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PROPOSED RULEMAKING

STATE BOARD
OF NURSING

[49 PA. CODE CH. 21]

Clinical Nurse Specialists

[38 Pa.B. 3246]
[Saturday, June 14, 2008]

   The State Board of Nursing (Board) proposes to amend Chapter 21 by adding a new Subchapter H (relating to clinical nurse specialists) to read as set forth in Annex A.

Effective Date

   The regulations will be effective upon publication of the final-form rulemaking in the Pennsylvania Bulletin.

Statutory Authority

   The regulations are required by the act of July 20, 2007 (P. L. 320, No. 49) (Act 49), which amended the Professional Nursing Law (act) (63 P. S. §§ 211--225.5) to authorize the Board to certify clinical nurse specialists (CNSs) in accordance with statutory criteria, to provide title protection for CNSs, to require CNSs to complete continuing education to renew their certification, and to require CNSs to maintain professional liability insurance. Section 5 of Act 49 requires the Board to promulgate regulations to implement Act 49 within 18 months of its effective date, or by March 18, 2009.

Background and Purpose

   CNSs are nurses educated at the master's degree level. Prior to the amendments made by Act 49, CNSs were not recognized as a distinct category of master's educated nurse under the act. The amendments are required to effectuate Act 49.

Description of Proposed Amendments

   The Board proposes a comprehensive new Subchapter H. The specific proposals are outlined as follows.

§ 21.801 (relating to definitions)

   Section 21.801 will provide definitions for terms used throughout the subchapter.

§ 21.802 (relating to scope)

   This section will set out the scope of the Board's regulations in Subchapter H.

§ 21.803 (relating to applicability of rules relating to professional nurses)

   Because a CNS must also be a professional nurse licensed by the Board, this section provides that the general provisions in §§ 21.1--21.4 governing registered nurses and §§ 21.11--21.18a, relating to responsibilities of the registered nurse, apply to CNSs.

§ 21.804 (relating to approved educational programs; approval of credentialing organizations)

   This section provides that the Board will approve educational programs for CNSs, will maintain a list of approved educational programs on its web site, and will consider additional programs for inclusion on the approved list as required by section 6.2(c) of the act (63 P. S. § 216.2(c)).

§ 21.805 (relating to fees)

   This section provides for fees for both fee for service functions of the Board, such as the review and approval of the certification application, restoration of certification after sanction, reactivation after a lapse of 5 or more years, and verification of licensure history, and for biennial renewal fees for CNSs.

§ 21.811 (relating to qualifications for initial certification)

   This section sets forth the qualifications for certification, which mirror the qualifications in Act 49. To qualify for initial certification as a CNS, an applicant must hold a current, unrestricted license as a professional nurse in this Commonwealth. In addition, the nurse shall meet one of three sets of criteria.

   First, as set forth in paragraph (1), the nurse shall have completed a master's degree in nursing, doctorate degree in nursing or postmaster's degree or certificate in nursing at an accredited, Board-approved nursing education program that prepared the applicant to practice as a CNS and submit evidence of current National certification by examination as a CNS in a designated specialty area. The examination must be offered by a Board-recognized National nursing, nursing specialty or credentialing organization. These provisions mirror the qualifications in section 8.5(a)(1) of the act (63 P. S. § 218.5(a)(1)). In subparagraph (i), the Board provides that National nursing, nursing specialty and credentialing organizations may apply to the Board for recognition. In subparagraph (ii), the Board notes that it will maintain the list of Board-recognized organizations on its web site.

   National certification under § 21.811(1) includes the American Nurses Credentialing Center (ANCC) specialties--adult health CNS, adult psychiatric and mental health CNS, child/adolescent psychiatric and mental health CNS, gerontological CNS, pediatric CNS, public/community health CNS and diabetes management, advanced CNS. In addition, the Board anticipates that the Oncology Nursing Certification Corporation, the American Association of Critical Care Nurses, the Hospice and Palliative Nurses Association and the National Association of Orthopaedic Nurses may request inclusion on the list of Board-recognized providers of National examinations at the CNS level.

   Second, as set forth in paragraph (2), the nurse shall have completed a master's degree in nursing, doctorate degree in nursing or postmaster's degree or certificate in nursing at an accredited, Board-approved nursing education program that prepared the applicant to practice as a CNS and, if there is no certification examination available in the specialty area, shall demonstrate equivalence to National certification. These provisions mirror the qualifications in section 8.5(a)(2) of the act.

