Subchapter A. REGISTERED NURSES
GENERAL PROVISIONS Sec.
21.1. Definitions.
21.2. Scope.
21.3. [Reserved].
21.4. Applicability of general rules.
21.4a. Procedural matters.
21.5. Fees.
21.6. Professional corporations.
21.7. Temporary practice permits.
RESPONSIBILITIES OF THE REGISTERED NURSE
21.11. General functions.
21.12. Venipuncture; intravenous fluids.
21.13. Resuscitation and respiration.
21.14. Administration of drugs.
21.15. Monitoring, defibrillating and resuscitating.
21.16. Immunizations.
21.17. Anesthesia.
21.18. Standards of nursing conduct.
21.18a. Impaired professional program.
LICENSES
21.20. Licensure by examination.
21.21. Application for examination.
21.22. [Reserved].
21.23. Qualifications of applicant for examination.
21.24. Passage of the licensure examination.
21.25. Re-examination.
21.26. [Reserved].
21.27. [Reserved].
21.28. Licensure by endorsement.
21.29. Expiration and renewal of license.
21.29a. Reporting of crimes and disciplinary action.
21.29b. Reporting of address changes.
21.30. Registered nurses licensed outside of the United States or Canada.
21.30a. Continued competency.
APPROVAL OF SCHOOLS OF NURSING
21.31. Surveys; list of approved nursing education programs.
21.32. Objectives.
21.33. Types of approval.
21.33a. Types of approval.
21.33b. Minimum rate for graduates of nursing education programs to pass the National licensure examination.
21.34. Removal from approved list.
DISCONTINUANCE OF A SCHOOL OF NURSING
21.41. Notification; completion of program; records.
APPROVED PROGRAMS OF NURSING
21.51. Establishment.
ORGANIZATION AND ADMINISTRATION OF
NURSING PROGRAMS
21.61. Baccalaureate and associate degree programs: organizational requirements.
21.62. Diploma programs; organizational requirements.
21.63. Diploma programs utilizing cooperating agencies.
ADMINISTRATIVE AND INSTRUCTIONAL PERSONNEL
21.71. Nurse administrator, faculty and staff requirements.
21.72. Faculty policies; additional responsibilities of faculty and faculty assistants.
21.73. Internal nursing faculty organizations.
21.74. [Reserved].
21.75. [Reserved].
21.76. Faculty organizations.
21.77. [Reserved].
CURRICULUM FOR BACCALAUREATE, ASSOCIATE DEGREE AND DIPLOMA PROGRAMS
21.81. General curriculum requirements.
21.82. Curriculum evaluation.
21.83. Curriculum changes requiring Board approval.
21.84. Baccalaureate curriculum philosophy; purposes and objectives.
21.85. Baccalaureate general educational criteria.
21.86. Associate degree curriculum philosophy; purposes and objectives.
21.87. Associate degree general educational criteria.
21.88. Diploma curriculum philosophy; purposes, and objectives.
21.89. Diploma general educational criteria.
FACILITIES FOR ADMINISTRATION AND TEACHING
21.91. Facility and resource requirements.
STUDENTS
21.101. Selection and admission standards.
21.102. Admission of classes.
21.103. Transfer of students or advanced standing.
STUDENT SERVICES
21.111. Health program.
21.112. Student employment.
21.113. Student housing.
21.114. Counseling and guidance.
21.115. Financial aid.
21.116. Students’ rights.
STUDENTS LICENSED IN OTHER JURISDICTIONS
21.118. Post-basic nursing programs.
RECORDS
21.121. Program records.
21.122. Record maintenance.
21.123. Access and use of records.
21.124. Records to be filed with Board.
21.125. Custody of records.
21.126. [Reserved].
CONTINUING EDUCATION
21.131. Continuing education.
21.132. Continuing education hours.
21.133. Continuing education content.
21.134. Continuing education sources.
Authority The provisions of this Subchapter A issued under The Professional Nursing Law (63 P.S. § § 211—225.5), unless otherwise noted.
Source The provisions of this Subchapter A adopted May 22, 1951, unless otherwise noted.
Cross References This subchapter cited in 28 Pa. Code § 201.3 (relating to definitions).
GENERAL PROVISIONS
§ 21.1. Definitions.
The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise:
Act—The Professional Nursing Law (63 P.S. § § 211—225.5), which establishes standards for nursing schools and the conduct of nursing programs.
Approved—Approved by the Board.
Board——The State Board of Nursing of the Commonwealth.
Continuing education—An activity approved by the Board as a condition for renewal of licensure or certification for which proof of completion can be provided to the Board.
Diagnosing—Identification of and discrimination between physical and psychosocial signs and symptoms essential to effective execution and management of the nursing regimen.
Distance learning continuing education—Continuing education in which the individual participates in the educational activity by means of electronic media or through refereed journals, rather than in a classroom, laboratory or clinical setting where the faculty and participant are physically located in the same room.
Examination year—The period beginning on October 1st of a year through September 30th of the following year.
Graduate registered nurse—An individual who has graduated from an approved program of professional nursing in this Commonwealth or a comparable program in another state.
Human responses—Those signs, symptoms and processes which denote the interaction of the individual with an actual or potential health problem.
Patient (includes residents and clients)—A person, other than a spouse or immediate family member, who receives professional services from a registered nurse, regardless of whether the nurse receives remuneration for the services.
Practice of professional nursing—(i) Diagnosing and treating human responses to actual or potential health problems through such services as case findings, health teaching, health counseling, provision of care supportive to or restorative of life and well-being, and executing medical regimens as prescribed by a licensed physician or dentist.
(ii) The term does not include acts of medical diagnosis or prescription of medical therapeutic or corrective measures, except as may be authorized by rules and regulations jointly promulgated by the State Board of Medicine and the Board, which rules and regulations will be implemented by the Board.
Professional relationship—(i) For a registered nurse not involved in providing mental health services, the relationship which shall be deemed to exist for a period of time beginning with the first professional contact or consultation between a registered nurse and a patient and ending with the patient’s discharge from or discontinuance of services by the nurse or by the nurse’s employer. The administration of emergency medical treatment or transitory trauma care will not be deemed to establish a professional relationship.
(ii) For a registered nurse involved in providing mental health services, the relationship which shall be deemed to exist for a period of time beginning with the first professional contact or consultation between the nurse and patient and ending 2 years after discharge from or discontinuance of services. For a patient who is a minor, a professional relationship shall be deemed to exist for 2 years or until 1 year after the age of majority, whichever is longer, after discharge from or discontinuance of services.
Registered nurse—A nurse licensed under this subchapter to practice in this Commonwealth.
Sexual impropriety—The term includes the following offenses:(i) Making sexually demeaning or sexually suggestive comments about or to a patient, including comments about a patient’s body or undergarments.
(ii) Unnecessarily exposing a patient’s body or watching a patient dress or undress, unless for therapeutic purposes or the patient specifically requests assistance.
(iii) Examining or touching genitals without the use of gloves when performing an otherwise appropriate examination.
(iv) Discussing or commenting on a patient’s potential sexual performance or requesting details of a patient’s sexual history or preferences during an examination or consultation, except when the examination or consultation is pertinent to the issue of sexual function or dysfunction or reproductive health care. Discussion of a patient’s sexual practices and preferences shall be fully documented in the patient’s chart.
(v) Soliciting a date from a patient.
(vi) Volunteering information to a patient about one’s sexual problems, preferences or fantasies.
Sexual violation—The term includes the following offenses:(i) Sexual intercourse between a registered nurse and a patient during the professional relationship.
(ii) Genital to genital contact between a nurse and a patient during the professional relationship.
(iii) Oral to genital contact between a nurse and a patient during the professional relationship.
(iv) Touching breasts, genitals, or any other body part for any purpose other than appropriate examination or treatment, or using prolonged or improper examination techniques, or after the patient has refused or withdrawn consent.
(v) Encouraging a patient to masturbate in the presence of the nurse or masturbating while a patient is present.
(vi) Providing or offering to provide drugs or treatment in exchange for sexual favors.
(vii) Using or causing the use of anesthesia or any other drug affecting consciousness for the purpose of engaging in conduct that would constitute a sexual impropriety or sexual violation.
Systematic evaluation plan—An organized, continuous analysis of all nursing education program components, such as curriculum, faculty, facilities, policies and outcome measures, that addresses standards or benchmarks to be achieved and establishes an action plan if those standards or benchmarks are not achieved.
Treating—Selection and performance of those therapeutic measures essential to the effective execution and management of the nursing regimen and execution of the prescribed medical regimen.
Authority The provisions of this § 21.1 amended under sections 2.1(k) and 6.1 of The Professional Nursing Law (63 P.S. § § 212.1(k) and 216.1); and sections 9 and 17.6 of the Practical Nurse Law (63 P.S. § § 659 and 667.6).
Source The provisions of this § 21.1 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829; amended September 8, 2000, effective September 9, 2000, 30 Pa.B. 4730; amended May 19, 2006, effective May 20, 2006, 36 Pa.B. 2402; amended July 11, 2008, effective July 12, 2008, 38 Pa.B. 3796, 3806; amended April 24, 2009, effective April 25, 2009, 39 Pa.B. 2103. Immediately preceding text appears at serial pages (335510) to (335513).
Cross References This section cited in 49 Pa. Code § 21.803 (relating to applicability of rules relating to professional nurses).
§ 21.2. Scope.
(a) The Board administers the act by providing rules and regulations on standards for nursing schools and the conduct of the programs.
(b) The Board provides for licensure of graduate nurses from approved schools by examination, by endorsement and by renewal of licenses.
(c) The Board has the right to establish rules and regulations for the practice of nursing.
(d) The Board may impose disciplinary sanctions and assess civil penalties for cause.
(e) The Board may approve professional nursing education programs conducted in hospitals and accredited colleges, universities and postsecondary institutions that award academic degrees, and will make available a list of approved programs on its web site.
(f) The Board will regulate the practice of professional nursing.
Authority The provisions of this § 21.2 amended under section 2.1(k) of The Professional Nursing Law (63 P.S. § 212.1(k)).
Source The provisions of this § 21.2 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829; amended December 16, 2016, effective December 17, 2016, 46 Pa.B. 7822. Immediately preceding text appears at serial page (352041).
Cross References This section cited in 49 Pa. Code § 21.803 (relating to applicability of rules relating to professional nurses).
§ 21.3. [Reserved].
Authority The provisions of this § 21.3 reserved under section 2.1(k) of The Professional Nursing Law (63 P.S. § 212.1(k)).
Source The provisions of this § 21.3 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; reserved December 16, 2016, effective December 17, 2016, 46 Pa.B. 7822. Immediately preceding text appears at serial pages (352041) to (352042).
Cross References This section cited in 49 Pa. Code § 21.803 (relating to applicability of rules relating to professional nurses).
§ 21.4. Applicability of general rules.
Under 1 Pa. Code § 31.1 (relating to scope of part) 1 Pa. Code Part II (relating to general rules of administrative practice and procedure) is applicable to the activities of and proceedings before the Board.
Source The provisions of this § 21.4 adopted January 30, 1976, effective January 31, 1976, 6 Pa.B. 160; amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677.
Cross References This section cited in 49 Pa. Code § 21.803 (relating to applicability of rules relating to professional nurses).
§ 21.4a. Procedural matters.
(a) The consent of the patient to any sexual impropriety or violation is not a defense to any disciplinary charge for violation of the act or this subchapter.
(b) Evidence of specific instances, opinion evidence or reputation evidence of a patient’s past sexual conduct is not admissible in proceedings brought under § 21.18(b)(9) (relating to standards of nursing conduct). The Board may consider sexual relationships between the nurse and the patient occurring prior to the professional relationship.
(c) A nurse who attempts to raise as a defense an argument that conduct prohibited as a sexual violation or sexual impropriety was necessary or appropriate to the treatment of any patient shall be required to demonstrate competency in practice which relates directly to the treatment of sexual function or dysfunction. This competence may be demonstrated through educational training and supervised clinical experience. Appropriate discussions of sexual matters between a nurse and a patient shall be fully documented in patient records.
Authority The provisions of this § 21.4a issued under section 2.1(k) of The Professional Nursing Law (63 P.S. § 212.1(k)).
Source The provisions of this § 21.4a adopted September 8, 2000, effective September 9, 2000, 30 Pa.B. 4730.
Cross References This section cited in 49 Pa. Code § 21.803 (relating to applicability of rules relating to professional nurses).
§ 21.5. Fees.
(a) The following application fees are charged by the Board for services provided to licensees and applicants:
Licensure by examination—Board-approved nursing education program graduates … $95
Reexamination … $75
Licensure by endorsement … $120
Licensure by endorsement with examination … $145
Temporary practice permit … $70
Extension of temporary practice permit … $85
Fee for review and challenge of RN exam … $435
Licensure by examination—Graduates of out-of-State nursing education programs… $115
Verification of licensure… $45
Reactivation of inactive or lapsed license (5 years or longer)… $130
Restoration after suspension or revocation … $60
Certification of scores… $25
Verification of licensure with history… $50
(b) The following renewal fees are charged by the Board to support its operations:
Biennial renewal of license… $122
(c) The following fees are charged by the Board for services provided to nursing education programs:
Application for approval of new nursing education program … $2,195
Review of curriculum revisions fee… $585
Review of annual compliance report fee… $430
New nursing education program survey visit fee… $1,525
(d) The following fees related to continuing education are charged by the Board:
Approval of each hour of registered nurse continuing education activity by sources not listed in § 21.134(a) (relating to continuing education sources)… $115
Renewal of approval of registered nurse continuing education activity by sources not listed in § 21.134(a) … $35
(e) The following fee is charged for evaluations of programs requiring Board approval under § 21.30a(a)(2) (relating to continued competency)…$285
(f) In addition to the fees prescribed in subsection (a), which are payable directly to the Board, a candidate for the registered nurse licensing examination shall also pay a fee to the National Council of the State Board of Nursing (www.ncsbn.org) to cover costs associated with the preparation and administration of the registered nurse licensing examination.
