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Board of Registration Board of Registration

in Nursingin Nursing

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Module 3: Module 3:

Preparing for Practice as an Preparing for Practice as an Advanced Practice Registered Advanced Practice Registered

Nurse (APRN): Board Nurse (APRN): Board AuthorizationAuthorization

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Prohibition of PracticeProhibition of Practice

• Board authorization to practice must Board authorization to practice must be obtained prior to:be obtained prior to:• Engaging in practice as an Advanced Engaging in practice as an Advanced

Practice Nurse (APRN)Practice Nurse (APRN)• Using any APRN credentialsUsing any APRN credentials• Identifying self as APRN by signs, name Identifying self as APRN by signs, name

tag, stationary and similar devicestag, stationary and similar devices

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APRN AuthorizationAPRN Authorization

Written authorization granted by the Written authorization granted by the Massachusetts Board of Massachusetts Board of

Registration in Nursing to a Registration in Nursing to a Registered Nurse, under authority Registered Nurse, under authority of M.G.L. C. 112, s. 80B to engage of M.G.L. C. 112, s. 80B to engage in advanced practice nursing as in advanced practice nursing as

defined in 244 CMR 4.00defined in 244 CMR 4.00

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Becoming Authorized to Practice Becoming Authorized to Practice as an APRNas an APRN

• Graduation from formal Graduation from formal education program which has education program which has as its objective the preparation as its objective the preparation of nurses to practice in a of nurses to practice in a defined advanced practice roledefined advanced practice role

• Current, unencumbered MA Current, unencumbered MA Registered Nurse (RN) Registered Nurse (RN) licensurelicensure

• Determination of Good Moral Determination of Good Moral Character (GMC)Character (GMC)

• Attainment of certification Attainment of certification from a nationally recognized from a nationally recognized accrediting body approved by accrediting body approved by the Board in a category the Board in a category recognized in regulationrecognized in regulation

• Payment of feesPayment of fees

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Board Authorization Board Authorization Requirements for APRNRequirements for APRN

• Compliance with the requirements of 244 CMR 4.00, as evidenced by documentation filed with and acceptable to the Board

• Applications available at www.pcshq.com

• Read and follow instructions carefully to avoid delay

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Educational PreparationEducational Preparation• Satisfactory completion of a formal Satisfactory completion of a formal

educational program which has as its educational program which has as its objective the preparation of registered objective the preparation of registered nurses to practice in the advanced rolenurses to practice in the advanced role

• Program must be Board recognizedProgram must be Board recognized• Advanced physical assessmentAdvanced physical assessment• Advanced pathophysiologyAdvanced pathophysiology• Advanced pharmacology (minimum 24 Advanced pharmacology (minimum 24

hours beyond generic RN education)hours beyond generic RN education)

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EducationEducation

• Advanced nursing Advanced nursing knowledge and clinical knowledge and clinical skills acquired through an skills acquired through an Board recognized programBoard recognized program

• Advanced skills including Advanced skills including evaluation, diagnosis, and evaluation, diagnosis, and treatmenttreatment

• Not considered the generic Not considered the generic practice of registered nursepractice of registered nurse

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CNS Grandfather ClauseCNS Grandfather Clause

• Effective until December 31, 2016Effective until December 31, 2016• the Board will accept current CNS certification the Board will accept current CNS certification

granted by a Board-recognized certifying granted by a Board-recognized certifying organization as equivalent to the requirements organization as equivalent to the requirements for inclusion of pathophysiology, advanced for inclusion of pathophysiology, advanced assessment and pharmacology in educational assessment and pharmacology in educational curricula curricula

• the CNS who is authorized by the Board on the the CNS who is authorized by the Board on the basis of this equivalent competency will be basis of this equivalent competency will be eligible to renew his or her authorization eligible to renew his or her authorization

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RN licenseRN license

• Current, unencumberedCurrent, unencumbered

• Has met good moral character Has met good moral character requirementsrequirements

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Application ProcessApplication Process

• Obtain instructions and Obtain instructions and application from Professional application from Professional Credentialing Services (PCS)Credentialing Services (PCS)

• www.pcshq.comwww.pcshq.com • Read, complete in entirety, Read, complete in entirety,

follow directionsfollow directions to avoid to avoid delaydelay

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Each application for initial, Each application for initial, additional or reciprocal additional or reciprocal authorization must be authorization must be received by PCS, fully received by PCS, fully completed and legible, completed and legible,

with all required with all required documentation, before it documentation, before it

will be reviewed.will be reviewed.