   In § 21.811(2)(i)--(iii), the Board sets forth how an applicant can demonstrate equivalence to National certification. Paragraph (2)(i)(A) allows a CNS to take a CNS certifying examination in an area that encompasses the CNS's specialty area. Paragraph (2)(i)(B) allows a CNS to demonstrate certification by an organization that utilizes a method of measuring competence other than an examination; generally, portfolio review. Paragraph (2)(i)(B) explains how an organization offering an alternative to examination may obtain approval from the Board and paragraph (2)(iii) provides that the Board will maintain a list of approved organizations for alternative review on its web site.

   The Board anticipates that the Wound, Ostomy, Continence Nurses Association, which offers a portfolio review at the CNS level, will request recognition under paragraph (2)(ii).

   Third, the nurse may have graduated from an educational program that culminated in the award of a master's degree or higher in a related discipline that previously qualified the nurse for National certification as a CNS and evidence of current National certification by the American Nurses Credentialing Center (ANCC), in accordance with section 8.5(b)(1) of the act.

   A nurse would be eligible for certification as a CNS under § 21.811(3) as, for example, an adult psychiatric mental health CNS if the nurse held a bachelor's degree in nursing and a master's degree in psychology, which previously qualified the nurse to sit for the ANCC CNS certifying examination.

§ 21.812 (relating to qualifications for certification by endorsement or change of clinical specialty area)

   Section 21.812 provides for certification by endorsement from another state, territory or possession of the United States or a foreign country and change of clinical specialty area by a CNS already certified by the Board.

§ 21.813 (relating application for certification)

   Section 21.813 provides information about the application for certification and supporting documentation for applicants for initial certification, applicants for certification by endorsement and applicants for certification in an additional specialty area.

§ 21.821 (relating to CNS standards of conduct)

   This section provides that, in addition to the standards of conduct for professional nurses in § 21.18 (relating to standards of nursing conduct), a CNS may undertake a specific practice or procedure only if the CNS has the necessary knowledge, preparation, experience and competency to properly execute the practice or procedure and that the CNS must practice within the scope of practice of the particular clinical specialty area in which the nurse is certified by the Board. This provision mirrors a provision related to certified registered nurse practioners (CRNPs).

§ 21.822 (relating to biennial renewal of certification)

   This section sets forth the particulars related to a CNS's biennial renewal of the CNS certification. As with CRNPs, the certification expiration date is tied to the nurse's RN license expiration date. The biennial continuing education required by statute is cross-referenced in § 21.822(d).

§ 21.823 (relating to CNS-level continuing education; waiver; sanctions)

   The Board also provides, in § 21.823(a), that in lieu of meeting the continuing education requirement in section 12.1(b) of the act (63 P. S. § 222(b)), a CNS may submit proof that the CNS has completed 30 hours of continuing education required by section 8.5(c)(2) of the act. This provision is similar to the provision requiring continuing education of CRNPs. Both CRNPs and CNSs will be required to complete just 30 hours of continuing education at the professional nurse level to renew their RN license, rather than requiring a CNS to complete an additional 30 hours of continuing education at the RN level to renew the CNS certificate.

   Section 21.823(b) sets forth the circumstances under which the Board might waive the continuing education requirement, and provides that a request for waiver must be made at least 90 days prior to the end of the renewal period.

   Finally, § 21.283(c) reminds licensees that they may be sanctioned for failure to meet the statutorily-mandated continuing education requirements.

§ 21.824 (relating to inactive status and reactivation)

   To renew a license that has been placed on inactive status, a CNS shall provide proof of compliance with the continuing education requirement in the biennial renewal period immediately preceding the request for reactivation. This provision is consistent with provisions related to CRNPs. In addition, if the CNS's professional nursing license was also on inactive status, the CNS will have to renew the RN license and, if necessary, meet the continued competency requirements for RNs in § 21.30a (relating to continued competency).

§ 21.825 (relating to sources of continuing education)

   This section provides for preapproved providers of continuing education courses, similar to the provisions related to both professional nurses and CRNPs. The section also provides for CNSs or continuing education providers to obtain Board approval for continuing education. Finally, this section provides for CNSs to obtain continuing education credit for individual study, teaching, publishing, and the like.