Authority The provisions of this § 21.5 issued under section 11.2(a) and (d) of The Professional Nursing Law (63 P.S. § 221.2(a) and (d)); and section 17.6 of the Practical Nurse Law (63 P.S. § 667.6); amended under sections 2.1(k), 11(b), 11.2 and 12.1 of The Professional Nursing Law (63 P.S. § § 212.1(k), 221(b), 221.2 and 222); sections 13.1 and 17.5 of the Practical Nurse Law (63 P.S. § § 663.1 and 667.5); section 22.1 of the Podiatry Practice Act (63 P.S. § 42.21c); and sections 810(a)(3) and (7) and 812.1(a) of The Administrative Code of 1929 (71 P.S. § § 279.1(a)(3) and (7) and 279.3a(a)).
Source The provisions of this § 21.5 adopted December 25, 1987, effective December 26, 1987, 17 Pa.B. 5329; amended June 8, 1990, effective June 9, 1990, 20 Pa.B. 3078; amended July 27, 1990, effective July 28, 1990, 20 Pa.B. 4086; amended November 29, 1991, effective November 30, 1991, 21 Pa.B. 5521; amended June 12, 1992, effective immediately and applies to biennial renewals commencing May 1, 1992, 22 Pa.B. 2976; amended June 18, 1993, effective June 19, 1993, 23 Pa.B. 2827; amended November 26, 1993, effective November 27, 1993, 23 Pa.B. 5634; amended June 16, 2000, effective June 17, 2000, 30 Pa.B. 3040; amended November 17, 2000, effective November 18, 2000, 30 Pa.B. 5952; amended June 2, 2006, effective June 3, 2006, 36 Pa.B. 2673; amended July 11, 2008, effective July 12, 2008, 38 Pa.B. 3796, amended August 20, 2010, effective August 21, 2010, 40 Pa.B. 4755; amended July 26, 2019, effective July 27, 2019, 49 Pa.B. 3891. Immediately preceding text appears at serial pages (385107) to (385108).
Cross References This section cited in 49 Pa. Code § 21.7 (relating to temporary practice permits); 49 Pa. Code § 21.29 (relating to expiration and renewal of license); 49 Pa. Code § 21.30a (relating to continued competency); 49 Pa. Code § 21.134 (relating to continuing education sources); and 49 Pa. Code § 21.605 (relating to biennial renewal).
§ 21.6. Professional corporations.
A registered nurse may form a professional corporation with other registered nurses or other health care practitioners who treat human ailments and conditions, and who are licensed to provide health care services in this Commonwealth without receiving a referral or supervision from another health care practitioner.
Source The provisions of this § 21.6 adopted November 29, 1991, effective November 30, 1991, 21 Pa.B. 5521.
Cross References This section cited in 49 Pa. Code § 21.803 (relating to applicability of rules relating to professional nurses).
§ 21.7. Temporary practice permits.
(a) A graduate registered nurse may only practice professional nursing under supervision and if the graduate registered nurse holds a current temporary practice permit. “Supervision” means that a licensed registered nurse is physically present in the area or unit where the graduate registered nurse is practicing. The Board may grant a temporary practice permit to a graduate registered nurse as follows:
(1) A graduate registered nurse who wishes to practice professional nursing shall submit an application for a temporary practice permit for a graduate registered nurse on a form provided by the Board and remit the fee specified in § 21.5 (relating to fees). A temporary practice permit granted under this section is valid for up to 1 year from the date of issuance, unless extended under paragraphs (3) and (4), and immediately expires if the applicant fails the licensing examination.
(2) At least 90 days prior to the expiration date of the temporary practice permit, the graduate registered nurse shall:
(i) Submit an application for licensure by examination as a registered nurse.
(ii) Remit the fee specified in § 21.5.
(iii) Submit the licensure examination registration form and fee required to the professional testing organization.
(3) At least 60 days prior to the expiration date of the temporary practice permit, the graduate registered nurse who wishes to extend the expiration date of the temporary practice permit because of illness or extreme hardship shall:
(i) Submit an application for temporary practice permit extension on a form provided by the Board.
(ii) Remit the fee specified in § 21.5.
(iii) Provide a detailed, written explanation of the reason the extension is requested. If requesting an extension due to illness, the applicant shall provide certification of the illness from the applicant’s treating physician.
(4) The Board will not grant an extension to an individual who fails to meet the requirements of paragraphs (2) and (3).
(b) The Board may grant a temporary practice permit to an individual who holds a current registered nurse license issued by another state, territory or possession of the United States or Canada (a currently-licensed registered nurse). The temporary practice permit will expire in 1 year, unless the individual fails the licensure examination, in which case the temporary practice permit will immediately expire. The Board may extend the temporary practice permit period in cases of illness or extreme hardship as set forth in paragraph (5).
(1) A currently-licensed registered nurse who wishes to practice professional nursing during the period from the date of submission of the Applicant Data Sheet of the application for licensure until the Board makes a determination on the application for licensure or 1 year, whichever comes first, shall:
(i) Submit an application for temporary practice permit for a currently-licensed registered nurse on a form provided by the Board.
(ii) Remit the fee specified in § 21.5.
(2) An individual applying for a temporary practice permit for a currently-licensed registered nurse shall demonstrate proficiency in English by submitting proof that the individual’s nursing education program was conducted in English or that the individual has received a passing score on a Board-approved English proficiency examination. The Board will make available a list of Board-approved English proficiency examinations on its web site. This information must be submitted with the Applicant Data Sheet of the application for licensure.
(3) Within 45 days of the date the temporary practice permit is issued, an individual who has been granted a temporary practice permit for a currently-licensed registered nurse shall submit the Verification of Licensure Form of the application for licensure and shall:
(i) Request verification of licensure from the foreign jurisdiction and retain documentation of the submission of the request to provide to the Board upon request.
(ii) Request certification of the applicant’s nursing education program from the licensing board or appropriate educational authorities. The certification of nursing education shall be submitted to the Board in English directly from the appropriate educational authorities. The applicant shall retain documentation of the submission of the request to provide to the Board upon request.
(iii) Submit an application for an education evaluation to a Board-approved foreign credentials evaluator if required under § § 21.23(b) and 21.28(c) (relating to qualifications of applicant for examination; and licensure by endorsement) and retain documentation of the application submitted to the evaluator to provide to the Board upon request.
(iv) If the applicant is required to take the licensure examination, submit the licensure examination registration form and fee required to the professional testing organization and retain documentation of the submission of the application to take the examination to provide to the Board upon request.
(4) An individual who has been granted a temporary practice permit for a currently-licensed registered nurse shall ensure that all documentation in support of the application for licensure is received by the Board no later than 90 days prior to the expiration date of the temporary practice permit. An individual whose supporting documentation has not been received by the Board at least 90 days prior to the expiration date of the temporary practice permit shall submit, within 10 days of receiving notice of the deficiency from the Board, a detailed written explanation of why the supporting documentation has not been supplied to the Board in a timely manner.
(5) An individual who has been granted a temporary practice permit for a currently-licensed registered nurse and who has complied with paragraphs (2)—(4) may request an extension of the individual’s temporary practice permit because of illness or extreme hardship by:
(i) Submitting a temporary practice permit extension application provided by the Board.
(ii) Remitting the fee specified in § 21.5.
(iii) Submitting a written, detailed explanation of the reasons the extension is requested. If requesting an extension due to illness, the applicant shall provide certification of the illness from the applicant’s treating physician.
(iv) Providing proof of the timely request for verification of licensure referenced in paragraph (3)(i).
(6) The request for temporary practice permit extension shall be submitted to the Board no less than 60 days prior to the expiration date of the temporary practice permit.
(7) The Board will not grant an extension to an individual who fails to meet the requirements of paragraphs (2)—(6).
Authority The provisions of this § 21.7 issued and amended under section 2.1(k) of The Professional Nursing Law (63 P.S. § 212.1(k)).
Source The provisions of this § 21.7 adopted May 19, 2006, effective May 20, 2006, 36 Pa.B. 2402; amended December 16, 2016, effective December 17, 2016, 46 Pa.B. 7822. Immediately preceding text appears at serial pages (378842) and (351261) to (351263).
Cross References This section cited in 49 Pa. Code § 21.23 (relating to qualifications of applicant for examination); and 49 Pa. Code § 21.28 (relating to licensure by endorsement).
RESPONSIBILITIES OF THE REGISTERED NURSE
§ 21.11. General functions.
(a) The registered nurse assesses human responses and plans, implements and evaluates nursing care for individuals or families for whom the nurse is responsible. In carrying out this responsibility, the nurse performs all of the following functions:
(1) Collects complete and ongoing data to determine nursing care needs.
(2) Analyzes the health status of the individuals and families and compares the data with the norm when possible in determining nursing care needs.
(3) Identifies goals and plans for nursing care.
(4) Carries out nursing care actions which promote, maintain and restore the well-being of individuals.
(5) Involves individuals and their families in their health promotion, maintenance and restoration.
(6) Evaluates the effectiveness of the quality of nursing care provided.
(b) The registered nurse is fully responsible for all actions as a licensed nurse and is accountable to clients for the quality of care delivered.
(c) The registered nurse may not engage in areas of highly specialized practice without adequate knowledge of and skills in the practice areas involved.
(d) The Board recognizes standards of practice and professional codes of behavior, as developed by appropriate nursing associations, as the criteria for assuring safe and effective practice.
Source The provisions of this § 21.11 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677. Immediately preceding text appears at serial page (9690).
Cross References This section cited in 49 Pa. Code § 21.411 (relating to interpretations regarding the general functions of registered nurses—statement of policy); 49 Pa. Code § 21.412 (relating to interpretations regarding venipuncture, intravenous fluids, resuscitation and respiration—statement of policy); 49 Pa. Code § 21.413 (relating to interpretations regarding the administration of drugs—statement of policy); and 49 Pa. Code § 21.803 (relating to applicability of rules relating to professional nurses).
Notes of Decisions Nursing Care Actions
Where nurse had disconnected patient from respirator to perform unauthorized evaluation of spontaneous respiration, failed to perform external cardiac resuscitation, etc., subsection (a)(2) and (4) was not unconstitutionally vague with respect to nurse’s conduct since nurse’s actions were ‘‘unauthorized, contra-indicated and a serious deviation from acceptable nursing practice.’’ Rafferty v. State Board of Nurse Examiners, 471 A.2d 1339 (Pa. Cmwlth. 1984); reversed in part 499 A.2d 289 (Pa. 1995); on remand 505 A.2d 359 (Pa. Cmwlth. 1986).
A nurse violated subsection (a)(4) by leaving patient experiencing rare premature ventricular contractions failing to call code team when so instructed and failing to attach cardiac monitor strip to patient’s chart, but such actions did not constitute violations of 49 Pa. Code § 21.13 which merely establishes limitations on who may perform resuscitation and respiration and circumstances under which those procedures may be performed. State Board of Nurse Examiners v. Rafferty, 471 A.2d 1339 (Pa. Cmwlth. 1984); reversed in part 499 A.2d 289 (Pa. 1995); on remand 505 A.2d 359 (Pa. Cmwlth. 1986).
Nurse violated subsection (a)(4) by disconnecting comatose patient from respirator to check for spontaneous respirations, leaving patient without oxygen for 30 seconds, when there had been no special circumstances such as patient displaying signs of becoming conscious. State Board of Nurse Examiners v. Rafferty, 471 A.2d 1339 (Pa. Cmwlth. 1984); reversed in part 499 A.2d 289 (Pa. 1995); on remand 505 A.2d 359 (Pa. Cmwlth. 1986).
A nurse did not wilfully violate subsection (a)(4) in lightly slapping the hand of a patient who had a grip on her arm, since the nurse had to have the use of her arm in order to keep the patient from falling and other attempts to make the patient loosen his grip had failed. Leukhardt v. State Board of Nurse Examiners, 403 A.2d 645 (Pa. Cmwlth. 1979).
Vagueness
Where the Board of Nurse Examiners found no willful, repeated, deliberate or knowing violation, but merely acts which were deemed to deviate from accepted practice and errors of judgment, the court held that there was no violation of subsection (a) (1) and (4). Rafferty v. State Board of Nurse Examiners, 471 A.2d 1339 (Pa. Cmwlth. 1984); reversed in part 499 A.2d 289 (Pa. 1995); on remand 505 A.2d 359 (Pa. Cmwlth. 1986).
Willful Violations
Board of Nurse Examiners need not prove specific intent to violate the statute or regulations in order to establish a ‘‘willful’’ violation. State Board of Nurse Examiners v. Rafferty, 471 A.2d 1339 (Pa. Cmwlth. 1984); reversed in part 499 A.2d 289 (Pa. 1995); on remand 505 A.2d 359 (Pa. Cmwlth. 1986).
§ 21.12. Venipuncture; intravenous fluids.
Performing of venipuncture and administering and withdrawing intravenous fluids are functions regulated by this section, and these functions may not be performed unless:
(1) The procedure has been ordered in writing for the patient by a licensed doctor of the healing arts.
(2) The registered nurse who performs venipunctures has had instruction and supervised practice in performing venipunctures.
(3) The registered nurse who administers parenteral fluids, drugs or blood has had instruction and supervised practice in administering parenteral fluids, blood or medications into the vein.
(4) A list of medications which may be administered by the registered nurse is established and maintained by a committee of physicians, pharmacists and nurses from the employing agency or the agency within whose jurisdiction the procedure is being performed if no employing agency is involved.
(5) The intravenous fluid or medication to be administered is the fluid or medication specified in the written order.
(6) The blood is identified as the blood ordered for the patient.
(7) An accurate record is made concerning the following:
(i) The time of the injection.
(ii) The medication or fluid injected.
(iii) The amount of medication or fluid injected.
(iv) Reactions to the fluid.
Source The provisions of this § 21.12 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829. Immediately preceding text appears at serial pages (47492) and (44732).
Cross References This section cited in 49 Pa. Code § 21.412 (relating to interpretations regarding venipuncture, intravenous fluids, resuscitation and respiration—statement of policy); 49 Pa. Code § 21.413 (relating to interpretations regarding the administration of drugs—statement of policy); and 49 Pa. Code § 21.803 (relating to applicability of rules relating to professional nurses).
§ 21.13. Resuscitation and respiration.