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Good Moral CharacterGood Moral Character

Licensed nurses in Massachusetts who fulfill Licensed nurses in Massachusetts who fulfill the the Good Moral Character Good Moral Character requirement are requirement are honest, trustworthy, accountable, reliable, have honest, trustworthy, accountable, reliable, have integrity, and are able to distinguish between integrity, and are able to distinguish between right and wrong. They also avoid aggression to right and wrong. They also avoid aggression to self and others, and avoid injustice and deceit.self and others, and avoid injustice and deceit.

• Review Review Module 2: Standards of PracticeModule 2: Standards of Practice for for detailed GMC informationdetailed GMC information

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Right to ReviewRight to Review• If you are denied license If you are denied license

based on the Good Moral based on the Good Moral Character requirement, you Character requirement, you have the right to review your have the right to review your denial.denial.

• You will be required to provide You will be required to provide documentation which can documentation which can reasonably substantiate the reasonably substantiate the existence of specific areas of existence of specific areas of factual dispute relevant to the factual dispute relevant to the issue. issue.

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CertificationCertification

• Review Review Module 4: Competence: A Legal Module 4: Competence: A Legal Requirement to Advanced Registered Nursing Requirement to Advanced Registered Nursing PracticePractice for detailed certification information for detailed certification information

• Must have completed Must have completed requirements and attained requirements and attained certification from Board certification from Board approved, national, approved, national, professional certifying professional certifying organizationorganization

• Certification in Board Certification in Board recognized category in recognized category in regulations at 244 CMR regulations at 244 CMR 4.004.00(CNP, PCNS, CRNA, CNM, (CNP, PCNS, CRNA, CNM,

CNS)CNS)

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Prescriptive Practice Prescriptive Practice GuidelinesGuidelines

• With the exception of CNM, APRN’s with With the exception of CNM, APRN’s with prescriptive authority must have guidelinesprescriptive authority must have guidelines

• CNS do not have prescriptive practiceCNS do not have prescriptive practice

• Review Review Module 5: Legal Scope of APRN Module 5: Legal Scope of APRN PracticePractice for detailed guideline for detailed guideline informationinformation

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Legal DocumentationLegal Documentation

• In all records required by federal and state In all records required by federal and state laws and regulations and accepted standards laws and regulations and accepted standards of nursing practiceof nursing practice• Must be accurate, complete, legibleMust be accurate, complete, legible• Sign name and initials as they appear on Sign name and initials as they appear on

your license (CNP, PCNS, CRNA, CNM, CNS)your license (CNP, PCNS, CRNA, CNM, CNS)

• May use certification credentials on business May use certification credentials on business cards, stationary, advertisements, and other cards, stationary, advertisements, and other similar correspondencesimilar correspondence

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Authorization Authorization DocumentationDocumentation• Once authorized, the Board will send you written Once authorized, the Board will send you written

notification of your authorization approvalnotification of your authorization approval

• You will receive a wallet sized document soon You will receive a wallet sized document soon after indicating your APRN Board approved after indicating your APRN Board approved categorycategory

• Your Board authorization will appear on the Your Board authorization will appear on the Board’s website under “Check a License” and is Board’s website under “Check a License” and is considered the most “up to date” information considered the most “up to date” information and is primary source verificationand is primary source verification

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Authorization Renewal Authorization Renewal Requirements Requirements

• Due on your birthday in the even numbered Due on your birthday in the even numbered yearsyears