§ 21.826 (relating to requirements for continuing education courses)

   This section sets forth the minimum standards for courses, including adequate instructors, facilities and an established mechanism to measure the quality of the continuing education program.

§ 21.827 (relating to continuing education course approval)

   This section relates to the approval of a continuing education course. Every continuing education provider shall provide a certificate of attendance to nurses who complete the program. Providers who are not on the list of preapproved providers, shall submit information to the Board to determine whether the provider's proposed course should be authorized for continuing education credit.

§ 21.828 (relating to CNS responsibilities)

   This section provides that the CNS is required to maintain documentation of the continuing education completed. The section also describes the verification procedure on the biennial renewal application.

§ 21.831 (relating to penalties for violations)

   This section sets forth the penalties for violations of the act or regulations of the Board.

Fiscal Impact and Paperwork Requirements

   The regulations will have no adverse fiscal impact on the Commonwealth or its political subdivisions, because the costs of the Board's activities are supported by fees charged to licensees and others who benefit from specific activities of the Board. The regulations will impose no additional paperwork requirements upon the Commonwealth or political subdivisions.

Sunset Date

   The Board continuously monitors the effectiveness of its regulations. Therefore, no sunset date has been assigned.

Regulatory Review

   Under section 5(a) of the Regulatory Review Act (71 P. S. § 745.5(a)), on June 4, 2008, the Board submitted a copy of this proposed rulemaking and a copy of a Regulatory Analysis Form to the Independent Regulatory Review Commission (IRRC) and to the Chairpersons of the Senate Consumer Protection and Professional Licensure Committee and the House Professional Licensure Committee. A copy of this material is available to the public upon request.

   Under section 5(g) of the Regulatory Review Act, IRRC may convey any comments, recommendations or objections to the proposed rulemaking within 30 days of the close of the public comment period. The comments, recommendations or objections shall specify the regulatory review criteria which have not been met. The Regulatory Review Act specifies detailed procedures for review, prior to final publication of the rulemaking, by the Board, the General Assembly and the Governor of comments, recommendations or objections raised.

Public Comment

   Interested persons are invited to submit written comments, suggestions or objections regarding this proposed rulemaking to Ann Steffanic, Board Administrator, State Board of Nursing, P. O. Box 2649, Harrisburg, PA 17105-2649, within 30 days of publication of this proposed rulemaking in the Pennsylvania Bulletin. Please reference No. 16A-5133 (clinical nurse specialists), when submitting comments.

MARY E. BOWEN, RN, DNS, CNAA,   
Chairperson

   Fiscal Note: 16A-5133. No fiscal impact; (8) recommends adoption.

Annex A

TITLE 49.  PROFESSIONAL AND VOCATIONAL STANDARDS

PART I.  DEPARTMENT OF STATE

Subpart A.  PROFESSIONAL AND OCCUPATIONAL AFFAIRS

CHAPTER 21.  STATE BOARD OF NURSING

Subchapter H.  CLINICAL NURSE SPECIALISTS

GENERAL PROVISIONS

Sec.

21.801.Definitions.
21.802.Scope.
21.803.Applicability of rules relating to professional nurses.
21.804.Approved educational programs; approval of credentialing organizations.
21.805.Fees.

CERTIFICATION REQUIREMENTS

21.811.Qualifications for initial certification.
21.812.Qualifications for certification by endorsement or change of clinical specialty area.
21.813.Application for certification.

MAINTENANCE OF CERTIFICATION

21.821.CNS standards of conduct.
21.822.Biennial renewal of certification.
21.823.CNS-level continuing education; waiver; sanctions.
21.824.Inactive status and reactivation.
21.825.Sources of continuing education.
21.826.Requirements for continuing education courses.
21.827.Continuing education course approval.
21.828.CNS responsibilities.

PENALTIES FOR VIOLATION

21.831.Penalties for violations.

GENERAL PROVISIONS

§ 21.801.  Definitions.

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

   Act--The Professional Nursing Law (63 P. S. §§ 211--225.5), which provides for the certification of CNSs.

   Approved--Approved by the Board.

   Approved program--Those educational programs accredited by the NLNAC or CCNE for preparing a professional nurse to practice as a CNS.

