.
(b) Violations of any of the standards shall be
included within the scope of the term "unprofessional conduct" as
used in RSA 326-B:37, II(h) and shall result in disciplinary action by the
board.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #7769, eff
10-1-02; ss by #8873, eff 4-24-07; ss by #10300, eff 3-22-13; ss by #13673, eff
6-23-23
Nur
501.02 Ethical Conduct Standards. A licensee, or, as applicable, an applicant
for licensing shall:
(a) Perform during nursing care or
nursing-related activities only those acts which are within the licensee's
competency;
(b) Submit only truthful and correct information
in any application or other document filed with or statement made to the board;
(c) Participate in good faith in any mediation
recommended by the board;
(d) Promptly, and in any case within 10 business
days, inform the board in writing of any disciplinary action taken by a state,
regional or national regulatory board or agency;
(e) Promptly, and in all cases within 10 business
days, inform the board in writing of any civil action or insurance claim filed
against the licensee that alleges malpractice, and inform the board of in
writing within 10 business days of any decisions made in such civil actions or
any claims paid on such insurance claims; and
(f) Obey in good faith and within any time period
specified any disciplinary orders issued by the board, including orders
requiring the payment of fees or fines.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #7769, eff
10-1-02; ss by #8873, eff 4-24-07; ss by #10300, eff 3-22-13; ss by #13673, eff
6-23-23
Nur
501.03 General Ethical Standards. A licensed nurse or nursing assistant shall:
(a) Hold the health and safety of clients to be
of first consideration and render to each client the full measure of their
ability as an essential health care provider;
(b) Always strive to perfect, enlarge, and
utilize their knowledge in conjunction with their professional judgment;
(c) Observe the law and uphold the
nursing profession;
(d) Be truthful and respectful of information
received and rendered;
(e) Hold confidential the information received
from clients and their caregivers;
(f) Not agree to practice under terms or
conditions which through interference with professional judgment and skill
would cause deterioration in the licensee's ability to render safe care at all
times; and
(g) Fulfill all professional obligations
conscientiously.
Source. #7769, eff 10-1-02; ss by #8873, eff 4-24-07;
ss by #10300, eff 3-22-13; ss by #13673, eff 6-23-23
Nur 501.04 Professional Duties.
(a) An Advanced Practice
Registered Nurse (APRN) shall, pursuant to RSA 326-B:11 (III) and RSA 326-B:37,
II, (h), be under a professional duty to comply with the requirements of the
Controlled Drug Prescription Health and Safety Program, RSA 318-B:31-38, and
all administrative rules of the board of pharmacy adopted thereunder.
(b) Pursuant to RSA 318-B:36, the following actions shall result in a
disciplinary proceeding and the imposition of sanctions upon an APRN by the
board in accordance with its rules:
(1) Prescribing or dispensing
of controlled substances in schedule II-IV without having registered with the
program;
(2) The knowing disclosure of
program information by a person authorized to receive it, in a manner that
violates RSA 318-B or administrative rules of the board of pharmacy;
(3) The use of program
information by a person authorized to receive it, for a purpose that violates
RSA 318-B or administrative rules of the board of pharmacy; or
(4) Permitting the use or
disclosure of program information under control of the nurse by a person not
authorized to receive it, in violation of RSA 381-B or administrative rules of
the board of pharmacy.
(c) RESERVED
Source. #10954, eff 10-22-15; amd
in (d) & (e) by EMERGENCY RULE, #10995, eff 12-18-15, EXPIRES: 6-15-16; amd in paras (d) & (e) by #11116, REPEAL OF EMERGENCY
RULE, eff 6-9-16
Nur 501.05 Prescription of an Opioid Antagonist by an
APRN.
(a)
An Advanced Practice Registered Nurse (APRN) shall be
under a professional duty to comply with the requirements of the Controlled
Drug Act, RSA 318-B, and administrative rules of the board of pharmacy adopted
thereunder, and shall be afforded the benefit of the exemption for actions
taken with an opioid antagonist provided in RSA 318-B:15, IV.
Source. #11056, eff 3-19-16
PART Nur 502 OPIOID PRESCRIBING
Nur
502.01 Applicability. This part shall apply to the prescribing of
opioids for the treatment of non-cancer and non-terminal pain, and shall not
apply to the supervised administration of opioids in a health care setting.
Source. #11117, eff 6-9-16; ss by #12070, eff 1-1-17
Nur
502.02 Noncompliance with Standards as
Unprofessional Conduct. The ethical
standards set forth in this part shall bind all licensees, and noncompliance
with these standards shall constitute unprofessional conduct as used in NH RSA
326-B:37, II(h). The board shall
investigate violations of these standards and impose disciplinary sanctions for
such violation by following the disciplinary procedures set forth in Nur 402,
and the hearings procedures in Nur 207.
Source. #11117, eff 6-9-16; ss by #12070, eff 1-1-17
Nur 502.03 Definitions. Except where the context makes another
meaning manifest, the following words have the meanings indicated when used in
this chapter:
(a)
“Acute pain” means the normal, predicted physiological response to a
noxious chemical, thermal, or mechanical stimulus and typically is associated
with invasive procedures, trauma, and disease.
It can be generally time-limited, often less than 3 months in duration;
(b)
“Administer” means an act whereby a single dose of a drug is instilled
into the body of, applied to the body of, or otherwise given to a person for
immediate consumption or use;
(c)
“Addiction” means a primary, chronic, neuro-biologic disease with
genetic, psychosocial, and environmental factors influencing its development
and manifestations. It is characterized
by behaviors that include impaired control over drug use, craving, compulsive
use, or continued use despite harm. The
term does not include physical dependence and tolerance, which are normal
physiological consequences of extended opioid therapy for pain;
(d)
“Chronic pain” means a state in which non-cancer pain persists beyond
the usual course of an acute disease or healing of an injury, or that may or
might not be associated with an acute or chronic pathologic process that causes
continuous or intermittent pain over months or years. It also includes intermittent episodic pain
that may require periodic treatment. For the purposes of these rules, chronic
pain does not include pain from cancer or terminal disease;
(e)
“Clinical coverage” means specified and prearranged coverage that is
available 24 hours a day, 7 days a week, to assist in the management of
patients with chronic pain;
(f)
“Dose unit” means one pill, one capsule, one patch, or one liquid dose;
(g)
“Medication-assisted treatment” means any treatment of opioid addiction that
includes a medication, such as methadone, buprenorphine, or naltrexone, that is
approved by the FDA for opioid detoxification or maintenance treatment;
(h)
“Morphine equivalent dose (MED)” means a conversion of various opioids
to a morphine equivalent dose by the use of board-approved conversion tables;
(i) “Prescription” means a verbal, written,
facsimile, or electronically transmitted order for medications for
self-administration by an individual patient;
(j)
“Risk assessment” means a process for predicting a patient’s likelihood
of misusing or abusing opioids in order to develop and document a level of
monitoring for that patient;
(k) “ Treatment agreement” means a
written agreement that outlines the joint responsibilities of Advanced Practice
Registered Nurse (APRN) and patient; and
(l)
“Treatment plan” means a written plan that reflects the particular
benefits and risks of opioid use for each individual patient and establishes
goals, expectations, methods, and time course for treatment.
Source. #11117, eff 6-9-16; ss by #12070, eff 1-1-17
(from Nur 502.02)
Nur 502.04 Acute Pain. If opioids are indicated and clinically
appropriate for prescription for acute pain, prescribing licensees shall:
(a)
Conduct and document a physical examination and history;
(b)
Prescribe the lowest effective dose for a limited duration;
(c)
Document the prescription and rationale for all opioids;
(d)
Ensure that the patient has been provided information that contains the
following:
(1) Risk of side effects, including addiction and
overdose resulting in death;
(2) Risks of keeping unused medication;
(3) Options for safely securing and disposing of
unused medication; and
(4) Danger in operating motor vehicle or heavy
machinery;
(e)
Comply with all federal and state controlled substance laws, rules and
regulations;
(f)
Conduct and document a risk assessment, such as the evidence-based
screening tool Screener and Opioid Assessment for Patients with Pain (SOAPP);
(g)
Document an appropriate treatment plan and consideration of
non-pharmacological modalities and non-opioid therapy;
(h)
Utilize a written informed consent that explains the following risks
associated with opioids:
(1) Addiction;
(2) Overdose and death;
(3) Physical dependence;
(4) Physical side effects;
(5) Hyperalgesia;
(5) Tolerance; and
(6) Crime victimization;
(i) In an emergency department, urgent care
setting, or walk-in clinic:
(1) Not prescribe more than the minimum amount of
opioids medically necessary to treat the patient’s medical condition. In most
cases, an opioid prescription of 3 or fewer days is sufficient, but a licensee
shall not prescribe for more than 7 days; and
(2) If prescribing an opioid for acute pain that
exceeds a board-approved limit, document the medical condition and appropriate
clinical rationale in the patient’s medical record; and
(j)
Not be obligated to prescribe opioids for more than 30 days, but if
opioids are indicated and appropriate for persistent, unresolved acute pain
that extends beyond a period of 30 days, the licensee shall conduct an
in-office follow-up with the patient prior to issuing a new opioid
prescription.
Source. #11117, eff 6-9-16; ss by #12070, eff 1-1-17
(from Nur 502.03)
Nur 502.05 Chronic Pain. If opioids are indicated and clinically
appropriate for prescription for chronic pain, prescribing licensees shall:
(a)
Conduct and document a history and physical examination;
(b)
Conduct and document a risk assessment, including, but not limited to,
the use of an evidence- based screening tool such as the Screener and Opioid
Assessment for Patients with Pain (SOAPP);
(c)
Document the prescription and rationale for all opioids;
(d)
Prescribe for the lowest effective dose for a limited duration;
(e)
Comply with all federal and state controlled substances laws, rules, and
regulations;
(f)
Utilize a written informed consent that explains the following risks
associated with opioids:
(1) Addiction;
(2) Overdose and death;
(3) Physical dependence;
(4) Physical side effects;
(5) Hyperalgesia;
(6) Tolerance; and
(7) Crime victimization;
(g)
Create and discuss a treatment plan with the patient. This shall include, but not be limited to the
goals of treatment, in terms of pain management, restoration of function,
safety, time course for treatment, and consideration of non-pharmacological
modalities and non-opioid therapy. Informed consent documents and treatment
agreements may be part of one document and for the sake of convenience;
(h)
Utilize a written treatment agreement that is included in the medical
record and specifies conduct that triggers the discontinuation or tapering of
opioids;
(i) The treatment agreement shall also address,
at a minimum, the following:
(1) The requirement of safe medication use and
storage;
(2) The requirement of obtaining opioids from
only one prescriber or practice;
(3) The consent to periodic and random drug
testing; and
(4) The prescriber’s responsibility to be
available or to have clinical coverage available;
(j)
Document the consideration of a consultation with an appropriate
specialist in the following circumstances:
(1) When the patient receives a 100 mg morphine
equivalent dose daily for longer than 90 days;
(2) When a patient is at high risk for abuse or
addiction; or
(3) When a patient has a co-morbid psychiatric
disorder;
(k) Reevaluate treatment plan and use of opioids
at least twice a year;
(l)
Require random and periodic urine drug testing at least annually for all
patients using opioids for longer than 90 days.
Unanticipated findings shall be addressed in a manner that supports the
health of the patient; and
(m)
Have clinical coverage available for 24 hours per day, 7 days per week,
to assist in the management of patients; and
(n)
The prescriber may forego the requirements for a written treatment
agreement and for periodic drug testing for patients:
(1) Who are residents in a long term,
non-rehabilitative nursing home facility where medications are administered by
licensed staff; or
(2) Who are being treated for episodic,
intermittent pain and receiving no more than 50 dose units of opioids in a 3
month period.
Source. #11117, eff 6-9-16; ss by #12070, eff 1-1-17
(from Nur 502.04)
Nur 502.06 Prescription Drug Monitoring Program.
(a)
Prescribers required to register with the program under RSA 318-B:31-40,
or their delegate, shall query the Prescription Drug Monitoring Program to
obtain a history of schedule II-IV controlled substances dispensed to a
patient, prior to prescribing an initial schedule II, III, and IV opioids for
the management or treatment of this patient’s pain and then periodically and at
least twice per year, except when:
(1) Controlled medications are to be administered
to patients in a health care setting;
(2) The program is
inaccessible or not functioning properly, due to an internal or external
electronic issue; or
(3) An emergency department is experiencing a higher
than normal patient volume such that querying the program database would
materially delay care.
(b)
A licensee shall document the exceptions described in (a)(2) and (3)
above in the patient’s medical record.
Source. #11117, eff 6-9-16; ss by #12070, eff 1-1-17
(from Nur 502.05)
Nur 502.07 Medication Assisted Treatment. Licensees who prescribe medication assisted
treatment shall adhere to the principles outlined in the American Society of
Addiction Medicine’s National Practice Guideline For the Use of Medications in
the Treatment of Addiction Involving Opioid Use (2015) found at
http://www.asam.org/quality-practice/guidelines-and-consensus-documents/npg/complete-guideline
as cited in Appendix II.
Source. #12070, eff 1-1-17 (from Nur 502.06)
Chapter Nur 600 NURSING EDUCATION PROGRAM APPROVAL
PART
Nur 601 PURPOSE
Statutory
Authority: RSA 326-B: 4-a, XV, RSA
326-B: 27.
Nur 601.01 Purpose.
(a)
The purpose of this chapter is to set minimum standards that must be met
by programs that educate those who seek to enter, or who are in and seek to
advance in, the nursing profession.
(b)
These standards are intended to safeguard the life, health, and public
welfare of the people of
(1) Providing for safe nursing practices by
setting legal standards for the educational preparation of nurses;
(2) Promoting self-evaluation of educational
programs;
(3) Providing for interested persons a list of
educational programs meeting legal standards; and
(4) Providing an educated, safe workforce.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #9096, eff 2-23-08;
ss by #10301, eff 3-22-13; ss by #11024, eff 1-23-16
Nur 601.02 Definitions.
(a) “Clinical preceptor” means a registered nurse who:
(1) Holds either a current unencumbered New Hampshire
registered nurse license or a current and unencumbered multi-state registered
nurse license issued by a compact state pursuant to RSA 326-B: 46;
(2) Is employed by a cooperating agency, who assists a
nursing student participating in a clinical practicum with acclimating to the
role of the nurse; and
(3) Evaluates student progress in meeting the goals and objectives
of the program.
(b) “Clinical teacher”
means a registered nurse who holds either a current unencumbered New Hampshire
registered nurse license or a current and unencumbered multi-state registered
nurse license issued by a compact state
pursuant to RSA 326-B:46, and who will be responsible for the supervision and
guidance of no more than 2 nursing
students during a clinical experience.
(c) “Cooperating agency” means a participating agency providing student clinical
experiences.
(d) “Distance
education” means instruction offered by any means, whether synchronous or
asynchronous, where the student and faculty are in separate physical locations.
(e)
“First level nurse” means a nurse who provides and coordinates patient
care after graduating from an approved program of at least 2 years in
length. Regionally, he or she might be
referred to as a professional nurse or registered nurse.
(f) “Full approval” means the status granted to a
nursing education program that has graduated its first class and is determined
by the board to have complied with Section 326- B: 32 and these rules.
(g) “Good academic standing”
means the nursing student is in compliance with his or her institution’s degree
program’s definition of good standing and is making satisfactory progress
toward the completion of degree requirements within the time limits of the
degree program, including approved extensions.
(h)
“Home state/jurisdiction” means the National Council of State Boards of
Nursing (NCSBN) member state/jurisdiction where the nursing education program
has legal domicile.
(i) “Host
state/jurisdiction” means the NCSBN member state/jurisdiction, outside of the
home state/jurisdiction where students participate in didactic coursework
through distance learning and/or clinical experiences.
(j) “Initial approval” means the status granted to a new nursing education
program that has been approved by the board to admit students.
(k) “Institutional accreditation” means the formal recognition or
acceptance of the governing institution by an accrediting agency recognized by
the United States Department of Education.
(l)
“NCLEX- PN” means an examination offered through the NCSBN entitled the
National Council Licensure Examinations by Practical Nurses.
(m)
“NCLEX- RN” means an examination offered through the NCSBN entitled the
National Council Licensure Examinations by Registered Nurses.
(n) “Nurse educator” means a person
who holds either a current unencumbered New Hampshire registered nurse license
or a current and unencumbered multi-state registered nurse license issued by a
compact state pursuant to RSA 326-B:46, and who provides instruction in core
theoretical or clinical nursing courses.
(o) “Program accreditation” means the
formal recognition or acceptance of the nursing education program by a
specialized professional nursing accrediting agency recognized as such by the
United States Department of Education.
(p) “Probation” means the status granted to a nursing education program when
there is evidence at any time of non-compliance with RSA 326- B: 32 or these
rules.
(q)
“Second level nurse” means a nurse who provides basic nursing care under
the direction of a first level nurse.
Regionally, he or she might be referred to as a practical nurse or
vocational nurse.
(r) “Sponsoring institution official”
means the person with authority to bind the educational institution in all
matters related to nursing program approval and ongoing oversight of the
nursing program.
(s)
“Withdrawal of approval” means
an action taken by the board when it has been determined that the
program fails substantially to meet the standards set forth in RSA 326-B: 32 or
these rules and fails to correct the deficiencies within the time specified by
the board.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #9096, eff 2-23-08;
ss by #10301, eff 3-22-13; ss by #11024, eff 1-23-16
PART Nur 602 NURSE EDUCATION PROGRAM ORGANIZATIONAL, STAFF
AND FACULTY, AND CURRICULAR REQUIREMENTS
Nur 602.01 Program Organization.
