Sen. Toi W. Hutchinson
Filed: 2/27/2018
 
 

 

 

 
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1
AMENDMENT TO SENATE BILL 339 




2    AMENDMENT NO. ______. Amend Senate Bill 339 by replacing 
3everything after the enacting clause with the following:

 
4    "Section 5. The Nurse Practice Act is amended  by changing 
5Sections 50-10, 50-75, and 60-35 and by adding Section 80-65 as 
6follows:
 


7    (225 ILCS 65/50-10)
  (was 225 ILCS 65/5-10)



8    (Section scheduled to be repealed on January 1, 2028)

9    Sec. 50-10. Definitions. Each of the following terms, when 
10used
in this Act, shall have the meaning ascribed to it in this 
11Section, except
where the context clearly indicates otherwise:




12    "Academic year" means the customary annual schedule of 
13courses at a
college, university, or approved school, 
14customarily regarded as the school
year as distinguished from 
15the calendar year.

16    "Address of record" means the designated address recorded 
 
 
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1by the Department in the applicant's or licensee's application 
2file or license file as maintained by the Department's 
3licensure maintenance unit.
4    "Advanced practice registered nurse" or "APRN" means a 
5person who has met the qualifications for a (i) certified nurse 
6midwife (CNM); (ii) certified nurse practitioner (CNP); (iii) 
7certified registered nurse anesthetist (CRNA); or (iv) 
8clinical nurse specialist (CNS) and has been licensed by the 
9Department.  All advanced practice registered nurses licensed 
10and practicing in the State of Illinois shall use the title 
11APRN and may use specialty credentials CNM, CNP, CRNA, or CNS 
12after their name. All advanced practice registered nurses may 
13only practice in accordance with national certification and 
14this Act.

15    "Advisory Board" means the Illinois Nursing Workforce 
16Center Advisory Board.
17    "Approved program of professional nursing education" and 
18"approved
program of practical nursing education" are programs 
19of professional or
practical nursing, respectively, approved 
20by the Department under the
provisions of this Act.

21    "Board" means the Board of Nursing appointed by the 
22Secretary.
23    "Center" means the Illinois Nursing Workforce Center.
24    "Collaboration" means a process involving 2 or more health 
25care professionals working together, each contributing one's 
26respective area of expertise to provide more comprehensive 
 
 
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1patient care.
2    "Competence" means an expected and measurable level of 
3performance that integrates knowledge, skills, abilities, and 
4judgment based on established scientific knowledge and 
5expectations for nursing practice. 
6    "Comprehensive nursing assessment" means the gathering of 
7information about the patient's physiological, psychological, 
8sociological, and spiritual status on an ongoing basis by a 
9registered professional nurse and is the first step in 
10implementing and guiding the nursing plan of care. 
11    "Consultation" means the process whereby an advanced 
12practice registered nurse seeks the advice or opinion of 
13another health care professional.
14    "Credentialed" means the process of assessing and 
15validating the qualifications of a health care professional.
16    "Dentist" means a person licensed to practice dentistry 
17under the Illinois Dental Practice Act.
18    "Department" means the Department of Financial and 
19Professional Regulation.
20    "Email address of record" means the designated email 
21address recorded by the Department in the applicant's 
22application file or the licensee's license file, as maintained 
23by the Department's licensure maintenance unit.
24    "Focused nursing assessment" means an appraisal of an 
25individual's status and current situation, contributing to the  
26comprehensive nursing assessment performed by the registered 
 
 
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1professional nurse or advanced practice registered nurse or the 
2assessment by the physician assistant, physician, dentist, 
3podiatric physician, or other licensed health care 
4professional, as determined by the Department, supporting 
5ongoing data collection, and deciding who needs to be informed 
6of the information and when to inform. 
7    "Full practice authority" means the authority of an 
8advanced practice registered nurse licensed in Illinois and 
9certified as a nurse practitioner, clinical nurse specialist, 
10or nurse midwife to practice without a written collaborative 
11agreement and: 
12        (1) to be fully accountable to patients for the quality 
13    of advanced nursing care rendered; 
14        (2) to be fully accountable for recognizing limits of 
15    knowledge and experience and for planning for the 
16    management of situations beyond the advanced practice 
17    registered nurse's expertise; the full practice authority 
18    for advanced practice registered nurses includes accepting 
19    referrals from, consulting with, collaborating with, or 
20    referring to other health care professionals as warranted 
21    by the needs of the patient; and 
22        (3) to possess the authority to prescribe medications, 
23    including Schedule II through V controlled substances, as 
24    provided in Section 65-43. 
25    "Hospital affiliate" means a corporation, partnership, 
26joint venture, limited liability company, or similar 
 