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

   CCNE--Commission on Collegiate Nursing Education--The organization recognized by the United States Secretary of Education as a National accreditation agency that provides a nongovernmental peer review process in accordance with Nationally recognized standards established for the practice of accreditation in the United States.

   CNS--Clinical nurse specialist--A registered nurse licensed in this Commonwealth who meets the educational and examination or equivalency requirements of the act and who is certified by the Board to function in a particular clinical specialty area.

   National certification--The credential awarded by a Board-recognized organization evidencing that an individual has passed a National certification examination to practice as a CNS in a particular specialty area and has maintained current National certification in the area as specified by the organization.

   National certification organization--An organization recognized by the Board and maintained on the approved list on the Board's web site that has as one of its purposes the examination of individuals to practice as CNSs in a particular specialty area.

   NLNAC--National League for Nursing Accrediting Commission--The organization that is recognized as the accrediting body for all types of nursing education programs by the United States Department of Education and that is responsible for the specialized accreditation of nursing education programs, both postsecondary and higher degrees.

   Nursing specialty organization--An organization recognized by the Board and maintained on the approved list on the Board's web site that has as one of its purposes the evaluation of the credentials of an individual to practice as a CNS in a particular specialty area.

§ 21.802.  Scope.

   In this subchapter the Board:

   (1)  Provides for certification of CNSs who meet the qualifications set forth in the act.

   (2)  Administers the act by providing rules and regulations relating to the issuance and renewal of CNS certification.

   (3)  Provides rules and regulations for the conduct of CNSs.

   (4)  Regulates the practice of CNSs.

§ 21.803.  Applicability of rules relating to professional nurses.

   Sections §§ 21.1--21.4a, 21.6 and 21.11--21.18a apply to nurses certified under this subchapter.

§ 21.804.  Approved educational programs; approval of credentialing organizations.

   (a)  The Board will approve educational programs as set forth in section 6.2(c) of the act (63 P. S. § 216.2(c)).

   (b)  The Board will maintain a list of approved educational programs on its web site as set forth in section 6.2(c)(2) of the act.

   (c)  Educational programs that prepare nurses to practice as CNSs created after March 20, 2008, shall submit evidence that the program meets the criteria in section 6.2(c)(1) of the act to the Board for inclusion on the list of approved programs.

   (d)  Organizations that evaluate the credentials of nurses for certification by the Board under § 21.811(b) (relating to qualifications for certification) shall submit documentation of their credentials review process and standards to the Board for consideration and inclusion on the list of approved organizations.

§ 21.805.  Fees.

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

   Certification as a CNS         $100

   Biennial renewal fee         $  50

   Restoration of certificate after sanction      $  50

   Restoration of certificate after lapse of    5 years or greater         $  50

   Fee for verification of certification      $  15

   Fee for certification of license history      $  30

   Approval of a continuing education activity,   per credit hour         $  75

   (b)  In addition to the application fee prescribed in subsection (a), which is payable directly to the Board, a candidate for National certification will also pay an additional fee to the National certification organization. A candidate may contact the National certification organization for more information regarding the National CNS examination and examination fee. In addition to the application fee prescribed in subsection (a), which is payable directly to the Board, a candidate for credentials review by a Board-recognized organization will also pay an additional fee to the credentialing organization. A candidate may contact the credentialing organization for more information regarding the evaluation of credentials and the fee for credentials evaluation.

CERTIFICATION REQUIREMENTS

§ 21.811.  Qualifications for initial certification.

   An applicant for initial certification as a CNS by the Board shall hold a current, unrestricted license to practice professional nursing in this Commonwealth and show evidence of one of the following:

   (1)  Nursing education and National certification by examination. Completion of an accredited, Board-approved master's degree in nursing, doctorate degree in nursing or postmaster's degree or certificate in nursing that prepared the applicant to practice as a CNS and current National certification by examination at the CNS level from a Board-recognized National nursing, nursing specialty or credentialing organization in a designated specialty area, as provided in section 8.5(a)(1) of the act (63 P. S. § 218.5(a)(1).