(a)
Institutions seeking approval to offer either an RN or LPN nursing
educational program shall:
(1) Have the legal authority to conduct an
educational program;
(2) Establish academic policies, ensure financial
support and maintain adequate human and material resources;
(3) Establish policies that comply with all
ethical requirements adopted by the
(4) Satisfy one or both of the following:
a. Be part of an existing educational
institution accredited by the U.S. Department of Education; or
b. Have approval by the
(5) Present an organizational chart depicting the
authoritative, communicative, collaborative and cooperative lines within the
institution and between groups and cooperating agencies contributing to the
program’s educational goals;
(6) Appoint a nursing program director who:
a. Holds a current
and unencumbered
b. Meets criteria required by Nur 602.06;
c. Reports to the sponsoring official; and
d. Has the authority and responsibility for the
program’s administration;
(7) Authorize the director to prepare and
administer the program’s budget, and make recommendations to the sponsoring
institution’s officials regarding the program’s fiscal needs; and
(8) For programs located within the state of
(b)
The director shall initiate and maintain current contractual agreements
with cooperating agencies providing student-learning experiences which shall:
(1) Indicate
instructional responsibilities, instructional activities, nurse-educator and
staff orientations, and patient-care responsibilities;
(2) Be developed with the cooperating agency
providing the learning resources;
(3) Require
periodic review according to program policies and provide notice for contract
termination sufficient to prevent interruption of the program;
(4) Require full control of learning activities
by the sponsoring institution including selection, instruction and evaluation
of learning activities; and
(5) Establish times for nurse-educators and
agency members to meet jointly to review the program’s philosophy, objectives,
learning experiences, expected outcomes and future directions.
(c)
The requirements of (b) above shall not apply to observational
experiences.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #9096, eff 2-23-08
(from Nur 601.03); ss by #9395, eff 2-25-09; ss by #10301, eff 3-22-13; ss by
#11024, eff 1-23-16
Nur 602.02 Program Policies. Each sponsoring institution shall adopt and
make publicly available clearly written student and institutional policies and
procedures, including but not limited to:
(a)
Admission;
(b)
Transfer;
(c)
Evaluation;
(d)
Dismissal and termination;
(e)
Withdrawal;
(f)
Grading;
(g)
Successful completion and graduation;
(h)
Grievance and due process;
(i) Illness;
(j)
Personal leave;
(k)
Confidentiality and access to student records housed within the nursing
department;
(l)
Tuition and refund.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #9096, eff 2-23-08
(from Nur 601.04); ss by #10301, eff 3-22-13; ss by #11024, eff 1-23-16
Nur 602.03 Program Fiscal, Human and Physical
Resources.
(a)
The program shall provide sufficient learning resources for students and
staff, including print and non-print materials, to accommodate the needs of all
students and nurse educators.
(b)
The program shall develop and make available for review policies that
address acquisition and deletion of library materials, including both print and
non-print materials.
(c)
The program shall provide and make available to nursing students and nurse-educators
sufficient hardware, software, related equipment and electronic resources to
support current educational practices.
(d)
The sponsoring institution shall provide to nurse-educators classroom
and office space comparable to that of other sponsoring institution faculty
that provides:
(1) Privacy for individual conferences;
(2) Sufficient work area to accomplish assigned
tasks;
(3) Sufficient office equipment and teaching
tools to meet faculty needs;
(4) Clean, safe environmental conditions with
comfortable temperatures;
(5) Adequate lighting; and
(6) Audio-visual or simulator equipment necessary
for care demonstrations.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #9096, eff 2-23-08
(from 601.05); ss by #9395, eff 2-5-09; ss by #10301, eff 3-22-13; ss by
#11024, eff 1-23-16
Nur 602.04 Program Documents.
(a)
Program documents pertaining to students shall be accurate, complete,
confidential, and secure, and contain the following data:
(1) Admission and re-admission;
(2) Dismissal and termination;
(3) Grading;
(4) Graduation;
(5) Evaluation;
(6) Failure;
(7) Withdrawal;
(8) Health; and
(9) Personal leave.
(b)
The institution shall provide for permanent preservation, security and
retrievability of student documents including a transcript indicating dates of
entrance, progression, completion and courses.
(c)
Faculty records shall include documentation of:
(1) Current and unencumbered
(2) Performance evaluations.
(d)
Sponsoring institutions shall retain and make available records
regarding administration and nurse-educator evaluative procedures.
(e)
The sponsoring institution shall prepare and file with the board no
later than January 1 of the following calendar year an annual report that
includes:
(1) State and regional and professional
accrediting agency findings;
(2) Current catalogue and program policies that
accurately depict the nursing programs actually offered during the
program year;
(3) The name and address of the sponsoring
institution official, and the director of the nursing program;
(4) The name, nursing specialty and academic
preparation of each nurse-educator;
(5) Each nurse-educator’s work load in terms of
hours and weeks and the program director’s responsibilities in terms of
teaching, administration and student guidance;
(6) A list of cooperating agencies;
(7) Current curricular plan and anticipated
curricular or program changes;
(8) The number of applications, enrollments,
transfers, dismissals, failures, and graduates, by year for the previous 5
years;
(9) A 3-year summary of the NCLEX-PN or NCLEX-RN
scores received by program graduates;
(10) Program budget data along with a copy of:
a. The sponsoring institution’s
most recent fiscal audit of receipts and expenditures relating to the program,
b. Opinion letters of the auditors; and
c. Management’s response to audit findings; and
(11) The dated signature of the program director.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #9096, eff 2-23-08
(from Nur 601.06); ss by #10301, eff 3-22-13; ss by #11024, eff 1-23-16
Nur 602.05 Nurse Educator Approval.
(a)
Each sponsoring institution shall submit for each proposed nurse
educator Form “Application for Faculty Approval Board Approved Education
Programs”, as amended 04-06-2015.
(b)
No nurse-educator shall assume responsibilities for which approval under
this section is requested until such approval has been granted by the board.
(c) Each faculty member, preceptor, employee or
agent of a distance education pre-licensure education program who is in contact
with patients and students shall hold a current and active license to practice
in the place where the patients are located that is not encumbered and meets
all licensing requirements of the state of NH.
(d)
Faculty of distance education pre-licensure programs who teach clinical
experiences in NH shall seek and obtain nurse-educator approval pursuant to Nur
602.07.
(e)
Faculty who teach distance education didactic nursing courses, or who
have oversight of students or preceptors but do not provide care for patients,
shall hold a current and active license to practice that is not encumbered and
meets the requirements of the home state
or jurisdiction where the nursing program is approved.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #9096, eff 2-23-09 (from
Nur 601.08); ss by #10301, eff 3-22-13; ss by #11024, eff 1-23-16
Nur 602.06 Director’s Qualifications.
(a)
The program shall complete and submit Form “Application for Faculty
Approval Board, Approved Education Programs”, as amended 04-06-2014.
(b)
The director of a nursing program offering a degree leading to a
registered nurse license shall possess and document the following minimum
qualifications:
(1) For a program that offers a doctoral level
nursing degree, the following criteria are required:
a. A nursing master’s degree, and a doctoral degree with a focus in nursing; and
b. At least 5 years of
administrative/educational experience in nursing;
(2) For a program that offers a masters level
nursing degree, following criteria are required:
a. A master’s degree in nursing and a doctorate
with a focus in nursing; and
b. At least 5 years of
administrative/educational experience in nursing; and
(3) For a program that offers a baccalaureate
level degree, the following criteria are required:
a. A master’s degree in nursing; and
b. At least 5 years of
administrative/educational experience in nursing.
(c)
The director of a nursing program offering an associate degree leading
to a registered nurse license shall possess and document the following minimum
qualifications:
(1) A master’s degree in nursing; and
(2) At least 5 years of
administrative/educational experience in nursing.
(d)
The director of a nursing program offering a diploma or associate degree
leading to a practical nurse license shall possess and document the following
minimum qualifications:
(1) A master’s degree in nursing; and
(2) At least 5 years of
administrative/educational experience in nursing.
(e)
For programs located within the state of
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #9096, eff 2-23-08
(from Nur 601.09); ss by #10301, eff 3-22-13; ss by #11024, eff 1-23-16
Nur
602.07 Nurse-Educator Qualifications.
(a)
Nurse-educators in programs offering the baccalaureate, masters, or
doctorate degree leading to a registered nurse license shall possess the
following minimum qualifications including:
(1) A master’s degree in nursing or a
baccalaureate in nursing with a master’s degree or doctorate in:
a. Public health;
b. Health care administration/leadership;
c. Health promotion; or
d. Another field related to health care or
education;
(2) At least 2 years of relevant nursing
experience in their specific area of educational responsibility; and
(3) Comply with Nur 602.05.
(b)
Nurse-educators in programs offering the associate degree or the diploma
leading to a registered nurse license shall possess and document the following
minimum qualifications:
(1) A master’s degree in nursing or a
baccalaureate in nursing with a master’s degree in:
a. Public health;
b. Health care administration/leadership;
c. Health promotion; or
d. Another field related to health care or
education;
(2) Have and document at least 2 years
of relevant nursing experience in their specific area of educational
responsibility; and
(3) Comply with Nur 602.05.
(c)
Nurse-educators in educational programs offering the diploma leading to
a practical nurse license shall possess and document the following minimum
qualifications including:
(1) Both of the following:
a. A master’s degree in nursing or a
baccalaureate in nursing with a master’s degree in:
1. Public health;
2. Health care administration/ leadership;
3. Health promotion; or
4. Another field related to health care or
education;
b. At least 2 years of relevant nursing experience in
their specific area of educational responsibility; or
(2) A
bachelor’s degree in nursing and at least 4 years of relevant nursing
experience in their specific area of educational responsibility.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #9096, eff 2-23-08
(from Nur 601.10); ss by #9395, eff 2-25-09; ss by #10301, eff 3-22-13; ss by
#11024, eff 1-23-16; ss by #12824, eff 7-6-19
Nur 602.08 Temporary Nurse-Educator Approval.
(a)
Each sponsoring institution and program director may seek a temporary
nurse-educator approval for an individual who fails to meet criteria as
required by Nur 602.07.
(b)
The sponsoring institution shall submit a request that provides the
following information:
(1) The
nurse-educator’s name, address, teaching and practice experience, educational
qualifications;
(2) The nurse-educator’s
anticipated instructional assignment and supervision of that assignment; and
(3) The details of an academic study plan and
timeframe designed to bring the nurse-educator into compliance with Nur 602.07.
(c) Board approval for a temporary nurse-educator
shall be granted if:
(1) The nurse-educator has successfully completed
a baccalaureate degree nursing program, or can document:
a. Successful matriculation in a graduate or doctorate program having met
generalist requirements for a BSN or MS degree and with a program focus as
listed in Nur 602.07(a); and
b. That he or she
holds a current and unencumbered
(2) The nurse-educator has and documents at least
2 years of clinical experience in the
area of the anticipated teaching assignment to prepare the nurse-educator to
instruct students in that area;
(3) The anticipated assignment is congruent with
educational and experiential preparation;
(4) Supervision is adequate for the anticipated
assignment; and
(5) The academic study-plan meets the
requirements of (b) above.
(d)
Temporary nurse-educator approval shall be extended if the applicant has
matriculated and demonstrated
progress in master’s degree education program with a program focus as listed in
Nur 602.07(a) as evidenced by taking at least one full course per
semester. Each such extension shall
remain in effect for 12 months and the total time allotted for master’s degree
completion, including any extensions, shall not exceed 48 months.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #9096, eff 2-23-08 (from
Nur 601.11); ss by #9395, eff 2-25-09; ss by #10301, eff 3-22-13; ss by #11024,
eff 1-23-16
Nur 602.09 Nurse-Educator Responsibilities.
(a)
A nurse-educator shall be responsible for the instruction and
supervision of no more than 8 students during clinical learning activities at
cooperating agencies.
(b)
A nurse educator shall be responsible
for the instruction of no more than 12 students when:
(1) The student is directly supervised by a
registered nurse, who is serving as either a clinical teacher or preceptor, in
a health care setting; and
(2) A method of access to program faculty for
purposes of communication of student progress and evaluation is identified for
each student at the onset of the clinical experience.
(c)
At the cooperating agency the student to nurse-educator ratio shall be
determined after considering the following:
(1) Level of student’s educational preparation;
(2) Quality of nursing care required;
(3) Number of care-recipients assigned;
(4) Faculty expertise;
(5) Cooperating agency policies; and
(6) The limitations imposed pursuant to (a) and
(b) above.
(d)
During a clinical learning experience, nurse-educators may seek
expertise of other health-care providers for specific learning activities based
on written objectives, but the nurse-educator shall be readily available and
shall meet with students to assist with integration of learning activities.
(e)
Nurse-educators shall meet periodically, but at least annually,
according to sponsoring institution and program policies, to recommend
educational and policy revisions based on program review and evaluation.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #9096, eff 2-23-08
(from Nur 601.12); ss by #10301, eff 3-22-13; ss by #11024, eff 1-23-16
Nur 602.10 Substitute Nurse-Educator.
(a)
In programs leading to registered or practical nurse licensure a
substitute nurse-educator for a specific clinical site shall be designated by
the program director when a nurse-educator is absent due to illness, education
or other unexpected circumstances.
(b)
Appointment of substitute nurse educators for longer than one semester
shall require approval by the board using the same criteria as set forth in Nur
602.07.
(c)
The program director shall be responsible to ensure that the assignment
of the substitute nurse-educator:
(1) Is appropriate to the clinical content;
(2) Is of limited duration; and
(3) Maintains the program integrity.
(d)
Substitute nurse-educators shall be selected on the basis of:
(1) The level of the students’ educational
preparation;
(2) The substitute nurse-educator’s education and
demonstrated clinical expertise; and
(3) Institutional and cooperating agency
policies.
(e)
A substitute nurse-educator shall:
(1) Hold a current and unencumbered
(2) Be employed at the clinical site at the time
of approval as a substitute nurse-educator;
(3) Have been employed at such site for at least
3 months;
(4) Have been approved by the program director on
the director’s evaluation of the factors in (c) above; and
(5) Have been oriented by the program director,
or designee, to the curriculum and student performance expectations.
(f)
The substitute nurse-educator shall not:
(1) Maintain his or her own clients or patients
during the time that he or she acts as a substitute nurse-educator; or
(2) Be responsible for the instruction of more
than 8 students, except as provided under Nur 602.09 (b).
Source. #9096, eff 2-23-08; ss by #10301, eff
3-22-13; ss by #11024, eff 1-23-16
Nur 602.11 Program Philosophy and Outcomes.
(a)
Each nursing program shall develop and maintain a clearly written
statement of the nursing program’s philosophy, reflecting the mission statement
of the sponsoring institution, that defines the nurse-educators’ beliefs
regarding the concepts identified as foundational to the program.
(b)
The nursing program’s anticipated outcomes shall be grounded in the
philosophy and the organizing framework and shall serve to evaluate student
performance as well as criteria for selecting learning activities.
Source. #9096, eff 2-23-08; ss by #10301, eff
3-22-13; ss by #11024, eff 1-23-16
Nur 602.12 Curricular Requirements.
(a)
The curriculum shall be derived from the program’s written philosophy
and organizing framework and shall demonstrate logical sequencing and internal
consistency.
(b)
To promote health and prevent disease, registered nurse programs shall
provide a minimum of 1080 hours of nursing classroom instruction and concurrent
clinical practice offering students the opportunity to care for individuals,
families, groups and communities during various developmental stages who are
experiencing physiological, or psychosocial, or environmental disruptions.
(c)
To promote health and prevent disease practical nurse programs shall
provide a minimum of 600 hours of nursing classroom instruction and concurrent
clinical practice offering students the opportunity to care for individual,
families, groups and communities during various developmental stages that shall
be considered to be in physiologically or psychosocially, noncomplex, stable
situations.
(d)
Curricular content related to nursing courses shall include concurrent
theoretical and clinical components designed to provide instructional
activities benefiting individuals, families, and groups across the life span.
(e)
Curriculum components shall include:
(1) Experiences
that promote clinical judgment, clinical management, and commitment to
improving quality and safety of the health care system; and
(2) Evidence-based
learning experiences and methods of instruction, including distance education
methods, which are consistent with the curriculum, provided that:
a. Faculty supervised clinical practice shall
provide clinical hours consistent with Nur 602.12 (b), (c) and (d);
b. Simulation may be utilized as a teaching
strategy in laboratory and clinical settings to meet objectives for purpose of
calculating the hours in the curriculum;
c. Simulation will not be in lieu of an entire
clinical experience; and
d. Clinical
experiences, including those with preceptors, shall be directed by readily
available nurse-educator faculty members; and
Source. #9096, eff 2-23-08; ss by #10301, eff
3-22-13; ss by #11024, eff 1-23-16
Nur 602.13 Course Content, Registered Nursing.
(a)
Nursing as an applied science,
shall, at a minimum, include choices from the natural, physical and
behavioral sciences and the humanities including but not limited to the
following:
(1) Anatomy & physiology
(2) Genetics;
(3) Microbiology;
(4) Nutrition;
(5) Pathophysiology;
(6) Physics;
(7) Chemistry;
(8) Pharmacology;
(9) Mathematics;
(10) Communications;
(11) Anthropology;
(12) Sociology;
(13) Psychology;
(14) Human development throughout the life span;
(15) Literature;
(16) Philosophy;
(17) Ethics and Bioethics;
(18) History.