External cardiac resuscitation and artificial respiration, mouth-to-mouth, are procedures regulated by this section, and these functions may not be performed unless both of the following provisions are met:
(1) External cardiac resuscitation and artificial respiration, mouth-to-mouth, shall only be performed by a nurse on an individual when respiration or pulse, or both, cease unexpectedly.
(2) A nurse may not perform external cardiac resuscitation and artificial respiration, mouth-to-mouth, unless the nurse has had instruction and supervised practice in performing the procedures.
Source The provisions of this § 21.13 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677. Immediately preceding text appears at serial page (9691).
Cross References This section cited in 49 Pa. Code § 21.803 (relating to applicability of rules relating to professional nurses).
Notes of Decisions Nurse violated 49 Pa. Code § 21.11(a)(4) by leaving patient experiencing rare premature ventricular contractions, failing to call code team when so instructed and failing to attach cardiac monitor strip to patient’s chart, but such actions did not constitute violations of § 21.13 which merely establishes limitations on who may perform resuscitation and respiration and circumstances under which those procedures may be performed. State Board of Nurse Examiners v. Rafferty, 471 A.2d 1339 (Pa. Cmwlth. 1984); reversed in part 499 A.2d 289 (Pa. 1995); on remand 505 A.2d 359 (Pa. Cmwlth. 1986).
§ 21.14. Administration of drugs.
(a) A licensed registered nurse may administer a drug ordered for a patient in the dosage and manner prescribed.
(b) A licensed registered nurse, responsible for administering a drug, may supervise a graduate nurse or a nursing student in an approved nursing education program in the administration of the drug. In this section, ‘‘supervise’’ means the licensed registered nurse is physically present in the area or unit where the student or unlicensed graduate is practicing. This definition is not intended to limit in any way the practice of practical nursing as defined in the Practical Nurse Law (63 P.S. § § 651—667).
Authority The provisions of this § 21.14 amended under section 2.1(k) of The Professional Nursing Law (63 P.S. § 212.1(k)); and section 17.6 of the Practical Nurse Law (63 P.S. § 667.6).
Source The provisions of this § 21.14 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended November 4, 1977, effective November 5, 1977, 7 Pa.B. 3263; amended December 19, 2003, effective December 20, 2003, 33 Pa.B. 6219. Immediately preceding text appears at serial pages (261719) to (261720).
Cross References This section cited in 28 Pa. Code § 107.64 (relating to administration of drugs); 49 Pa. Code § 21.413 (relating to interpretations regarding the administration of drugs—statement of policy); and 49 Pa. Code § 21.803 (relating to applicability of rules relating to professional nurses).
§ 21.15. Monitoring, defibrillating and resuscitating.
The use of monitoring, defibrillating or resuscitating equipment, or a combination of the three, hereinafter called ‘‘therapy,’’ is a proper function of a registered nurse and is a function regulated by this section; the function may not be performed unless all of the following provisions are met:
(1) The employer, through written policy, has agreed that the registered nurse may administer the therapy.
(2) A committee of licensed physicians and nurses within the employing agency has established written criteria prescribing when the therapy shall be administered by a registered nurse either in the presence or absence of the attending physician.
(3) The techniques for administering the therapy have been established by a committee of licensed physicians and registered nurses within the employing agency.
(4) The registered nurse has had instruction and supervised practice in administering the therapy.
(5) The registered nurse has demonstrated competency in administering the therapy to the satisfaction of the employer.
(6) The registered nurse shall have employed the prescribed techniques in administering the therapy in accordance with the established criteria.
Source The provisions of this § 21.15 amended November 19, 1970, effective November 20, 1970, 1 Pa.B. 804; amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677. Immediately preceding text appears at serial pages (9691) to (9692).
Cross References This section cited in 49 Pa. Code § 21.413 (relating to interpretations regarding the administration of drugs—statement of policy); and 49 Pa. Code § 21.803 (relating to applicability of rules relating to professional nurses).
§ 21.16. Immunizations.
(a) Immunization and skin testing is a proper function of a registered nurse and is a function regulated by this section, and the function may not be performed unless all of the following conditions are met:
(1) A written order has been issued by a licensed physician. The order may be a standing order applicable to individuals or groups.
(2) The policies and procedures under which the registered nurse may administer immunizing agents and do skin testing have been established by a committee representing the nurses, the physicians and the administration of the agency or institution. These written policies and procedures shall be available to the nurse. The committee shall also perform the following functions:
(i) Identify the immunizing and skin testing agents which the nurse may administer.
(ii) Determine contraindications for the administration of specific immunizing and skin testing agents.
(iii) Outline medical principles governing the treatment of possible anaphylactic reactions.
(iv) Establish instruction and supervised practice required to insure competency in administering immunizing and skin testing agents.
(b) Following skin testing, the size of the induration or its absence may be observed and recorded by the properly instructed registered nurse.
Source The provisions of this § 21.16 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677. Immediately preceding text appears at serial page (9692).
Cross References This section cited in 49 Pa. Code § 21.803 (relating to applicability of rules relating to professional nurses).
§ 21.17. Anesthesia.
The administration of anesthesia is a proper function of a registered nurse and is a function regulated by this section; this function may not be performed unless:
(1) The registered nurse has successfully completed the educational program of a school for nurse anesthetists accredited by the Council on Accreditation of Education Programs of Nurse Anesthesia of the American Association of Nurse Anesthetists.
(2) The registered nurse is certified as a Registered Nurse Anesthetist by the Council on Certification or on Recertification of Nurse Anesthetists of the American Association of Nurse Anesthetists.
(3) The certified nurse anesthetist is authorized to administer anesthesia in cooperation with a surgeon or dentist. The nurse anesthetist’s performance shall be under the overall direction of the chief or director of anesthesia services. In situations or health care delivery facilities where these services are not mandatory, the nurse anesthetist’s performance shall be under the overall direction of the surgeon or dentist responsible for the patient’s care.
(4) Except as otherwise provided in 28 Pa. Code § 123.7(c) (relating to dental anesthetist and nurse anesthetist qualifications), when the operating/anesthesia team consists entirely of nonphysicians, such as a dentist and a certified registered nurse anesthetist, the registered nurse anesthetist shall have available to her by physical presence or electronic communication an anesthesiologist or consulting physician of her choice.
(5) A noncertified registered nurse who has completed an approved anesthesia program may administer anesthesia under the direction of and in the presence of the chief or director anesthesia services or a Board certified anesthesiologist until the announcement of results of the first examination given for certification for which she is eligible. If a person fails to take or fails to pass the examination, the person shall immediately cease practicing as a nurse anesthetist. If the applicant, due to extenuating circumstances, cannot take the first scheduled examination following completion of the program, the applicant shall appeal to the Board for authority to continue practicing.
(b) For purposes of this section, ‘‘cooperation’’ means a process in which the nurse anesthetist and the surgeon work together with each contributing an area of expertise, at their individual and respective levels of education and training.
Source The provisions of this § 21.17 adopted October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2827. Immediately preceding text appears at serial page (81100).
Cross References This section cited in 49 Pa. Code § 21.803 (relating to applicability of rules relating to professional nurses).
Notes of Decisions Willful Violation
The provisions of 49 Pa. Code § 21.17 (relating to anesthesia) are wilfully violated even though a physician is present at the time the anesthetic is administered if the nurse administers the anesthetic without the physician’s direction or awareness. McCarl v. State Board of Nurse Examiners, 396 A.2d 866 (Pa. Cmwlth. 1979).
§ 21.18. Standards of nursing conduct.
(a) A registered nurse shall:
(1) Undertake a specific practice only if the registered nurse has the necessary knowledge, preparation, experience and competency to properly execute the practice.
(2) Respect and consider, while providing nursing care, the individual’s right to freedom from psychological and physical abuse.
(3) Act to safeguard the patient from the incompetent, abusive or illegal practice of any individual.
(4) Safeguard the patient’s dignity, the right to privacy and the confidentiality of patient information. This standard does not prohibit or affect reporting responsibilities under 23 Pa.C.S. Chapter 63 (relating to the Child Protective Services Law), the Older Adults Protective Services Act (35 P.S. § § 10211—10224) and other statutes which may mandate reporting of this information.
(5) Document and maintain accurate records.
(b) A registered nurse may not:
(1) Knowingly aid, abet or assist another person to violate or circumvent a law or Board regulation.
(2) Discriminate, while providing nursing services, on the basis of age, marital status, sex, sexual preference, race, religion, diagnosis, socioeconomic status or disability.
(3) Knowingly permit another individual to use his license or temporary permit for any purpose or knowingly permit the unlicensed person under the registered nurse’s jurisdiction or supervision to misrepresent that the individual is a licensed nurse.
(4) Misappropriate equipment, materials, property, drugs or money from an employer or patient.
(5) Solicit, borrow or misappropriate money, materials or property from a patient or the patient’s family.
(6) Leave a nursing assignment prior to the proper reporting and notification to the appropriate department head or personnel of such an action.
(7) Knowingly abandon a patient in need of nursing care. Abandonment is defined as the intentional deserting of a patient for whom the nurse is responsible.
(8) Falsify or knowingly make incorrect entries into the patient’s record or other related documents.
(9) Engage in conduct defined as a sexual violation or sexual impropriety in the course of a professional relationship.
(c) A registered nurse who fails to comply with an obligation or prohibition under this section is subject to disciplinary and corrective measures under section 14 of the act (63 P.S. § 224).
(d) The Board may, in addition to any other disciplinary or corrective measure set forth in this section, levy appropriate civil penalties as authorized by section 13(b) of the act (63 P.S. § 223(b)) upon a nurse found to have engaged in conduct constituting a sexual impropriety or sexual violation.
Authority The provisions of this § 21.18 amended under section 2.1(k) of The Professional Nursing Law (63 P.S. § 212.1(k)).
Source The provisions of this § 21.18 adopted April 30, 1993, effective May 1, 1993, 23 Pa.B. 2115; amended September 8, 2000, effective September 9, 2000, 30 Pa.B. 4730. Immediately preceding text appears at serial pages (261722) and (209951).
Cross References This section cited in 49 Pa. Code § 21.4a (relating to procedural matters); 49 Pa. Code § 21.288 (relating to CRNP standards of conduct); 49 Pa. Code § 21.369 (relating to general curriculum requirements); 49 Pa. Code § 21.803 (relating to applicability of rules relating to professional nurses); and 49 Pa. Code § 21.821 (relating to CNS standards of conduct).
§ 21.18a. Impaired professional program.
When the Board is empowered to take disciplinary or corrective action against a nurse for conduct defined as a sexual violation or sexual impropriety, the nurse will not be eligible for placement into an impaired professional program under section 14.1 of the act (63 P.S. § 224.1).
Authority The provisions of this § 21.18a issued under section 2.1(k) of The Professional Nursing Law (63 P.S. § 212.1(k)).
Source The provisions of this § 21.18a adopted September 8, 2000, effective September 9, 2000, 30 Pa.B. 4730.
Cross References This section cited in 49 Pa. Code § 21.803 (relating to applicability of rules relating to professional nurses).
LICENSES
§ 21.20. Licensure by examination.
An applicant for licensure by examination shall comply with the requirements of § 21.23 (relating to application for examination), pass the examination and complete at least 3 hours of approved training in child abuse recognition and reporting in accordance with § 21.508(a) (relating to child abuse recognition and reporting—mandatory training requirement).
Authority The provisions of this § 21.20 added under section 2.1(k) of The Professional Nursing Law (63 P.S. § 222.1(k)); section 17.6 of the Practical Nurse Law (63 P.S. § 667.6); and 23 Pa.C.S. § 6383(b)(2).
Source The provisions of this § 21.20 added March 25, 2022, effective March 26, 2022, 52 Pa.B. 1916.
§ 21.21. Application for examination.
(a) A candidate for the licensing examination may submit an application together with the required fee no sooner than 90 days prior to completing a professional nursing education program.
(b) A candidate will not be authorized to take the examination unless the candidate has satisfied the requirements of the act necessary for eligibility, including confirmation of completion of an approved professional nursing educational program.
(c) Graduates of professional nursing education programs outside of this Commonwealth shall file an official transcript validating program completion with the application.
(d) An applicant seeking a waiver of the 1-year requirement in § 21.23(c) (relating to qualifications of applicant for examination) shall submit documentation to demonstrate that an emergency, illness, military service or other good cause prevented compliance, or that the candidate holds a license to practice nursing in another state or country.
Authority The provisions of this § 21.21 issued under section 506 of The Administrative Code of 1929 (71 P.S. § 186); and section 1 of The Professional Nursing Law (63 P.S. § 212.1); amended under section 812.1 of The Administrative Code of 1929 (71 P.S. § 279.3a); and section 2.1(k) of The Professional Nursing Law (63 P.S. § 212.1(k)).
Source The provisions of this § 21.21 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended March 20, 1981, effective March 21, 1981, 11 Pa.B. 1027; amended April 29, 1983, effective April 30, 1983, 13 Pa.B. 1439; amended June 8, 1990, effective June 9, 1990, 20 Pa.B. 3078; amended December 16, 2016, effective December 17, 2016, 46 Pa.B. 7822. Immediately preceding text appears at serial page (351271).
§ 21.22. [Reserved].
Authority The provisions of this § 121.22 issued under section 506 of The Administrative Code of 1929 (71 P.S. § 186); and section 1 of The Professional Nursing Law (63 P.S. § 212.1); reserved under section 2.1(k) of The Professional Nursing Law (63 P.S. § 212.1(k)).
Source The provisions of this § 121.22 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended April 29, 1983, effective April 30, 1983, 13 Pa.B. 1439; reserved December 16, 2016, effective December 17, 2016, 46 Pa.B. 7822. Immediately preceding text appears at serial page (351271).
§ 21.23. Qualifications of applicant for examination.
(a) An applicant shall demonstrate proficiency in English by submitting proof that the applicant’s nursing education program was conducted in English or that the applicant has, prior to being approved to take the licensure examination, received a passing score on a Board-approved English proficiency examination, unless the applicant has already met this requirement in satisfaction of § 21.7(b)(2) (relating to temporary practice permits). The Board will make available a list of Board-approved English proficiency examinations on its web site.
(b) An applicant who graduated from a professional nursing education program in a country or territory outside of the United States or Canada shall have the applicant’s education evaluated by a Board-approved foreign credentials evaluator to determine whether the education obtained is equivalent to the program of study required in this Commonwealth at the time the program was completed.
