RN Engage 2.0: Scope and Standards of Practice (Nursing Practice)

• Lesson focuses on the nursing scope and standards of practice.
• Discusses standards of professional practice and their impact on client care delivery for nursing students, LPNs, RNs, and APRNs.
• State-level Nurse Practice Acts (NPAs) regulate nursing within each state.
• State boards of nursing (BONs) execute the provisions of NPAs.
• The scope and its standards depend on the nurse's professional license.
• Standards of professional practice are developed by the American Nurses Association (ANA).
• Nursing licensure is obtained after successful completion of the National Council Licensure Examination (NCLEX-RN or NCLEX-PN).
• The National Council of State Boards of Nursing develops the NCLEX.
• Addresses obtaining and maintaining licensure, certification, and credentialing.

Standards of Professional Practice and Client Care

• Standards of professional practice establish expectations for professional behavior.
• Standards of professional practice aim to protect the nurse, the client, and the facility.
• Each nurse is accountable for a code of conduct and ethical values.
• The American Nurses Association (ANA) sets standards for both nursing practice and professional performance.
• Nursing practice in the U.S. is regulated by each state’s Nurse Practice Act (NPA).

State Nurse Practice Acts

• NPAs are current laws/regulations governing nursing practice in each state/territory.
• NPAs identify conditions for licensure.
• States protect clients receiving care by requiring professional nurses to have a license.
• Registered nurses and licensed practical nurses must adhere to the prescribed scope of practice.
• Safe and competent client care depends on adhering to the scope of practice.

Nurse Practice Acts (NPA)

• Defining scope of practice is a two-step process:
  • State legislature passes a law (NPA).
  • State legislature identifies a regulatory body like the State Board of Nursing (BON).
• Each state BON enforces regulations and rules set by the NPA.
• The NPA provides general guidelines, while states create detailed rules/regulations.
• NPAs define terms/phrases used to create regulatory statutes.
• NPAs grant authority to an administrative agency like the BON to enforce regulations, uphold nurse rights, and protect the public.
• NPAs specify membership/qualifications of nurses on the BON.
• Includes board members' terms, meetings, and election of officers.
• Each BON includes RNs, LPNs, APRNs, and public representation.
• Educational program standards, curriculum rules, and clinical learning experiences must be approved by the BON.
• Approval is based on meeting NPA requirements.
• Standards and the scope of nursing practice are evaluated against the NPA.
• Regulations/rules are set to align with the nursing process.
• NPAs include standards for nursing strategies involving critical thinking and decision-making.
• Standards are established for client advocacy, delegation, teaching, and evaluating interventions.
• The NPA identifies specific nursing titles (RN, LPN, LVN, APN) and protects these titles from unauthorized use for public welfare.
• The NPA details requirements for RN, LPN, and LVN licensure exams.
• These requirements include criminal background checks, substance abuse violations, and failure to report actions against a nurse’s license.
• BONs have statutory authority to implement disciplinary actions based on NPA regulations.
• Nurses may be penalized for failing to report disciplinary actions for wrongful acts or omissions.
• Wrongful acts include practice-related errors, drug misuse, boundary violations, sexual misconduct, client abuse, fraud, and positive background checks related to a crime.
• Each nurse must know and adhere to the state NPA and regulations, found on the state BON’s website.
• Each state legislature passes laws for a governmental body to formulate and revise the NPA.
• This includes the content for the scope of nursing practice provisions.
• Nurses must follow the scope of practice as a legal and ethical requirement.
• Claiming ignorance of NPA regulations is not a defense for irresponsible practice.
• Changes in the scope of practice occur as the nursing profession adapts to healthcare demands.
• Nurses must stay current in their roles and responsibilities, as defined in the NPA.

Scope and Standards

• The scope and standards of nursing practice are established via state law.
• This state law defines nurses' duties and authorizes what they can legally perform.

Scope of Nursing Practice

• The scope of nursing practice alleviates client suffering and promotes client healing.
• The scope of nursing practice does this through competent nursing practice and professional performance.
• Nurses licensed in a primary state must follow that state’s scope of practice.
• Nursing can occur wherever a client needs healthcare, information, or advocacy.
• A nurse's engagement in the total scope of practice depends on their education, experience, and the types of clients served.
• The standards define responsibilities expected of every nurse, regardless of their role, population, or specialty.
• The ANA standards are titled the Standards of Nursing Practice and the Standards of Professional Performance.