(b)
The curriculum of the nursing education program shall include knowledge,
skills, and abilities necessary for the scope and guidelines of competent
nursing practice expected at the level of licensure with coursework in:
(1) Biological, physical, social and behavioral
sciences to promote safe and effective nursing practice;
(2) Professional responsibilities, legal and
ethical issues, history and trends in nursing and health care;
(3) Didactic
content and supervised clinical experiences in the prevention of illness, the
promotion, restoration and maintenance of health in patients across the
lifespan, including end of life, and from diverse backgrounds; and
(4) Didactic content and supervised clinical
experience which integrates the Quality and Safety Education for Nurses (QSEN)
(2012), as referenced in Appendix II, to include patient safety,
patient-centered care, evidence-based practice, teamwork and collaboration,
quality improvement and informatics, reflect contemporary practice and
nationally established patient health & safety goals.
(c)
All clinical experiences/assignments shall require the following:
(1) A contractual arrangement between the program
and cooperating agency;
(2) Evidence
of organized student orientation to the cooperating agency;
(3) Orientation of program faculty and nursing
staff serving in the roles of nurse clinical educator, clinical teacher, or preceptor/practicum facilitator to
the educational program’s philosophy, objectives and purposes;
(4) Regularly
scheduled discussion regarding learning experiences that include, but are not
limited to, clinical conferences, formal meetings, and phone conferences;
(5) Awareness
of and adherence to policies that address role and responsibilities of student,
clinical teacher, and preceptor/practicum facilitator; and
(6) An evaluation process of the learning
experience that addresses student learning at the conclusion of each
experience;
(d)
Additional requirements for clinical experiences and assignments shall
include:
(1) No more than 2 students shall
be assigned to a registered nurse preceptor;
(2)
Regular communication regarding student progress shall occur between an
assigned registered nurse
preceptor, student and program faculty member responsible for oversight of the
clinical experience;
(3) Clinical preceptors shall have
an unencumbered license to practice as a nurse at or above the level for which
the student is being prepared, in the jurisdiction where the clinical
experience is being conducted; and
(4) Clinical teachers shall have
access to program faculty for purposes of communicating student progress with
learning outcomes, inquiries and evaluation of student.
Source. #9096, eff 2-23-08; ss by #10301, eff
3-22-13; ss by #11024, eff 1-23-16
Nur 602.14 Course Content, Practical Nursing.
(a)
Nursing as an applied science,
shall, at a minimum, include choices from the natural, physical and behavioral
sciences and the humanities including but not limited to the following:
(1) Anatomy & physiology
(2) Microbiology;
(3) Nutrition;
(4) Pathophysiology;
(5) Chemistry;
(6) Pharmacology;
(7) Mathematics;
(8) Communications;
(9) Sociology;
(10) Psychology;
(11) Human development throughout the life span;
(12) Literature; and
(13) Ethics, or Bioethics.
(b) The curriculum of the nursing education program
shall coursework that addresses knowledge, skills, and abilities necessary for
the scope and guidelines of competent nursing practice expected at the level of
licensure with coursework in:
(1) Biological, physical, social and behavioral
sciences to promote safe and effective nursing practice;
(2) Professional responsibilities, legal and
ethical issues, history and trends in nursing and health care;
(3) Didactic content and supervised clinical
experiences in the prevention of illness, the promotion, restoration and
maintenance of health in patients across the lifespan, including end of life,
and from diverse backgrounds;
(4) Faculty supervised clinical practice, which
shall provide clinical hours consistent with Nur 602.12 (b), (c) and (d);
(5) Didactic content and supervised clinical
experience which integrates the Quality and Safety Education for Nurses (QSEN),
(2012), as referenced in Appendix II, to include patient safety,
patient-centered care, evidence-based practice, teamwork and collaboration,
quality improvement and informatics, reflect contemporary practice, and
nationally established patient health & safety goals.
(c)
All clinical experiences/assignments shall be required to have the
following:
(1) A contractual arrangement between the program
and cooperating agency;
(2) Evidence of organized student orientation to
the cooperating agency;
(3) Orientation of program faculty and / nursing
staff to the educational program’s philosophy, objectives and purposes;
(4) Regularly scheduled discussion regarding
learning experiences that include, but are not limited to, clinical
conferences, formal meetings, and phone conferences;
(5) Awareness of and adherence to policies that
address role and responsibilities of student and faculty; and
(6) An evaluation process of the learning
experience that addresses student learning at the conclusion of each
experience.
Source. #9096, eff 2-23-08; ss by #10301, eff
3-22-13; ss by #11024, eff 1-23-16
Nur 602.15 Distance Education-Pre-Licensure.
(a)
The curriculum of the distance nursing education program shall include
knowledge, skills and abilities necessary for the scope and standards of
competent nursing practice expected at the level of licensure.
(b)
Distance education provided by nursing faculty shall meet the same
requirements, rigor and quality as an on-campus program and shall comply with
Nur 602.11 and Nur 602.09.
(c)
A distance learning pre-licensure nursing education program shall be
approved by the board of nursing in its home state or jurisdiction.
(d)
If the board as host state receives a complaint against a distance
learning pre-licensure program that is approved in another state/jurisdiction,
it shall file that complaint with the home state/jurisdiction for investigation
and action.
(e)
Distance learning pre-licensure nursing education programs in the home
state shall provide oversight to the students in the host states and shall be responsible for the student’s supervision.
(f)
Each distance learning pre-licensure nursing education program shall
have accreditation from a regional or national accreditation entity approved as
such by the U.S. Department of Education for programs of nursing education.
(g)
A distance learning pre-licensure education program seeking to serve
students in
(h)
No provisions of this rule shall be construed to prohibit the practice
of nursing by a student currently enrolled in and actively pursuing completion
of a pre-licensure nursing education program, if all the following are met:
(1) The student is participating in a program
located in
(2) The student is participating in this
jurisdiction in a component of a program located in another jurisdiction that
is approved by a board of nursing that is a member of NCSBN.
(3) The student’s practice is under the auspices
of an approved program; and
(4) The student acts under the supervision of a
licensed RN serving for the program as a faculty member or teaching assistant.
(i) The distance education program shall
establish:
(1) A systematic plan of evaluation for
assessment of student learning and program outcomes; and
(2) A systematic plan to intervene effectively
should untoward clinical or professional issues arise.
(j) Approved pre-licensure nursing education
programs located in jurisdictions other than New Hampshire that contract with
health care facilities or agencies in New Hampshire to provide clinical
experience for nursing students shall register their intent with the board
prior to providing the experience.
Notification of intended placement of students in NH shall occur 6 weeks
in advance of the clinical experience. Schools seeking clinical placement in NH
shall complete and submit, “Form New Hampshire Petition for Non-New Hampshire
Based Pre-Licensure Programs Offering Clinical Experience in
Source. #9096, eff 2-23-08; ss by #10301, eff
3-22-13; ss by #11024, eff 1-23-16
Nur 602.16 Program Changes.
(a)
The director of a nursing education program shall provide written notice
to the board at least 3 months prior to implementation of any curricular design
changes.
(b) The following changes to
curricular or program design shall require board approval:
(1) Revisions to
the philosophy, organizing framework, and student learning and program
outcomes;
(2) A significant increase or decrease in planned
enrollment that may affect the overall faculty-student ratio or the capacity of
institutional facilities or regional practice sites;
(3) Departure from the current educational
methods or practices;
(4) Anticipated timeframe for implementing and
evaluating changes;
(5) Revision of curriculum; to include changes in
more than 10% of credit hours;
(6) Length of program;
(7) Implementation of a pilot program or project;
(8) Implementation
of any relocation, satellite, off campus program or distance education
component;
(9) Changes in availability of adequate practice
sites for the program that result in reduction in student enrollment or faculty
positions; or
(10) Changes in nursing program leadership.
(c)
The sponsoring institution seeking board approval for curricular changes
shall document:
(1) Description of the proposed change with
cumulative, data evidence- based, criteria for change;
(2) Rationale for the change;
(3) Human, financial, and physical resources required;
(4) Integration with the current philosophy,
purposes, organizing framework and
curriculum; and
(5) Evaluative process for assessing change.
(d)
The board shall apply the criteria set forth in Nur 602.12 when
considering approval of changes in curricular or program design pursuant to (a)
above.
Source. #9096, eff 2-23-08; ss by #10301, eff
3-22-13; ss by #11024, eff 1-23-16
Nur 602.17 Accreditation Required.
(a)
Each nursing program that has not been approved by the board prior to
October 1, 2007, shall obtain accreditation from a regional or national nursing accreditation entity approved as such
by the U. S. Department of Education for programs of nursing education and
submit proof of such accreditation as part of its application for full approval
by the board.
(b)
Unaccredited nursing programs that do not show student outcomes that
meet or exceed minimum state or national NCLEX scores for licensure shall not
be recognized in
Source. #11024, eff 1-23-16 (from Nur 602.16)
Nur 602.18 Comparable Education.
(a) Comparable education for practical nursing
shall include the following requirements:
(1)
Licensing by comparable education for practical nursing shall only be available to pre-licensure students
within the state of
(2)
An applicant seeking licensure as an LPN shall complete and submit Form
“Licensing by Examination Comparable Education” 2-2015; and
(3)
Each person seeking licensure as an LPN by comparable education shall
provide, prior to sitting for the NCLEX- PN,
evidence of completion of courses in:
a. Fundamentals of Nursing;
b. Medical/Surgical Nursing;
c. Mental Health Nursing;
d. Maternal and Child Health;
e. Pediatric Nursing; and
f. All other applicable nursing courses required
by Nur 602.14; and
(4)
Course work hours shall total a minimum of 600 hours of instruction.
(b) Military personnel who meet
(c) The NCLEX- PN shall be taken only twice if
approved by comparable education.
(d) Each person seeking licensure as an RN by
comparable education for registered nursing, prior to sitting for the NCLEX RN,
shall provide the following:
(1)
An official transcript or other evidence of completion of courses that
verifies completion of generalist requirements for a nursing degree pursuant to
Nur 602.13; and
(2)
An official transcript or other evidence of completion of course work hours
that total a minimum of 1,080 hours of instruction pursuant to Nur 602.12.
Source. #11024, eff 1-23-16
PART Nur 603 NURSE EDUCATION PROGRAM APPROVAL
Nur 603.01 Approval Process.
(a)
Upon receipt of an application for a nurse education program approval
and payment of all applicable fees under Nur 607.01, the board shall:
(1) Confer initial approval pursuant to Nur
603.01;
(2) Extend initial approval for up to2 years;
(3) Confer full approval pursuant to Nur 603.05;
or
(4) Deny approval pursuant to Nur 603.06.
(b)
The board shall provide written notification to the sponsoring
institution official and director within 10 working days of its decision,
including all findings of program deficiencies and actions needed for compliance
with these rules and RSA 326-B: 32.
(c)
The sponsoring institution may appeal the board’s decision by requesting
a hearing within 30 days of the date of the notification.
(d)
The sponsoring institution’s official and director shall be given notice
of the hearing as required by RSA 541-A:31, III, and Nur 207.02.
(e)
The board shall, following a hearing held pursuant to Nur 200, notify in
writing within 10 working days the sponsoring institution’s official and
director of the board’s decision.
(f)
Based upon the application for approval and the evidence adduced at the
hearing, the board shall:
(1) Confer full approval;
(2) Confer initial approval;
(3) Affirm its previous decision; or
(4) Deny approval.
(g)
Failure of the sponsoring institution to respond to the board’s order
resulting from the hearing under (e), above, shall result in denial or
withdrawal of approval pursuant to Nur 603.09.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #9096, eff 2-23-08
(from Nur 602.02); ss by #10301, eff 3-22-13; ss by #11024, eff 1-23-16
Nur 603.02 Application and Initial Approval.
(a)
The board shall confer initial approval to sponsoring institutions
seeking to establish a nursing program following review and compliance with:
(1) The provisions of (b) and (c) below; and
(2) RSA 326-B: 32.
(b)
The sponsoring institution shall file an application with the board, at
least 12 months before anticipated enrollment of students, providing the
following:
(1) The name of the sponsoring institution and
the sponsoring institution official;
(2) Documentation, in the form of applicable
statutes, the institution’s charter, or articles of incorporation, that the
sponsoring institution is authorized to conduct such a program;
(3) An indication
of whether the application proposes RN educational preparation or LPN
educational preparation;
(4) The sponsoring institution’s rationale for
establishing the program, which shall include:
a. The details of the program planned;
b. The length of the program;
c. The expected program opening date; and
d. Anticipated enrollment;
(5) A comprehensive feasibility study that shall
address at least the following:
a. Documentation of the need and demand for such
a program in
b. The projected impact the program would have
on existing programs in the region where the program is being proposed;
c. A hiring plan for qualified program
administrators, faculty, and staff;
d. The sources and number of potential students;
and
e. The names of
proposed cooperating agencies and contact information, including evidence of
their intent to contribute to the achievement of the clinical objectives of the
program;
(6) The name of a qualified registered nurse
director who meets board criteria as required by Nur 602.06;
(7) Documentation of human, fiscal, and material resources, including the
number of nurse-educators representing specialty areas, to meet educational
needs;
(8) Documentation of meeting the surety indemnification
requirements of RSA 188-G:3 and Hedc 304.11,
including requiring the company that issues the bond to notify the board
directly in the event of non-renewal or cancellation;
(9) Anticipated nurse-educator to student ratio;
(10) Proof of institutional accreditation from a
regional or national accreditation entity approved as such by the U. S.
Department of Education and proof of application for accreditation for programs
of nursing, as required by Nursing 602.17; and
(11) A proposed time line for initiating and
expanding the program.
(c)
The sponsoring institution shall submit to the board, at least 6 months
prior to anticipated student attendance, the following:
(1) An overview of the proposed total curriculum
that includes:
a. A statement of its philosophy, organizing
framework and student learning and program outcomes.
b. A master plan of curriculum, indicating the
sequence for both nursing and non-nursing courses, as well as pre- and
co-requisites for such courses;
c. A description of each course and its
objectives;
d. Course syllabi for all first-year nursing
courses;
e. A plan for total program evaluation,
addressing at least the following:
1. Student progress;
2. Curriculum and course content;
3. Proposed
nurse educators and instructional methods;
4. Cooperating agencies;
5. Physical, human and fiscal resources required to achieve student
success;
6. Attrition, recruitment, and retention;
7. Total program integration;
8. Clinical opportunities and availability of
resources; and
9. Contracts for clinical sites; and
f. Documentation to demonstrate that the program
has:
1. Adequate support resources including:
(i) A library;
(ii) Learning resources
and technology designed to enhance learning that is comprehensive, state of the
art, and sufficient to meet faculty and student needs;
(iii) Classroom space;
(iv) At least one laboratory;
(v) Office equipment and supplies;
(vi) Office space;
(vii) Secretarial support; and
(viii) Academic counseling staff and resources for
the projected enrollment;
2.
Adequate financial resources for planning, implementing, and continuing
the program; and
(2) Clearly written student and institutional
policies and procedures that address at least the following:
1. Admission criteria and decision making
authority;
2. Transfer;
3. Evaluation;
4. Dismissal and termination;
5. Withdrawal;
6. Grading;
7. Program completion and graduation;
8. Grievances and due process;
9. Illness;
10. Personal leave;
11. Confidentiality of and access to student
records maintained by the program; and
12. Tuition, other costs, and refunds.
(d)
The board shall conduct an on-site survey of the proposed program and
agencies to determine compliance with all applicable requirements for the
establishment of the nursing education program.
(e)
The board shall afford the sponsoring institution the opportunity to
comment on the survey in writing.
(f)
If the board finds that the resources and plans meet all the applicable
rules for establishing the new nursing education program, the board shall grant
initial approval conditioned upon:
(1) The maximum enrollment for the first class of
students correlates with the required program resources;
(2) Enrollment of the first class of students
within one year of such initial approval;
(3) Receipt of program approval from the higher
education commission; and
(4) Acknowledgement that if the above conditions
of initial approval are not met, the board’s approval shall expire.
(g) Sponsoring institutions shall notify the board
immediately in the event that the surety indemnification required pursuant to
RSA 188-G: 3 and Hedc 304.11 is not renewed or is
cancelled.
(h)
Notification to the board by the surety company that issued the bond
shall not relieve the sponsoring institution from providing notification of the
non-renewal or cancellation of such required surety indemnification.
(i) Sponsoring institutions shall seek full
program approval within 6 months following the issuance of its first diplomas
and issuance of NCLEX results.
(j)
If the board finds that the resources and plans do not meet all the
rules for establishing a new nursing program, the program may submit a new plan
no sooner than 6 months after being informed that the original plans were not
satisfactory.
(k)
A program that received initial approval that expired due to failure to
enroll students within one year shall not submit a new application for initial
approval until at least 12 months have passed since the rescission.
(l)
A sponsoring institution that seeks to establish another nurse education
program at a different level shall not apply before receiving full approval of
the previous program.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #9096, eff 2-23-08
(from Nur 602.04); ss by #10301, eff 3-22-13; ss by #11024, eff 1-23-16
Nur 603.03 Program Annual Report and Self-Study.
(a)
The sponsoring institution shall annually complete and submit form, “New
Hampshire Board of Nursing Program Annual Report”; as amended 2015.
(b)
Approved programs that have received national nursing accreditation
shall submit a self- study report that correlates with the required timeframe
for the national accreditation report. For approved programs not accredited, a
self -study report shall be required every 5 years.
(c)
self- study report shall address the following criteria:
(1) A systematic evaluation of:
a. Student learning outcomes;
b. Graduate competencies;
c. Program outcomes; and
d. Results of trended and aggregated data used
for program improvement; and
(2) Sources of evidence used to measure
achievement of program outcomes, to include, but not be limited to:
a. Student retention, attrition, and on-time
program completion rates;
b. Type and number of faculty, faculty
competence and faculty retention/turnover;
c. Laboratory and clinical learning experiences;
d. NCLEX examination pass rates for graduates
taking the examination for the first time;
e. Proposed future curriculum adjustments
related to NCLEX performance;
f. Proposed future curriculum adjustments
related to employer and graduate satisfaction;
g. Proposed performance improvement initiatives
related to program outcomes; and
h. Review and resolution of program complaints
and review of grievances.