(c) A candidate for licensure shall take the examination for the first time within 1 year of completing the professional nursing education program unless prevented by emergency, illness, military service or other good cause shown, or the candidate holds a license to practice nursing in another state or country.
Authority The provisions of this § 21.23 issued under section 506 of The Administrative Code of 1929 (71 P.S. § 186); and section 1 of The Professional Nursing Law (63 P.S. § 212.1); amended under section 2.1(k) of The Professional Nursing Law (63 P.S. § 212.1(k)).
Source The provisions of this § 21.23 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended May 22, 1981, effective May 23, 1981, 11 Pa.B. 1802; amended April 29, 1983, effective April 30, 1983, 13 Pa.B. 1439; amended December 16, 2016, effective December 17, 2016, 46 Pa.B. 7822. Immediately preceding text appears at serial pages (351271) to (351272).
Cross References This section cited in 49 Pa. Code § 21.7 (relating to temporary practice permits); 49 Pa. Code § 21.20 (relating to licensure by examination); and 49 Pa. Code § 21.21 (relating to application for examination).
§ 21.24. Passage of the licensure examination.
The candidate for licensure shall pass the licensure examination approved by the Board.
Authority The provisions of this § 21.24 issued under section 506 of The Administrative Code of 1929 (71 P.S. § 186); and section 1 of The Professional Nursing Law (63 P.S. § 212.1); amended under section 2.1(k) of The Professional Nursing Law (63 P.S. § 212.1(k)).
Source The provisions of this § 21.24 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended April 29, 1983, effective April 30, 1983, 13 Pa.B. 1439; amended December 16, 2016, effective December 17, 2016, 46 Pa.B. 7822. Immediately preceding text appears at serial page (351272).
§ 21.25. Re-examination.
(a) A candidate shall submit a re-examination application, including the required fee for re-examination.
(b) The candidate may take the licensing examination as many times as necessary to pass the licensure examination.
(c) Candidates who apply for re-examination 2 years or more after initial examination shall satisfy the administrative and education requirements prevailing at the time of reapplication.
Authority The provisions of this § 21.25 issued under section 506 of The Administrative Code of 1929 (71 P.S. § 186); and section 1 of The Professional Nursing Law (63 P.S. § 212.1); amended under section 2.1(k) of The Professional Nursing Law (63 P.S. § 212.1(k)).
Source The provisions of this § 21.25 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended April 29, 1983, effective April 30, 1983, 13 Pa.B. 1439; amended December 16, 2016, effective December 17, 2016, 46 Pa.B. 7822. Immediately preceding text appears at serial pages (351272) and (378843).
§ 21.26. [Reserved].
Source The provisions of this § 21.26 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829; reserved April 24, 2009, effective April 25, 2009, 39 Pa.B. 2103. Immediately preceding text appears at serial page (238267).
§ 21.27. [Reserved].
Authority The provisions of this § 21.27 reserved under section 2.1(k) of The Professional Nursing Law (63 P.S. § 212.1(k)).
Source The provisions of this § 21.27 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829; reserved December 16, 2016, effective December 17, 2016, 46 Pa.B. 7822. Immediately preceding text appears at serial page (378843).
§ 21.28. Licensure by endorsement.
(a) A registered nurse who has graduated from an approved professional nursing education program in the United States or Canada and who obtained licensure in another jurisdiction having passed an examination considered by the Board to be equivalent to the examination required for licensure in this Commonwealth may be granted licensure by endorsement.
(b) An applicant for licensure by endorsement shall meet the requirements as stated in the act.
(c) A registered nurse who has graduated from a professional nursing education program in a country or territory outside of the United States or Canada deemed equivalent to the program of study required in this Commonwealth at the time the program was completed and who obtained licensure in that country or territory upon having passed an examination considered by the Board to be equivalent to the examination required for licensure in this Commonwealth may be granted licensure by endorsement without examination. The Board will base educational equivalency upon an evaluation administered by a Board-approved foreign credentials evaluator.
(d) An applicant for licensure by endorsement whose license in the other jurisdiction is not current for 5 years or longer shall, prior to receiving a license in this Commonwealth, satisfy the requirements of § 21.30a(a)(1) or (2) (relating to continued competency).
(e) An applicant for licensure by endorsement shall demonstrate proficiency in English by submitting proof that the applicant’s nursing education program was conducted in English or that the applicant received a passing score on a Board-approved English proficiency examination unless the applicant has met this requirement in satisfaction of § 21.7(b)(2) (relating to temporary practice permits). The Board will make available a list of Board-approved English proficiency examinations on its web site.
(f) An applicant for licensure by endorsement shall complete at least 3 hours of approved training in child abuse recognition and reporting in accordance with § 21.508(a) (relating to child abuse recognition and reporting—mandatory training requirement).
Authority The provisions of this § 21.28 amended under 2.1(k) of The Professional Nursing Law (63 P.S. § 212.1(k)); section 17.6 of the Practical Nurse Law (63 P.S. § 667.6); and 23 Pa.C.S. § 6383(b)(2).
Source The provisions of this § 21.28 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829; amended March 22, 1991, effective March 23, 1991, 21 Pa.B. 1165; amended June 18, 1993, effective June 19, 1993, 23 Pa.B. 2827; amended November 28, 1997, effective November 29, 1997, 27 Pa.B. 6210; amended December 16, 2016, effective December 17, 2016, 46 Pa.B. 7822; amended March 25, 2022, effective March 26, 2022, 52 Pa.B. 1916. Immediately preceding text appears at serial pages (385121) to (385122).
Cross References This section cited in 49 Pa. Code § 21.7 (relating to temporary practice permits); 49 Pa. Code § 21.118 (relating to post-basic nursing programs); and 49 Pa. Code § 21.134 (relating to continuing education sources).
§ 21.29. Expiration and renewal of license.
(a) The Board will assign registered nurses to one of the following license expiration dates:
(1) April 30 in the even-numbered years.
(2) October 31 in the even-numbered years.
(3) April 30 in the odd-numbered years.
(4) October 31 in the odd-numbered years.
(b) Notice of the renewal period of a license will be sent to each active licensee prior to the expiration date of the licensee’s license.
(c) The applicant for license renewal may complete and submit an application online or may mail a completed application form to the Board’s administrative office. When applying for licensure renewal, a registered nurse shall:
(1) Complete and submit the renewal application, including disclosing any license to practice nursing or any allied health profession in any other state, territory, possession or country.
(2) Pay the biennial renewal of licensure fee in § 21.5 (relating to fees).
(3) Verify that the registered nurse has complied with the continuing education requirements mandated by section 12.1 of the act (63 P.S. § 222) during the biennial period immediately preceding the application for renewal in accordance with § § 21.131—21.134 (relating to continuing education). School nurses, who as certified education specialists are required to obtain continuing professional education under the Public School Code of 1949 (24 P.S. § § 1-101—27-2702), shall verify by signed statement that the school nurse has complied with the continuing education requirements for certification by the Department of Education.
(3.1) Ensure that the registered nurse has completed at least 2 hours of approved training in child abuse recognition and reporting in accordance with § 21.508(b) (relating to child abuse recognition and reporting—mandatory training requirement).
(4) Disclose any discipline imposed by a state licensing board on any nursing or allied health profession license or certificate in the previous biennial period and any criminal charges pending or criminal conviction, plea of guilty or nolo contendere, or admission into a probation without verdict or accelerated rehabilitative disposition during the previous biennial period unless prior notification has been made under § 21.29a (relating to reporting of crimes and disciplinary action).
(d) When communicating with the Board, licensees shall identify themselves by full name, current address and license number.
Authority The provisions of this § 21.29 amended under sections 2.1, 11 and 12.1(a) of The Professional Nursing Law (63 P.S. § § 212.1, 221 and 222(a)); section 17.6 of the Practical Nurse Law (63 P.S. § 667.6); and 23 Pa.C.S. § 6383(b)(2).
Source The provisions of this § 21.29 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829; amended March 22, 1985, effective March 23, 1985, 15 Pa.B. 1082; amended July 11, 2008, effective July 12, 2008, 38 Pa.B. 3796; amended October 16, 2015, effective October 17, 2015, 45 Pa.B. 6196; amended December 16, 2016, effective December 17, 2016, 46 Pa.B. 7822; amended March 25, 2022, effective March 26, 2022, 52 Pa.B. 1916. Immediately preceding text appears at serial pages (385122) and (396891).
Cross References This section cited in 49 Pa. Code § 21.29a (relating to reporting of crimes and disciplinary action); 49 Pa. Code § 21.331 (relating to biennial renewal of certification); and 49 Pa. Code § 21.822 (relating to biennial renewal of certification).
§ 21.29a. Reporting of crimes and disciplinary action.
(a) A registered nurse shall notify the Board of pending criminal charges within 30 days of the filing of the criminal charges or on the biennial renewal application under § 21.29(c)(4) (relating to expiration and renewal of license), whichever is sooner.
(b) A registered nurse shall notify the Board of a criminal conviction, plea of guilty or nolo contendere, or an admission into a probation without verdict or accelerated rehabilitative disposition program within 30 days of the disposition or on the biennial renewal application under § 21.29(c)(4), whichever is sooner.
(c) A registered nurse shall notify the Board of disciplinary action in the nature of a final order taken against the registered nurse by the licensing authority of another state, territory or country within 90 days of receiving notice of the disciplinary action, or on the biennial renewal application under § 21.29(c)(4), whichever is sooner.
Authority The provisions of this § 21.29a issued under sections 2.1(k) and 12.1(a) of The Professional Nursing Law (63 P.S. § § 212.1(k) and 222(a)).
Source The provisions of this § 21.29a adopted October 16, 2015, effective October 17, 2015, 45 Pa.B. 6196.
Cross References This section cited in 49 Pa. Code § 21.29 (relating to expiration and renewal of license).
§ 21.29b. Reporting of address changes.
A registered nurse shall notify the Board within 14 days of a change of address.
Authority The provisions of this § 21.29b issued under section 2.1(k) of The Professional Nursing Law (63 P.S. § 212.1(k)).
Source The provisions of this § 21.29b adopted December 16, 2016, effective December 17, 2016, 46 Pa.B. 7822.
§ 21.30. Registered nurses licensed outside of the United States or Canada.
(a) A registered nurse educated and licensed outside of the United States or Canada may not practice professional nursing in this Commonwealth until the registered nurse is issued a license or temporary practice permit by the Board.
(b) A graduate nurse licensed in another country may participate in an accredited graduate program in nursing for 2 years without licensure and compensation in this Commonwealth.
Authority The provisons of this § 21.30 amended under section 2.1(k) of The Professional Nursing Law (63 P.S. § 212.1(k)).
Source The provisions of this § 21.30 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended June 17, 1977, effective June 18, 1977, 7 Pa.B. 1641; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829; amended December 16, 2016, effective December 17, 2016, 46 Pa.B. 7822. Immediately preceding text appears at serial page (378846).
Cross References This section cited in 49 Pa. Code § 21.5 (relating to fees); and 49 Pa. Code § 21.822 (relating to biennial renewal of certification).
§ 21.30a. Continued competency.
(a) A registered nurse whose license has lapsed for 5 years or longer or has been placed on inactive status for 5 years or longer, as permitted in section 11(b) of the act (63 P.S. § 221(b)), may reactivate the license by doing one of the following:
(1) Successfully completing the initial licensing examination approved by the Board and submitting the examination fee in § 21.5 (relating to fees).
(2) Successfully completing a Board-approved reactivation program, which requires passage of a nursing achievement examination.
(3) Providing evidence to the Board that the applicant has a current license and has practiced as a registered nurse in another jurisdiction at some period of time within the last 5 years.
(b) A registered nurse whose license has been suspended for 5 years or longer may reactivate the license after complying with the terms of the suspension Order by doing either of the following:
(1) Successfully completing the initial licensing examination approved by the Board and submitting the examination fee in § 21.5.
(2) Successfully completing a Board-approved reactivation program which requires passage of a nursing achievement examination.
Authority The provisions of this § 21.30a amended under section 2.1(k) of The Professional Nursing Law (63 P.S. § 212.1(k)).
Source The provisions of this § 21.30a adopted June 18, 1993, effective June 19, 1993, 23 Pa.B. 2827; amended December 16, 2016, effective December 17, 2016, 46 Pa.B. 7822. Immediately preceding text appears at serial pages (378846) and (346571).
Cross References This section cited in 49 Pa. Code § 21.28 (relating to licensure by endorsement); 49 Pa. Code § 21.332a. (relating to inactive status and reactivation); and 49 Pa. Code § 21.602 (relating to volunteer license).
APPROVAL OF SCHOOLS OF NURSING
§ 21.31. Surveys; list of approved nursing education programs.
(a) Survey visits are made of basic nursing programs conducted in hospitals, colleges or universities of exchange visitor programs and of cooperating agencies. In this section, ‘‘cooperating agency’’ means an educational institution or health care delivery system which cooperates with the controlling institution. The survey report is presented to the Board and a written report of recommendations or requirements, or both, is sent to the school, college or university.
(b) Classified lists of approved schools of nursing and of exchange visitor programs are compiled and published annually and are made available for distribution.
(c) A list of approved cooperating agencies that provide educational programs for schools of nursing is compiled and published annually and is made available for distribution.
(d) For purposes of activities relating to the approval and status of nursing education programs, the term ‘‘Board’’ used in this subchapter may mean the Board’s educational advisors appointed under section 2.1(i) of the act (63 P.S. § 212.2(i)). Only the Board may, by a majority vote, confer initial approval status on a proposed nursing education program, extend the maximum 2-year period for correction of deficiencies or remove a program from the approved list.
Authority The provisions of this § 21.31 amended under sections 2.1(k) and 6.1 of The Professional Nursing Law (63 P.S. § § 212.1(k) and 216.1); and sections 9 and 17.6 of the Practical Nurse Law (63 P.S. § § 659 and 667.6).
Source The provisions of this § 21.31 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829; amended April 24, 2009, effective April 25, 2009, 39 Pa.B. 2103. Immediately preceding text appears at serial page (335523).
§ 21.32. Objectives.
