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24.159.301    DEFINITIONS

(1) "Accrediting organization" means a professional organization that establishes standards and criteria for continuing education programs.

(2) "Advanced Practice Registered Nurse" or "APRN" means a registered nurse licensed by the board to practice as an advanced practice registered nurse pursuant to 37-8-202, MCA. Four APRN roles are recognized by Montana law:

(a) Certified Nurse Practitioner (CNP);

(b) Certified Nurse Midwife (CNM);

(c) Certified Registered Nurse Anesthetist (CRNA); and

(d) Clinical Nurse Specialist (CNS).

(3) "Assistive person" or "AP" means any person, regardless of title, who is not a licensed nurse and who functions in an assistive role to the nurse and receives delegation of nursing tasks. 

(4) "Board" means the Montana Board of Nursing.

(5) "Certifying body" means a board-recognized national certifying organization that uses psychometrically sound and legally defensible examinations for certification in APRN roles and population focus.

(6) "Charge Nurse" means the nurse who is in charge of patient and/or resident care during a nursing shift. An LPN may serve as a charge nurse in the absence of an RN in a long-term care facility, pursuant to 37-8-102, MCA.

(7) "CNOR" means the documented validation of the professional achievement of identified standards of practice by an individual registered nurse providing care for patients before, during, and after surgery.

(8) "Competency" means performing skillfully and proficiently the functions that are within the role of the licensee, and demonstrating the interrelationship of essential knowledge, judgment, and skills.

(9) "Contact hours" means the time period of instruction determined by the continuing education provider and indicated on the participant's certificate of completion. One academic semester credit equals 15 contact hours; one academic quarter credit equals 12.5 contact hours.

(10) "Continuing education" means a planned learning activity that occurs in a classroom, online, audio-conference, video-conference, or as independent study. All continuing education must be approved by an accrediting organization or provided by an accredited academic institution of higher learning, a continuing education provider, or a certifying body.

(11) "Continuing education provider" means an entity approved by an accrediting organization to provide continuing education programs.

(12) "Delegation" means the act of authorizing and directing an AP to perform a specific nursing task in a specific situation in accordance with these rules.

(13) "Department" means the Montana Department of Labor and Industry as provided for in Title 2, chapter 15, part 17, MCA.

(14) "Direction" means a communication of a plan of care based upon assessment of a patient by a registered nurse or a licensed independent health care provider pursuant to 37-8-102, MCA, that sets forth the parameters for the provision of care or for the performance of a procedure.

(15) "Direct supervision" means the supervisor is on the premises and is quickly and easily available.

(16) "Drug" means a substance defined by 37-7-101, MCA.

(17) "Focused nursing assessment" is conducted by a licensed practical nurse and is an appraisal of an individual's status and situation at hand, contributing to the comprehensive assessment by the registered nurse, supporting ongoing data collection, deciding who needs to be informed of the information, and when to inform.

(18) "Health team" means a group of health care providers which may, in addition to health care practitioners, include the client, family, and significant others.

(19) "Immediate supervision" means the supervisor is on the premises and is within audible and visual range of the patient.

(20) "Independent study" means a self-paced learning activity directed by a continuing education provider that includes both a mechanism for evaluation and feedback to the learner.

(21) "National accreditation" means the ongoing review, evaluation, and approval of nursing education programs by a national nursing accrediting agency that is recognized by the U.S. Department of Education. Nursing education programs without national accreditation are nonaccredited programs.

(22) "National professional organization" means a board-recognized professional nursing membership organization that delineates nursing practice standards and guidelines.

(23) "New nursing education program" means the initiation or addition of a new terminal degree or certificate in nursing education that prepares graduates for initial licensure.

(24) "Nursing assessment" means a systematic collection of data to determine the patient's health status and to identify any actual or potential health problems.

(25) "Nursing procedures" means those nursing actions selected and performed in the delivery of safe and effective patient/client care.

(26) "Nursing process" means the traditional systematic method nurses use when they provide:

(a) nursing care including assessment;

(b) nursing analysis;

(c) planning;

(d) nursing intervention; and

(e) evaluation.

(27) "Nursing task" means an activity that requires the use of nursing knowledge, skills, and/or abilities.

(28) "Ordering" means authorizing durable medical devices and equipment, nutrition, diagnostic, and supportive services, including, but not limited to, home healthcare, hospice, and physical and occupational therapy.

(29) "Peer review" means the process of evaluating the practice of nursing, conducted by a peer-reviewer.

(30) "Peer-reviewer" for APRN practice means a licensed APRN or physician whose credentials and practice encompass the APRN's scope and type of practice setting. The peer-reviewer may be a consultant working for a professional peer review organization.