(d)
The board’s review of the program’s evaluation shall include a site
visit by board representatives which:
(1) Shall be
conducted in conjunction with the national nursing accreditation body survey
visit;
(2) Is intended to assess, clarify, verify and
evaluate the material submitted in the self-study; and
(3) Shall provide the basis for determining
compliance with these rules and RSA 326-B: 32.
(e)
Programs accredited by a national nursing organization authorized by the
federal agency authorized to accredit nursing programs may submit that
organization’s accreditation report to the board if it is:
(1) Within 3 years of the board’s date of review;
and
(2) Cross referenced and revised to demonstrate
compliance with these rules.
(f)
Following review of the institution’s self-study, the board
representatives’ site visit, and other materials submitted by the sponsoring
institution, the board shall take action as noted in Nur 603.01(f) based upon
the degree of compliance with these rules and RSA 326-B: 32.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #9096, eff 2-23-08 (from
Nur 602.06); ss by #10301, eff 3-22-13; ss by #11024, eff 1-23-16 (from Nur
603.04)
Nur 603.04 Full Approval.
(a)
Following initial approval, the sponsoring institution may request the
board to confer full approval if the program:
(1) Is in compliance with all of the conditions
imposed by the board under Nur 603.02;
(2) Has filed all annual reports required by Nur
603.03;
(3) Has filed all self-study materials required
by Nur 603.03;
(4) Is determined to be in compliance with all
board rules and RSA 326-B: 32 based upon the self-study, as validated by the
site visit;
(5) Meets the nationally determined NCLEX pass
rates average of the current year for first time test takers when the annual
pass rates for the three most recent calendar years are averaged; and
(6) Has received, subsequent to the receipt of
the initial approval from the board, all necessary approvals from the higher education commission.
(b)
The board shall deny full approval for failure to comply with RSA 326-B:
32 or these rules, and:
(1) Commence the process to place the program on
probation pursuant to Nur 603.05; or
(2) Commence the process to withdraw approval
pursuant to Nur 603.06.
(c)
The board shall provide written notification to the sponsoring
institution official and director within 10 working days of its decision. The notification shall indicate any program
deficiencies and actions needed for compliance with these rules and RSA 326-B:
32.
(d)
The sponsoring institution may appeal the board’s decision by requesting
a hearing within 30 days of the date of the notification.
(e)
The sponsoring institution’s official and director shall be given notice
of the hearing as required by RSA 541-A: 31, III, and Nur 207.02.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #9096, eff 2-23-08;
ss by #10301, eff 3-22-13; ss by #11024, eff 1-23-16 (from Nur 603.05)
Nur 603.05 Program Probation.
(a)
If the board denies a request of a sponsoring institution to grant full
approval to a nursing education program under Nur 603.04, the board shall enter
a written order that:
(1) Changes the status of the program from
“initially approved” to “approved on probation”;
(2) Identifies all deficiencies required to be
corrected for the program to come into compliance with these rules and RSA
326-B: 32;
(3) Provides a reasonable period of time of not
less than 90 days to submit an action plan to correct the identified program
deficiencies; and
(4) Provides notice of the right of the
sponsoring institution to seek a hearing pursuant to Nur 200 to address the
findings of the board.
(b)
The appeal of an order hereunder shall not stay the change in the status
of the program, but shall stay the obligation of the program to comply with the
remainder of this section pending:
(1) Full resolution of the issues in the hearing
conducted pursuant to Nur 200;
(2) Further order of the board; or
(3) Receipt of an order from a court of competent
jurisdiction directing the board or the program to initiate additional action.
(c) If the nursing program accepts the change in
status without appeal it shall:
(1) Within 90 days of the order, provide the board with a report
that discusses factors contributing to the program deficiencies noted by the
board, including:
a. Program graduation rates for the last 3
years;
b. Number of nursing faculty teaching on
full-time and part-time basis, including adjunct clinical faculty;
c. National Council
Licensure Examination for Registered Nurses (NCLEX-RN®) pass rates for the last
3 years; or
d. National Council Licensure
Examination for Practical Nurses (NCLEX-PN®) pass rates for the last 3 years;
and
e. How program evaluation
data is collected and used for program planning and improvement; and
(2) Provide the board with a written plan of
correction covering the next 12 month period, to include but not be limited to:
a. Timelines for improvement;
b. Adjustment to the mission,
philosophy and organizing framework of the nursing program;
c. Changes in faculty resources and workload;
d. Changes in student support services;
e. Receipt of additional fiscal resources;
f. Changes to program admission, progression,
and graduation policies; and
g. How student, graduate, and employer data is
collected to measure program satisfaction among these key stakeholders.
(d)
No later than one calendar year after notification of a change to
probation status, the sponsoring institution shall either:
(1) Correct the deficiencies identified pursuant
to (a) above and come into compliance with board requirements; or
(2) Request an extension of time, in which it
shall:
a. Explain why the identified deficiencies have
not been corrected within the allotted time;
b. Provide a summary of the program’s good faith
efforts to come into compliance within the allotted time; and
c. Present a plan of action to come into
compliance within the extension.
(e)
The board shall extend the one year time frame up to 6-months if:
(1) The efforts made to come into compliance
demonstrate good faith; and
(2) The plan of action to come into compliance is
realistic and complete.
(f)
After 18 months of probation, the program administrator shall be
required to appear before and present to the board a current analysis of
program effectiveness, problems identified, outcomes of correction plan and
timeline for improvement if the nursing program has not:
(1) Demonstrated consistent measurable progress
toward implementation of the correction plan; or
(2) Maintained NCLEX scores for first time test
takers above the national benchmark for its graduates.
(g)
While on probationary status, a nursing program shall as ordered by the
board:
(1) Limit or suspend admissions and enrollment;
(2) Not add new sites or expand the program;
(3) Submit to additional site visits; and
(4) Submit interim data, including but not
limited to:
a. Progress reports;
b. Syllabi of courses, and evaluations of
faculty performance;
c. Reviews of
textbooks, and electronic resources used to promote student learning outcomes;
d. National nursing accreditation findings; and
e. Financial and student records when necessary
to verify the accuracy of the institution’s self-study.
(h)
The board shall reinstate initial or full approval status if:
(1) The program submits evidence of compliance
with nursing education standards within the specified time frame; and
(2) NCLEX scores for first time test takers are
maintained for a minimum of two years at or above the national pass rate
averages.
(i) If the program does not meet the criteria for
reinstatement of its approval status, it shall be summoned by the board to show
cause why approval of the program should not be withdrawn.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #9096, eff 2-23-08
(from Nur 602.05); ss by #10301, eff 3-22-13; ss by #11024, eff 1-23-16; amd by #11145, eff 7-28-16
Nur 603.06 Withdrawal of Approval.
(a)
When a program previously placed on probation fails to demonstrate
compliance with RSA 326-B: 32 or these rules as set forth in the board’s
probation order(s), the board shall enter an order:
(1) Directing the sponsoring institution’s
official and the director to appear at a hearing;
(2) Directing the sponsoring institution to
present evidence why the program’s approval should not be withdrawn; and
(3) Describing the areas of continued deficiency.
(b)
The sponsoring institution shall, at least 10 days prior to the hearing,
present documentation that it believes fully describes its efforts to come into
compliance in the areas identified in the order as being of continued
deficiency.
(c)
The board shall review the documentation submitted pursuant to (b) above
and all other evidence presented at the hearing and make a decision regarding
compliance with these rules and the program’s approval status within 90 days.
(d) The board shall provide written notification to
the sponsoring institution official and director within 10 working days of its
decision.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #9096, eff 2-23-08
(from Nur 602.07); ss by #10301, eff 3-22-13; ss by #11024, eff 1-23-16 (from
Nur 603.09)
Nur 603.07 Program Approval Status Re-Evaluation. An approved nurse education program shall
have its approval status re-evaluated:
(a)
If the ownership or organizational structure changes;
(b)
If an institution is discovered by the board to have offered false
information regarding a program;
(c)
If complaints are received regarding alleged violations of these rules
or laws;
(d)
If there is a change in the program’s accreditation status by a regional
or national accrediting body approved by the U.S. Department of Education for
programs of nursing;
(e)
If the board receives complaints from students, consumers, instructors,
employers, other interested parties;
(f)
If the board receives information that indicates that the program is or
was out of compliance with any provision in this chapter;
(g)
If the approval of the higher education
commission is withdrawn;
(h)
Pursuant to Nur 603.04 (b) (c) and as directed by the board;
(i) If a nursing education program’s first-time
test taker NCLEX pass rate falls below the NCLEX standard for the examination
given as determined by the National Council of State Boards of Nursing; or
(j)
If the board is notified by complaint or report of student attrition,
faculty turnover, or inability of students to obtain clinical learning
opportunities in numbers that are elevated for the program under consideration
or for all programs in
Source. #9096, eff 2-23-08; ss by #10301, eff
3-22-13; ss by #11024, eff 1-23-16; ss by #11024, eff 1-23-16
Nur 603.08 Approved Program Accreditation Requirement.
(a) A program that has been approved
prior to October 1, 2007, shall be required to obtain accreditation from a
regional or national accrediting body approved by the U.S. Department of
Education for programs of nursing if the status of the program is required to
be reviewed pursuant to Nur 603.07(g) or (i).
(b)
Following any visit by the accrediting agency, a nursing program shall
submit a complete copy of all site visit reports to the board within 15 days of
receipt by the program and notify the board within 15 days of any change or
pending changes in program accreditation status or reporting requirements.
(c)
The administrator of a nursing program that loses accreditation status
or allows its accreditation status to lapse shall file an application for
renewal of accreditation pursuant to Nur 603.07 within 30 days of loss or lapse
in accreditation status.
Source. #9096, eff 2-23-08; ss by #10301, eff
3-22-13; ss by #11024, eff 1-23-16
Nur 603.09 Termination.
(a)
No program shall be voluntarily terminated by the sponsoring institution
prior to the earlier of:
(1) The passage of one full academic year; or
(2) The graduation of the last admitted class.
(b)
When a sponsoring institution decides to terminate a nursing program, it
shall notify the board within 30 days of that decision.
(c)
Upon notification pursuant to (b) above, the institution shall suspend
admissions and continue the program as required pursuant to (a) above.
(d)
The institution shall provide the board with a plan to phase out the
program including, but not limited to:
(1) The timeline for ending the program;
(2) Plans for student program completion,
including details of assistance to be provided in arranging transfer to other
approved programs;
(3) Arrangements for the secure storage and
appropriate permanent access to academic records and transcripts by students
and faculty; and
(4) Plans to notify all students, at their last
known address, who attended the program within the last 5 years, but failed to
complete the program, of the plan to terminate the program and how such
students may obtain assistance with program completion.
(e)
A program whose approval is withdrawn involuntarily pursuant to Nur
603.06 shall be ordered by the board to provide a plan of termination that
complies with the criteria in (d) above.
Source. #9096, eff 2-23-08 (from Nur 602.08); ss by
#10301, eff 3-22-13; ss by #11024, eff 1-23-16 (from Nur 603.10)
PART Nur 604 CERTIFICATE OF LICENSED PRACTICAL NURSE
INTRAVENOUS THERAPY COURSE
Nur 604.01 Overview.
(a)
To promote the health, safety and welfare of individuals receiving
specific intravenous fluids and drugs, and pursuant to RSA 326-B, LPNs may be
instructed in the performance of intravenous therapy.
(b)
An LPN who has successfully completed a board approved intravenous
therapy course shall provide IV therapy under the direction of a physician or
dentist, or as delegated by a registered nurse.
(c)
LPNs shall be instructed that they are accountable and responsible for
their delegated activities and shall only perform intravenous therapy for
clients weighing greater than 32 kilograms.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #9096, eff 2-23-08;
ss by #10301, eff 3-22-13; ss by #11024, eff 1-23-16
Nur 604.02 Application Process for Course Approval.
(a)
Any institution planning to sponsor a course designed to prepare LPNs to
provide intravenous therapy shall submit the documentation required by (b)
below to the board for initial approval 6 months prior to course
implementation. Board approval shall be required prior to course
implementation.
(b)
Initial course approval by the board shall be granted if there is
compliance with these rules, as well as documentation of the following:
(1) That the purposes of the program are
consistent with Nur 601.01(b), (1) – (4);
(2) That the
curricular organization of the program, including the number of classroom and
clinical hours as well as the number hours of theoretical and clinical
instruction meet the requirements of Nur 602.12;
(3) That the course content and course objectives
meet the requirements of Nur 602.12;
(4) Program policies for admission criteria and
educational policies;
(5) Each course offered as part of the program shall
provide one or more mechanisms for:
a. The evaluation of the academic performance of
the student by the instructor; and
b. The evaluation of the proficiency of the
instructor by his or her students; and
c. Each cooperating agency’s ability to provide
the quality and quantity of learning opportunities necessary to meet
instructional needs.
(c)
The board shall initially, and every 3 years following full approval,
review the documents required pursuant to (b) above for compliance with these
rules;
(d)
Following review of documents as required by (c) above, the board shall:
(1) Grant initial approval;
(2) Grant full approval after one year of initial
approval and every 3 years thereafter, if the course continues to meet criteria
as required by these rules;
(3) Impose probation after notice and opportunity
for hearing, on a course at any time the course is not in compliance with RSA
326-B or these rules; or
(4) Withdraw approval, after notice and
opportunity for hearing, if a course on probation fails to correct
deficiencies within the timeframe established by the board.
(e) In addition to determining program
status pursuant to (d) above, the board shall offer recommendations for
compliance or course enhancement;
(f)
The board shall notify the sponsoring institution within 10 working days
of the board’s decision. The decision shall be tentative but shall become final
if no appeal is received within 30 days;
(g)
If the sponsoring institution fails to meet criteria and the board
withdraws approval, the board shall notify the sponsoring institution within 10
working days of the board’s decision;
(h)
Pursuant to RSA 326-B, the sponsoring institution may appeal within 30
working days the board’s decision by requesting a hearing to present evidence
supporting course approval;
(i) The board shall provide notice of the hearing
sponsoring institution pursuant to Nur 207.02;
(j)
The board shall contact the sponsoring institution to determine
compliance with RSA 326-B and these rules if complaints are received regarding
the course, the instruction, course policies or graduates’ performance;
(k)
Course changes shall be presented to the board for determination of
compliance with this part.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #9096, eff 2-23-08;
ss by #10301, eff 3-22-13; ss by #11024, eff 1-23-16
Nur 604.03 Intravenous Therapy Course Content.
(a)
The purpose of the course shall be clearly written and reflect the
sponsoring institution’s beliefs regarding:
(1) Care-recipients;
(2) Care-providers;
(3) Characteristics of that care;
(4) The environments within which that care is
provided; and
(5) The education needed to provide intravenous
therapy as a nursing intervention.
(b)
The expected outcomes of the course and participants’ behaviors shall be
clearly stated in the course outline.
(c)
An organizational chart shall demonstrate the authoritative and
cooperative relationships between the sponsoring institution and cooperating
agency(s).
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #10301, eff
3-22-13; ss by #11024, eff 1-23-16
Nur 604.04 Intravenous Therapy Course Evaluation. The course coordinator and instructors shall
evaluate each course based on standardized or instructor evaluative tools
designed to obtain information regarding:
(a)
Theoretical content and clinical experience;
(b)
Instruction and educational policies; and
(c)
Performance of course graduates by employers.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #9096, eff 2-23-08;
ss by #10301, eff 3-22-13; ss by #11024, eff 1-23-16
Nur 604.05 Intravenous Therapy Course Provider
Qualifications.
(a)
The course shall only be offered by a sponsoring institution licensed
under RSA 151, or a
(b)
The sponsoring institution shall retain a course coordinator who shall
have the responsibility for the course’s administration.
(c)
The course coordinator shall:
(1) Hold a current and unencumbered registered
nurse license in New Hampshire, a current and unencumbered multi-state RN
license issued by a compact state, or shall hold a current active RN license to
practice that is not encumbered and meet requirements in the jurisdiction where
the program is approved;
(2) Meet the requirements of Nur 602.07(c) (1);
(3) Document at least 3 years of registered nurse
experience in a management or supervisory position, including experience in the
education role;
(4) Assist with developing, implementing and oversight of the budget;
(5) Plan, implement, and evaluate the course;
(6) Hire, supervise and evaluate qualified
instructors;
(7) Secure
adequate facilities and material resources to support the course; and
(8) Determine course policies related to:
a. Student admission;
b. Retention;
c. Testing and grading;
d. Student dismissal from the course; and;
e. Successful completion criteria.
(d)
The course coordinator shall complete and submit annually the NH Board
of Nursing Form “LPN IV Therapy Program
Annual Report” as amended 12- 2014.
(e)
The student LPN shall submit to the board within 30 days of course
completion a certification of completion from the sponsoring program.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #9096, eff 2-23-08;
ss by #10301, eff 3-22-13; ss by #11024, eff 1-23-16
Nur 604.06 Instruction.
(a)
Instructors shall participate in:
(1) Classroom and clinical teaching;
(2) Student evaluation;
(3) Course implementation and evaluation; and
(4) Development of course policies and other
course activities as assigned.