Standards of Practice

• Standards of practice are explanatory statements describing a competent level of care.
• Standards of practice apply to all registered nurses.
• Nurses graduate with a standard skill set for entry-level practice.
• Nursing has general and specialty standards (e.g., medical-surgical nursing).
• The Academy of Medical-Surgical Nurses developed standards specific to medical-surgical practice.
• Medical-surgical nurses need specialized knowledge/skills.
• According to standards, they must participate in ongoing professional development.
• Nurses are held accountable to the standards of their specialty.
• The BON ensures each nurse practices within legal laws.
• Facilities cannot create policies allowing nurses to exceed their state NPA.
• Changes in the scope of practice are common due to the evolving healthcare environment.
• Competent nurses use the standards of practice with the nursing process.
• The nursing process guides nurses in delivering quality-based care.
• Nursing process includes assessment, analysis, planning, implementation, and evaluation.
• All licensed nurses must follow the state-mandated scope of practice.
• The scope of practice defines duties a nurse is competent and authorized to perform.
• Stipulates activities nurses can and cannot perform legally.

Standards of Professional Performance

• Nurses evaluate their own nursing practice.
• Nurses should seek information and guidance to ensure competent care.
• Nurses are responsible for professional actions and behavior.
• Includes interactions with clients, colleagues, and society.
• The Standards of Professional Performance describe expected behaviors, including quality of practice.

Nursing Students

• Educational nursing programs are regulated and approved by state BONs.
• This regulation and approval ensures programs cover the knowledge and skills needed for safe and competent care.
• Nursing programs must meet state requirements under the NPA to gain BON approval.
• This includes administrative rules and regulations.
• New schools can become accredited by the Accreditation Commission for Education in Nursing (ACEN) and the Commission on Collegiate Nursing Education (CCNE).
• Nursing program requirements may vary by state, the state BON must approve a nursing program.
• BONs continue to monitor nursing programs and offer recommendations.
• Educational standards for ongoing/new nursing programs are benchmarks set, approved, and monitored by the BON.
• The BON monitors programs to ensure safe and competent students graduate, protecting the public.
• Students must graduate from a BON-approved program and pass the National Council Licensure Examination (NCLEX) to obtain licensure.
• Nursing schools must verify to the BON that students have met program requirements and clinical learning objectives.
• Hands-on clinical learning experiences are important, in settings such as medical-surgical, maternal-newborn, pediatric, and psychiatric-mental health care.
• Faculty supervision assists students in broadening their knowledge, skills, clinical judgment and decision making.
• Programs can apply the Quality and Safety Education for Nursing (QSEN) competencies to assist faculty in teaching quality and safety.

QSEN

• The QSEN project began in 2005, based on the Institute of Medicine’s (2003) core competencies for all health clinicians in order to provide safe and quality care.
• Nursing-specific competencies were created by QSEN faculty and an advisory board.
• These competencies provide prelicensure students with knowledge, skills, and attitudes for quality and safety.
• The six QSEN competencies are patient-centered care, teamwork and collaboration, evidence-based practice (EBP), quality improvement (QI), safety, and informatics.
• Patient-centered care involves caring, compassionate, and culturally sensitive care.
• This compassionate care addresses a client’s physiological, psychological, sociological, spiritual, and cultural needs, preferences, and values.
• Teamwork and collaboration involves being aware of personal strengths and limitations.
• Evidence-based practice (EBP) competency involves analyzing the difference between evidence-based care and normal care.
• Quality improvement (QI) competency entails applying care-related and organizational processes to improve health care services.
• Safety competency involves minimizing risk factors and maintaining a secure environment.
• Informatics competency involves using technology as a communication and information-gathering tool for clinical decision-making.

NLN Competencies

• The National League of Nursing (NLN) fosters excellence in nursing education. NLN builds a strong and diverse nursing workforce.
• The mission of the NLN is to advance health in the nation and global community.
• The NLN’s nursing mission is guided by core values—caring, integrity, diversity, and excellence.
• The NLN Integrating Competencies ensure students are educated at the same fundamental level.
• The National League of Nursing Integrating Competencies address prelicensure and postlicensure nursing programs.
• New graduates should demonstrate human flourishing, nursing judgment, professional identity, and spirit of inquiry.
• Graduates should be ready to encourage human flourishing, demonstrate safe judgment, cultivate professional identity, and sustain a spirit of inquiry.