(31) "Population focus" for APRN practice means the section of the population which the APRN is certified to practice within. The categories of population focus are: family/individual across the lifespan, adult-gerontology, neonatal, pediatrics, women's health/gender-related, or psychiatric/mental health.

(32) "Practical Nurse" means the same thing as "Licensed Practical Nurse," "PN," and "LPN," unless the context of the rule dictates otherwise. The practice of practical nursing is defined at 37-8-102, MCA.

(33) "Preceptorship" for APRN education means supervised training in the role, population focus, or specialty area of APRN practice.

(34) "Prescriber" as defined in 37-7-502, MCA, means a medical practitioner as defined in 37-2-101, MCA, licensed under the professional laws of the state to administer and prescribe medicine and drugs.

(35) "Prescribing" means specifying advanced nursing intervention(s) intended to implement the defined strategy of care.

(36) "Prescription drug" as defined in 37-7-101, MCA, means any drug that is required by federal law or regulation to be dispensed only by a prescription subject to section 503(b) of the Federal Food, Drug, and Cosmetic Act, 21 U.S.C. 353.

(37) "PRN medication" ("pro re nata," Latin for "according as circumstances may require") means medication taken as necessary for the specific reason stated in the medication order, together with specific instructions for its use.

(38) "Registered Nurse" means the same thing as "RN" and "Professional Nurse," unless the context of the rule dictates otherwise. The practice of professional nursing is defined at 37-8-102, MCA.

(39) "Routine medication" means medication taken regularly at the same time each day using the same route, or on the same days of the week, at the same time, using the same route.

(40) "Simulation" means instructional techniques designed to replace or amplify real clinical nursing experiences with guided experiences that evoke or replicate substantial aspects of the real world in a fully interactive manner. The evidence-based learning shall replicate patient care scenarios and are designed to foster clinical decision-making and critical thinking. Scenarios may include the use of medium or high-fidelity mannequins, standardized patients, role playing, and computer-based critical thinking simulations. An instructional simulation scenario shall include the elements of pre-briefing, replication of a patient care scenario, and debriefing. Skill acquisition and task training alone, as in the traditional use of a skills laboratory, do not qualify as simulated client care and therefore do not meet the requirements for direct client care hours.

(41) "Stable" means a situation in which the patient's clinical and behavioral status is determined to be non-fluctuating or in which the fluctuations are expected and the interventions planned.

(42) "Standard" means an authoritative statement by which the board can judge the quality of nursing education or practice. A standard is established by authority, custom, or general consent as a model or example; something set up for the measure of quantity, weight, extent, value, or quality. A standard is substantially well established by usage in speech and writing and widely recognized as acceptable.

(43) "Standardized procedures" means routinely executed nursing actions for which there is an established level of knowledge and skill.

(44) "Strategy of care" means the goal-oriented plan developed to assist individuals or groups to achieve optimum health potential. This includes initiating and maintaining comfort measures, promoting and supporting human functions and responses, establishing an environment conducive to well-being, providing health counseling and teaching, and collaborating on certain aspects of the medical regimen, including, but not limited to, the administration of medications and treatments.

(45) "Supervision" or "general supervision" means provision of guidance by a qualified nurse or a person specified in 37-8-102, MCA, for the accomplishment of a nursing task or activity with initial direction of the task or activity and periodic inspection of the actual act of accomplishing the task or activity.

(46) "Supervisor" means the health care professional identified by these rules as the person qualified to supervise another in the performance of nursing procedures and care.

(47) "Verification" of licensure, education, or prior disciplinary action against a license must be submitted to the board in writing, from a primary source.


History: 37-1-131, 37-8-202, MCA; IMP, 37-1-131, 37-8-101, 37-8-102, 37-8-202, 37-8-422, MCA; NEW, 1982 MAR p. 1603, Eff. 8/27/82; AMD, 1991 MAR p. 2435, Eff. 12/13/91; TRANS, from Commerce, & AMD, 2006 MAR p. 2035, Eff. 8/25/06; AMD, 2008 MAR p. 1709, Eff. 8/15/08; AMD, 2008 MAR p. 2641, Eff. 11/7/08; AMD, 2010 MAR p. 2651, Eff. 11/13/10; AMD, 2011 MAR p. 2144, Eff. 10/14/11; AMD, 2013 MAR p. 1609, Eff. 9/6/13; AMD, 2016 MAR p. 1010, Eff. 6/4/16; AMD, 2017 MAR p. 604, Eff. 5/13/17; AMD, 2019 MAR p. 1055, Eff. 7/27/19; AMD, 2021 MAR p. 991, Eff. 8/7/21.

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