(b)
Instructors shall meet the following criteria:
(1) Faculty, preceptors, or others employed by, or
who are agents of the LPN intravenous course program and who are in contact
with patients shall hold a current and active license to practice nursing that
is not encumbered and meets requirements in New Hampshire where the students
and patients are located;
(2) Faculty who teach didactic courses, or who
have oversight of students or preceptors but do not provide care for patients,
shall hold a current and active license to practice nursing that is not
encumbered and meet requirements in the home state/jurisdiction where the LPN
intravenous course is approved; and
(3) All faculty, regardless of function in the
program shall document at least 3 years of clinical registered nurse
experience, at least one year of which shall be providing intravenous therapy.
(c) Instructors shall not teach more than 4
students during a clinical experience.
(d)
Guest lecturers with specialized knowledge, experience, or both, in
content areas required by Nur 604.07 may participate in student instruction for
specific learning activities under the supervision of the course coordinator.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #9096, eff 2-23-08;
ss by #10301, eff 3-22-13; ss by #11024, eff 1-23-16
Nur 604.07 Curriculum.
(a)
The curriculum of the LPN IV therapy course shall include knowledge,
skills and abilities necessary for the scope and standards of competent nursing
practice expected at the level of licensure.
The LPN IV therapy course provided by nursing faculty shall meet the
same requirements, rigor and quality of the board approved pre-licensure
nursing programs.
(b)
The curriculum shall prepare the LPN to:
(1) Initiate intravenous therapy and administer crystalloid
intravenous fluids;
(2) Initiate, monitor and regulate the prescribed
flow rate of solutions required by (1) above;
(3) Maintain the intravenous site;
(4) Replace solutions required by (1) above;
(5) Discontinue intravenous devices in accordance
with institutional policy;
(6) Add
medications and nutrients to intravenous fluids in accordance with (1) above
and institutional policy;
(7) Add medications and nutrients to fluids
previously mixed by a registered pharmacist or the pharmaceutical manufacturer
in accordance with institutional policy;
(8) Flush intermittent devices with physiological
saline or a heparin solution; and
(9) Administer medications by concentration,
manual administration or intermittent infusion; and
(10) Access CVAD per institutional policy.
(c)
Participants shall not be instructed in administration of or administer
the following:
(1) Fluids used in research, or oncology therapy;
(2) Blood or blood products;
(3) Hyperalimentation solutions, colloids and
lipids; and
(4) Intravenous therapy to clients who weigh less
than 32 kilograms.
(d)
Intravenous therapy course content shall include:
(1) A minimum of
30 hours of theoretical content and laboratory practice pertinent to
intravenous therapy;
(2) Review of the law and rules pertinent to
nursing in
(3) Review of anatomy and physiology particularly
as it relates to the transport system, fluid replacement and intravenous
therapy;
(4) Information pertinent to the relationship
between intravenous therapy and human regulatory functions, as well as the clinical
manifestations resulting from fluid and electrolyte imbalance and pathological
disturbances;
(5) Principles of infection control and aseptic
procedures;
(6) Use of equipment and methods for assessing
and correcting equipment malfunctions;
(7) Review of principles related to the
compatibility and incompatibility of drugs and solutions;
(8) Calculations pertinent to the administration
of intravenous fluids and drugs;
(9) Maintenance, monitoring, and discontinuance
of intravenous treatment systems;
(10) Care of the patient experiencing local or
systemic adverse complications resulting from intravenous therapy; and
(11) Care of the high risk patient.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #9096, eff 2-23-08;
ss by #10301, eff 3-22-13; ss by #11024, eff 1-23-16
Nur 604.08 Participants.
(a)
Applicants for the course shall:
(1) Demonstrate the ability to read and write
common terminology used in intravenous therapy;
(2) Have the ability to perform the physical
activities related to intravenous therapy;
(3) Hold a current and unencumbered practical
nurse license in New Hampshire or a current and unencumbered multi-state LPN
license issued by a compact state; and
(4) Maintain competence to safely perform
intravenous therapy using principles of pharmaco-kinetics.
(b)
To practice intravenous therapy in
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #9096, eff 2-23-08;
ss by #10301, eff 3-22-13; ss by #11024, eff 1-23-16
PART Nur 605 NURSING REFRESHER COURSE
Nur 605.01 Course Availability.
(a)Sponsoring institutions seeking
approval for a refresher course shall comply with Nur 605.02 – Nur 605.05.
(b) One year following initial
approval, the board’s representatives shall review the course to determine
compliance with this chapter.
(c)
The course coordinator of an approved Refresher Program shall complete
and submit annually to the board Form “Refresher Course Annual Report”, as
amended 12-20-2014.
(d)
Continuing approval shall be granted every3 years based on compliance.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #9096, eff 2-23-08;
ss by #10301, eff 3-22-13; ss by #11024, eff 1-23-16
Nur 605.02 Refresher Course Application.
(a)
A sponsoring institution submitting an application to offer a structured
nursing refresher course shall submit an application and supporting documents
pursuant to (b) below for board approval 3 months prior to course initiation.
(b)
The applicant shall provide a complete application that:
(1) Demonstrate that the projected budget will
support the course;
(2) Includes a statement
of philosophy and purpose consistent with fully educating and providing
necessary skills for the workforce;
(3) Includes a course calendar describing all
content, learning activities, and objectives stated in behavioral terms;
(4) Describes the methods of instruction and
evaluation;
(5) Includes a complete reference of current
literature and resources pertinent to content that will be available to those
taking the course;
(6) Describes its expected student outcome; and
(7) Specifies its criteria for measurement of
successful completion.
(c)
The board shall grant the application if the application complies with
(b) above.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #9096, eff 2-23-08
(from Nur 603.02); ss by #10301, eff 3-22-13; ss by #11024, eff 1-23-16
Nur 605.03 Refresher Course Criteria.
(a)
A refresher course shall last no longer than 6 months and consists of:
(1) A minimum of 80 hours of clinical practice directly
supervised by a registered nurse;
(2) A minimum of 40 hours of theoretical
instruction;
(3) A calendar of current readings and activities
pertinent to nursing education and practice;
(4) A description
of the expected educational outcomes based on content required by Nur 602.13;
and
(5) A method for evaluating the course.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #9096, eff 2-23-08;
ss by #10301, eff 3-22-13; ss by #11024, eff 1-23-16
Nur 605.04 Refresher Course Coordinator.
(a)
Prior to assuming responsibility and accountability for the course, the
course coordinator shall be approved by the board. The board shall grant such approval if the
course coordinator meets the criteria specified in (b) below.
(b)
The course coordinator located within
(1) Possess a current and unencumbered registered
nurse license in
(2) All course coordinators, shall document at least 3 years’ experience
as a nurse educator or education coordinator within 5 years of request for
approval and meet Nur 602.06 (a) and (b) (3) a.; and
(3) Document at least 5 years of nursing
practice.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #9096, eff 2-23-08
(from Nur 603.04); ss by #10301, eff 3-22-13; ss by #11024, eff 1-23-16
Nur 605.05 Refresher Course Instructors.
(a)
Each refresher course instructor shall:
(1) Possess a current and unencumbered registered
nurse license in
(2) Document at least 3 years of active nursing
practice, to include clinical nursing faculty within the 5 years immediately
prior to request for approval; and
(3) Meet Nur 602.07 (a) (1) b.
(b) The sponsoring institution shall
ensure that there are sufficient instructors to:
(1) Meet the instructor to student ratio of 1:8;
(2) Meet the educational goals of the course; and
(3) Ensure that the safety and welfare of
care-recipients, care-providers and instructors is not compromised.
(c)
Refresher course instructors shall:
(1) Determine successful completion of the
theoretical and clinical content;
(2) Evaluate effectiveness of instructional
methods and instructors; and
(3) Assess suitability of cooperating agencies.
(d)
Upon successful completion of the refresher course, the course
coordinator shall provide to the reentry nurse and the board a written
statement that includes the following:
(1) The name of the course graduate;
(2) The number of theoretical and clinical hours;
(3) The date of successful completion; and
(4) The instructor’s signature and date
validating the nurse’s ability to safely meet standards as required by RSA
326-B:12 or RSA 326-B13.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #9096, eff 2-23-08
(from Nur 603.06); ss by #10301, eff 3-22-13; ss by #11024, eff 1-23-16
Nur 605.06 Refresher Course Offered through Distance
Education Programs.
(a)
Faculty, preceptors, course coordinator and instructors and others
employed by, or who are agents of, the refresher course program and who are in
contact with patients shall hold a current and active license or privilege to
practice that is not encumbered and meets requirements in the state/
jurisdiction where the students/ patients are located.
(b)
Coordinator and faculty who teach didactic nursing, or faculty who have
oversight of students or preceptors but do not provide care for patients, shall
hold a current and active license or privilege to practice that is not
encumbered and meet requirements in the home state/jurisdiction where the
refresher course program is
approved.
Source. #11024, eff 1-23-16
PART Nur 606 NURSING PROGRAM APPROVAL FEES
Nur 606.01 Fees.
(a)
The fees set forth in Table 6.1 “Fees” shall be applicable for all applications
for initial approval under this chapter and ongoing approval as deemed
necessary by the board:
Table 6.1 “Fees”
Action |
Fee |
Application for
Initial Approval |
$1000.00 for
first site visit; $500.00 per subsequent
site visit |
Application for
Additional Program Approval (as part of Initial Approval) |
$250.00 |
Complications
with Accreditation or Continuing Approval Requiring Site Visit |
$1000.00 for
each resulting site visit |
Stipends for
Program Approval Evaluation Team Members |
$750.00 for Team
Chair $500.00 per Non-Chair Team Member |
(b) In addition to the fixed fees
listed in Table 6.1 “Fees”, applicants shall pay the actual cost, as calculated and shown on an invoice sent by the board to the applicant following
completion of the site visit, of the following for board members only:
(1) Transportation to and from the site visit for
evaluation team members;
(2) Transportation of the team members during the
site visit;
(3) Lodging required for the site visit for
evaluation team members;
(4) Meals during the site visit for evaluation team members, taken after the
evaluation team members depart for the site and before their return from the
site;
(5) All expenses of the team members or board
incurred in preparation for, during, or after the site visit, as necessitated
by the site visit, including but not limited to:
a. Copying or reproduction of documents; and
b. Office consumables such as paper, computer
disks, and postage.
(c)
All fees except for stipends shall be paid by the sponsoring institution
directly to the board within 30 days of submission of an invoice or invoices by
the board. If paying by check, such
check shall be made payable to “Treasurer, State of
(d)
Stipends shall be payable to the individual evaluation team members but
shall be sent to the board for distribution to the team members. Payment of stipends shall be made within 30
days of submission of an invoice or invoices by the board.
Source. #9302, INTERIM, eff 10-24-08, EXPIRES:
4-22-09; ss by #9395, eff 2-25-09; ss by #10301, eff 3-22-13; ss by #11024, eff
1-23-16; amd by #11145, eff 7-28-16
PART Nur 607 INNOVATIVE APPROACHES
Nur 607.01 Pilot Program for Innovative Approaches
for Teaching and Learning.
(a)
The purpose of a pilot program is to:
(1) Foster innovative models of nursing education
to address the changing needs in health care delivery systems;
(2) Ensure that innovative approaches are
conducted in a manner consistent with the board’s role of protecting the
public; and
(3) Ensure that innovative approaches conform to
the quality outcome standards and core education criteria established by the
board.
(b)
A program applying for a pilot program shall:
(1) Hold full approval by the board of nursing;
(2) Have no substantiated complaint, discipline
or deficiencies in the past 2 years, and
(3) Have been compliant with all board rules
during the past 2 years.
(c)
The following written information shall be provided to the board at
least 30 days prior to a board meeting:
(1) Identifying information including name of
program, address, responsible party and contact information;
(2) A brief description of the
current program, including accreditation and Board approval status;
(3) Identification of the regulation or
regulations that the proposed innovative approach would alter;
(4) Length of time for which the innovative
approach is requested;
(5) Description of the innovative approach,
including objectives;
(6) Brief explanation of the rationale for the
innovative approach at this time;
(7) Explanation of how the proposed innovation differs
from approaches in the current program;
(8) Available evidence supporting the innovative
approach;
(9) Identification of faculty, program, and
sponsoring institution resources that support the proposed innovative approach;
(10) Expected
impact the innovative approach will have on the program, including
administration, students, faculty, and other program resources;
(11) Plan for implementation, including timeline;
(12) Plan for evaluation of the proposed
innovation, including measurable outcomes, method of evaluation, and frequency
of evaluation; and
(13) Additional application information as
requested by the board.
(d)
The board shall approve an
application for innovation that meets the following criteria or approve the
application with modifications as agreed between the board and the nursing
education program:
(1) Eligibility criteria in (b) and application
criteria in (c) are met;
(2) The innovative approach will not compromise
the quality of education or safe practice of students;
(3) Resources are sufficient to support the
innovative approach;
(4) Rationale with available evidence supports
the implementation of the innovative approach;
(5) The implementation plan is reasonable to achieve
the desired outcomes of the innovative approach;
(6) The timeline provides for a sufficient period
to implement and evaluate the innovative approach; and
(7) The plan for
periodic evaluation is comprehensive and supported by appropriate methodology.
(e) The board
shall:
(1) Deny the application or request additional
information if the program does not meet the criteria in (b) and(c); or
(2) Rescind the approval of the innovation or
require the program to make modifications if:
a. The board receives substantiated evidence
indicating adverse impact ;
b. The program fails to implement or evaluate
the innovative approach as presented and approved; or
c. The program fails to maintain the eligibility criteria in (b).
(f)
An education program that is granted approval for an innovation shall
maintain eligibility criteria in (b) and submit:
(1) Progress reports conforming to the evaluation
plan annually; and
(2) A final evaluation report that conforms to
the evaluation plan, detailing and analyzing the outcomes data.
(g)
If the innovative approach has achieved the desired outcomes and the
final evaluation has been submitted, the program may request that the
innovative approach be continued.
(h)
The board shall grant the request to continue approval if the innovative
approach has achieved desired outcomes, has not compromised public protection
and is consistent with core nursing education criteria.
Source. #11024, eff 1-23-16
PART Nur 608
NURSE EXTERNS
Nur
608.01 Definitions.
(a) “Nurse externship” means a clinical learning
program pursuant to RSA 326-B:32(I)(a), whether paid, for course credit, or
uncompensated, that supplements an RN student’s education and training through
placement in a health care facility at which the nurse extern performs nursing
tasks or activities under supervision.
(b) “Nurse extern preceptor” means a board
licensed RN or APRN working at a New Hampshire health care facility that meets
the qualifications outlined in Nur 608.05.
(c) “Nurse extern” means a student enrolled in
board approved RN education program who practices in a non-licensed capacity in
a New Hampshire health care facility.
(d) “Supervision” means direction by a qualified
nurse extern preceptor for the accomplishment of a nursing task or activity,
including initial direction and periodic inspection of the actual
accomplishment of the task or activity.
Source. #13707, 9-27-23
Nur
608.02 Nurse Extern Programs.
(a) Nurse education programs with approval
pursuant to Nur 603.04 may seek to add nurse externship programs to its
clinical learning program.
(b) Nurse education programs shall submit written
notice of the addition of a nurse externship program pursuant to Nur 602.16.
(c) The board may, upon notice and an opportunity
to be heard, revoke the approval of the nurse extern program if any nurse
extern or nurse extern preceptor commits any act that would be subject to
discipline under RSA 326-B:37 or Nur 402.04(b).
The nurse extern preceptor shall be responsible for the nurse extern’s
conduct during the duration of the approved nurse externship agreement as it
pertains to the scope of the externship agreement.
Source. #13707, 9-27-23
Nur
608.03 Nurse Extern Qualifications.
(a) In order to qualify as a nurse extern, the
individual shall:
(1) Be enrolled
and in good standing in a board approved RN education program;
(2)
Have successfully completed a clinical or simulation course in their
current RN education program;
(3)
Have successfully completed a pharmacology course or its equivalent if
their nurse externship is to involve assistance with medication administration;
and
(4) Be
assigned a nurse extern preceptor to act as a nurse extern for a designated
time period not to extend more than 3 months beyond the person’s expected
graduation date from their RN training program.
(b) The board shall approve the nurse extern
application of any person satisfying the requirements of Nur 608.03(a).
(c) If a nurse extern ceases to meet any of the
requirements of Nur 608.03(a), the nurse extern shall inform the educational
program and nurse extern preceptor of the change and shall no longer serve as a
nurse extern.
(d) A nurse extern preceptor shall inform the
approved education program immediately of any violations of state laws, board’s
administrative rules, or any complaints made which would be a violation of any
state law or administrative rule regarding its nurse extern. The approved education program shall
thereafter immediately notify the board,
Source. #13707, 9-27-23
Nur
608.04 Nurse Extern Practice. As part of a nurse externship program, a
nurse extern may, under the supervision of the nurse extern preceptor, perform
any nursing task for which they have, through education or experience,
demonstrated competency.
Source. #13707, 9-27-23
Nur
608.05 Nurse Extern Preceptor
Qualifications.
(a) Each nurse extern preceptor seeking approval
to supervise a nurse extern shall:
(1) Be
employed at a health care facility licensed, certified, or accredited by the
appropriate New Hampshire authority;
(2) Be
in good standing; and
(3) Not
have been subject to any current or pending discipline by the board.
(b) After receiving notification under Nur
608.05(b), or on its own initiative, the board may, upon notice and an
opportunity to be heard, revoke the approval of any nurse extern preceptor
that:
(1) No
longer meets the requirements of Nur 608.03;
(2) Has
failed to provide supervision of a nurse extern; or
(3) Has
otherwise demonstrated an inability to provide safe, effective training
opportunities for nurse externs.