Nursing schools in this Commonwealth are approved to effectuate the following:
(1) Safeguard the preparation of nurses and assure safe standards of nursing practice in this Commonwealth.
(2) Stimulate and maintain continued growth and improvement of nursing education in this Commonwealth.
(3) Guide prospective students in the selection of approved schools which offer adequate resources for sound basic nursing education.
(4) Assure the graduates of nursing programs of eligibility for admission to examination for licensure.
(5) Assist graduates of schools of nursing in this Commonwealth to qualify for licensure by endorsement in other jurisdictions.
Source The provisions of this § 21.32 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677. Immediately preceding text appears at serial page (9696).
§ 21.33. Types of approval.
(a) The Board grants the following types of approval to nursing education programs:
(1) Initial. The Board may grant initial approval to a new nursing education program, with evidence that the standards of this subchapter are being met, for a period of time necessary to evaluate the results of the licensing examination taken by the first cohort of graduates. A program will not be placed on full approval status until it has graduated its first class and the class has achieved an acceptable rate of passing the National licensure examination, as set forth in § 21.33b (relating to minimum rate for graduates of nursing education programs to pass the National licensure examination). A program on initial approval status that fails to achieve an acceptable rate of passing the National licensure examination upon graduation of its first class will be placed on provisional approval status.
(2) Full. The Board will place on full approval a nursing education program which attains and maintains the standards of this subchapter.
(3) Provisional. The Board may place on provisional approval a nursing education program not meeting the standards of this subchapter. A nursing education program on full approval status will be placed on provisional approval status if the program fails to meet the provisions of § 21.33b.
(b) A nursing education program shall notify applicants for admission of the program’s approval status and, within 30 days of a change of status, shall notify applicants and students by electronic mail or first class mail that the program’s approval status has changed. The program shall provide the Board with a copy of the notice sent to applicants and students. A program shall provide additional notice to applicants and students at the direction of the Board.
Authority The provisions of this § 21.33 amended under sections 2.1(k) and 6.1 of The Professional Nursing Law (63 P.S. § § 212.1(k) and 216.1); and sections 9 and 17.6 of the Practical Nurse Law (63 P.S. § § 659 and 667.6).
Source The provisions of this § 21.33 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829; amended April 24, 2009, effective April 25, 2009, 39 Pa.B. 2103. Immediately preceding text appears at serial page (335524).
Cross References This section cited in 49 Pa. Code § 21.51 (relating to establishment).
§ 21.33a. Failure to comply with standards.
(a) If the Board receives information suggesting that a nursing education program has not maintained the standards of this subchapter, the Board will validate the information and will notify the program, in writing, of the alleged deficiency. The Board may request information from the program or conduct an announced or unannounced site visit before notifying the program of the alleged deficiency. The Board may informally resolve any deficiency.
(b) The Board will notify a program, in writing, that the program will be placed on provisional approval status.
(c) The Board will notify a program on provisional approval status, in writing, of the deficiencies and the amount of time that will be allowed for correction of the deficiencies that resulted in the program’s placement on provisional approval status. The Board may extend the time period for correction of deficiencies at its discretion if the program is making demonstrable progress toward the correction of deficiencies. If additional deficiencies are identified, the existing provisional period may be extended at the discretion of the Board.
(d) The Board may place restrictions on a nursing education program on provisional approval status as deemed necessary by the Board to bring the program into compliance with this subchapter and will notify the program, in writing, of the restrictions.
(e) The Board may require that a nursing education program on provisional approval status prepare and submit additional reports and will notify the program, in writing, of the reports required.
(f) The Board may make announced or unannounced site visits to a nursing education program on provisional approval status.
(g) A period of 2 years will be the maximum time period allowed for the correction of deficiencies that returns the program to compliance with the regulations. A program may petition the Board for extension of the maximum period and the Board may, by majority vote, extend the period for good cause demonstrated by the program.
(h) If the standards of this subchapter are met within the designated time, the nursing education program will be removed from provisional approval status. The Board will notify the program in writing of this action.
(i) If the standards of this subchapter are not met within the designated time, the nursing education program will be removed from the approved list as provided in § 21.34 (relating to removal from approved list).
(j) Within 10 days of service of a request under subsection (a) or (e) or notice of the imposition of a restriction under subsection (d), a nursing education program may appeal the action of the staff as provided in 1 Pa. Code § 35.20 (relating to appeals from actions of the staff).
(k) The failure of a program to cooperate with the Board by failing to provide requested information or reports, by refusing or limiting a site visit, or by refusing to adhere to restrictions mandated by the Board will be considered a violation of the standards for nursing education programs and may result in immediate referral of the program to the prosecution division to consider formal action to remove the program from the approved list as provided in § 21.34.
Authority The provisions of this § 21.33a adopted under sections 2.1(k) and 6.1 of The Professional Nursing Law (63 P.S. § § 212.1(k) and 216.1); and sections 9 and 17.6 of the Practical Nurse Law (63 P.S. § § 659 and 667.6).
Source The provisions of this § 21.33a adopted April 24, 2009, effective April 25, 2009, 39 Pa.B. 2103.
§ 21.33b. Minimum rate for graduates of nursing education programs to pass the National licensure examination.
A nursing education program shall prepare its graduates to pass the National licensure examination at a rate at least equal to the minimum rate set by the Board. The minimum rate for graduates to pass the National licensure examination are as follows:
(1) A nursing education program shall achieve and maintain a minimum pass rate of 60% or more of its first-time examinees during an examination year.
(2) Beginning on October 1, 2009, a nursing education program shall achieve and maintain a minimum pass rate of 70% or more of its first-time examinees during an examination year.
(3) Beginning on October 1, 2010, a nursing education program shall achieve and maintain a minimum pass rate of 80% or more of its first-time examinees during an examination year.
Authority The provisions of this § 21.33b adopted under sections 2.1(k) and 6.1 of The Professional Nursing Law (63 P.S. § § 212.1(k) and 216.1); and sections 9 and 17.6 of the Practical Nurse Law (63 P.S. § § 659 and 667.6).
Source The provisions of this § 21.33b adopted April 24, 2009, effective April 25, 2009, 39 Pa.B. 2103.
Cross References This section cited in 49 Pa. Code § 21.33 (relating to types of approval).
§ 21.34. Removal from approved list.
(a) The Board may remove a nursing education program from the approved list in accordance with the following procedures if the program fails to meet and maintain minimum standards, including the minimum passing rates on the National licensure examination, as established by this subchapter.
(1) The Board will give a nursing education program notice of its intent to remove the program from the approved list.
(2) The notice of intent to remove a program from the approved list will set forth the alleged violations of the standards for nursing education programs.
(3) A program served with notice of intent to remove will be given 45 days in which to file a written answer to the notice.
(4) The nursing education program will be provided an opportunity to appear at a hearing to demonstrate why approval should not be withdrawn.
(5) The nursing education program and the Commonwealth will be provided an opportunity to file post-hearing briefs.
(6) The Board will issue a written decision which will set forth findings of fact and conclusions of law.
(7) The Board’s written decision is a final decision of a governmental agency subject to review under 2 Pa.C.S. § 702 (relating to appeals).
(b) If a nursing education program is removed from the approved list, the controlling institution shall provide for the completion of the program for students currently enrolled by placing the students in an approved program.
(c) If a nursing education program is removed from the approved list, the controlling institution shall make provision for permanent retention of student and graduate records in conformance with § § 21.123 and 21.125 (relating to access and use of records; and custody of records).
(d) If a nursing education program is removed from the approved list, the program shall give students notice of the protection granted under section 6.2(a) of the act (63 P.S. § 216.2(a)).
Authority The provisions of this § 21.34 amended under sections 2.1(k) and 6.1 of The Professional Nursing Law (63 P.S. § § 212.1(k) and 216.1); and sections 9 and 17.6 of the Practical Nurse Law (63 P.S. § § 659 and 667.6).
Source The provisions of this § 21.34 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829; amended April 24, 2009, effective April 25, 2009, 39 Pa.B. 2103. Immediately preceding text appears at serial page (335524).
Cross References This section cited in 49 Pa. Code § 21.33a (relating to failure to comply with standards).
DISCONTINUANCE OF A SCHOOL OF NURSING
§ 21.41. Notification; completion of program; records.
(a) Written notification of intent to discontinue a program of nursing shall be submitted to the Board within a reasonable time, but not less than 6 months prior to discontinuance.
(b) When a class is not admitted in a given year, the nursing program shall close unless approval has been granted by the Board based on the justification for continuation submitted to the Board.
(c) If a program is discontinued, it is the responsibility of the controlling institution to provide for the completion of the program for students currently enrolled, either by placing the students in an approved program or continuing the enrolled classes until completion. If the program is continued until completion, approved and qualified instruction shall be assured. A controlling institution is a university, college or hospital which conducts programs of education in nursing.
(d) The controlling institution has the legal responsibility to make provision for permanent retention of student and graduate records in conformity of § 21.125 (relating to custody of records).
Source The provisions of this § 21.41 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829. Immediately preceding text appears at serial page (30246).
Cross References This section cited in 49 Pa. Code § 21.364 (relating to removal from approved list; discontinuance of CRNP program).
APPROVED PROGRAMS OF NURSING
§ 21.51. Establishment.
(a) A nursing education program shall be developed under the leadership of a registered nurse as follows:
(1) A nursing education program may be developed under the authority of a regionally accredited university or college and will be known as a degree-granting nursing education program.
(2) A nursing education program may be developed under the authority of a hospital approved by the Joint Commission on Accreditation of Hospitals and will be known as a diploma nursing education program.
(3) A Board-approved diploma nursing education program may transition to a degree-granting nursing education program under the authority of a university or college pursuing regional accreditation and will be known as a program in transition.
(b) A nursing education program may be developed only if there is an adequate faculty and adequate clinical facilities and the philosophy of the parent institution encompasses dual programs of education.
(c) Prior to establishment or transition, a nursing education program shall:
(1) Complete a feasibility study which includes:
(i) Sufficient statistical data to support the need for a program within the community and to assure availability of an adequate supply and flow of interested candidates.
(ii) Identification of available clinical recourses for program implementation based on the projected enrollment and faculty. In viewing the clinical resources, the study must speak to other nursing education programs that share the teaching facilities identified in the study.
(iii) Letters of intent from the cooperating agencies indicating positive commitment to the nursing education program and the availability of sufficient clinical resources to meet the educational requirements of the program.
(iv) Actual cost of the program including faculty needed, clinical teaching resources, education supplies, office supplies, and the like, and sufficient evidence of stable financial support.
(2) Submit 18 copies of the feasibility study to the Board for approval.
(3) Employ the nurse administrator of the educational unit at least 12 months prior to the intended admission date of students. Board approval of the nurse administrator’s credentials shall be obtained prior to the appointment. For a program in transition, the nurse administrator may serve as administrator of both the degree-granting and diploma nursing education program during the transition period.
(4) Submit 18 copies of the tentative planned education program to the Board. For degree-granting and diploma nursing education programs, the submission shall be made at least 8 months prior to the intended admission date of students. For a program in transition, the submission shall be made at least 3 months prior to the intended admission date of students.
(5) Employ the teaching faculty at least 1 semester before the initiation of their teaching responsibilities.
(d) Change of ownership shall be processed as the establishment of a new program.
(e) The planned educational program must include:
(1) Organization and administrative policies of the controlling institution.
(2) Administrative structure and functions of the nursing school.
(3) Educational preparation and nursing experience of faculty members employed.
(4) Statement of the philosophy, purposes and objectives of the program.
(5) Proposed curriculum design based on sound educational concepts and including detailed course descriptions and identification of clinical practice.
(6) Admission policies.
(7) Educational standards.
(8) Copy of proposed budget projected for a minimum of 5 years.
(9) Copies of written agreements with cooperating agencies and facilities to be used in the program.
(f) A program in transition shall submit the following to the Board with the program’s feasibility study:
(1) A copy of the certificate of authority to operate a degree-granting institution from the Department of Education.
(2) Documentation of the university or college’s pursuit of regional accreditation.
(3) Documentation that the diploma program has maintained full approval status under § 21.33 (relating to types of approval) for at least 3 years prior to the intended date for admission of students.
(g) A program in transition shall:
(1) Submit an annual report detailing the progress of the transition to the Board. If requested by the Board’s educational advisor, a program in transition shall appear before the Board to respond to questions or concerns that arise from the annual progress report.
(2) Be subject to a site review by the Board’s education advisor after the first class has been awarded degrees and the results of the licensing examination taken by the first class are available.
(3) Continue on initial approval under § 21.33(a) until the university or college has obtained full regional accreditation.
(h) Following the review of the program and before final Board action is taken to grant permission to recruit students, an initial faculty and nursing education program survey will be made by a nursing educational advisor of the Board.
Authority The provisions of this § 21.51 amended under sections 2.1(k) and 6.1 of The Professional Nursing Law (63 P.S. § § 212.1(k) and 216.1).
Source The provisions of this § 21.51 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829; amended December 2, 2005, effective December 3, 2005, 35 Pa.B. 6527. Immediately preceding text appears at serial pages (209959) to (209960).
ORGANIZATION AND ADMINISTRATION OF NURSING PROGRAMS
§ 21.61. Baccalaureate and associate degree programs: organizational requirements.
(a) The educational unit in nursing shall be established as a department, division, school or college of the controlling institution in accordance with the structural plan of the institution.
(b) Relationships with central administrative officers, interrelationships among other disciplines and services of the institution and representation on institutional councils and committees for faculty of the educational unit in nursing shall be consistent with the interaction and responsibilities accorded to other faculty members of the institution.
(c) Adequate funds shall be allocated and properly budgeted for the sound and effective operation of the program.
(d) Policies in effect for faculty members of the educational unit in nursing shall be those in effect for faculty members throughout the controlling institution, except where specified otherwise in this chapter.
(e) The educational unit in nursing shall have administrative authority and responsibility consonant with the general policies of the controlling institution.
(f) The resources, facilities and services of the controlling institution shall be available to and used by the educational unit in nursing and shall be adequate to meet the needs of the faculty and the students.
(g) Cooperating agencies shall be subject to the following provisions:
(1) Agreements to utilize field agencies outside the structural control of the controlling institution shall be initiated by the educational unit in nursing.
