Illinois nursing and advanced practice nursing act of 1998 and the rules to administer the act: A brief overview, The

Chart, May/Jun 2001 by Brent, Nancy J

The professional nurse or advanced practice nurse (APN) who seeks licensure in Illinois, or who is already licensed in Illinois, must be familiar with the many state laws that affect nursing practice and nursing education. Often, the professional nurse or the APN focuses concerns relating to their respective practice on liability concerns when care results in an injury or death to the patient(s). Liability concerns which may result under regulatory laws relating to the practice of professional nursing are often overlooked or ignored until the nurse finds himself or herself facing accountability under one of more of those laws. What is ironic about this selective liability approach by professional nurses is that it ignores the fact that the potential for liability for patient injury or death, for example, can clearly overlap with the potential for liability under the state's regulatory network. There is no "one-or-the-other" mutually exclusive arena for potential liability in professional nursing practice. If, for example, a professional nurse's or APN's alleged conduct results in patient injury or death, or if documentation is not properly done or not done at all, the nurse can be held liable in the arenas of both civil and administrative law. The end result is a suit against the nurse for alleged malpractice and a complaint to the Illinois Department of Professional Regulation for an alleged violation of the Illinois Nursing and Advanced Practice Nursing Act of 1998 (INAPNA) and/or its Rules to Administer the Act (225 ILCS 225 65/1 - 65/49 (2000); 68 IL AD 1300.10-1300.70, with Appendixes (2000)).

Likewise, educational requirements for nursing education programs mandated by the INAPNA are not often reviewed by nurses licensed in Illinois or those seeking licensure in the state. Important requirements concerning obtaining a license and school of nursing program requirements focusing on such things as faculty requirements and National Council Licensure Examination (NCLEX) pass rates can be helpful to the individual beginning his or her nursing education program as well as to the practicing professional or APN.

ADMINISTRATION AND ENFORCEMENT OF THE INAPNA

The INAPNA is administered and enforced by the Illinois Department of Professional Regulation (IDPR), the governmental agency legislatively mandated to do so (Illinois Department of Professional Regulation. Enforcement Division. Available on the Department's web site at www.dpr.state.il.us/how/pag_e10.asp, accessed February 12, 2001). The IDPR must do so, however, in conjunction with the Board of Nursing for the registered professional nurse and licensed practical nurse, and with the Advanced Practice Nursing Board for the advanced practice nurse. The Board of Nursing's role is to, among other things: conduct hearings and disciplinary conferences when allegations of the Act are purported against a registered professional nurse or licensed practical nurse, recommend actions to be taken against a nurse licensee upon the completion of a hearing, and participate in the approval, withdrawal of approval or discipline of nursing education programs (225 ILCS 65/10-25 (1998)). The Advanced Practice Nursing Board is responsible for reviewing complaints it receives when an advanced practice nurse's professional conduct is alleged to be in violation of the Act, recommending courses of treatment needs by the advanced practice nurse, and recommending discipline against the advanced practice nurse (225 ILCS 65/15-35 (1999); 225 ILCS 65/ 15-50 (1998)).

Qualifications for each board of nursing's members and respective terms are also included in the Act. For example, the Board of Nursing must be composed of seven registered nurses, two licensed practical nurses, and one public, non-voting member. The RNs and LPNs must meet specific educational and practice requirements. The Advanced Practice Nursing Board is composed of nine members, four of whom are advanced practice nurses (225 ILCS 65/10-25 (1999); 225 ILCS 65/15-35 (1999)).

DEFINITIONS

One of the first sections that should be read in the INAPNA is its Definition Sections for the registered professional nurse, licensed practical nurse and the APN. How the Act uses the terms within it is carefully explained. Moreover, the definitions include the legal scope of practice acceptable in Illinois. For example, the definition of "registered professional nurse practice" provides the State of Illinois's viewpoint about nursing practice and its varied roles, including, but not limited to, the ability of the nurse to: 1) assess health care needs, 2) conduct nursing diagnosis, planning, implementation, and nursing evaluation, and 3) delegate to and supervise individuals who assist the registered professional nurse implementing the plan of care (225 ICLS 65/5-100) (1998)). Likewise, "advanced practice nursing" is defined by, among other things, the caring for patients using advanced diagnostic skills, ordering diagnostic tests, prescribing medications and using medical, therapeutic and corrective measures to treat illness and improve health status. APN categories in Illinois include the certified nurse midwife (CNM), certified nurse practitioner (CNP), certified registered nurse anesthetist (CRNA), and certified clinical nurse specialist (CNS) (225/ICLS 65/15-5 (1999)).