Source. #13707, 9-27-23
CHAPTER Nur 700 NURSING ASSISTANTS
Statutory Authority: RSA 326-B:4-a, XIII
PART Nur 701 NURSING ASSISTANT REGISTRY
Nur
701.01 Purpose. These rules set forth requirements pursuant to
RSA 326-B:9 and RSA 326-B:32 requiring nursing assistant training and
competency testing. The Omnibus Budget
Reconciliation Act (OBRA) of 1987; Section 1819 and 1919 of the Social Security
Act (42 U.S.C. 1395 & 1396) and RSA 326-B authorize a registry that lists
all nursing assistants who qualify through education and testing to provide
nursing-related activities.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07; ss by #10302, eff
3-22-13; ss by #10570, eff 4-17-14
PART
Nur 702 COMPETENCY EVALUATION
Nur 702.01 Frequency and Place.
(a)
The board shall arrange with other boards, agencies, associations or
organizations for the purchase, administration, use and scoring of competency
evaluations consisting of a written/oral, and skills evaluation.
(b)
Competency evaluations shall be administered to applicants at a time and
place determined by the number of applicants, security requirements and cost.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; amd
by #7101, eff 9-20-99; ss by #7738, eff 8-6-02; ss by #8664, INTERIM, eff
6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07 (formerly Nur 703.01); ss
by #10302, eff 3-22-13; ss by #10570, eff 4-17-14
Nur
702.02 Subject Matter.
(a) The skills part of the competency evaluation
shall consist of a minimum of 5 nursing-related activities at varying levels of
difficulty commonly performed by nursing assistants and based on content noted
in Nur 704.
(b) A
(1) Use of communication techniques;
(2) Noting observations of a care-recipient's
environment;
(3) Identifying hazardous conditions in the
environment;
(4) Demonstrating emergency measures;
(5) Manipulating adaptive devices or special
equipment;
(6) Recording stages of the developmental
process;
(7) Ambulating, positioning, supporting or
transferring a care-recipient;
(8) Providing personal care;
(9) Determining temperature, pulse, respirations
or blood pressure;
(10) Providing nutrition or hydration;
(11) Recording intake or output;
(12) Noting abnormalities in behavior or bodily
functions;
(13) Identifying violations of confidentiality or
human rights;
(14) Noting and recording results of simple
laboratory tests;
(15) Identifying infection control techniques;
(16) Identifying religious symbols and artifacts;
(17) Identifying nursing and medical equipment;
(18) Describing and reporting abuse;
(19) Recognizing, applying, monitoring restraints
and restraint alternatives; and
(20) Manipulating, and utilizing adaptive devices
to promote rest, comfort and independence.
(c) The integrated written or oral part of the
competency evaluation shall include testing for knowledge and comprehension of
commonly performed nursing-related activities as follows:
(1) Role functions;
(2) Holistic care through the lifespan;
(3) Communication skills;
(4) Safety and emergency procedures;
(5) Care-recipient's rights, dignity, and
confidentiality;
(6) Personal hygiene;
(7) Ambulation and movement;
(8) Nutrition and bodily waste;
(9) Environmental and personal safety;
(10) Emotional support;
(11) The developmental process;
(12) Utilization of resources;
(13) Comfort, rest, and activity;
(14) Physical and occupational skills; and
(15) Observing, reporting and documenting.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07 (formerly Nur 703.02); ss
by #10302, eff 3-22-13; ss by #10570, eff 4-17-14
Nur
702.03 Scores.
(a) A candidate shall successfully complete the
written part and the skills demonstration part of the competency evaluation,
noted in Nur 702.01(a), as set forth in Nur 702.02(b) and Nur 702.02(c), to be
eligible to apply for licensing.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #7738, eff 8-6-02
New. #8873, eff 4-24-07 (formerly Nur 703.03); ss
by #10302, eff 3-22-13; ss by #10570, eff 4-17-14
Nur
702.04 Procedure.
(a) The board shall review any testing service's
policies to ensure that:
(1) The test reliability and valid;
(2) The reading level is consistent with practice
as a licensed nursing assistant (LNA)
and RSA 326-B:16, II;
(3) Test items are grounded in common
nursing-related activities based on a national or regional job analysis;
(4) It employs
security measures to ensure freedom from tampering and breech
of confidentiality;
(5) The test is legally defensible;
(6) The administration and evaluation of skills
demonstrations will be monitored by registered nurses with 2 years of
experience with the elderly, or chronically ill of any age;
(7) Tests are graded on a pass or fail basis; and
(8) There will be accurate, concise and prompt
reporting of scores.
(b)
In the event any part of the competency evaluation is lost, destroyed,
damaged or security violated, the applicant shall retake and pass that
particular part of the competency evaluation prior to application for
licensing.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; amd
by 7101, eff 9-20-99; ss by #7738, eff 8-6-02
New. #8873, eff 4-24-07 (formerly Nur 703.04); ss
by #10302, eff 3-22-13; ss by #10570, eff 4-17-14
PART
Nur 703 RECORDS
Nur 703.01 Registry Reporting.
(a)
The board shall keep on file the name, address, telephone number, date
of certification, date license was issued, and license number of every
individual providing nursing-related activities.
(b)
The registry file shall contain any legally proven acts of neglect,
abuse, or misappropriation of personal or public property, and disciplinary
actions taken by the board pursuant to OBRA 1987, RSA 326-B, and these rules.
(c)
The board shall disclose the date of registry entry of any nursing
assistant and upon request shall disclose proven acts of abuse, neglect, or
misappropriation of personal or public property or other actions taken by the
board.
#5887,
eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM, eff 6-24-06,
EXPIRED: 12-21-06
New. #8873, eff 4-24-07 (formerly Nur 704.03); ss
by #10302, eff 3-22-13; ss by #10570, eff 4-17-14
PART Nur 704 EDUCATIONAL PROGRAMS FOR NURSING ASSISTANTS
Nur
704.01 Purpose.
(a) Pursuant to RSA 326-B:9, and RSA 326-B:32 and
to ensure the health, safety and welfare of individuals and groups for whom
nursing care shall be delegated, these rules set forth requirements for
programs providing education for persons who wish to become nursing assistants
and provide nursing-related activities.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07 (formerly Nur 706.01); ss
by #9395, eff 2-25-09; ss by #10302, eff 3-22-13; ss by #10570, eff 4-17-14
Nur 704.02 Approval.
(a)
Individuals or sponsoring institutions who wish to implement a nursing
assistant educational program shall seek board approval at least 12 months
before implementation.
(b) One year following initial approval, the
board’s representatives shall review the program on site to determine
compliance with this chapter.
(c)
Form “Nursing Assistant Educational Program Self
Assessment Report”, 11-2013 noting activities pertinent to this chapter
shall be completed and submitted to the board by the sponsoring individuals or
sponsoring institutions who wish to implement a nursing assistant educational
program on the non-site review years.
(d)
Every 2 years following the first on-site review, the program’s
sponsoring institution shall complete and submit a review summary of the program in accordance
with Nur 704.04-Nur 704.10. Every 4
years, after the first on -site review, the program’ sponsoring institution
shall submit a written request for an onsite visit as a requirement for
continued program approval.
(e)
The board shall notify in writing the program’s sponsoring institution of
its action indicating any program deficiencies and actions required for
compliance with the rules or law.
(f)
The board shall provide for a hearing when a program fails to
demonstrate compliance with rules or the law, or fails to provide an acceptable
plan for correcting identified deficiencies.
(g)
A sponsoring institution may appeal the board’s decision within 30 days
of notification of the board’s decision by requesting a hearing with the board.
(h)
A sponsoring institution shall be notified of the date, time and place
of the appeals hearing.
(i) The board shall, upon review of the evidence
pursuant to Nur 704.04 through Nur 704.13,
approve a program based on compliance with requirements of this chapter.
(j)
The board shall take one of the following actions if an educational
program for nursing assistants does not comply with the requirements of this
chapter.
(1) Offer recommendations for
compliance or program enhancement without changing the approval status of the
program where the violations are minor and do not impair the effectiveness of
the program;
(2) After opportunity for a hearing
pursuant to Nur 200, approve the program with conditions for compliance within
a specified period of time where the violations are more significant than in
(1) above, but are still capable of being quickly remedied; or
(3) After opportunity for a
hearing pursuant to Nur 200, withdraw approval of the program where the
seriousness or extent of the violations is such that the board determines that
the violations cannot be remedied while the program is in operation.
(k)
The board shall notify the sponsoring institution within 10 working days
following the appeals hearing of the board’s decision. Failure to take
appropriate action as required in the board’s decision shall result in denial
or withdrawal of approval.
(l)
The board shall review a program, if it receives complaints from
students, consumers, instructors, employers or others concerned with students
or graduates of the program.
(m)
Programs proposed or implemented by sponsoring institutions determined
to be in noncompliance with federal or state rules/laws shall not be granted
approval, or shall have their program approval withdrawn until requirements are
met.
(n) Program proposals not approved by the board
may be revised and submitted for reconsideration but the program shall not be
implemented during the revision period.
Source. (See Revision Note #1 at chapter heading for
Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM,
eff 6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07 (formerly Nur 706.02); ss by
#9395, eff 2-25-09; ss by #10302, eff 3-22-13; ss by #10570, eff 4-17-14; amd by #11177, eff 9-17-16
Nur 704.03 Initial Approval.
(a)
Any sponsoring institution planning to offer a program designed to
educate nursing assistants shall initially submit documents to the board for
approval at least 12 months prior to the implementation of the program.
(b)
Board approval shall be received by the sponsoring institution prior to
initiating a program and shall be based upon compliance with Nur 704.04 through
Nur 704.10.
(c)
Documents to be submitted for program approval shall include the
following:
(1) A comprehensive feasibility
study that shall address at least the following:
a. Documentation of the need
and demand for such a program in
b. The projected impact the
program would have on existing programs in the region where the program is
being proposed;
c. A hiring plan for qualified
program administrators, faculty, and staff;
d. The sources and number of
potential students; and
e. The names of proposed cooperating agencies, including evidence of their
intent to contribute to the achievement of the clinical objectives of the
program;
(2) Credentials of the program
coordinator;
(3) Credentials of the
instructor(s);
(4) Philosophy of the
educational program with expected student outcomes;
(5) Curricular organization;
(6) Course and unit objectives;
(7) Course outlines describing
content;
(8) Schedule of instruction
indicating classroom and clinical hours, examinations;
(9) Methods of instruction and
evaluation;
(10) Clinical experiences and
list of cooperating agencies;
(11) Program policies; and
(12) Written narrative
describing items noted in Nur 704.03(c)(1) through (11).
(d)
Directors of board-approved registered or practical nurse educational
programs noted in Nur 600 may issue nursing assistant certificates to students
who have successfully completed course content noted in Nur 704.09.
Source. (See Revision Note #1 at chapter heading for Nur
100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #8664, INTERIM, eff
6-24-06, EXPIRED: 12-21-06
New. #8873, eff 4-24-07 (formerly Nur 706.03); ss
by #9395, eff 2-25-09; ss by #10302, eff 3-22-13; ss by #10570, eff 4-17-14
Nur
704.04 Program Coordinator
Qualifications.
(a) The sponsoring institution shall appoint the
program coordinator who shall have the responsibility and accountability for
program administration. The sponsoring
institution shall complete and submit Form “Application for Faculty Approval,
Board Approved Education Programs,” 11-14-2013 for approval of the appointed
program coordinator. Additionally, the
sponsoring institution shall cause to be submitted a current resume including
employment experience and length of employment documenting compliance with Nur
704.04 for program coordinator qualifications, Nur 704.06 for instructor
qualifications, Nur 805.03 for medication nurse reviewer qualifications, and
Nur 805.04 for medication skills instructor qualifications.
(b)
If
in compliance with the following criteria, the coordinator shall receive board
approval:
(1) Possesses a current New Hampshire
unencumbered registered nurse license or a multi-state RN license from another
compact state;
(2) Validates 2 years
experience with the elderly or chronically ill of any age with 1 year
experience in the provision of long term care (LTC) facility services; and
(3) Demonstrates competence to teach adult
learners through one of the following:
a. Baccalaureate educational preparation; or
b. Successful completion of a board-approved
Train-the-Trainer course:
1.
Taught by a registered nurse with 3 years of clinical experience;
2.
Reviewed by the board every 2 years for compliance with Nur 704; and
3.
Offering a curriculum related to:
(i) Learning styles;
(ii) Written and clinical performance;
(iii) Evaluations;
(iv) Teaching strategies;
(v) Textbook selection; and
(vi) Classroom management.
Source. #8873, eff 4-24-07 (formerly Nur 706.04); ss
by #9395, eff 2-25-09; ss by #10302, eff 3-22-13; ss by #10570, eff 4-17-14; ss
by #12835, eff 7-26-19
Nur 704.05 Coordinator Responsibilities.
(a)
The coordinator shall:
(1) Be responsible for planning,
implementing and evaluating the program;
(2) Maintain:
a. Course documents, including
descriptions of each course’s content;
b. A list of nursing-related
activities;
c. A list of individuals who
successfully complete the program; and
d. A list of the as dates of
all programs;
(3) Maintain a physical
presence in
(4) Provide a certificate to the
student upon successful program completion; and
(5) Submit to the board names,
address, telephone number and employer, if known, of those persons successfully
completing a nursing assistant program within 30 days of program completion.
Source. #8873, eff 4-24-07 (formerly Nur 706.05); ss
by #9395, eff 2-25-09; ss by #10302, eff 3-22-13; ss by #10570, eff 4-17-14
Nur 704.06 Instructor Qualifications.
(a) The sponsoring institution shall submit for faculty approval for program
instructors. The sponsoring institution
shall complete and submit Form “Approval for Board Approved Education
Programs,” 11-14-13;
(b) The instructor shall:
(1) Comply with
Nur 704.04(b) (1) and Nur 704.04(b)(3); or
(2)
Comply with Nur 704.04(b)(2 and (3) and possess a current New Hampshire
unencumbered licensed practical nurse license (LPN) or a multi-state LPN license issued by a
compact state.
Source. #8873, eff 4-24-07 (formerly Nur 706.06); ss
by #9395, eff 2-25-09; ss by #10302, eff 3-22-13; ss by #10570, eff 4-17-14; ss
by #13141, EMERGENCY RULE, eff 12-4-20, EXPIRED: 6-2-21
Nur
704.07 Instruction.
(a)
The instructor shall be responsible for classroom and clinical teaching.
(b) Instructors shall implement and give to each
student written policies regarding:
(1) Class attendance;
(2) Academic
achievement;
(3) Theoretical
and clinical competence; and
(4) Other program
policies affecting students.
(c) The student-to-instructor ratio shall not
exceed 8:1 in the clinical setting.
(d) The instructor shall have no other work
responsibilities while instructing clinical and classroom learning experiences.
(e) Qualified resource people from the
health-care field appointed by the course coordinator may participate in
instructing students.
(f) The instructor assigning learning activities
to students shall determine whether they are qualified, through classroom and
laboratory experience, to perform nursing-related activity(s).
(g) Students shall be responsible and accountable
for the activities assigned and shall not perform nursing-related activities
for which they have not been theoretically and clinically prepared.
(h) At all times, students shall be clearly
identified as acting in the student role.
Source. #8873, eff 4-24-07 (formerly Nur 706.07); ss by
#9395, eff 2-25-09; ss by #10302, eff 3-22-13; ss by #10570, eff 4-17-14
Nur
704.08 Admission Standards. Each applicant for admission to a nursing
assistant program shall:
(a) Document the ability to read, comprehend,
write, and communicate in English, relative to job-related assignments;
(b) Not have been convicted of a crime
constituting any of the following unless such conviction was annulled by a
court of competent jurisdiction:
(1) Murder or manslaughter;
(2) Robbery;
(3) Felonious theft;
(4) Felonious assault;
(5) Sexual crime involving a child;
(6) Kidnapping; and
(7) Endangering the welfare of a child or
incompetent person.
Source. #8873, eff 4-24-07 (formerly Nur 706.08); ss
by #9395, eff 2-25-09; ss by #10302, eff 3-22-13; ss by #10570, eff 4-17-14
Nur 704.09 Curriculum.
(a) The philosophy of the program shall be
written and clearly reflect the sponsoring institution’s beliefs regarding care-recipients,
care-providers, care-characteristics, environment within which care shall be
provided, and educational preparation for providing nursing-related activities.
(b)
The course objectives shall identify expected student outcomes.
(c)
Following successful completion of the program, a nursing assistant
shall be able to:
(1) Form a relationship,
communicate and interact effectively with individuals and groups;
(2) Demonstrate comprehension
related to individuals’ emotional, mental, physical and social health needs
through skillful, direct nursing-related activities;
(3) Assist individuals to
attain and maintain functional independence in a home or health-care facility;
(4) Exhibit behaviors
supporting and promoting care-recipients’ rights;
(5) Demonstrate observational
and documenting skills required for reporting of people’s health, safety,
welfare, physical and mental condition, and general well-being; and
(6) Provide safe
nursing-related activities under the supervision of a registered or licensed
practical nurse.
(d)
Content shall include the following information:
(1) Pathological, physical, psychological,
social, cultural and religious influences related to the life cycle and the
aging process;
(2) End of life issues; and
(3) Legal, ethical and moral
issues involved when providing nursing-related activities.
(e)
Prior to direct care with care-recipients, students shall receive 16
hours of instruction including the following:
(1) Orientation to the role;
(2) Holistic approach to care
throughout the lifespan;
(3) Communication skills;
(4) Safety and emergency
procedures including the Heimlich Maneuver; and
(5) Protection of
care-recipients’ rights, dignity and their confidentiality.