(2) Cooperating agencies or services selected by the school shall be approved by the appropriate State and National bodies, if such exist.
(3) The agreement between the educational unit in nursing and the cooperating agency shall be developed jointly, recorded in writing, reviewed periodically by both parties, revised as occasion requires and consistently adhered to by those responsible for implementing the provisions.
(4) The agreement shall insure full control of student education by the faculty of the program; faculty shall have the freedom to teach and guide students and to select appropriate learning experiences in consultation with designated members of the agency staff.
(5) The field agencies selected for use shall have the quality and variety of resources for planned learning experiences needed for the program of the educational unit in nursing.
(6) Approval by the Board shall be obtained before the educational unit in nursing may utilize a new field agency for learning experiences. An Agency Data form, provided by the Board, shall be submitted for each new field agency used for the first time.
(h) The faculty of the educational unit in nursing shall conduct planned periodic evaluation of its organization and administration.
Source The provisions of this § 21.61 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829. Immediately preceding text appears at serial pages (30247) to (30248).
§ 21.62. Diploma programs; organizational requirements.
(a) The nursing school shall be established as an educational unit of the governing body.
(b) Adequate funds shall be allocated and properly budgeted for sound and effective operation of the school.
(c) The organizational plan for the school of nursing shall provide for relationships with the governing body, individuals and cooperating agencies responsible for and participating in the school operation.
(d) The authority and the administrative responsibility for the school shall be delegated by the governing body to the director of the school.
(e) The faculty shall formulate policies that relate to the operation of the school.
(f) Approval by the Board shall be obtained before the educational unit in nursing may utilize a cooperating agency or a new field agency for learning experiences. An Agency Data form, provided by the Board, shall be submitted for each new cooperating agency and field agency.
Source The provisions of this § 21.62 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677. Immediately preceding text appears at serial pages (9699) to (9700).
§ 21.63. Diploma programs utilizing cooperating agencies.
(a) Cooperating agencies within this Commonwealth shall be subject to the following:
(1) The agreement between the educational unit in nursing and the cooperating agency shall be developed jointly, recorded in writing, reviewed periodically by both parties, revised as occasion requires and consistently adhered to by those responsible for implementing the provisions.
(2) Cooperating agencies on the approved list shall submit changes on curriculum content to the Board for approval before schools are notified of the changes.
(b) Cooperating agencies outside of this Commonwealth shall be subject to the following:
(1) The state board of nursing of the state in which the cooperating agency is located shall be contacted to determine the approval status of that agency in that state. Only fully approved programs may be considered.
(2) The school wishing to establish agreements with a cooperating agency shall initiate meetings with the proposed cooperating agency to determine:
(i) Compatibility of the educational philosophy and objectives of the cooperating agency with those of the parent school.
(ii) Effectiveness with which the planned program of the cooperating agency can be utilized as a part of the total educational program of the school.
(iii) Quality of the faculty of the cooperating agency.
(iv) Ability of the cooperating agency to absorb an additional affiliating school.
(3) Following the exploratory meetings, the school shall submit written notification of intent to establish an affiliation with the cooperating agency for Board approval. The following shall accompany the letter of intent:
(i) A copy of the master curriculum plan of the school indicating the placement of the proposed program.
(ii) A copy of the course syllabus offered by the cooperating agency.
(iii) Faculty biographical forms on all faculty in the cooperating agency.
(iv) One copy of the annual report form required by the Board, completed by the cooperating agency.
(v) A copy of the agreement or contract between the cooperating agency and the affiliating school.
(vi) A list of affiliating schools utilizing the cooperating agency.
(c) A cooperating agency providing faculty and instruction for clinical nursing courses shall be responsible for submitting 15 copies of proposed curriculum changes to the Board prior to the announcement of change to the affiliating school.
(d) Diploma schools of nursing utilizing their own faculties shall be subject to the following provisions:
(1) Agreements to utilize field agencies outside the structural control of the controlling institution shall be initiated by the school of nursing.
(2) Cooperating agencies or services selected by the school shall be approved by the appropriate State and National bodies, if such exist.
(3) The agreement between the school of nursing and the cooperating agency shall be developed jointly, recorded in writing, reviewed periodically by both parties, revised as occasion requires and consistently adhered to by those responsible for implementing the provisions.
(4) The agreement shall insure full control of student education by the faculty of the program. The faculty shall have the freedom to teach and guide students and to select appropriate learning experiences in consultation with designated members of the agency staff.
(5) The field agencies selected for use shall have the quality and variety of resources for planned learning experiences needed for the purpose of the program of the school of nursing.
Source The provisions of this § 21.63 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829. Immediately preceding text appears at serial pages (30249) to (30250).
ADMINISTRATIVE AND INSTRUCTIONAL PERSONNEL
§ 21.71. Nurse administrator, faculty and staff requirements.
(a) A nursing education program shall employ a sufficient number of qualified faculty, faculty assistants, allied faculty and staff to accomplish the objectives of the curriculum and the systematic evaluation plan. The minimum faculty and staff requirements are as follows:
(1) Full-time nurse administrator.
(2) Full-time faculty members in the areas of practice encompassed within the curriculum.
(3) Additional faculty members as needed.
(4) Allied faculty members as needed.
(5) Adequate personnel to provide program support services, including administrative, clerical, library, admissions, financial aid and student services.
(b) The nurse administrator’s credentials shall be submitted to the Board for approval. The nurse administrator’s qualifications are as follows:
(1) The nurse administrator of a baccalaureate degree nursing education program shall hold at least one graduate degree in nursing. The nurse administrator shall hold an earned doctoral degree or have a specific plan for completing doctoral preparation within 5 years of appointment. The nurse administrator shall have experience in nursing practice, nursing education and administration. A professional nurse who does not hold at least one graduate degree in nursing, but who has experience in nursing practice, nursing education and administration may be considered on an individual basis.
(2) The nurse administrator of an associate degree or diploma program shall hold at least one graduate degree in nursing. The nurse administrator shall have experience in nursing practice, nursing education and administration. A professional nurse who does not hold at least one graduate degree in nursing, but who has experience in nursing practice, nursing education and administration may be considered on an individual basis.
(3) The length of appointment of an interim or acting nurse administrator of a nursing education program may not exceed 1 year.
(4) The nurse administrator shall hold either a temporary practice permit to practice professional nursing or be currently licensed as a professional nurse in this Commonwealth.
(c) Faculty qualifications are as follows:
(1) Faculty members teaching required nursing education courses shall hold at least one graduate degree in nursing, shall be currently licensed as professional nurses in this Commonwealth, and shall have expertise in their areas of instruction.
(2) Faculty members without a graduate degree in nursing shall be designated faculty assistants. Faculty assistants shall be currently licensed as professional nurses in this Commonwealth. Faculty assistants may teach required nursing education courses only when fully qualified faculty are not available and shall teach under the direct guidance of a faculty member qualified as set forth in paragraph (1). Faculty assistants shall have a baccalaureate degree in nursing and shall give evidence of a plan for obtaining a graduate degree in nursing. A person may teach as a faculty assistant in a nursing education program in this Commonwealth for a maximum cumulative period of 5 years.
(3) Faculty members without a degree in nursing, but who hold at least one graduate degree in a subject area pertinent to their area of teaching, shall be designated as allied faculty members. Allied faculty members may teach basic sciences or specialized areas of health care practice.
(4) Faculty employed to teach dietetics-nutrition shall be currently licensed to practice dietetics-nutrition in this Commonwealth.
(5) An individual who enhances faculty-directed clinical learning experiences by guiding selected clinical activities shall be designated as a clinical preceptor. A clinical preceptor shall hold a current license to practice professional nursing in the state of the clinical experience.
(i) Faculty shall have input into the selection of preceptors.
(ii) Faculty shall retain responsibility for planning and evaluating student learning experiences when students are engaged in clinical activities with a preceptor.
(iii) If a faculty member is not physically present in the area in which students are practicing, a faculty member shall be immediately available by telephone or other means of telecommunication when students are engaged in clinical activities with a preceptor.
(d) Program support personnel shall be qualified by education and experience to serve in the capacity in which they are employed.
Source The provisions of this § 21.71 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended February 25, 1977, effective February 26, 1977, 7 Pa.B. 521; amended January 20, 1978, effective January 21, 1978, 8 Pa.B. 201; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829; amended July 11, 2008, effective July 12, 2008, 38 Pa.B. 3806. Immediately preceding text appears at serial pages (209964) to (209965).
§ 21.72. Faculty policies; additional responsibilities of faculty and faculty assistants.
(a) The faculty shall be employed by and responsible to the controlling institution.
(b) Policies, including personnel policies in effect for nursing faculty, must be those in effect for faculty members throughout the controlling institution except where specified otherwise in this chapter.
(c) Functions and responsibilities of each faculty member must be defined in writing.
(d) Teaching hours and additional duties of nurse faculty must be consistent with the policies of the controlling institution.
(e) The nurse administrator and nursing faculty shall be afforded the time and opportunity to engage in leadership activities within their profession commensurate with their responsibilities.
(f) There shall be a planned and active faculty development program designed to meet the needs of the faculty. Faculty members shall maintain a record of participation in continuing education, professional self-development and other activities that promote the maintenance of expertise in their respective areas of teaching.
(g) Faculty assistants shall maintain a record of their activities leading to the completion of a graduate degree in nursing which shall be submitted to the Board upon request.
Source The provisions of this § 21.72 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended February 25, 1977, effective February 26, 1977, 7 Pa.B. 521; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829; amended July 11, 2008, effective July 12, 2008, 38 Pa.B. 3806. Immediately preceding text appears at serial page (209965).
§ 21.73. Internal nursing faculty organizations.
(a) There shall be a nursing faculty organization appropriate to its size and in harmony with other educational units within the controlling institution.
(b) Policies and rules of procedure governing the faculty organization shall be in written form and periodically reviewed by the faculty.
(c) Members of the faculty shall participate in the activities of the faculty organization in ways consistent with their rank and responsibilities.
(d) Committees shall be established as needed to implement the functions of the faculty effectively, and the purposes and membership of each shall be clearly defined.
(e) Committee reports and faculty actions shall be recorded, filed systematically and kept available for reference.
Source The provisions of this § 21.73 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829. Immediately preceding text appears at serial page (34222).
§ 21.74. [Reserved].
Source The provisions of this § 21.74 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended January 21, 1977, effective January 22, 1977, 7 Pa.B. 223; amended January 20, 1978, effective January 21, 1978, 8 Pa.B. 201; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829; reserved July 11, 2008, effective July 12, 2008, 38 Pa.B. 3806. Immediately preceding text appears at serial pages (209966) to (209967).
§ 21.75. [Reserved].
Source The provisions of this § 21.75 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; reserved July 11, 2008, effective July 12, 2008, 38 Pa.B. 3806. Immediately preceding text appears at serial page (209967).
§ 21.76. Faculty organizations.
(a) Rules and regulations of the faculty organization shall be in writing and shall be revised by the faculty periodically.
(b) The committee structure shall be consistent with the size and needs of the faculty.
(c) Committee reports and faculty actions shall be recorded, filed systematically and kept available for reference.
Source The provisions of this § 21.76 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677. Immediately preceding text appears at serial pages (9704) to (9705).
§ 21.77. [Reserved].
Source The provisions of this § 21.77 reserved October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677. Immediately preceding text appears at serial page (9705).
CURRICULUM FOR BACCALAUREATE, ASSOCIATE DEGREE,
AND DIPLOMA PROGRAMS
§ 21.81. General curriculum requirements.
(a) The curriculum shall be developed, implemented and evaluated by the faculty and shall implement the philosophy and objectives of the school.
(b) The curriculum shall be organized and developed to include the knowledge, attitudes, skills and abilities necessary for the specific levels of student achievement.
(c) Physical and biological sciences shall include content from the areas of anatomy and physiology, chemistry, microbiology, physics and nutrition, which may be integrated, combined or presented as separate courses; the scientific facts and principles drawn from these areas serve as a basis for planning and implementing nursing care. When the basic sciences are presented as distinct academic courses—that is, chemistry, anatomy and physiology and microbiology—there shall be a related laboratory experience. A related laboratory experience is defined as an assigned period of time during which students participate in the testing of scientific principles.
(d) Selected courses shall be included in the humanities and social and behavioral sciences that support the philosophy, purposes, educational concepts and terminal objectives of the program.
(e) The curriculum shall provide concurrent theory and clinical experience in the care of men, women and children in age groups and with the health problems characteristic of each group. Experiences shall be provided which include preventive aspects of nursing care during acute and chronic illness and rehabilitative care. Opportunities shall be provided for the student to participate in case findings, health teaching and health counseling for patients and their families. Evening and night assignments are considered part of the curriculum only in terms of the objectives to be achieved and if faculty supervision is provided.
(f) Content related to history, trends and professional responsibilities of nursing may be integrated, combined or taught as separate courses.
(g) The Board encourages curriculum experimentation designed to replicate or validate educational theories or to promote open-ended career development.
Authority The provisions of this § 21.81 issued under section 506 of The Administrative Code of 1929 (71 P.S. § 186).
Source The provisions of this § 21.81 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended June 12, 1980, effective June 14, 1980, 10 Pa.B. 2404; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829. Immediately preceding text appears at serial pages (34224) and (50845).
§ 21.82. Curriculum evaluation.
The curriculum shall be evaluated according to a plan developed by the faculty and shall include the following:
(1) Careful review of aspects of the educational program based on the stated philosophy and objectives.
(2) Continuous evaluation of instructional procedures, learning experiences and student progress.
(3) Opportunities for students to participate in self-evaluation of their own learning experiences.
(4) Performance of graduates on the licensing examination.
(5) Opinions of graduates regarding the adequacy of their nursing program.
(6) Evaluation of graduates by their employers.
(7) Record system in operation which will assist in the evaluation of the educational program.
Source The provisions of this § 21.82 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677. Immediately preceding text appears at serial page (9707).
§ 21.83. Curriculum changes requiring Board approval.
(a) Major curriculum changes that require Board approval include:
(1) Alteration of the program philosophy, purposes and objectives which influences or affects the integration of material into the total curriculum, such as changes in course content or instruction, shifting content, changing course placement, adding or deleting courses, changing the length of a course or the program and changing the allotment.
