Rep. Sara Feigenholtz

Filed: 4/19/2017

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1 AMENDMENT TO HOUSE BILL 313

2 AMENDMENT NO. ______. Amend House Bill 313, AS AMENDED,

3 with reference to page and line numbers of House Amendment No.

4 2, on page 292, immediately below line 25, by inserting the

5 following:

6 ""Comprehensive nursing assessment" means the gathering of

7 information about the patient's physiological, psychological,

8 sociological, and spiritual status on an ongoing basis by a

9 registered professional nurse and is the first step in

10 implementing and guiding the nursing plan of care."; and

11 on page 293, by replacing lines 23 and 24 with "comprehensive

12 nursing assessment performed by the registered professional

13 nurse or advanced practice registered nurse or the assessment

14 by the physician assistant,"; and

15 on page 295, by deleting lines 9 through 14; and

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1 on page 295, line 16, after "performs.", by inserting "An

2 individual or entity shall not mandate that a registered

3 professional nurse delegate nursing interventions if the

4 registered professional nurse determines it is inappropriate

5 to do so. A nurse shall not be subject to disciplinary or any

6 other adverse action for refusing to delegate a nursing

7 intervention based on patient safety."; and

8 on page 296, lines 5 and 6, by replacing "at the direction of

9 ~~as delegated~~ by" with "under the guidance of ~~as delegated by~~";

10 and

11 on page 296, line 26, after "injury,", by inserting

12 "development and implementation of the nursing plan of care,";

13 and

14 on page 297, line 1, by replacing "through care coordination"

15 with ", care coordination,"; and

16 on page 303, by replacing lines 13 and 14 with "being licensed

17 under this Act shall~~, in addition to any other penalty provided~~

18 ~~by law,~~ pay a civil penalty to the Department"; and

19 on page 307, by replacing line 18 with "interventions or

20 guiding the practice of a licensed practical nurse ~~activities~~

21 ~~or tasks~~ as authorized under this Act;"; and

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1 on page 307, immediately below line 18, by inserting the

2 following:

3 "(19) Discipline or take other adverse action against a

4 nurse who refused to delegate a nursing intervention based

5 on patient safety; and"; and

6 on page 307, line 19, by replacing "(19)" with "(20)"; and

7 on page 314, line 12, after "delegation", by inserting "by a

8 registered professional nurse"; and

9 on page 314, line 19, by deleting "or advanced practice

10 registered nurse"; and

11 on page 314, lines 24 and 25, by deleting "or advanced practice

12 registered nurse"; and

13 on page 315, line 12, by deleting "or advanced practice

14 registered nurse"; and

15 on page 315, by replacing lines 13 and 14 with the following:

16 "(1) delegate nursing interventions to other

17 registered professional nurses, licensed practical nurses,

18 and other unlicensed personnel based on the comprehensive

19 nursing assessment that includes, but is not limited to:";

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1 and

2 on page 315, by replacing lines 23 through 25 with "licensed

3 nurses;"; and

4 on page 315, immediately below line 25, by inserting the

5 following:

6 "(3) in community-based or in-home care settings,

7 delegate the administration of medication (limited to oral

8 or subcutaneous dosage and topical or transdermal

9 application) to unlicensed personnel, if all the

10 conditions for delegation set forth in this Section are

11 met;"; and

12 on page 315, line 26, by replacing "(3)" with "(4)"; and

13 on page 316, line 1, by replacing "delegation." with

14 "delegation; or"; and

15 on page 316, immediately below line 7, by inserting the

16 following:

17 "(5) in community-based or in-home care settings,

18 delegate, guide, and evaluate the implementation of

19 nursing interventions as a component of patient care

20 coordination after completion of the comprehensive patient

21 assessment based on analysis of the comprehensive nursing

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1 assessment data; care coordination in in-home care and

2 school settings may occur in person, by telecommunication,

3 or by electronic communication."; and

4 on page 316, line 10, by deleting "or advanced practice nurse";

5 and

6 on page 316 line 11, after "registered", by inserting

7 "professional"; and

8 on page 316, lines 11 and 12, by deleting "or advanced practice

9 "registered nurse"; and

10 on page 316, lines 24 and 25, by deleting "or advanced practice

11 registered nurse"; and

12 on page 316, line 26, after "judgment,", by inserting "the";

13 and

14 on page 316, line 26, after "assessment,", by inserting "the";

15 and

16 on page 318, line 9, by replacing "have" with "has ~~have~~"; and

17 on page 327, immediately below line 20, by inserting the

18 following:

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1 "(2.5) the applicant has successfully completed a

2 licensure examination approved by the Department;"; and

3 on page 327, line 21, by replacing "an LPN" with "a licensed

4 practical nurse"; and

5 on page 336, line 4, by deleting "directed"; and

6 on page 336, line 6, by replacing "direction" with "guidance";

7 and

8 on page 336, lines 7 and 8, by replacing "~~or as directed by~~"

9 with "or as directed by"; and

10 on page 336, by replacing lines 13 and 14 with "contributing to

11 the ongoing comprehensive nursing assessment of the patient

12 performed by the registered professional nurse. ~~Collecting~~

13 ~~data and collaborating in the~~"; and

14 on page 341, line 15, by replacing "have" with "has ~~have~~"; and

15 on page 350, immediately below line 18, by inserting the

16 following:

17 "(2.5) the applicant has successfully completed a

18 licensure examination approved by the Department;"; and

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1 on page 350, line 19, by replacing "an LPN" with "a registered

2 professional nurse"; and

3 on page 358, line 25, after "injury,", by inserting "the

4 development and implementation of the nursing plan of care,";

5 and

6 on page 359, line 8, by replacing "includes" with "may

7 include"; and

8 on page 359, line 10, after "situation", by inserting "on an

9 ongoing basis through the comprehensive nursing assessment";

10 and

11 on page 359, line 11, by replacing "the" with "comprehensive

12 nursing"; and

13 on page 359, line 20, after "administration", by inserting

14 "according to Section 50-75 of this Act"; and

15 on page 359, line 21, after "Evaluating", by inserting

16 "patient"; and

17 on page 359, line 23, by deleting "and assigning"; and

18 on page 359, immediately below line 25, by inserting the

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1 following:

2 "(7.5) Advocating for the patient."; and

3 on page 360, by replacing lines 18 and 19 with "and sustain

4 evidence-based nursing services that are safe and effective.";

5 and

6 on page 360, by deleting lines 20 and 21; and

7 on page 375, by replacing line 10 with the following:

8 "(7) Delegating selected nursing interventions

9 ~~activities or tasks~~ to".