(f)
Theoretical and clinical experiences shall include assisting
care-recipients with nursing-related activities in the following areas:
(1) Personal hygiene including
bathing, grooming, dressing;
(2) Ambulation, and movement
including range of motion, turning, positioning, transferring;
(3) Nutrition and elimination including
feeding and hydration, toileting, bowel and bladder training;
(4) Environmental and personal safety involving housekeeping concerns,
adaptive devices, special clothing;
(5) Emotional support including
appropriate responses and techniques used with the cognitively impaired and
demented, the aging process, identification of resources, preservation of
dignity, assuring freedom from fear and reprisal;
(6) Comfort, rest, and
activities including privacy, physical and occupational skills; and
(7) Emergency situations
including appropriateness of action or non-action, fire drills, security of the
environment, resources available.
(g)
The course content, learning activities, and objectives shall be offered
at the educational level appropriate to the applicants.
(h)
Students shall be prepared to observe and report activities
appropriately.
(i) The program shall consist of a minimum of 100
hours of instruction. Of this time,
there shall be 40 hours of theory and 60 hours of concurrent clinical
experience.
(j)
Instructors shall prepare and administer written/oral and skills tests
formulated from program objectives and expected outcomes.
(k)
Instructors shall require the following:
(1) A grade of 70, or greater, in
examinations testing for theoretical content; and
(2) A grade of “pass” on skills
test.
(l)
Instructors shall prepare and give to each student at the successful
completion of the program a performance record of nursing-related activities
that includes but is not limited to:
(1) Skill(s) performed;
(2) Date(s) of skill
performance;
(3) Satisfactory or
unsatisfactory performance; and
(4) Instructor signature and
date of performance evaluation.
(m)
Upon successful completion of the program, the coordinator shall provide
to the successful candidate a certificate indicating the following:
(1) Student name;
(2) Name of sponsoring agency;
(3) Hours of clinical and
theoretical instruction;
(4) Date of program initiation
and successful completion; and
(5) Signature of program
coordinator.
Source. #8873, eff 4-24-07 (formerly Nur 706.09); ss
by #9395, eff 2-25-09; ss by #10302, eff 3-22-13; ss by #10570, eff 4-17-14
Nur 704.10 Program Facilities and Resources.
(a)
The physical facilities and educational materials shall meet the needs
of the program, the number of students, and the instructional staff.
(b)
Sponsoring agencies shall provide for:
(1) Clean, safe environmental
conditions with comfortable temperatures;
(2) Adequate lighting; and
(3) Audio-visual or simulated
equipment necessary for care demonstrations.
(c)
Sponsoring institutions that fail to have the appropriate educational
facilities may contract with cooperating agencies to provide clinical and
classroom facilities prior to student placement. Said contract shall delineate roles,
responsibilities and time-frames pertinent to the program.
(d)
The sponsoring institution shall submit Form “Application For Board
Approval of a Cooperating Agency for LNA/MNA Education,” 11-2013, 3 months
prior to placement of students within the cooperating agency.
(e) The
application, noted in (d) above, shall include the following:
(1) Instructor and staff
responsibilities, and orientations;
(2) Annual meetings addressing
the program philosophy, objectives, learning activities and future plans;
(3) The student faculty ratio,
which shall not exceed 8:1, for each unit;
(4) Copy of contract or
agreement providing for adequate time for termination;
(5) A description of the
planned physical, material and human resources intended to support learning
activities; and
(6) Cooperative plans with
other programs using the agency.
(f)
Cooperating agencies shall have sufficient care-recipients, and material
resources to provide for learning activities identified by the
coordinator/instructor.
(g) Sponsoring institutions and cooperating
agencies/institutions shall be licensed by the department of health and human
services or the appropriate state agency.
Source. #8873, eff 4-24-07 (formerly Nur 706.10); ss
by #9395, eff 2-25-09; ss by #10302, eff 3-22-13; ss by #10570, eff 4-17-14
Nur 704.11 Comparable Experience.
(a)
Individuals may apply for a license as a nursing assistant by
documenting comparable or greater nursing educational experience and
successfully completing one of the following:
(1) A registered or practical nursing educational
course that contains content noted in Nur 704.09 within 5 years immediately
prior to date of application;
(2) A nursing assistant program that meets the
requirements of Nur 704.09(i) within 5 years
immediately prior to date of application and a board-approved competency
evaluation that measures the content noted in Nur 704.09 within 2 years
immediately prior to date of application;
(3) A challenge examination offered by an
approved nursing assistant program and board-approved competency evaluation as
described in Nur 702 within 2 years immediately prior to date of application,
provided the qualifying applicant possesses an official transcript of
structured education that contains curriculum noted in Nur 704.09 taken within
5 years immediately prior to date of application; or
(4) Have provided 200 hours of nursing or nursing
assistant care within 2 years immediately prior to application and
appropriate state registry verification of a practice in good standing.
(b) Programs that provide a challenge option for
individuals seeking licensure through comparable education shall provide the
board with a self assessment report. Any program that provides a challenge option
to individuals seeking licensure through comparable education shall complete
and submit, on an annual basis, Form “Nursing Assistant Challenge Program Self Assessment Report,” 11/2013.
Source. #9395, eff 2-25-09 (from Nur 704.10); ss by
#10302, eff 3-22-13; ss by #10570, eff 4-17-14
CHAPTER Nur 800 CERTIFICATE OF MEDICATION
ADMINISTRATION FOR LICENSED NURSING ASSISTANTS AND MEDICATION ADMINISTRATION
EDUCATION PROGRAM
PART
Nur 801 CERTIFICATE OF MEDICATION
ADMINISTRATION
Nur 801.01 Licensed Nursing Assistant’s Certificate
of Medication Administration.
(a)
A licensed nursing assistant shall not be eligible to administer
medication unless:
(1) Such nursing assistant holds a valid
certificate of medication administration issued by the board of nursing; or
(2) Pursuant to Nur 404.04(b).
(b)
A licensed nursing assistant shall receive an initial certificate of
medication administration when such assistant has:
(1) Participated and completed a board-approved
medication administration education program;
(2) Passed with the required score the
examination described in Nur 806.03; and
(3) Paid the fee specified in Nur 301.06(b)(4).
Source. #7742, eff 8-13-02; ss by #8873, eff 4-24-07
(formerly Nur 902.01); ss by #9395, eff 2-25-09; ss by #10303, eff 3-22-13; ss
by #10572, eff 4-17-14; ss by #12439, eff 12-22-17
Nur 801.02 - REPEALED
Source. #7742, eff 8-13-02; ss by #8873, eff 4-24-07
(formerly Nur 902.02); rpld by #10303, eff 3-22-13
PART Nur 802 ELIGIBILITY FOR AND
APPLICATION TO APPROVED MEDICATION ADMINISTRATION EDUCATION PROGRAMS
Nur
802.01 Eligibility To Be a Student in
A Board Approved Medication Administration Education Program. A person shall be eligible to be a student in
board-approved medication administration education program if such person:
(a) Holds a valid and unencumbered nursing
assistant license issued by the board;
(b) Has been employed as a licensed nursing
assistant within the past 5 years for the hours-equivalent of 2 years of full
time employment;
(c) Possesses proficiency in English and basic
mathematics as determined by the sponsoring institution;
(d) Has not been convicted of a felony; and
(e)
Meets the requirements for enrollment set forth in Nur 802.02.
Source. #7742, eff 8-13-02; ss by #8873, eff 4-24-07
(formerly Nur 903.01); ss by #10303, eff 3-22-13; ss by #10572, eff 4-17-14
Nur
802.02 Student Enrollment
Requirements. A person eligible
under Nur 802.01 who seeks to enroll in a board-approved medication
administration education program shall:
(a) Comply with the application procedures
specified by the sponsoring institution;
(b) Comply with the tuition requirements of the
sponsoring institution;
(c) State to the sponsoring institution the
desire to be proficient in the administration of medications; and
(d) Submit to the sponsoring institution 2
character references from nurse managers or directors on behalf of the employer
affirming the applicant's honesty, integrity, compassion and enthusiasm for
nursing-related activities.
Source. #7742, eff 8-13-02; ss by #8873, eff 4-24-07
(formerly Nur 903.02); ss by #10303, eff 3-22-13; ss by #10572, eff 4-17-14
Nur 802.03 Duty of Students. While receiving education through a
board-approved medication administration education program, a student shall
comply with all of the regulations and requirements of the sponsoring
institution and of the program.
Source. #7742, eff 8-13-02; ss by #8873, eff 4-24-07
(formerly Nur 903.03); ss by #10303, eff 3-22-13; ss by #10572, eff 4-17-14
PART Nur 803 BOARD APPROVAL OF
MEDICATION ADMINISTRATION EDUCATION PROGRAMS
Nur
803.01 Eligibility for Board Approval
of Medication Administration Education Program. A medication administration education program
shall be approved by the board if it meets the requirements of this chapter.
Source. #7742, eff 8-13-02; ss by #8873, eff 4-24-07
(formerly Nur 904.01); ss by #10303, eff 3-22-13; ss by #10572, eff 4-17-14
Nur 803.02 Board Approval Process.
(a)
An educational institution, public agency, non-profit organization or
for-profit business planning to sponsor and seek initial, full or renewed
approval for a medication administration education program shall submit
documents to the board 12 months prior to program implementation.
(b)
No medication administration education program sought to be approved by
the board shall be implemented before it has received approval by the board.
(c)
The board shall grant the following approvals if a medication
administration education program qualifies for them:
(1) Initial approval valid for
one year; and
(2) Full approval after one
year of initial approval renewable every 2 years thereafter as long as the
program continues to comply with the requirements of this chapter.
(d)
After issuing full approval to a medication administration education
program, the board’s representative shall review the program onsite to
determine compliance with this chapter.
(e) The board shall take one or
more of the following actions if a medication administration education program
pursuant to Nur 804 through Nur 806 does not comply with the requirements of
this chapter:
(1) Offer recommendations for
compliance or program enhancement without changing the approval status of the
program where the violations are minor and do not impair the effectiveness of
the program;
(2) After opportunity for a hearing
pursuant to Nur 200, approve the program with conditions for compliance within
a specified period of time where the violations are more significant than in
(1) above, but are still capable of being quickly remedied; or
(3) After opportunity for a
hearing pursuant to Nur 200, withdraw approval of the program where the
seriousness or extent of the violations is such that the board determines that
the violations cannot be remedied while the program is in operation. .
(f)
The board shall give written notice to the program and its sponsoring
institution within 10 working days of its decision to withdraw approval of the
program.
(g)
A program for which the approval of the board has been withdrawn shall
have the right to request reconsideration of the decision to withdraw approval
within 30 working days of the date of such decision.
Source. #7742, eff 8-13-02; ss by #8873, eff 4-24-07
(formerly Nur 904.02); ss by #10303, eff 3-22-13; ss by #10572, eff 4-17-14; amd by #12028, eff 10-28-16
Nur 803.03 Documents to be Submitted By A Medication Administration
Education Program Seeking Board Approval.
A medication administration education program seeking any of the
approvals listed in Nur 803.02(c) shall submit to the board:
(a)
A statement describing:
(1) How the program curriculum
reflects current practice standards;
(2) The organization of the
curriculum including:
a. The content of each of the
courses; and
b. The goals and objectives of
each of the courses;
(3) The total number of
theoretical and clinical hours; and
(4) The processes used, in
addition to the examination described in Nur 806.03, to evaluate the progress
of the students;
(b)
If applicable, a copy of the written contract between the program or its
sponsoring institution and the entity which has agreed to provide the setting
required by Nur 806.02(c);
(c)
Written permission for the board to visit the program site for the
purpose of assessing the program's compliance with the requirements for board
approval; and
(d) If necessary to make effective the permission
described in (c) above, written permission from the program's sponsoring
institution for the board to visit the program site for the purpose of
assessing the program's compliance with the requirements for board approval.
Source. #7742, eff 8-13-02; ss by #8873, eff 4-24-07 (formerly
Nur 904.03); ss by #10303, eff 3-22-13; ss by #10572, eff 4-17-14
PART
Nur 804 GENERAL ADMINISTRATIVE
REQUIREMENTS
Nur 804.01 Annual Report.
(a)
A board-approved medication administration education program shall
complete and submit Form “Request for
Onsite Visit and Continued Approval”, 11-2013 to the board annually the
following information:
(1) The number of students
admitted to the program during the year reported;
(2) The number of students
completing the program during the year reported;
(3) The name or names of the
medication skills instructors; and
(4) The number of times during
the year reported that the entire program was offered by the sponsoring
institution.
Source. #7742, eff 8-13-02; ss by #8873, eff 4-24-07
(formerly Nur 905.01); ss by #10303, eff 3-22-13; ss by #10572, eff 4-17-14
Nur 804.02 Written Verification of Program Completion.
(a)
When each student has completed the curriculum of the medication
administration education program and passed the examination described in Nur
806.03, the medication administration education program attended by the student
shall issue the student a written verification of completion showing:
(1) The name and residential
address of the student;
(2) The name of the sponsoring
institution;
(3) The name of the issuing
medication administration education program;
(4) The date of issuance of the
written verification;
(5) The number of hours of
theoretical instruction and the number of hours of clinical instruction
received by the student;
(6) A statement that the student has attained proficiency in
the following methods of medication administration:
a.
Topical;
b.
Oral;
c.
Nasal;
d.
Ocular;
e.
Auricular;
f.
Vaginal;
g.
Rectal;
h. Enteral
tubes;
i. Parenteral route, limited to
insulin from a labeled and pre-set or pre-drawn insulin delivery device; and
j.
Parenteral route, limited to epinephrine from a labeled and pre-set or
pre-drawn delivery device; and
(7) The signature of the
medication nurse-reviewer.
(b)
A medication administration education program shall report to the board
the names, addresses, telephone numbers and employers, if known of students who
have passed the examination described in Nur 806.03 within 5 working days of
the students' passing the examination.
(c)
A medication administration education program shall report to the board
the names of the students to whom it has issued the written verification
described in (a) above.
Source. #7742, eff 8-13-02; ss by #8873, eff 4-24-07
(formerly Nur 905.02); ss by #10303, eff 3-22-13; ss by #10572, eff 4-17-14; amd by #12692, eff 12-22-18
PART Nur 805 PROGRAM PERSONNEL
Nur 805.01 Program Staff.
(a)
The staff of a medication administration education program shall consist
of:
(1) A program administrator who
shall be a medication nurse-reviewer approved by the board pursuant to Nur
805.03; and
(2) As many medication skills
instructors approved pursuant to Nur 805.04 as are required by the size of the
student body.
(b)
The medication nurse-reviewer who administers the program may
simultaneously be a medication skills instructor if such double role is
practicable.
Source. #7742, eff 8-13-02; ss by #8873, eff 4-24-07
(formerly Nur 906.01); ss by #10303, eff 3-22-13; ss by #10572, eff 4-17-14
Nur 805.02 Ancillary Instructors. Both the medication nurse-reviewer and a
medication skills instructor shall have the authority to appoint a person with
expertise in one or more of the program's curriculum topics to teach one or
more courses or hours of the theoretical component of the curriculum if such
expert's instruction is:
(a) Within the area of expertise; and
(b)
Under the supervision of a medication skills instructor.
Source. #7742, eff 8-13-02; ss by #8873, eff 4-24-07
(formerly Nur 906.02); ss by #10303, eff 3-22-13; ss by #10572, eff 4-17-14
Nur 805.03 Medication Nurse-Reviewer.
(a) A medication nurse-reviewer seeking to be
hired to administer a medication administration education program shall
complete and submit Form “Application for Faculty Approval Board Approved
Education Programs,” 11-14-2013, and be approved
by the board in accordance with (b) below.
(b)
The board shall approve a medication nurse-reviewer who:
(1) Holds an unencumbered RN
license issued by the board or another compact state;
(2) Has successfully completed
a baccalaureate nursing program or has met the requirements of Nur
704.04(b)(3); and
(3) Has had 3 years of
experience in a management or supervisory position in a healthcare facility.
(c)
A medication nurse-reviewer hired to administer a medication
administration education program shall perform the following functions:
(1) Assist the sponsoring
institution with developing and implementing the budget for the program;
(2) Plan, implement and
evaluate the program;
(3) Hire, supervise and evaluate
the program's medication skills instructors;
(4) Secure facilities and
material resources adequate to support the program;
(5) Ensure that the program
continues to meet the requirements of the board;
(6) Submit to the board the
documents required to be submitted by Nur 803.03, Nur 804.01 and Nur 804.02(b)
and (c); and
(7) With respect to a quality
assurance committee designed to ensure safe and effective medication
administration by program students, either:
a. Establish such a committee;
or
b. Approve a committee previously
established by the sponsoring institution if such committee has the same
purpose as would a newly established committee.
Source. #7742, eff 8-13-02; ss by #8873, eff 4-24-07
(formerly Nur 906.03); ss by #10303, eff 3-22-13; ss by #10572, eff 4-17-14
Nur 805.04 Medication Skills Instructor.
(a) Medication skills instructors seeking to be
hired to teach in a medication administration education program shall complete
and submit Form “Application for Faculty Approval Board Approved Education
Programs,” 11-14-2013, and be approved by the board in accordance with (b)
below.
(b)
The board shall approve a medication skills instructor who:
(1) Holds an unencumbered RN
license issued by the board or another compact state; and
(2) Has successfully completed
a baccalaureate nursing program or has met the requirements of Nur
704.04(b)(3).