BSN Essentials

• The American Association of Colleges of Nursing (AACN) represents schools of nursing throughout the United States.
• The AACN serves as the voice for nursing education; it forms quality standards, promotes implementation, guides nurses in improving health care, and gains community support.
• The AACN's Bachelor of Science in Nursing Essentials consist of ten domains.
• These domains encompass the essentials that outline the expected curriculum content and required competencies for prelicensure baccalaureate programs.
• Domain 1, Knowledge for Nursing Practice: Applying and integrating knowledge from nursing and other disciplines for clinical judgment and innovation.
• Domain 2, Person-Centered Care: Coordinated, holistic, individualized, compassionate care that includes evidence-based practice.
• Domain 3, Population Health: Delivery of healthcare that includes public health and other entities to improve health outcomes through prevention and disease management.
• Domain 4, Scholarship for the Nursing Discipline: Generating, translating, applying, and disseminating nursing knowledge.
• Domain 5, Quality and Safety: Minimizing harm using improvement principles and effectiveness of systems.
• Domain 6, Interprofessional Partnerships: Collaboration with others to improve outcomes and health care experiences.
• Domain 7, System-Based Practice: Responding and leading within complex health care systems to provide equitable and safe care.
• Domain 8, Informatics and Healthcare Technologies: Utilizing informatics and other technologies to provide care and collect data to support decisions.
• Domain 9, Professionalism: Developing a professional identity that includes accountability, values, and personal characteristics.
• Domain 10, Personal, Professional, and Leadership Development: Includes self-reflection, resiliency, personal well-being, life-long learning, and leadership development.

NCSBN Transition to Practice

• The National Council of State Boards of Nursing (NCSBN) has studied problems related to the education and retention of new graduate nurses as they transition into practice.
• The NCSBN noted that the failure of new nurses to transition into the nursing role properly can have severe repercussions for practice, education, and retention.
• Roughly 25% of new nurses leave their job within the first year of practice.
• In 2011, NCSBN conducted research on the transition of new graduate nurses.
• The study used a sample of more than 1,000 new graduate registered nurses practicing in hospitals.
• The new graduates used the NCSBN Transition to Practice (TTP) model, a program developed by NCSBN, along with the guidance of a preceptor.
• This TTP program uses interactive models to reinforce skills and knowledge of graduate nurses through evidence-based modules.
• Content covered includes communication and teamwork, patient-centered care, evidence-based practice, quality improvement, and informatics.
• Results from the 2011 study showed that TTP participants provided safer care and demonstrated higher competency.
• TTP Participants also reported feeling less stressed and had increased work satisfaction, resulting in higher nurse retention rates.

Practical Nurses

• The National Association for Practical Nurse Education and Services (NAPNES) sets standards for LPN/LVN education.
• NAPNES advances the practice and education of practical and vocational nurses.
• Its “Standards of Practice and Educational Competencies of Graduates of Practical/Vocational Nursing Programs” provides an outline describing the scope and content of practical/vocational nursing education programs.
• The competencies outlined address the areas of professional behaviors, communication, assessment, planning, and caring interventions.
• Licensed practical nurses graduate after spending up to 18 months in an approved practical nursing certificate program.
• Upon completion, LPN/LVN graduates should demonstrate professional accountability/behavior and understand ethical, legal, and regulatory policies as defined in their state NPA.
• LPN/LVN graduates should: Effectively communicate with clients, families, and other providers.
• Demonstrate competence in data collection, report data, and evaluate client response.
• Use collected data to collaborate with the RN to plan client care based on nursing analysis and information.
• Display a caring demeanor in the delivery of safe and individualized therapeutic care.
• Care for clients as directed by the healthcare provider (RN, physician, or dentist).
• Perform interventions or delegate tasks to assistive personnel after completing nursing programs.
• LPN/LVNs must apply to the state BON for permission to take the NCLEX-PN.
• After meeting the requirements for the exam, the student must successfully pass the NCLEX-PN to become officially licensed by the BON.
• If the student fails the exam, there is a 45-90 day waiting period before retaking the exam.
• The scope of practice laws for LPNs are determined by the state.
• Each state's BON regulates activities the practical nurse can and cannot perform, as described in the NPA.
• State regulations may vary from one state to another for LPNs, just as they do for RNs.
• It is imperative for LPNs to be familiar with and follow their state’s NPA, which outlines those activities that are within their scope of practice.
• Facilities can narrow the state’s scope of practice.
• Employers can limit a nurse's role and responsibilities as outlined in the scope of employment, it can never be broader than what the NPA regulations deem within the nurse’s roles and responsibilities.
• The LPN performs many basic nursing functions.
• The LPN often works in different settings than the RN, which entails different job duties.
• The LPN frequently works in long-term care facilities, urgent care clinics, rehabilitation centers, and acute care hospitals.
• The LPN is not permitted to diagnose or independently treat clients.
• Thus, the LPN always works under the direct supervision of an RN or health care provider or APRN.
• The steps of the nursing process for the LPN are planning, implementing, and evaluating.