   (i)  For purposes of conferring certification under this paragraph, an organization may apply to the Board for inclusion on the list of Board-recognized National nursing, nursing specialty and credentialing organizations for purposes of this section. An applicant shall provide evidence that it is accredited or recognized by the American Board of Nursing Specialties (ABNS) or the National Council of State Boards of Nursing (NCSBN) to offer a CNS certification examination. The CNS certification examination offered by the organization must have, as a minimum prerequisite, the completion of a master's degree in nursing, doctorate degree in nursing or post-master's degree or certificate in nursing in the specialty area of examination.

   (ii)  The Board will provide on its web site a list of the National nursing, nursing specialty and credentialing organizations recognized by the Board for conferring CNS National certification by examination under this paragraph.

   (2)  Nursing education and equivalency to National certification by examination. Completion of an accredited, Board-approved master's degree in nursing, doctorate degree in nursing, or postmaster's degree or certificate in nursing that prepared the applicant to practice as a CNS and, if there is no certification examination available in the specialty area, evidence that the applicant has met the equivalence requirements under section 8.5(a)(2) of the act as follows:

   (i)  An applicant for certification as a CNS under this paragraph may demonstrate equivalence to National certification by examination in the CNS's specialty area as follows:

   (A)  For a CNS who, by virtue of the CNS's educational program being accepted by a National certification organization, is authorized to take a National certification examination in a CNS specialty, the CNS may demonstrate a passing score on a National CNS certifying examination from a National certification organization on the list under paragraph (1)(ii), in an area that encompasses the CNS's specialty area.

   (B)  For a CNS who is not eligible to take a National certification examination in the CNS specialty area or in an area that encompasses the CNS specialty area, the CNS may demonstrate certification by a Board-recognized National nursing, nursing specialty or credentialing organization within the past 3 years, or recertification if the certification or other process occurred more than 3 years ago.

   (ii)  For purposes of conferring certification under subparagraph (i)(B), an organization may apply to the Board for inclusion on the list of Board-recognized National nursing, nursing specialty and credentialing organizations by submitting documentation of the organization's credentials review standards and process. The Board will recognize organizations that include a reliable mechanism to evaluate an individual's ability to apply the skills and knowledge obtained in the individual's educational program at the advanced practice nursing level in a particular specialty.

   (iii)  The Board will provide on its web site a list of the National nursing, nursing specialty and credentialing organizations recognized by the Board for certification of CNSs under subparagraph (i)(B).

   (3)  Related education and National certification. Completion of an educational program that culminated in the award of a master's degree in nursing or higher degree, in a related discipline that, prior to the effective date of Act 49 of 2007, which amended the act (July 20, 2007), qualified a nurse for National certification as a CNS, and current National certification as a CNS by the American Nurses Credentialing Center (ANCC), as provided in section 8.5(b)(1) of the act.

§ 21.812.  Qualifications for certification by endorsement or change of clinical specialty area.

   (a)  Certification by endorsement. An applicant for certification by the Board who holds a current, unrestricted license, certificate or authorization to practice as a CNS from another state, territory or possession of the United States or a foreign country, shall meet the certification requirements of the Board at the time of application.

   (b)  Change of clinical specialty area. A CNS who is already certified by the Board may apply for certification in an additional specialty area. To be granted certification in an additional specialty area, the CNS shall meet the educational and National certification or equivalency requirements for the specialty area in which the CNS is applying for certification.

§ 21.813.  Application for certification.

   (a)  An applicant for certification as a CNS shall submit an application form provided by the Board to the Board for its review and approval.

   (b)  An applicant for initial certification as a CNS shall include documentation satisfactory to the Board that the applicant meets the educational qualifications and National certification requirements in § 21.811 (relating to qualifications for initial certification).

   (c)  In addition to the documentation in subsections (a) and (b), an applicant for certification by endorsement shall include documentation satisfactory to the Board of the following:

   (1)  Verification of current, unrestricted licensure, certification or authority to practice as a professional nurse and CNS issued by the proper licensing authority of another state, territory or possession of the United States or a foreign country.

   (2)  A written statement from the out-of State licensing, credentialing or authorizing entity setting forth the licensure, certification or authorization to practice requirements at the time the applicant was first licensed, certified or authorized to practice by that entity.

   (d)  An applicant who holds certification from the Board as a CNS who is applying for certification in an additional specialty area under § 21.812(b) (relating to qualifications for certification by endorsement or change clinical specialty area) shall submit, in addition to the documentation required under subsections (a) and (b), documentation of the following:

   (1)  Official transcript from the applicant's CNS program and any additional educational programs, including degree awarded, demonstrating a concentration in the specialty area in which the applicant is seeking certification.