 
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1organization, other than a hospital, that is devoted primarily 
2to the provision, management, or support of health care 
3services and that directly or indirectly controls, is 
4controlled by, or is under common control of the hospital. For 
5the purposes of this definition, "control" means having at 
6least an equal or a majority ownership or membership interest. 
7A hospital affiliate shall be 100% owned or controlled by any 
8combination of hospitals, their parent corporations, or 
9physicians licensed to practice medicine in all its branches in 
10Illinois. "Hospital affiliate" does not include a health 
11maintenance organization regulated under the Health 
12Maintenance Organization Act. 
13    "Impaired nurse" means a nurse licensed under this Act who 
14is unable to practice with reasonable skill and safety because 
15of a physical or mental disability as evidenced by a written 
16determination or written consent based on clinical evidence, 
17including loss of motor skills, abuse of drugs or alcohol, or a 
18psychiatric disorder, of sufficient degree to diminish his or 
19her ability to deliver competent patient care.
20    "License-pending advanced practice registered nurse" means 
21a registered professional nurse who has completed all 
22requirements for licensure as an advanced practice registered 
23nurse except the certification examination and has applied to 
24take the next available certification exam and received a 
25temporary permit from the Department.
26    "License-pending registered nurse" means a person who has 
 
 
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1passed the Department-approved registered nurse licensure exam 
2and has applied for a license from the Department.  A 
3license-pending registered nurse shall use the title "RN lic 
4pend" on all documentation related to nursing practice.
5    "Nursing intervention" means any treatment based on 
6clinical nursing judgment or knowledge that a nurse performs. 
7An individual or entity shall not mandate that a registered 
8professional nurse delegate nursing interventions if the 
9registered professional nurse determines it is inappropriate 
10to do so. A nurse shall not be subject to disciplinary or any 
11other adverse action for refusing to delegate a nursing 
12intervention based on patient safety. 
13    "Physician" means a person licensed to practice medicine in 
14all its branches under the Medical Practice Act of 1987.
15    "Podiatric physician" means a person licensed to practice 
16podiatry under the Podiatric Medical Practice Act of 1987.




17    "Practical nurse" or "licensed practical nurse" means a 
18person who is
licensed as a practical nurse under this Act and 
19practices practical
nursing as defined in this Act.  Only a 
20practical nurse
licensed under this Act is entitled to use the 
21title "licensed practical
nurse" and the abbreviation 
22"L.P.N.".

23    "Practical nursing" means the performance of
nursing 
24interventions requiring the nursing knowledge, judgment, and 
25skill
acquired by means of completion of an approved practical 
26nursing education
program.  Practical nursing includes 
 
 
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1assisting in the nursing process under the guidance of a 
2registered professional nurse or an advanced practice 
3registered nurse.  The
practical nurse may work under the 
4direction of a licensed physician, dentist, podiatric 
5physician, or other health care professional determined by the 
6Department.

7    "Privileged" means the authorization granted by the 
8governing body of a healthcare facility, agency, or 
9organization to provide specific patient care services within 
10well-defined limits, based on qualifications reviewed in the 
11credentialing process.

12    "Registered Nurse" or "Registered Professional Nurse" 
13means a person
who is licensed as a professional nurse under 
14this Act and practices
nursing as defined in
this Act.  Only a 
15registered
nurse licensed under this Act is entitled to use the

16titles "registered nurse" and "registered professional nurse" 
17and the
abbreviation, "R.N.".