(2) Reorganization of the entire curriculum.
(3) Changes in clinical facilities involving contractual agreements.
(b) When a program change is contemplated, a plan shall be presented to the Board showing:
(1) Rationale for the change.
(2) Present program.
(3) Proposed changed program.
(4) Philosophy and objectives of the proposed program.
(5) Old and new master rotation or organizational curriculum plans.
(6) The school bulletin and other pertinent information.
(c) Fifteen copies of the materials listed in subsection (b) shall be submitted to the Board at least 3 weeks prior to the Board meetings at which the matters are considered.
Source The provisions of this § 21.83 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended January 18, 1980, effective January 19, 1980, 10 Pa.B. 217; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829. Immediately preceding text appears at serial pages (50846) to (50847).
§ 21.84. Baccalaureate curriculum philosophy; purposes and objectives.
(a) A clear statement of philosophy and purposes of the baccalaureate nursing program, consistent with the philosophy and purposes of the controlling institution, shall be formulated and adopted.
(b) The philosophy, purposes and objectives of the educational unit in nursing shall be developed and clearly stated by the faculty and shall be reviewed and revised at stated time intervals by this group.
(c) The philosophy and purposes of the educational unit in nursing shall be consistent with currently accepted social, educational and nursing standards.
(d) The objectives of the nursing program shall be consistent with the purposes of the educational unit.
(e) The terminal objectives of the program shall identify behavioral changes that are expected to occur in the student.
Source The provisions of this § 21.84 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829. Immediately preceding text appears at serial pages (50847) and (30257).
§ 21.85. Baccalaureate general educational criteria.
(a) The educational policies of the educational unit in nursing shall be consistent with those of the controlling institution.
(b) The curriculum shall reflect the philosophy and purposes of the educational unit in nursing and shall implement the objectives of the program.
(c) There shall be an educational rationale for the selection and distribution of courses and for the selection of theoretical and clinical laboratory content in nursing courses.
(d) The rationale for the allocation of credit for nursing courses shall be consistent with the practice of the institution.
(e) The courses shall be planned on the academic term basis common to the institution.
(f) The learning experiences and methods of instruction shall provide opportunity for fulfilling the purposes of the educational unit in nursing and the objectives of the program.
(g) Learning experiences and methods that promote critical thinking and synthesis of learning shall be utilized in the teaching-learning process.
(h) Consideration shall be given to individual differences among students.
(i) The program shall build its professional education on a general education basis.
(j) Courses in general education shall be shared with students in other disciplines of the controlling institution.
(k) Provision shall be made for students to take electives in upper divisional general education courses.
(l) Nursing courses shall be organized to use and reinforce relevant learnings from preceding and concurrent nursing courses.
(m) Education in the nursing major shall be offered largely at the upper divisional level.
(n) Nursing courses and curriculum shall be organized to continue the development of values, understandings, knowledge and skills needed in all aspects of professional nursing.
(o) Preparation insuring professional nursing competencies shall be provided through selected and supervised learning experiences.
(p) The ratio of credits in nursing, that is, the major field of study, general education and elective credits shall be consistent with the nature, purposes and requirements of the parent institution.
(q) The ratio of students to faculty shall assure optimal learning opportunities in clinical laboratory sessions and shall be consistent with the objectives of the clinical nursing courses.
(r) The curriculum for baccalaureate nursing programs shall give evidence of providing learning experiences which will prepare graduates for professional nursing practice. The standards of practice are defined and delineated by the nursing profession.
(s) Course syllabi that identify all aspects of each course shall be developed and readily available.
Source The provisions of this § 21.85 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829. Immediately preceding text appears at serial pages (30257) to (30258).
§ 21.86. Associate degree curriculum philosophy; purposes and objectives.
(a) A clear statement of philosophy and purposes of the associate degree program in nursing, consistent with the philosophy and purposes of associate degree education and with the controlling institution, shall be formulated and adopted.
(b) The philosophy, purposes and objectives of the educational unit in nursing shall be developed and clearly stated by the faculty and shall be reviewed and revised at stated time intervals by this group.
(c) The philosophy and purposes of the educational unit in nursing shall be consistent with currently accepted social, associate degree education and nursing standards.
(d) The objective of the nursing program shall be consistent with the purposes of the educational unit.
(e) The terminal objectives of the program shall identify behavioral changes that are expected to occur in the student.
Source The provisions of this § 21.86 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829. Immediately preceding text appears at serial page (30258).
§ 21.87. Associate degree general educational criteria.
(a) The educational policies of the educational unit in nursing shall be consistent with those of the controlling institution.
(b) The curriculum shall reflect the philosophy and purposes of the educational unit in nursing and shall implement the objectives of the program.
(c) There shall be an education rationale for the selection and distribution of courses and for the selection of theoretical and clinical laboratory content in nursing courses.
(d) The rationale for the allocation of credit for nursing courses shall be consistent with the practice of the institution.
(e) The courses shall be planned on the academic term basis common to the institution.
(f) The learning experiences and methods of instruction shall provide opportunity for fulfilling the purposes of the educational unit in nursing and the objectives of the program.
(g) The nursing curriculum shall demonstrate the accepted pattern of development for associate degree education and be consistent with college policy.
(h) Courses in general education shall be shared with students in other programs of the controlling institution.
(i) Nursing courses shall be organized to use and reinforce relevant learnings from preceding and concurrent courses.
(j) Preparation insuring associate degree nursing competencies shall be provided through selected and supervised learning experiences.
(k) The ratio of credits in nursing to general education and elective credits shall be consistent with other associate degree programs in the college.
(l) The ratio of students to faculty shall assure optional learning opportunities in clinical laboratory sessions and shall be consistent with the objectives of the clinical nursing courses.
(m) The curriculum for associate degree nursing programs shall give evidence of providing learning experiences which will prepare graduates for associate degree nursing practice as defined and delineated by the nursing profession.
(n) Course syllabi that identify all aspects of each course shall be developed and readily available.
Source The provisions of this § 21.87 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829. Immediately preceding text appears at serial pages (30258) to (30259).
§ 21.88. Diploma curriculum philosophy; purposes, and objectives.
(a) A clear statement of philosophy, purposes and objectives consistent with the philosophy and objectives of the governing body shall be formulated and adopted.
(b) The philosophy, purposes and objectives of the school shall be developed by the faculty and reviewed at stated intervals.
(c) The philosophy of the school shall express beliefs about education, nursing and the responsibility of the school to the student.
(d) The terminal objectives of the school shall identify behavioral changes that are expected to occur in the student.
Source The provisions of this § 21.88 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829. Immediately preceding text appears at serial pages (30259) to (30260).
§ 21.89. Diploma general education criteria.
(a) The selection of learning experiences and methods of instruction shall provide opportunities for fulfilling the stated objectives of the program of studies or of the curriculum.
(b) Each school year shall be divided into specific time periods.
(c) The curriculum shall be planned in a sequence so that each course utilizes and strengthens the preceding and concurrent courses.
(d) Theory and practice shall be offered concurrently and be so planned that demands on the student within each time period are comparable.
(e) Course outlines that identify all aspects of each course shall be developed and readily available.
(f) The ratio of students to faculty shall assure optional learning opportunities in the clinical sessions and shall be consistent with the objectives of the clinical nursing course.
Source The provisions of this § 21.89 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677. Immediately preceding text appears at serial page (9712).
FACILITIES FOR ADMINISTRATION AND TEACHING
§ 21.91. Facility and resource requirements.
(a) The physical structures that serve the purpose of the nursing program and are available for student or faculty use, or both, include those that are provided in the immediate environment and those that are off the school premises.
(b) Facilities and resources of the school shall include the following:
(1) Offices and administrative and instructional personnel provided with appropriate and adequate space and equipment essential for attainment of the objectives of the program.
(2) Sufficient number and size of accessible classrooms, conference rooms and laboratories to meet the needs of the program, as follows:
(i) Such facilities shall be attractive, with effective lighting, adequate heating and ventilation.
(ii) The educational facilities shall be provided with equipment and supplies to meet the teaching and learning requirements of both students and teachers.
(iii) The selection and maintenance of the kind and quality of facilities needed in the individual nursing program shall be determined by the curriculum design and teaching methods utilized by the faculty.
(3) Adequate storage space for general supplies and equipment. Policies shall be in existence for the replacement of equipment, furnishings and supplies.
(4) Library facilities and resources, which are planned and maintained to meet the specific needs of the student and the faculty, as follows:
(i) The physical equipment of the library shall include adequate lighting and ventilation, sufficient tables and comfortable chairs, space for proper display of library holdings and exhibits and appropriate work space for the librarian.
(ii) Provision shall be made for adequate storage space to maintain the safety and security of the library materials and holdings.
(iii) Library holdings shall include sufficient reference titles, periodicals and other educational materials to achieve the objectives of the curriculum.
Source The provisions of this § 21.91 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677. Immediately preceding text appears at serial pages (9712) to (9713).
STUDENTS
§ 21.101. Selection and admission standards.
(a) Policies and procedures related to the selection and admission of students are the responsibility of the individual school. Consideration shall be given to scholastic aptitude, academic achievement, personal qualities and physical and emotional health necessary to fulfill the objectives of the program.
(b) Students admitted to baccalaureate and associate degree programs shall meet the requirements for admission to the university or college and additional requirements that may be established for the nursing major.
(c) Applicants shall have completed work equal to a standard high school course with a minimum of 16 units, including 4 units of English, 3 units of Social Studies, 2 units of Mathematics (1 of which is Algebra) and 2 units of Science with a related laboratory or the equivalent.
Source The provisions of this § 21.101 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829. Immediately preceding text appears at serial pages (30261).
§ 21.102. Admission of classes.
The Board recommends that only one class be admitted per year. The number of candidates for each class shall be determined by the educational and clinical resources which the school can provide.
Source The provisions of this § 21.102 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677. Immediately preceding text appears at serial page (9713).
§ 21.103. Transfer of students or advanced standing.
The school shall have a written policy consistent with its philosophy and objectives concerning criteria for granting advanced standing or accepting transfer students. The policies of the baccalaureate and associate degree programs shall be consistent with those of the controlling institution. Diploma programs shall assume responsibility for formulating their own policies and submitting them for Board approval. The Board requires that transfer students complete, as a minimum, the senior or final level in the school granting the diploma or degree.
Source The provisions of this § 21.103 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829. Immediately preceding text appears at serial pages (30261) to (30262).
STUDENT SERVICES
§ 21.111. Health program.
(a) There shall be written objectives and policies for the health program.
(b) The health program shall include at least the following:
(1) Preentrance and periodic health examinations.
(2) Provisions for necessary immediate professional health care.
(3) An immunization policy.
(4) A policy addressing student absences due to illness which gives the student the opportunity to attain the learning objectives not achieved due to absences.
(c) Appropriate cumulative student health records shall be maintained throughout the enrollment of the student.
Source The provisions of this § 21.111 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829; amended March 22, 1991, effective March 23, 1991, 21 Pa.B. 1165; amended April 26, 1996, effective April 27, 1996, 26 Pa.B. 2005. Immediately preceding text appears at serial pages (209976) to (209977).
§ 21.112. Student employment.
(a) If students are employed in health agencies, they may not be employed as registered or practical nurses unless they are currently licensed.
(b) Student employment shall be on a voluntary basis and not a requirement of the institution.
(c) Remuneration for employment shall be within the range of the salary scale for the position.
Source The provisions of this § 21.112 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677. Immediately preceding text appears at serial page (9715).
§ 21.113. Student housing.
Policies concerning student housing provided by the institution shall include the following:
(1) Adequate space, equipment and furnishings for each student, such as desk, chairs, proper lighting, ventilation and closet space.
(2) Safe and adequately maintained facilities directly related to personal hygiene and personal security measures which include appropriate supervision of housing facilities and periodic inspection of safety devices, such as extinguishers, housing exits and fire drills.
(3) Provision of facilities which promote recreational and social activities.
(4) Facilities for obtaining adequate, well-balanced meals.
Source The provisions of this § 21.113 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677. Immediately preceding text appears at serial page (9716).
§ 21.114. Counseling and guidance.
(a) The scope of the counseling program shall be clearly defined in accordance with the objectives of the program.
(b) A program should include personal, professional and academic counseling, initiated by either faculty or students.
(c) Adequate provisions should be made for referral of students to appropriate counselors when assistance is needed for solving problems of students.
Source The provisions of this § 21.114 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829. Immediately preceding text appears at serial pages (30263) to (30264).
§ 21.115. Financial aid.
(a) Policies and procedures relating to scholarships, loans and grants shall be developed within the framework of the philosophy of the controlling institution and defined in writing.
(b) It is recommended that each school maintain a list of available resources for financial assistance and that applicants and students be informed of these resources.
(c) Students accepting financial aid should be made aware of the provisions and responsibilities incurred with such assistance.
Source The provisions of this § 21.115 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677. Immediately preceding text appears at serial page (9716).
§ 21.116. Students’ rights.
There shall be written specific policies pertaining to students’ rights and grievances, with procedures for implementation.
Source The provisions of this § 21.116 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829. Immediately preceding text appears at serial page (30264).
STUDENTS LICENSED IN OTHER JURISDICTIONS
§ 21.118. Post-basic nursing programs.
(a) A registered nurse currently licensed in another jurisdiction of the United States or Canada who has graduated from an approved program of nursing and who is enrolled in an accredited graduate nursing program, a bachelor of science nursing program, or a refresher course in nursing may practice nursing in a clinical setting as required by the educational program of studies without obtaining a Pennsylvania license so long as the student does not receive compensation except in the form of stipends, scholarships and other awards related to the training program.
(b) A student who meets the description in subsection (a) and who also desires to practice as a registered nurse while participating in the training program shall submit an application for licensure by endorsement and obtain a temporary practice permit as provided by § 21.28 (relating to licensure by endorsement).
Source The provisions of this § 21.118 adopted March 22, 1991, effective March 23, 1991, 21 Pa.B. 1165.
RECORDS
§ 21.121. Program records.
(a) A record system essential to the operation of the program shall be maintained.
(b) Records shall be kept in locked fireproof files.
Source The provisions of this § 21.121 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677. Immediately preceding text appears at serial page (9717).