   (2)  Proof of current National certification as a CNS from a Board-recognized National certification organization or proof the applicant meets the equivalency requirements for the specialty area in which the applicant is applying for certification.

   (e)  An applicant shall remit the certification fee in § 21.805 (relating to fees).

   (f)  An applicant shall submit additional information as identified on the application or as requested in writing by the Board. If supporting material is not provided within 12 months, the applicant will be required to file a new application.

MAINTENANCE OF CERTIFICATION

§ 21.821.  CNS standards of conduct.

   In addition to the standards of conduct for a professional nurse in § 21.18 (relating to standards of nursing conduct), a CNS shall undertake a specific practice or procedure only if the CNS has the necessary knowledge, preparation, experience and competency to properly execute the practice or procedure.

§ 21.822.  Biennial renewal of certification.

   (a)  The certification of a CNS will expire at the same time as the CNS's professional nursing license as provided in § 21.29 (relating to expiration and renewal of license).

   (b)  Notice of application for renewal will be forwarded biennially to each active CNS at the CNS's address of record with the Board prior to the expiration date of the current biennial period.

   (c)  As a condition of biennial renewal, a CNS shall hold a valid, unexpired and unrestricted professional nursing license.

   (d)  As a condition of biennial renewal, a CNS shall complete a minimum of 30 hours of Board-approved continuing education in the 2 years prior to renewal as required by section 8.5(c)(2) of the act (63 P. S. § 218.5(c)(2)), unless the requirement is waived by the Board or the CNS's certification is on inactive status.

   (e)  The applicant shall remit the required renewal fee in § 21.805 (relating to fees) with the applicant's renewal application forms. Upon approval of the renewal application, the CNS will receive a certification for the current renewal period.

   (f)  Any written communication with the Board must be typed or printed and include the CNS's full name, including former names, the current address and certification number.

§ 21.823.  CNS-level continuing education; waiver; sanctions.

   (a)  In lieu of meeting the requirements of section 12.1(b) of the act (63 P. S. § 222(b)), a CNS may submit proof of completion of the continuing education requirement in section 8.5(c)(2) of the act (63 P. S. § 218.5(c)(2)).

   (b)  The Board may waive the requirements of continuing education in cases of illness or undue hardship. It is the duty of each licensee who seeks a waiver to notify the Board in writing and request the waiver at least 90 days prior to the end of the renewal period. The Board will grant, deny or grant in part the request for waiver.

   (c)  An individual failing to meet the continuing education requirements for a biennial period will be sanctioned in accordance with § 43b.18a (related to schedule of civil penalties for nurses).

§ 21.824.  Inactive status and reactivation.

   A CNS who places the CNS's certification on inactive status is not required to meet the continuing education requirements in section 8.5(c)(2) of the act (63 P. S. § 218.5(c)(2)) during the period the certification is on inactive status. Upon application for reactivation of certification, the CNS shall provide the documentation in § 21.828(b) (relating to CNS responsibilities) to demonstrate that the CNS has met the continuing education requirements for the biennial period immediately preceding the request for reactivation.

§ 21.825.  Sources of continuing education.

   (a)  The following providers of continuing education and credentialing organizations have currently met the standards for course approval for continuing education and, provided that these providers and credentialing organizations agree to abide by §§ 21.826 and 21.827 (relating to requirements for continuing education courses; and continuing education course approval), they are preapproved to offer creditable continuing education, subject to reevaluation as set forth in subsection (b):

   (1)  Board-approved CNS educational programs and CNS educational programs approved by other state boards of nursing or that hold current accreditation issued by a National nursing accreditation organization.

   (2)  National and interntional nursing organizations and their state and local affiliates.

   (3)  National and international medical and osteopathic organizations and their state and local affiliates.

   (4)  National pharmaceutical organizations and their state and local affiliates.

   (5)  National nursing specialty organizations.

   (6)  Continuing education programs approved by other state boards of nursing for CNSs.

   (b)  The approval given to the providers and credentialing organizations in subsection (a) is subject to reevaluation. A rescission of provider or credentialing organization approval will be made in accordance with 1 Pa. Code Part II (relating to General Rules of Administrative Practice and Procedure) or by amendment of this section.