Data Collection (LPN)

• The LPN can observe, check, monitor, and collect client data to report to the RN.
• The LPN can determine the client’s level of pain.
• The LPN can assist in triage during disasters.
• The LPN can report changes in the client’s condition to the supervising RN or client’s health care provider.

Planning (LPN)

• The LPN can assist the RN with planning supportive and restorative care for stable clients.
• The LPN can delegate tasks to another LPN or nonlicensed assistive personnel (AP).
• The LPN delegating the task should consider the scope of practice/skill level of the person to whom the task is being delegated.

Implementation (LPN)

• The LPN can participate in interdisciplinary care.
• The LPN can recommend referrals and consultations.
• The LPN can assist with intravenous (IV) therapy.
• The LPN can monitor blood products.
• The LPN can care for peripheral IV lines.
• The LPN can choose correct communication.
• The LPN can assist with implementing interventions.
• The LPN can reinforce instructions with the client.

Evaluation (LPN)

• The LPN can collaborate with the RN and participate in the evaluation of the client’s response to care.
• The LPN can assist in reviewing and revising the client’s care plan.

Registered Nurses

• An RN holds a diploma, associate’s degree, or bachelor’s degree in nursing.
• An RN has successfully passed the NCLEX-RN exam.
• An RN has met all of the state's BON’s licensing obligations.
• The registered nurse agrees to follow the state’s scope of practice as determined by the BON.
• Each state’s BON decides its own scope of practice.
• The scope of practice may differ from one state to another.
• The RN can work independently in various settings.
• Standards of practice are descriptive statements.
• Standards of practice describe a competent level of care.
• RN standards of practice use the critical thinking model known as the nursing process.
• The RN uses the nursing process as the basis for decision-making and actions taken.

Assessment (RN)

• The RN can independently perform client assessments.

Analysis (RN)

• The RN can perform triage.
• The RN can determine priorities of client care.
• The RN can determine the implications of client findings in expected, unexpected, or emergent situations.

Planning (RN)

• The RN can develop the client’s plan of care.
• This includes client outcomes and appropriate nursing interventions.
• The RN can provide ongoing monitoring.
• The RN can delegate tasks among RNs, LPNs, and APs.
• The RN should consider the individual’s scope of practice and skill level when delegating a task to other health care providers.

Implementation (RN)

• The RN can provide comprehensive nursing care.
• The RN can develop and implement teaching plans.
• The RN can lead or participate in interdisciplinary care.
• The RN can provide IV therapy, which includes the administration of blood products, IV fluids, IV bolus, and medications.
• The RN can care for central venous lines.

Evaluation (RN)

• The RN can evaluate client responses to care.
• The RN can revise the plan of care based on client responses.
• The RN can initiate referrals to facilitate continuity of care.

Advanced Practice Registered Nurses

• APRNs have earned at least a master's degree in nursing.
• APRN roles include:
  • Certified Nurse Anesthetist (CRNA)
  • Certified Nurse-Midwife (CNM)
  • Clinical Nurse Specialist (CNS)
  • Certified Nurse Practitioner (NP)
• NPs choose a specialty track (e.g., geriatric care, primary care, psychiatric care).
• The APRN is licensed as an independent practitioner who can practice autonomously.
• NPs care for clients throughout the lifespan in various healthcare settings.
• Settings include private practices, hospitals, clinics, emergency rooms, urgent care centers, nursing homes, retail clinics, and home health.
• APRNs’ scope of practice differs from state to state.
• The APRN is a decision-maker in planning care, prescribing medication, and evaluating the client.
• Further responsibilities of the APRN role include leadership, education, professional development, participation in professional organizations, and involvement in health care policy activities.

Standards of Professional Nursing Practice

• The standards of professional nursing practice define responsibilities expected of every nurse, regardless of role, population, or specialty.
• The standards of professional nursing practice consist of the Standards of Practice and the Standards of Professional Performance.