Source. #7742, eff 8-13-02; ss by #8873, eff 4-24-07
(formerly Nur 906.04); ss by #10303, eff 3-22-13; ss by #10572, eff 4-17-14
PART
Nur 806 PROGRAM CURRICULUM
Nur
806.01 Theoretical Component of the
Program Curriculum. There shall be a
theoretical component of the medication administration education program
consisting of a minimum of 30 hours covering the following topics:
(a)
Information related to individual rights regarding accepting or denying
medications;
(b)
Review of the law and rules pertinent to nursing and nursing-related
activities in
(c)
Review of the policies, protocols and procedures of the entity offering
the setting for the clinical component of the curriculum if the medication
administration education program does not itself offer the setting;
(d)
Review of anatomy and physiology as it relates to medication
administration;
(e)
Principles of infection control and aseptic procedures as they relate to
medication administration;
(f)
Use of equipment, and methods for assessing, monitoring and reporting
equipment malfunctions;
(g)
The 5 principles of medication administration as follows:
(1) Administration of the
correct medication;
(2) Administration of the
correct dosage of the medication;
(3) Administration of the
medication to the correct client;
(4) Administration of the
medication to the client at the correct time; and
(5) Administration of the
medication to the client by the correct method of administration;
(h)
Methods of administration of medication to stable clients;
(i) Common reactions to medications;
(j)
Quality management related to storage, disposal, security, recording and
error control pertinent to medications;
(k)
Methods of documenting:
(1) The administration of
medications;
(2) The storage and disposal of
medications;
(3) Security for supplies of
medications; and
(4) Errors in the
administration of medications;
(l)
Effective communications with clients about their medications; and
(m)
Behaviors and performance expected of a licensed nursing assistant
administering medications.
Source. #7742, eff 8-13-02; ss by #8873, eff 4-24-07
(formerly Nur 907.01); ss by #10303, eff 3-22-13; ss by #10572, eff 4-17-14
Nur
806.02 Clinical Component of the
Program Curriculum.
(a)
There shall be a clinical component of the medication administration
education program consisting of a minimum of 30 hours.
(b)
The content of the clinical component
shall be designed to teach the accurate and safe administration of medications
by the following methods:
(1)
Topical;
(2)
Oral;
(3)
Nasal;
(4)
Ocular;
(5)
Auricular;
(6)
Vaginal;
(7)
Rectal;
(8)
Enteral tubes; and
(9)
Parenteral route, limited to:
a. Insulin from a labeled and pre-set or pre-drawn
insulin delivery device; and
b. Epinephrine from a labeled
and pre-set or pre-drawn delivery device.
(c) Such clinical component shall be implemented
in one or more settings in which:
(1) There are one or more nursing clients who are
in-patients;
(2) A nursing care plan has been established for
such clients by a registered nurse;
(3) The care of such clients is managed by a
healthcare team;
(4) The student is permitted to participate in
the care of the clients; and
(5) There is a quality assurance committee which
reviews the administration of medication by licensed nursing assistants and
advises the healthcare team on the matter.
(d) The quality assurance committee required by
(c)(5) above shall be the committee established or approved pursuant to Nur
805.03(c)(7) if the jurisdiction of such committee reaches to the setting or
settings of the clinical component of the curriculum.
(e)
In the clinical component of the curriculum, the medication skills
instructor to student ratio shall not exceed 1:4 during any hour of
instruction.
Source. #7742, eff 8-13-02; ss by #8873, eff 4-24-07
(formerly Nur 907.02); ss by #10303, eff 3-22-13; ss by #10572, eff 4-17-14; amd by #12692, eff 12-22-18
Nur 806.03 Competency Evaluation Requirement. After completion of the theoretical and
clinical components of the medication administration education program a
student shall pass with a minimum score of 90% correct answers a written
examination which:
(a)
Has been designed and is administered by the medication administration
education program or organization approved by the board pursuant to Nur 803;
(b)
Fairly tests knowledge of the content of the curriculum of the
medication administration education program.
Source. #7742, eff 8-13-02; ss by #8873, eff 4-24-07
(formerly Nur 907.03); ss by #10303, eff 3-22-13; ss by #10572, eff 4-17-14
APPENDIX I
Rule |
Specific State
Statute the Rule Implements |
Nur 101 |
RSA 541-A:7 |
Nur 102.01(a) |
RSA 326-B:3, I |
Nur 102.01(b)(1)
– (6) |
RSA 326-B:4, I |
Nur 102.01(b)(7) |
RSA 326-B:9, XI |
Nur 102.02 |
RSA 326-B:4, XII;
RSA 326-B:5, II; RSA 541-A:16, I(a) |
Nur
102.02 (c) |
RSA
326-B:3, I |
Nur
102.03 – Nur 102.05 |
RSA 541-A:16, I(a) |
Nur 102.06 and
Nur 102.07(a) |
RSA 91-A:2, II |
Nur 102.07(b) |
RSA 541-A:16,
I(a) |
Nur 102.02 (c) |
RSA 326-B:3, I |
Nur 103.01 – Nur
103.03 |
RSA 541-A:16,
I(a) |
Nur 103.04 – Nur
103.05 |
RSA 91-A:4; RSA
541-A:16, I(a) |
Nur 103.04(b)
and (c) |
RSA 541-A:16,
I(a) |
Nur 103.06 |
RSA 326-B: 8 |
Nur 201, Nur
202 |
RSA 541-A:7 |
Nur 203 |
RSA
541-A:30-a, |
Nur 204 |
RSA 541-A:30-a,
|
Nur 205 |
RSA
541-A:30-a, |
Nur 206.01 |
RSA 541-A:16,
I(b)(2) |
Nur 206.02 |
RSA 326-B:37, I(b); RSA 326-B:38,
VI |
Nur 206.03 |
RSA 541-A:16, I(b)(2) |
Nur 207.01 |
RSA 541-A:16,
I(b)(2); RSA 541-A:7 |
Nur 207.02 |
RSA 326-B:38, IX;
RSA 541-A:31, |
Nur 207.03 |
RSA 541-A:16,
I(b)(2) |
Nur 207.04 |
RSA 541-A:32 |
Nur 207.05 |
RSA 326-B:38,
XII |
Nur 207.06 -
Nur 207.07 |
RSA 541-A:16,
I(b)(2) |
Nur 207.08 |
RSA 326-B:38,
IV(a); RSA 541-A:16, I(b)(2) |
Nur 207.09(a)
- (e) |
RSA 541-A:33 |
Nur 207.09(f) |
RSA 541-A:31, |
Nur 207.10 |
RSA
541-A:30-a, |
Nur 207.11(a) |
RSA 326-B:38,
X |
Nur 207.11(b)
- (d) |
RSA 541-A:16,
I(b)(2) |
Nur 207.12 |
RSA
541-A:30-a, |
Nur 207.13 |
RSA 541-A:16,
I(b)(2) |
Nur 207.14 |
RSA 541-A:36;
RSA 541-A:16, I(b)(2) |
Nur 207.15 |
RSA 514-A:35 |
Nur 207.16 |
RSA 514-A:36 |
Nur 208.01 |
RSA 326-B:38,
VIII; RSA 541-A:16, I(b )(2) |
Nur 208.02 and
Nur 208.03 |
RSA 541-A:16,
I(b)(2) |
Nur 208.04 |
RSA
541-A:30-a, |
Nur 209.01(a) |
RSA 326-B:38,
XI; RSA 541-A:16, I(b )(2) |
Nur 209.01(b)
through (g) |
RSA 326-B:39,
I; RSA 541-A:16, I(b)(2) |
Nur 209.02 -
Nur 209.03 |
RSA 541-A:16,
I(b)(2) |
Nur 210 |
RSA 541-A:16,
I(b)(2) |
Nur 211 |
RSA
541-A:16, I(c) |
Nur 211.01 |
RSA
326-B:38, VI |
Nur 211.02 |
RSA
326-B:38, VI and IX |
Nur 211.03 |
RSA
326-B:37, I(b); RSA 326-B:38, I, VI and |
Nur 211.04(a)
- (d), (f) and (g) |
RSA
541-A:16, I(b)(2) |
Nur 211.04(e) |
RSA
326-B:38, X |
Nur 212 |
RSA
541-A:16, I(c) |
Nur 212.01 |
RSA
541-A:5; RSA 541-A:16; RSA 541-A:18; RSA 541-A:19; RSA 541-A:19-a; RSA
541-A:19-c |
Nur 213 |
RSA
541-A:11, |
Nur 214 |
RSA
541-A:16, I(d) |
|
|
Nur 301 |
RSA 326-B:9, I and X; RSA 326-B:15 |
Nur 301.01 |
RSA 326-B:9, I,
X, XI; RSA 326-B:15; RSA 326:16 |
Nur 301.02 |
RSA 326-B:9, I,
X; RSA 326-B:16 |
Nur 301.03 |
RSA 326-B:9, I,
III; RSA 326-B:15; RSA 326-B:16; RSA 326-B:18 |
Nur 301.04 |
RSA 326-B:9, I;
RSA 326-B:24 |
Nur 301.05 |
RSA 326-B:9, I;
RSA 326-B:19; |
Nur 301.06 |
RSA 326-B:9, I; |
Nur
301.07 |
RSA
326-B:6 |
Nur
302.01 |
RSA
326-B:9, I; RSA 326-B:16, VI |
Nur 302.02 |
RSA 326-B:9,
I,VII; RSA 326-B:17 |
Nur 302.03 |
RSA 326-B:9, I,
X; RSA 326-B:20 |
Nur
302.04 |
RSA
326-B:9, I; RSA 326-B:18 |
Nur
302.05 |
RSA
326-B:9, I; RSA 326-B:19; RSA 326-B:21 |
Nur
302.06 |
RSA
326-B:9, I; RSA 326-B:27 |
Nur 302.07 |
RSA 326-B:9, I;
RSA 326-B:16, VI; |
Nur
303.01 |
RSA
326-B:9, I |
Nur 303.02 |
RSA 326-B:9,
VII; RSA 326-B:17 |
Nur
303.03 |
RSA
326-B:9, VII; RSA 326-B:19 |
Nur
303.04 |
RSA
326-B:9, VII; RSA 326-B:27 |
Nur 303.05 |
RSA 326-B:9, I,
IX, X; RSA 326-B:15 |
Nur 304.01 |
RSA 326-B:9, I;
RSA 326-B:20 |
Nur 304.02 |
RSA 326-B:9, I;
RSA 326-B:20 |
Nur 304.03 |
RSA 326-B:9, I,
X; RSA 326-B:20 |
Nur 304.04 |
RSA 326-B:9, I;
RSA 326-B:21 |
|
|
Nur 401.01 |
RSA 326-B:8, I;
RSA 326-B:22; RSA 326-B:46 |
Nur 401.01(a)(1)b. |
RSA 326-B:22 |
Nur 401.01(b) |
RSA
326-B:8, I; RSA 326-B:9, XI; RSA 326-B:22; RSA 326-B:46 |
Nur 401.02 |
RSA 326-B:23 |
Nur 401.03 |
RSA 326-B:22 |
Nur 401.03(e)-(h) |
RSA 326-B:9-a, I |
Nur 401.04 |
RSA 326-B:23 |
Nur 401.05 |
RSA 326-B:22 |
Nur 401.06 and
Nur 401.07 |
RSA 326-B:22 |
Nur 401.07 (a)
intro. and (a) (2)(b) &(f) |
RSA 326-B: 27 |
Nur 401.08 |
RSA 326-B:9, X |
Nur 402.01 |
RSA 326-B:37 |
Nur 402.02 |
RSA 541-A:16, I(b);
RSA 326-B:46, VII(a) |
Nur 402.03 |
RSA 326-B:37, IV |
Nur 402.04 |
RSA 541-A:16,
I(b); RSA 326-B:37, I – III |
Nur 403.01 |
RSA 326-B:31, II
and III |
Nur 403.02 and
Nur 403.03 |
RSA 326-B:31 |
Nur 403.04 and
Nur 403.05 |
RSA 326-B:31 |
Nur 404.01 and
Nur 404.02 |
RSA 541-A:8 |
Nur 404.03(a)(b) |
RSA 326-B:2; RSA 326-B:14 |
Nur 404.03 (c) |
RSA 541-A:8 |
Nur 404.04 |
RSA 541-A:16, I
(b); RSA 326-B:28 |
Nur 404.05 |
RSA 541-A:16,I (b); RSA 326-B:28 |
Nur 404.06 |
RSA 541-A:16, I
(b); RSA 326-B:28 |
Nur 404.07 |
RSA 541-A:16, I
(b); RSA 326-B:28 |
Nur 404.09 |
RSA 326-B:9, VI |
Nur 404.10 and
Nur 404.11 |
RSA 541-A:16,
I(b); RSA 326-B:28 |
Nur 404.12 |
RSA 326-B:9, IX |
Nur 404.13 |
RSA 326-B:30 |
Nur 405.01 |
RSA 326-B:30 |
Nur 405.02 |
|
Nur 406.01 |
RSA 326-B:4-a,
XVI |
Nur 406.02 |
RSA 326-B:4, I; |
|
|
Nur 501.01 |
RSA 326-B:9,
VIII; RSA 326-B:4, I, V & VII |
Nur 501.02 |
RSA 326-B:9,
VIII |
Nur 501.03 |
RSA 326-B:9,
VIII |
Nur
501.04 |
RSA 318-B:36; RSA
326-B:11, (III); RSA 326-B:37, II, (h); RSA 318-A:31-38;
RSA 326-B:37, II, (q) (2) |
Nur
501.05(a) |
RSA
326-B:11; RSA 318-B:15, IV |
Nur 502 |
RSA 326-B:9,
VIII; RSA 326-B:11,III; RSA 326-B:37, II (h); RSA 318-B:10, I |
Nur 601.01 |
RSA 541-A:7; RSA 541-A:8 |
Nur 601.02 |
RSA 541-A:7; RSA 541-A:8 |
Nur 602.01 |
RSA326-B:9, IV; RSA 326-B:32, I |
Nur 602.02 |
RSA 326-B:9; RSA 326-B; 32, I |
Nur 602.03 |
RSA 326-B:9; RSA 326-B:32, I |
Nur 602.04 - Nur 602.06 |
RSA 326-B:9, IV; RSA 326-B:32, I (b);
RSA 326-B:16, IV, V |
Nur
602.07 |
RSA
326-B:9, IV; RSA 326-B:32, I (b); RSA 326-B:16, IV, V |
Nur 602.08 - Nur 602.18 |
RSA 326-B:9, IV; RSA 326-B:32, I (b);
RSA 326-B:16, IV, V |
|
|
Nur 603 |
RSA 326-B:9. IV; RSA 326-B:32 |
Nur 603.05(c)(1)c. |
RSA 326-4,XIII |
Nur 604 |
RSA 326-B:9, V; RSA 326-B:13, III |
Nur 605 |
RSA 326-B:9, II; RSA 326-B:31 |
Nur 606 |
RSA 326-B:4, XIII |
Nur 607 |
RSA 326-B:9, IV; RSA 326-B:32, I (a) |
Nur 608 |
RSA 326-B:32 |
|
|
Nur 701 - Nur
702 |
RSA 326-B:14,
II-IV; RSA 326-B:9, I |
Nur 703 |
RSA 541-A:16(b) |
Nur 703.01 |
RSA 541-A:16,
I(b); RSA 326-B:4, IV |
Nur 704.01 -
Nur 704.10 |
RSA 326-B:9,
IV |
Nur 704.11 |
RSA 326-B:9, I |
|
|
Nur
801 |
RSA
326-B:14, II |
Nur
802 |
RSA
326-B:14, II |
Nur
803 |
RSA
326-B:9, IV and V; RSA 326-B:32 |
Nur
804 |
RSA
326-B:9, IV and V; RSA 326-B:32 |
Nur
805 |
RSA
326-B:9, IV and V; RSA 326-B:32 |
Nur
806.01 |
RSA
326-B:9, IV and V; RSA 326-B:32 |
Nur
806.02 |
RSA
326-B:9, IV and V; RSA 326-B:32 |
Nur
806.03 |
RSA
326-B:9, VII |
APPENDIX II
RULE |
Title |
Obtain at: |
Nur 301.01 |
Nurse Licensure Compact Model Rules and Regulations (as amended November 13, 2012) |
https://www.ncsbn.org/2539.htm |
Nur
301.01(f) |
Enhanced
Nurse Licensure Compact (eNLC) Model Rules and
Regulations (as
amended January 19, 2018) |
https://www.NCSBN.org/nlcrules |
Nur 401.01 |
Nurse Licensure Compact Model Rules and Regulations (as amended November 13, 2013) |
https://www.ncsbn.org/2539.htm |
Nur
401.01(b) |
Enhanced
Nurse Licensure Compact (eNLC) Model Rules and
Regulations (as
amended January 19, 2018) |
https://www.NCSBN.org/nlcrules |
Nur
502 |
RSA
326-B:9, VIII; XII RSA 326-B:11,III; RSA
326-B:37, II (h); RSA 318-B:10, I |
|
Nur 502.06 |
American Society of Addiction Medicine’s National Practice Guideline
For the Use of Medications in the Treatment of Addiction Involving Opioid Use
(2015) |
http://www.asam.org/quality-practice/guidelines-and-consensus-documents/npg/complete-guideline |
Nur
502.07 |
American
Society of Addiction Medicine’s National Practice Guideline For the Use of
Medications in the Treatment of Addiction Involving Opioid Use (2015) |
http://www.asam.org/quality-practice/guidelines-and-consensus-documents/npg/complete-guideline |
Nur 603.02 |
White Paper On The State Of
The Art Of Approval/Accreditation Process In Boards of Nursing, August
2004 |
Available free of charge from NCSBN website at www.ncsbn.org/2919.htm |
Nur 602.13(b)(4) |
Quality and Safety Education for Nurses (QSEN), (2012) |
http://qsen.org/. |