   (c)  CNSs may obtain credit for continuing education offered by providers not indicated in subsection (a) if the provider obtains Board approval of the continuing education prior to its implementation, or the CNS obtains Board approval of the continuing education prior to attending the continuing education. A continuing education provider or CNS may obtain Board approval of continuing education by submitting a request for approval and the supporting documentation in § 21.827(b) at least 60 days prior to the course. The Board will approve or disapprove the request within 45 days.

   (d)  CNSs may obtain credit for correspondence courses, taped study courses, and other independent or online study courses if the course is Board approved.

   (e)  Up to 15 hours will be credited for service as a teacher, preceptor, lecturer or speaker and for publication in a refereed journal or other scholarly publication relating to the CNS's area of practice.

   (f)  An hour for the purposes of CNS continuing education is 50 minutes.

§ 21.826.  Requirements for continuing education courses.

   Each course must have:

   (1)  An established mechanism to measure its quality, established criteria for selecting and evaluating faculty, and established criteria for the evaluation of each participant who completes the course.

   (2)  Adequate facilities with appropriate instructional materials to carry out continuing education programs.

   (3)  An instructor whose area of expertise is in the subject matter being taught.

§ 21.827.  Continuing education course approval.

   (a)  As a condition of approval, providers and cre- dentialing organizations are required to provide CNSs who complete continuing education courses with a certificate of completion which contains the information in § 21.828(a) (relating to CNS responsibilities).

   (b)  Providers or CNSs requesting Board approval for continuing education as set forth in § 21.825(c) (relating to sources of continuing education) shall pay the fee in § 21.805 (relating to fees) and submit the following information to the Board:

   (1)  The full name and address of the provider.

   (2)  The title of the program.

   (3)  The dates and location of the program.

   (4)  The faculty names, titles, affiliations, degrees and areas of expertise.

   (5)  The schedule of the program--title of subject, lecturer and time allocated.

   (6)  The total number of hours requested.

   (7)  The method of certifying and assuring attendance, and draft of certificate of attendance to be provided to course participants.

   (8)  The course objectives.

   (9)  The target audience.

   (10)  The core subjects.

   (11)  The instruction and evaluation methods.

   (12)  Other information requested by the Board.

   (c)  The provider shall provide CNSs who successfully complete a course with a certificate of attendance.

   (d)  A separate application shall be submitted whenever a change is made to any information submitted under subsection (b), except for information related to a change in date or location, or both.

§ 21.828.  CNS responsibilities.

   (a)  A CNS is required to maintain documentation of completion of continuing education, including:

   (1)  CNS's name.

   (2)  Dates attended.

   (3)  Continuing education hours.

   (4)  Title of course.

   (5)  Course provider.

   (6)  Location of course.

   (b)  Primary responsibility for documenting completion of the continuing education requirements rests with the CNS. A CNS seeking to renew certification shall verify compliance with continuing education requirements. Certificates of attendance and other documentation of completion of continuing education requirements must be maintained for 5 years. The Board approval letter sent to the applicant will be considered acceptable documentation of hours obtained through § 21.825(c) or (e) (relating to sources of continuing education).

   (c)  Falsification of information required under this section or failure to complete the continuing education requirements by those who continue to practice as a CNS may result in the institution of formal disciplinary action under section 14(a)(3) of the act (63 P. S. § 221(a)(3)) and § 21.831(3) (relating to penalties for violations).

PENALTIES FOR VIOLATION

§ 21.831.  Penalties for violations.

   Certification as a CNS may be suspended, revoked or otherwise restricted when, after notice and opportunity to be heard, the Board finds that:

   (1)  The CNS has engaged in the performance of functions and tasks beyond the scope of practice permitted for a CNS or beyond the scope of the CNS's clinical specialty area as provided in the act and this subchapter.

   (2)  The CNS has performed a task or function which the CNS does not have the necessary knowledge, preparation, experience and competency to perform properly or is not qualified under the act and this subchapter to perform.

   (3)  The CNS has violated the act or this subchapter, or engaged in any conduct prohibited for professional nurses.

[Pa.B. Doc. No. 08-1101. Filed for public inspection June 13, 2008, 9:00 a.m.]



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