NCSBN (NCLEX)

• The National Council of State Boards of Nursing (NCSBN) includes state BONs—representing the 50 states, the District of Columbia, and the four U.S. territories—that are responsible for regulating the practice of nursing.
• Some states have separate licensing agencies for RNs, practical nurses, and APRNs.
• The NCSBN is responsible for the development of the nurse licensure and certification exams, including the National Council Licensure Examination (NCLEX).
• The NCLEX-RN and NCLEX-PN exams are standardized adaptive tests developed by the NCSBN and used by state regulatory boards.
• Two purposes of the NCLEX are to determine if a candidate is safe to practice as an entry-level nurse and to ensure exams are fair and comprehensive.
• Every three years, the NCSBN updates the NCLEX-RN and NCLEX-PN test plans to ensure that the exams reflect current practice.
• The test plans serve as a resource for graduate nurses to use in preparing for the NCLEX-RN or NCLEX-PN exam.

NCLEX

• The state BON grants permission to practice once the applicant meets competency requirements.
• Licensure involves verifying graduation from an approved nursing education program, confirming successful completion of the NCLEX, and in some states, a criminal background check.
• To be eligible for the NCLEX, graduates must submit a licensure application and pay a fee to the state BON.
• Initial licensure requires disclosing any criminal record, substance misuse within the last five years, and disciplinary actions against a professional license.
• Graduates must register/make an appointment at a Pearson VUE testing center.
• The state BON validates the applicant’s eligibility to take the NCLEX exam.
• Registration will stay open for 365 days.
• Applicants receive validity dates on the Authorization to Test (ATT) email.
• The ATT is valid for approximately 90 days.
• Applicants forfeit the NCLEX registration if they do not receive eligibility notification from the state BON within 365 days.
• The NCLEX-RN and NCLEX-PN exams use a national standardized Computerized Adaptive Testing (CAT) method.
• CAT measures a candidate’s real competence by selecting test questions based on previous answers and difficulty.
• After each answer, the computer re-estimates the candidate’s ability and selects the next question with a 50% chance of being answered correctly.
• Once a candidate has answered the minimum number of questions correctly, the CAT will end the exam.
• All 50 states have the same criteria for passing; the NCLEX-RN and NCLEX-PN exams are graded as either pass or fail.
• The NCSBN created three rules to determine if a candidate passes or fails the NCLEX exam.
• The 95% confidence interval rule is most commonly used.
• With this rule, the computer stops when it is 95% certain that the candidate’s ability is above or below the passing standard.
• A maximum-length exam determines if the candidate passes or fails the exam.
• It is used when the candidate’s ability is close to the passing standard.
• The computer continues until the maximum number of items is reached.
• With this rule, the 95% rule will not be considered, and the candidate’s final ability estimate is used to determine pass or fail.
• A run-out-of-time rule is used when the candidate runs out of time.
• With this rule, the candidate runs out of time before reaching the maximum number of items and the computer cannot determine a pass or fail result.
• If this performance is above the standard, the student will pass; if it is below the standard, this candidate will fail.
• Candidates who fail the NCLEX-RN or NCLEX-PN must wait a minimum of 45 days before retaking the exam.
• The minimum number of questions for the NCLEX-RN is 85, and the maximum number of questions is 150.
• For the NCLEX-PN, the minimum number of questions is 85, and the maximum number of questions is 150.
• The questions asked on the NCLEX-RN and NCLEX-PN differ in content, as each exam is based on the education received and scope of practice.
• The NCLEX-RN emphasizes the management of care.
• The NCLEX-PN emphasizes the coordination of care.
• If a candidate is unsuccessful in passing the NCLEX-RN or NCLEX-PN, he or she is permitted to retake the exam after waiting a minimum of 45 days before the new attempt.
• Candidates are allowed to retake the NCLEX exam no more than a total of eight times a year
• Individual state BONs are responsible for issuing initial licenses.
• They review information to ensure the applicant has met all licensure requirements.

Licensure

• Licensure authorizes an individual to practice nursing within a specific scope of practice.
• Ensures individuals have met qualifications to protect the public.
• Nursing requires a valid license to practice legally.

Maintaining Licensure

• Periodic license renewal is required to maintain the right to practice nursing.
• State BONs implement procedures for license renewal, including mandated continuing education and practice hours.
• Requirements vary among state BONs, especially for nurses with multistate licensure.
• When renewing, nurses must disclose any criminal record, any condition or impairment affecting safe practice, and actions against a professional license.
• Nurses must adhere to state laws or risk BON disciplinary action.
• Actions that harm a client can lead to reprimand, probation, limits on practice, suspension, or revocation of license.
• Nurses must practice within their defined scope based on their education, knowledge, skills, and abilities.
• The BON can grant and revoke licenses for unsafe nurses.