• Current MA registered nurse licensureCurrent MA registered nurse licensure• Determination of GMCDetermination of GMC• CurrentCurrent certification from a nationally recognized certification from a nationally recognized

accrediting body approved by the Boardaccrediting body approved by the Board• Signature attesting to compliance with Board Signature attesting to compliance with Board

laws and regulations. READ WHAT YOU SIGN!!laws and regulations. READ WHAT YOU SIGN!!• Payment of feesPayment of fees

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On-line renewal is On-line renewal is recommendedrecommended

• FastFast

• SecureSecure

• Provides for immediate verification Provides for immediate verification via the Board’s website via the Board’s website

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Certification RenewalCertification Renewal

• A A requirementrequirement for Board authorization for Board authorization• Certification Certification mustmust be current to be current to

continue authorizationcontinue authorization• You are responsibleYou are responsible to fulfill the to fulfill the

requirements of the certifying requirements of the certifying organizationorganization

• You are responsibleYou are responsible to know when your to know when your certification renewal is duecertification renewal is due

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Wallet size documentationWallet size documentation

• You will receive two wallet sized You will receive two wallet sized documents when you renewdocuments when you renew

• Your RN licenseYour RN license

• Your APRN authorizationYour APRN authorization

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Scope of Practice Scope of Practice Category vs. Category vs. SpecializationSpecialization

• Board authorizes APRN practice by category, Board authorizes APRN practice by category, not by specialization not by specialization within the categorywithin the category

• Category competency determines:Category competency determines:• Ages of population servedAges of population served• Characteristics of population servedCharacteristics of population served• Medical conditions of population servedMedical conditions of population served• Activities performedActivities performed

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Demonstration of Demonstration of CompetencyCompetency

• Certification Certification • ExperienceExperience

• On the job trainingOn the job training

• On-going educationOn-going education• Attendance at educational sessionAttendance at educational session• Formal course workFormal course work

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Scope of PracticeScope of Practice

• An APRN’s scope of practice is An APRN’s scope of practice is determined by the knowledge, skills determined by the knowledge, skills and abilities attainedand abilities attained

• Able to demonstrate competency in Able to demonstrate competency in the activitythe activity

• Responsible for own practiceResponsible for own practice

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No longer practicing?No longer practicing?

• Should you want to rescind your APRN Should you want to rescind your APRN authorization, complete the Board’s form authorization, complete the Board’s form at at http://www.mass.gov/Eeohhs2/docs/dph/qhttp://www.mass.gov/Eeohhs2/docs/dph/quality/boards/nursing_aprn_resign_letter.puality/boards/nursing_aprn_resign_letter.pdfdf

• Remember!! Once you rescind your Remember!! Once you rescind your authorization you will be required to meet authorization you will be required to meet the current authorization requirements to the current authorization requirements to make authorization as an APRN currentmake authorization as an APRN current

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Review 4.00 and 9.00Review 4.00 and 9.00

• Go to the Board’s website to review:Go to the Board’s website to review:• 244 CMR 4.00: Massachusetts 244 CMR 4.00: Massachusetts

Regulations Governing Advanced Regulations Governing Advanced Practice Registered NursingPractice Registered Nursing

• 244 CMR 9.00: Standards of Conduct244 CMR 9.00: Standards of Conduct

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Get into the habit of Get into the habit of Checking the Board’s WebsiteChecking the Board’s Website

www.mass.gov/dph/boards/rnwww.mass.gov/dph/boards/rn

• News and UpdatesNews and Updates• Practice IssuesPractice Issues• AlertsAlerts• Regulatory GuidanceRegulatory Guidance• Advisory RulingsAdvisory Rulings• NewslettersNewsletters

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Board of Registration in NursingBoard of Registration in Nursing239 Causeway Street239 Causeway Street22ndnd Floor, Suite 200 Floor, Suite 200Boston, MA 02114Boston, MA 02114

On-Line RenewalOn-Line Renewal

www.mass.gov/dph/boards/rnwww.mass.gov/dph/boards/rn(go to (go to On Line ServicesOn Line Services in right margin) in right margin)