18    "Registered professional nursing practice" means a 
19scientific process founded on a professional body of knowledge 
20that includes, but is not limited to, the protection, 
21promotion, and optimization of health and abilities, 
22prevention of illness and injury, the administration of 
23medications and treatments prescribed by a physician, dentist, 
24podiatric physician, licensed optometrist, physician 
25assistant, or advanced practice registered nurse,  development 
26and implementation of the nursing plan of care, facilitation of 
 
 
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1nursing interventions to alleviate suffering, care 
2coordination, and advocacy in the care of individuals, 
3families, groups, communities, and populations.  "Registered 
4professional nursing practice" does not include the act of 
5medical diagnosis or prescription of medical therapeutic or 
6corrective measures.


7    "Professional assistance program for nurses" means a 
8professional
assistance program that meets criteria 
9established by the Board of Nursing
and approved by the 
10Secretary, which provides a non-disciplinary treatment

11approach for nurses licensed under this Act whose ability to 
12practice is
compromised by alcohol or chemical substance 
13addiction.

14    "Secretary" means the Secretary of  Financial and 
15Professional Regulation.
16    "Selected nursing task" means work that does not require 
17nursing knowledge, judgment, or decision making that may be 
18delegated if the delegating registered nurse:
19        (1) assesses that the specific task delegated can be 
20    safely carried out by the person the professional 
21    registered nurse delegates such work to;
22        (2) assesses such delegation is safe for the individual 
23    patient or client receiving that care of a selected nursing 
24    task; and
25        (3)   delegation of a selected nursing task complies as 
26    defined by the Department by rule.
 
 
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1    "Task" means work that does not require nursing knowledge, 
2judgment, or decision making, as defined by the Department by 
3rule. 
4    "Unencumbered license" means a license issued in good 
5standing.
6    "Written collaborative agreement" means a written 
7agreement between an advanced practice registered nurse and a 
8collaborating physician, dentist, or podiatric physician 
9pursuant to Section 65-35.

10(Source: P.A. 99-173, eff. 7-29-15; 99-330, eff. 1-1-16; 
1199-642, eff. 7-28-16; 100-513, eff. 1-1-18.)

 
12    (225 ILCS 65/50-75)
13    (Section scheduled to be repealed on January 1, 2028)

14    Sec. 50-75. Nursing delegation by a registered 
15professional nurse.
16    (a)  For the purposes of this Section:
17    "Delegation" means transferring to a specific individual 
18the authority to perform a specific nursing intervention in a 
19specific situation.
20    "Predictability of outcomes" means that a registered 
21professional nurse or advanced practice registered nurse has 
22determined that the patient's or individual's clinical status 
23is stable and expected to improve or the patient's or 
24individual's deteriorating condition is expected to follow a 
25known or expected course. 
 
 
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1    "Stability" means a registered professional nurse or 
2advanced practice registered nurse has determined that the 
3individual's clinical status and nursing care needs are 
4consistent. 
5    (b) This Section authorizes a registered professional 
6nurse or advanced practice registered nurse to:
7        (1) delegate tasks and nursing interventions to other 
8    registered professional nurses, licensed practical nurses, 
9    and other unlicensed personnel based on the comprehensive 
10    nursing assessment that includes, but is not limited to:
11            (A) the stability and condition of the patient;
12            (B) the potential for harm;
13            (C) the complexity of the nursing intervention to 
14        be delegated;
15            (D) the predictability of outcomes; and
16            (E) competency of the individual to whom the 
17        nursing intervention is delegated;
18        (2) delegate medication administration to other 
19    licensed nurses;
20        (3) in community-based or in-home care settings, 
21    delegate tasks and selected nursing tasks, as defined by 
22    the Department by rule, which may include delegating 
23    delegate the administration of medication (limited to oral 
24    or subcutaneous dosage and topical or transdermal 
25    application) to unlicensed personnel, if all the 
26    conditions for delegation set forth in this Section are 
 