Nurse Licensure Compact

• Nurses can provide services outside their primary state of residence with telehealth.
• Nurses use telehealth, machines, services, or interventions in which health-related information is provided remotely to improve client access to care.
• Examples of telehealth nursing include monitoring clients from virtual hospitals, using remote client monitoring units to collect data, staffing call centers, and providing care from a home office such as with case management.
• The Nurse Licensure Compact (NLC) allows nurses to practice in their primary state and other compact states under one multistate license.
• The NLC was developed in 1997 by NCSBN, and 41 states currently recognize the multistate license.
• A travel nurse is a registered nurse who takes a temporary assignment, typically lasting 13 weeks, in an area of specialty.
• The NLC is beneficial for nurses who practice across state lines, telehealth nursing, nurse educators, and nurses who provide services during disasters in other NLC states, as well as travel nurses.
• Nurses residing in a compact state and meet the uniform licensure requirements apply for a multistate license in another NLC state.
• Nurses must hold a valid/active license in their primary state to be approved for a multistate license.
• Nurses must follow rules of the state in which they are practicing.
• Nurses providing telehealth services must also understand the criteria for licensure renewal for both states.
• Nurses must follow the state's NPA in which they are practicing and are subject to legal ramifications.
• Single-state licensing requires a license in every state of practice.

Reciprocity

• States are "reciprocal states" when accepting a valid nursing license from another state.
• All 50 states practice reciprocity, as all graduate nurses take the same computerized NCLEX exam and have the same requirements for passing.
• Applying for initial licensure differs from applying for reciprocity.
• RNs who wish to transfer a single-state license must have a valid license with a clean record, submit an application with the state BON for a license, and pay a fee before being approved.
• Nurses are not required to retake exams, repeat classes, or reapply for specialty nursing certification.

National Certification in Specialty Practice

• Demonstrate proficiency through certificate programs or certification in a specialty area of practice.

Certificate Programs

• Certificate programs cover specific content and are offered by schools of nursing or for-profit organizations.
• Completion of these programs allows the nurse to enhance his or her practice in a specific area; to fortify his or her curriculum vitae or resume, making the nurse more marketable; and potentially, to result in an increase in both.
• Focus areas for programs include leadership, management, and behavioral health.
• Nurses completing the programs can list them on resumes and may see a salary increase.
• Some programs are restricted to nurses with advanced degrees, while others are open to undergraduate nurses.
• Certificate programs generally offer continuing education contact hours.

Certification

• Nurses can become experts in their specialty field through certification.
• Passing the NCLEX exam demonstrates minimum competency.
• Certification in a specialty area demonstrates knowledge, expert clinical judgment and reduces the risk of errors.
• Certification can lead to increased salary or promotion, resulting in nurses advancing on the facility's clinical ladder.
• Professional organizations offer certification programs, including review courses.
• Registered nurses can earn certification in areas such as ambulatory care, cardiac vascular, gerontological, informatics, medical-surgical, nurse executive, nursing case management, nursing professional development, pain management, pediatric, and psychiatric–mental health.
• Eligibility requirements include a nursing degree, a valid nursing license, specified hours providing direct care and passing of a certification exam.
• A nurse is then eligible to include the certification as part of his or her title,

Credentialing

• Credentialing confirms an individual’s abilities to practice as a health professional.
• Standards of care require the individual to complete a program of study and demonstrate abilities established as standards of care.

Nursing Credentials

• Nurses passing the NCLEX exam sign legal documentation with their credentials.
• Credentials show nurses have met standards of excellence.
• A nurse’s credentials are listed with the highest educational level attained first, followed by licensure, state designation, national certification, honors, and other certifications.
• Recredentialing occurs typically every 3 years or less.
• Recredentialing is governed by state and local statutes.
• A nurse can further their education by obtaining an MSN degree specializing as a nurse educator or nurse practitioner.

Credentialing

• Credentialing is a process that confirms an individual’s abilities to practice.
• Federal/local laws may dictate credentials and verification for organizations.
• Credentialing is completed upon hiring and updated routinely.
• Nurses must provide a copy of their resume, curriculum vitae, and an official transcript.

Learning Objectives:

• Discuss the standards of professional practice and their impact on the delivery of client care.
• Discuss the process for obtaining and maintaining licensure and credentialing.