2001 REGULAR SESSION (71st)                                                                                 A SB91 76

Amendment No. 76

 

 

 

     Amend sec. 2, page 1, line 13, after “assistant” by inserting:

“, certified registered nurse anesthetist”.

     Amend sec. 27, page 10, line 26, by deleting “800” and inserting “600”.

     Amend sec. 28, page 11, line 18, by deleting “or interaction”.

     Amend sec. 28, page 11, line 20, by deleting “or interaction”.

     Amend sec. 28, page 11, by deleting lines 21 and 22 and inserting:

“has an adverse impact on the quality of care rendered to a patient.”.

     Amend sec. 28, page 11, line 29, by deleting:

“for the sole purpose” and inserting:

“with the intent”.

     Amend sec. 28, page 11, by deleting lines 31 and 32 and inserting:

     “9.  The engaging in conduct that brings the medical profession into disrepute, including, without”.

     Amend the bill as a whole by adding new sections designated sections 77.1, 77.3 and 77.5, following sec. 77, to read as follows:

     “Sec. 77.1.  Section 1 of Assembly Bill No. 78 of this session is hereby amended to read 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 assistant, a licensed dentist or a licensed podiatric physician, not requiring the substantial specialized skill, judgment and knowledge required in professional nursing.

     Sec. 77.3.  Section 2 of Assembly Bill No. 78 of this session is hereby amended to read as follows:

     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 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. 77.5. Section 3 of Assembly Bill No. 78 of this session is hereby amended to read as follows:

     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 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 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.

FLUSH

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.”.