 
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1    met; 
2        (4) refuse to delegate, stop, or rescind a previously 
3    authorized delegation; or
4        (5) in community-based or in-home care settings, 
5    delegate, guide, and evaluate the implementation of 
6    nursing interventions as a component of patient care 
7    coordination after completion of the comprehensive patient 
8    assessment based on analysis of the comprehensive nursing 
9    assessment data; care coordination in in-home care and 
10    school settings may occur in person, by telecommunication, 
11    or by electronic communication. 
12    (c)  This Section prohibits the following:
13        (1) An individual or entity from mandating that a 
14    registered professional nurse delegate nursing 
15    interventions, tasks, or selected nursing tasks if the 
16    registered professional nurse determines it is 
17    inappropriate to do so.  Nurses shall not be subject to 
18    disciplinary or any other adverse action for refusing to 
19    delegate a nursing intervention based on patient safety.
20        (2) A registered professional nurse from the The 
21    delegation of medication administration to unlicensed 
22    personnel in any institutional or long-term facility,  
23    including, but not limited to, those facilities licensed by 
24    the Hospital Licensing Act, the University of Illinois 
25    Hospital Act, State-operated mental health hospitals, or 
26    State-operated developmental centers, except as  authorized 
 
 
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1    under Article 80 of this Act or otherwise specifically 
2    authorized by law. 
3        (3) A registered professional nurse from delegating 
4    nursing judgment, the comprehensive patient assessment, 
5    the development of a plan of care, and the evaluation of 
6    care to licensed or unlicensed personnel.
7        (4) A licensed practical nurse or unlicensed personnel 
8    who has been delegated a nursing intervention by a 
9    registered professional nurse from re-delegating that a 
10    nursing intervention. 

11        (5)    An unlicensed personnel who has been delegated a 
12    task or selected nursing task by a registered professional 
13    nurse from re-delegating that task or selected nursing 
14    task. 
15(Source: P.A. 100-513, eff. 1-1-18.)
 
16    (225 ILCS 65/60-35)
17    (Section scheduled to be repealed on January 1, 2028)

18    Sec. 60-35. RN scope of practice. The RN scope of nursing 
19practice is the protection, promotion, and optimization of 
20health and abilities, the prevention of illness and injury,  the 
21development and implementation of the nursing plan of care, the 
22facilitation of nursing interventions to alleviate suffering, 
23care coordination, and advocacy in the care of individuals, 
24families, groups, communities, and populations.  Practice as a 
25registered professional nurse means this full scope of nursing, 
 
 
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1with or without compensation, that incorporates caring for all 
2patients in all settings, through nursing standards of practice 
3and professional performance for coordination of care, and may 
4include, but is not limited to, all of the following: 
5        (1) Collecting pertinent data and information relative 
6    to the patient's health or the situation on an ongoing 
7    basis through the comprehensive nursing assessment.
8        (2) Analyzing  comprehensive nursing assessment data to 
9    determine actual or potential diagnoses, problems, and 
10    issues.
11        (3) Identifying expected outcomes for a plan 
12    individualized to the patient or the situation that 
13    prescribes strategies to attain expected, measurable 
14    outcomes.
15        (4) Implementing the identified plan, coordinating 
16    care delivery, employing strategies to promote healthy and 
17    safe environments, and administering or delegating 
18    medication administration according to Section 50-75 of 
19    this Act.
20        (5) Evaluating patient progress toward attainment of 
21    goals and outcomes.
22        (6) Delegating tasks,  nursing interventions, and 
23    selected nursing tasks to implement the plan of care.
24        (7) Providing health education and counseling.
25        (7.5) Advocating for the patient. 
26        (8) Practicing ethically according to the American 
 
 
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1    Nurses Association Code of Ethics.
2        (9) Practicing in a manner that recognizes cultural 
3    diversity.
4        (10) Communicating effectively in all areas of 
5    practice.
6        (11) Collaborating with patients and other key 
7    stakeholders in the conduct of nursing practice.
8        (12) Participating in continuous professional 
9    development.
10        (13) Teaching the theory and practice of nursing to 
11    student nurses.
12        (14) Leading within the professional practice setting 
13    and the profession.
14        (15) Contributing to quality nursing practice.
15        (16) Integrating evidence and research findings into 
16    practice.
17        (17) Utilizing appropriate resources to plan, provide, 
18    and sustain evidence-based nursing services that are safe 
19    and effective.

20(Source: P.A. 100-513, eff. 1-1-18.)
 
21    (225 ILCS 65/80-65 new)
22    Sec. 80-65. Repeal. This Article is scheduled to be 
23repealed on June 30, 2019.".