Assembly Bill No. 78–Assemblymen Dini, Anderson, Price, Bache, Buckley, Chowning, Gibbons, Giunchigliani, Goldwater, Humke, Koivisto, Marvel and Perkins

 

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AN ACT relating to health care; revising the definitions of “practice of practical nursing” and “practice of professional nursing” to specify that a nurse may accept direction from a physician’s assistant; authorizing a registered nurse to possess and administer certain drugs and medicines at the direction of a physician’s assistant; and providing other matters properly relating thereto.

 

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN

SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

 

   Section 1. NRS 632.017 is hereby amended to read as follows:

   632.017  “Practice of practical nursing” means the performance of

 selected acts in the care of the ill, injured or infirm under the direction of a

 registered professional nurse, an advanced practitioner of nursing, a

 licensed physician, a licensed physician’s assistant, a licensed dentist or a

 licensed podiatric physician, not requiring the substantial specialized skill,

 judgment and knowledge required in professional nursing.

   Sec. 2.  NRS 632.018 is hereby amended to read as follows:

   632.018  “Practice of professional nursing” means the performance of

 any act in the observation, care and counsel of the ill, injured or infirm, in

 the maintenance of health or prevention of illness of others, in the

 supervision and teaching of other personnel, in the administration of

 medications and treatments as prescribed by an advanced practitioner of

 nursing, a licensed physician, a licensed physician’s assistant, a licensed

 dentist or a licensed podiatric physician, requiring substantial specialized

 judgment and skill based on knowledge and application of the principles

 of biological, physical and social science, but does not include acts of

 medical diagnosis or prescription of therapeutic or corrective measures.

   Sec. 3.  NRS 454.213 is hereby amended to read as follows:

   454.213   A drug or medicine referred to in NRS 454.181 to 454.371,

 inclusive, may be possessed and administered by:

   1.  A practitioner.

   2.  A physician’s assistant at the direction of his supervising physician

 or a licensed dental hygienist acting in the office of and under the

 supervision of a dentist.

   3.  Except as otherwise provided in subsection 4, a registered nurse

 licensed to practice professional nursing or licensed practical nurse, at the

 direction of a prescribing physician, physician’s assistant, dentist,

 podiatric physician or advanced practitioner of nursing, or pursuant to a

 chart order, for administration to a patient at another location.

   4.  In accordance with applicable regulations of the board, a registered

 nurse licensed to practice professional nursing or licensed practical nurse

 who is:

   (a) Employed by a health care agency or health care facility that is

 authorized to provide emergency care, or to respond to the immediate

 needs of a patient, in the residence of the patient; and

   (b) Acting under the direction of the medical director of that agency or

 facility who works in this state.

   5.  An intermediate emergency medical technician or an advanced

emergency medical technician, as authorized by regulation of the state

 board of pharmacy and in accordance with any applicable regulations of:

   (a) The state board of health in a county whose population is less than

 100,000;

   (b) A county board of health in a county whose population is 100,000 or

 more; or

   (c) A district board of health created pursuant to NRS 439.370 in any

 county.

   6.  A respiratory therapist employed in a health care facility. The

 therapist may possess and administer respiratory products only at the

 direction of a physician.

   7.  A dialysis technician, under the direction or supervision of a

 physician or registered nurse only if the drug or medicine is used for the

 process of renal dialysis.

   8.  A medical student or student nurse in the course of his studies at an

 approved college of medicine or school of professional or practical

 nursing, at the direction of a physician and:

   (a) In the presence of a physician or a registered nurse; or

   (b) Under the supervision of a physician or a registered nurse if the

 student is authorized by the college or school to administer the drug or

 medicine outside the presence of a physician or nurse.

A medical student or student nurse may administer a dangerous drug in the

 presence or under the supervision of a registered nurse alone only if the

 circumstances are such that the registered nurse would be authorized to

 administer it personally.

   9.  Any person designated by the head of a correctional institution.

   10.  An ultimate user or any person designated by the ultimate user

 pursuant to a written agreement.

   11.  A nuclear medicine technologist, at the direction of a physician

 and in accordance with any conditions established by regulation of the

 board.

   12.  A radiologic technologist, at the direction of a physician and in

 accordance with any conditions established by regulation of the board.

   13.  A chiropractic physician, but only if the drug or medicine is a

 topical drug used for cooling and stretching external tissue during

 therapeutic treatments.

   14.  A physical therapist, but only if the drug or medicine is a topical

 drug which is:

   (a) Used for cooling and stretching external tissue during therapeutic

 treatments; and

   (b) Prescribed by a licensed physician for:

     (1) Iontophoresis; or

     (2) The transmission of drugs through the skin using ultrasound.

   15.  In accordance with applicable regulations of the state board of

 health, an employee of a residential facility for groups, as defined in NRS

 449.017, pursuant to a written agreement entered into by the ultimate user.

   16.  A veterinary technician at the direction of his supervising

 veterinarian.

   17.  In accordance with applicable regulations of the board, a registered

pharmacist who:

   (a) Is trained in and certified to carry out standards and practices for

 immunization programs;

   (b) Is authorized to administer immunizations pursuant to written

 protocols from a physician; and

   (c) Administers immunizations in compliance with the “Standards of

 Immunization Practices” recommended and approved by the United States

 Public Health Service Advisory Committee on Immunization Practices.

 

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