§ 21.122. Record maintenance.
Each nursing faculty shall select record forms specifically for the nursing program and shall include the following:
(1) Student records, including the following:
(i) Permanent record, including both clinical and theoretical experience and achievement, shall be kept ad infinitum.
(ii) Health records shall be kept for 5 years following completion of the program.
(2) Faculty records, including the following:
(i) ‘‘Display portion’’ of current nursing licenses.
(ii) Records of preparation and experience, including college transcripts.
(iii) Current record of continuing education activities.
(3) Administrative records, including the following:
(i) Affiliation agreements with cooperating agencies.
(ii) Minutes of meetings.
(iii) Annual reports.
(iv) Follow-up studies of graduates.
(v) Budgets.
(vi) Current written policies.
(4) School bulletin, as follows:
(i) Shall be comprehensive and current, since it serves as a contract of agreement between the applicant or student and the school.
(ii) Shall include clearly defined refund policies governing fees and tuition paid by the students.
(iii) Shall include clearly defined policies relating to admission, promotion, retention, transfer, advanced placement and dismissal.
Source The provisions of this § 21.22 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677. Immediately preceding text appears at serial pages (9717) to (9718).
§ 21.123. Access and use of records.
(a) Students shall have access to personal records as defined by Federal and State legislation.
(b) No information may be released from a student’s record without written permission of the student.
Source The provisions of this § 21.123 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677. Immediately preceding text appears at serial page (9718).
Cross References This section cited in 49 Pa. Code § 21.34 (relating to removal from approved list).
§ 21.124. Records to be filed with Board.
(a) An annual report of the school of nursing shall be sent to the Board using the form supplied by the Board.
(b) Upon completion of the entire program, a transcript or photocopy of the final record of the student shall be submitted along with the application for admission to the licensing examination. The transcript must bear the impression of the school seal and signature of the nurse administrator or authorized representative.
Source The provisions of this § 21.24 amended October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2829; amended July 11, 2008, effective July 12, 2008, 38 Pa.B. 3806. Immediately preceding text appears at serial page (319577).
§ 21.125. Custody of records.
(a) When a school closes, the controlling institution shall be responsible for the safekeeping of the records of students, and official copies shall be made available upon request.
(b) If the controlling institution also closes, advice should be obtained from the Board concerning the permanent safekeeping and availability of the records of the school of nursing.
(c) The Board shall be informed in writing concerning the permanent placement of these records.
Source The provisions of this § 21.125 adopted October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677.
Cross References This section cited in 49 Pa. Code § 21.34 (relating to removal from approved list); and 49 Pa. Code § 21.41 (relating to notification; completion of program; records).
§ 21.126. [Reserved].
Source The provisions of this § 21.126 adopted December 10, 1982, effective December 11, 1982, 12 Pa.B. 4236; amended September 20, 1985, effective September 21, 1985, 15 Pa.B. 3345; reserved December 25, 1987, effective December 26, 1987, 17 Pa.B. 5329. Immediately preceding text appears at serial page (103882).
CONTINUING EDUCATION
§ 21.131. Continuing education.
(a) Requirement of continuing education. A registered nurse seeking licensure renewal shall complete 30 hours of continuing education approved by the Board during the biennial period immediately preceding the application for renewal in accordance with section 12.1 of the act (63 P.S. § 222) and this subchapter. At least 2 of the 30 hours shall be completed in approved continuing education in child abuse recognition and reporting requirements in accordance with § 21.508(b) (relating to child abuse recognition and reporting—mandatory training requirement). The Board will not renew a license of a registered nurse who fails to verify compliance with the continuing education requirement. A registered nurse whose license is not renewed by the expiration of the biennial period may not engage in the practice of professional nursing until the continuing education requirements are satisfied and the license has been renewed, reinstated or reactivated.
(b) Exception. An applicant applying for initial licensure in this Commonwealth will not be required to meet the continuing education requirement on the first renewal immediately following licensure, except for the mandatory continuing education in child abuse recognition and reporting required under § 21.508(b).
(c) Board audits; proof of completion. The Board may perform audits on registered nurses to determine compliance with the continuing education requirements. A registered nurse shall retain documentation of the registered nurse’s completion of continuing education for at least 5 years. A registered nurse shall comply with a request for submission of documents verifying the registered nurse’s completion of continuing education. The following documents shall be retained and submitted upon request:
(1) For attendance at continuing education programs or courses, the registered nurse shall retain the certificate of attendance provided by the program or course provider.
(2) For academic courses taken from an accredited college or university, the registered nurse shall retain the transcript issued by the educational institution.
(3) For publication of a textbook or article, the registered nurse shall retain a copy of the published item, including the date of publication.
(4) For a research project, the registered nurse shall retain a copy of the research abstract, letter from the institutional review board granting approval for the research project and list of primary and co-investigators.
(5) For school nurses, evidence that the nurse’s certification by the Department of Education is current.
(d) Reinstatement of lapsed license or reactivation of inactive license. A registered nurse seeking to reinstate a lapsed license or reactivate an inactive license shall file an application for reinstatement or reactivation and submit, or cause to be submitted, documentation to demonstrate that the licensee completed 30 hours of continuing education, including at least 2 hours in approved child abuse recognition and reporting in accordance with § 21.508(b), within the biennial period immediately preceding application.
(e) Reinstatement of suspended license. A registered nurse seeking to reinstate a suspended license shall submit, or cause to be submitted, documentation to demonstrate that the registered nurse completed 30 hours of continuing education, including at least 2 hours in approved child abuse recognition and reporting in accordance with § 21.508(b), within the biennial period immediately preceding application for reinstatement.
(f) Carry over. Continuing education hours may not be carried over from one biennial renewal period to the next.
(g) Waiver. A registered nurse may request a waiver of the continuing education requirement because of serious illness, military service or other demonstrated hardship. The registered nurse shall submit the request and any supporting documentation to the Board in writing at least 90 days prior to the registered nurse’s license expiration date unless an emergency or hardship occurs within the 90-day period. The Board will grant, deny or grant in part the request for waiver.
(h) Disciplinary action authorized.
(1) Failure to complete a minimum of 30 hours of continuing education in a biennial period in accordance with subsection (a) will subject the registered nurse to discipline under section 13(b) of the act (63 P.S. § 223(b)) in accordance with the schedule of civil penalties in § 43b.18a (relating to schedule of civil penalties—nurses). A second or subsequent violation will subject the registered nurse to discipline under section 14(a)(3) of the act (63 P.S. § 224(a)(3)).
(2) A registered nurse who has not completed a minimum of 30 hours of continuing education shall make up the deficiency within 6 months of receiving notice of the deficiency.
(3) Notwithstanding any civil penalty assessed under paragraph (1), failure to provide the Board with documentation demonstrating the completion of 30 hours of approved continuing education within 6 months after receiving notice of a deficiency will subject the registered nurse to discipline under section 14(a)(3) of the act.
(4) Failure to comply with an audit request for continuing education documentation may subject a registered nurse to additional discipline under section 14(a)(4)(i) of the act.
Authority The provisions of this § 21.131 issued under sections 2.1(k) and 12.1 of The Professional Nursing Law (63 P.S. § § 212.1(k) and 222); amended under sections 2.1(k) and 12.1(a) of The Professional Nursing Law (63 P.S. § § 212.1(k) and 222(a)); section 17.6 of the Practical Nurse Law (63 P.S. § 667.6); and 23 Pa.C.S. § 6383(b)(2).
Source The provisions of this § 21.131 adopted July 11, 2008, effective July 12, 2008, 38 Pa.B. 3796; amended October 16, 2015, effective October 17, 2015, 45 Pa.B. 6196; amended March 25, 2022, effective March 26, 2022, 52 Pa.B. 1916. Immediately preceding text appears at serial pages (385152) to (385153).
Cross References This section cited in 49 Pa. Code § 21.29 (relating to expiration and renewal of license).
§ 21.132. Continuing education hours.
(a) The Board will accept hours of continuing education as designated by an approved provider, so long as each hour is at least 50 minutes of activity and each 1/2 hour is at least 30 minutes of activity.
(b) For purposes of determining acceptable hours of continuing education for academic coursework, the following apply:
(1) One academic trimester course is equivalent to 12 continuing education hours.
(2) One academic quarter course is equivalent to 10 continuing education hours.
(3) One academic semester course is equivalent to 15 continuing education hours.
Authority The provisions of this § 21.132 issued under sections 2.1(k) and 12.1 of The Professional Nursing Law (63 P.S. § § 212.1(k) and 222); amended under sections 2.1(k) and 12.1(a) of The Professional Nursing Law (63 P.S. § § 212.1(k) and 222(a)).
Source The provisions of this § 21.132 adopted July 11, 2008, effective July 12, 2008, 38 Pa.B. 3796; amended October 16, 2015, effective October 17, 2015, 45 Pa.B. 6196. Immediately preceding text appears at serial page (351278).
Cross References This section cited in 49 Pa. Code § 21.29 (relating to expiration and renewal of license); and 49 Pa. Code § 21.825 (relating to sources of continuing education).
§ 21.133. Continuing education content.
(a) Continuing education must be relevant to patient care or professional nursing in a general or specialty area and enhance the knowledge and application of the physical, social, biological and behavioral sciences.
(b) The Board may, for any given biennial license period and with adequate notice to registered nurses, require that up to 4 hours of continuing education be completed in designated topics.
(c) Courses in areas related to the practice of professional nursing such as the following are acceptable:
(1) Human sexuality.
(2) Death, dying and grief.
(3) Foreign language relevant to health care.
(4) Therapeutic interpersonal relationship skills.
(5) Patient rights.
(6) Pharmacology.
(d) Courses in areas impacting the practice of professional nursing, such as nursing administration, management, education, and diagnostic and procedural coding are acceptable.
(e) Group or individual research, as the principal or co-principal investigator, if approved by the institutional review board of the sponsoring institution, is acceptable and will be credited in the year completed as 15 hours of continuing education.
(f) Nonprofessional course content not directly related to patient care, such as courses in self-improvement, changes in attitude, financial gain, courses designed for lay people, basic life support or cardiopulmonary resuscitation, mandatory annual education on facility specific policies unrelated to the practice of professional nursing (such as facility leave policies) and employment orientation programs are not acceptable for meeting requirements for license renewal.
Authority The provisions of this § 21.133 issued under sections 2.1(k) and 12.1 of The Professional Nursing Law (63 P.S. § § 212.1(k) and 222); amended under sections 2.1(k) and 12.1(a) of The Professional Nursing Law (63 P.S. § § 212.1(k) and 222(a)).
Source The provisions of this § 21.133 adopted July 11, 2008, effective July 12, 2008, 38 Pa.B. 3796; amended October 16, 2015, effective October 17, 2015, 45 Pa.B. 6196. Immediately preceding text appears at serial pages (351278) and (335539).
Cross References This section cited in 49 Pa. Code § 21.29 (relating to expiration and renewal of license); and 49 Pa. Code § 21.134 (relating to continuing education sources).
§ 21.134. Continuing education sources.
(a) The following continuing education activities that meet the requirements of § 21.133 (relating to continuing education content) for registered nurses are approved:
(1) Activities sponsored by a Board-approved practical or professional nursing program or a Nationally accredited graduate nursing program.
(2) Activities sponsored by an accredited professional nursing, CRNP, Certified Registered Nurse Anesthetist, Clinical Nurse Specialist or Nurse Midwifery education program.
(3) Activities sponsored by accredited hospitals and health care facilities.
(4) Activities sponsored by hospitals and health care facilities licensed by the Department of Health or the Department of Public Welfare.
(5) Activities sponsored by regionally-accredited institutions of higher education.
(6) Activities sponsored by National nursing, medical, osteopathic and other health care professional organizations and their state and regional affiliates.
(7) Activities sponsored by National trade organizations, associations and their affiliated groups and state and regional affiliates.
(8) Activities approved by National nursing, risk management, health care quality and patient safety organizations.
(9) Activities sponsored by Federal and state agencies.
(10) Activities approved by a Board in another jurisdiction.
(b) The Board may approve other sources of continuing education on a case-by-case basis after the provider or registered nurse seeking approval submits the following:
(1) Full name and address of the provider.
(2) Title of the activity.
(3) Date and location of the activity.
(4) Faculty qualifications.
(5) Schedule of the activity, including, for activities with multiple presenters, the title of each subject, lecturer and time allotted.
(6) Hours of continuing education.
(7) Method of certifying and assuring attendance, and draft of certificate of attendance to be provided to course participants, as applicable.
(8) Course objectives.
(9) Curriculum.
(10) Target audience.
(11) Program coordinator.
(12) Instruction methods.
(13) Evaluation methods, including participant evaluation and activity evaluation.
(14) Other information requested in writing by the Board.
(c) Requests for approval of a continuing education activity under subsection (b) shall be submitted at least 90 days prior to commencement of the activity and shall be accompanied by the fee in § 21.5 (relating to fees).
(d) Upon approval of a continuing education activity under subsection (b), the Board will determine the number of continuing education hours awarded for the activity.
(e) A separate application and fee, as set forth in § 21.5, shall be submitted whenever a change is made to information submitted under subsection (b), except for information related to a change in date or location, or both, of the activity under subsection (b)(3).
(f) A continuing education provider shall award a certificate of attendance to professional nurses who complete the continuing education activity. The certificate must contain the information listed in subsection (b)(1)—(3) and (6) and the name of the individual to whom the certificate is awarded.
(g) Distance learning continuing education is acceptable for completion of all 30 continuing education hours required for license renewal.
Authority The provisions of this § 21.134 issued under sections 2.1(k) and 12.1 of The Professional Nursing Law (63 P.S. § § 212.1(k) and 222); amended under sections 2.1(k) and 12.1(a) of The Professional Nursing Law (63 P.S. § § 212.1(k) and 222(a)).
Source The provisions of this § 21.134 adopted July 11, 2008, effective July 12, 2008, 38 Pa.B. 3796; amended October 16, 2015, effective October 17, 2015, 45 Pa.B. 6196. Immediately preceding text appears at serial pages (335539) to (335540) and (363467).
Cross References This section cited in 49 Pa. Code § 21.5 (relating to fees); and 49 Pa. Code § 21.29 (relating to expiration and renewal of license).
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