Section 1000-01-.14 - STANDARDS OF NURSING COMPETENCEThe Board requires all nurses to document evidence of competence in their current practice role. The Board believes that the individual nurse is responsible for maintaining and demonstrating competence in the practice role whether the recipient of the nursing intervention is the individual, family, community, nursing staff, nursing student body, or other.
(1) Standards of Nursing Practice for the Registered Nurse (a) Standards Related to the Registered Nurse's Responsibility to Implement the Nursing Process - The Registered Nurse shall: 1. Conduct and document nursing assessments of individuals and groups by: (i) collecting objective and subjective data in an accurate and timely manner.(ii) accurately sorting, selecting, reporting and recording the data.(iii) validating, refining and modifying the data by utilizing available resources including interactions with the client, family, significant others, and health team members.2. Establish critical paths and teaching plans based on individual patient's plans of care after prioritizing need upon completion of a comprehensive assessment.3. Develop the plan of care/action based on a comprehensive assessment, desired outcomes, and current knowledge.4. Safely implement the plan of care/action either directly or by delegation.5. Establish and maintain a therapeutic nurse/client relationship.6. Seek resources for patients/clients with cultural, physical or language barriers.7. Use appropriate teaching skill for individual or group teaching.8. Evaluate the responses of individuals or groups to nursing interventions and revise the plan of care where appropriate. Evaluation shall involve the client, family, significant others and health team members.9. Communicate accurately in writing and orally with recipients of nursing care and other professionals.(b) Standards Related to the Registered Nurse's Responsibilities as a Member of the Nursing Profession - The Registered Nurse shall: 1. Integrate knowledge of the statutes and regulations governing nursing and function within the legal and ethical boundaries of nursing practice.2. Demonstrate personal responsibility for currency of practice and individual nursing actions.3. Identify practice abilities and limitations and obtain instruction and supervision as necessary when implementing essential functions of the practice role.4. Consult with nurses and other health team members and make referrals as necessary.5. Report unsafe practice and unsafe practice conditions to recognized legal authorities and to the Board where appropriate.6. Delegate to another only those nursing measures which that person is prepared or qualified to perform.7. Supervise others to whom nursing activities are delegated.8. Retain professional accountability for nursing care when delegating nursing interventions.9. Conduct practice without discrimination on the basis of age, race, religion, sex, sexual preference, national origin, language, handicap or disease.10. Demonstrate a respect for the dignity and rights of clients regardless of social or economic status, personal attributes or nature of health problems.11. Protect confidential information unless obligated by law to disclose such information.12. Demonstrate respect for the property of clients, family, significant others and the employer.13. Participate in activities designed to improve health care delivery in any setting.14. Exhibit ethical behavior.(2) All applicants for licensure, renewal of license, reactivation of license, or reinstatement of license must demonstrate competency. (a) For new licensees, successfully completing the requirements of Rule .01 or .02, as applicable, shall be considered proof of sufficient competence to constitute compliance with this rule.(b) For Registered Nurses who are practicing full or part-time, attesting to having practiced nursing during the past five (5) years and attesting to maintaining a personal file documenting professional competence shall be considered proof of sufficient competence to constitute compliance with this rule. Such personal file shall include evidence of continued competency in the work setting which shall consist of at least two (2) of the following parts: 1. Having had a satisfactory employer evaluation.2. Having had a satisfactory peer evaluation3. Having a satisfactory patient/client relationship.4. Having a contract renewal, re-appointment, or continuing contract.5. Having completed a written self-evaluation based on the standards in paragraph (1). 6. Having initially obtained or maintained, during the most recent biennial renewal period, certification from a nationally recognized certification body appropriate to practice. This part is required for advanced practice nurses pursuant to 1000-04.03.7. Having identified two (2) or more areas of interest or goals and subsequently having developed, implemented and evaluated, during the most recent biennial renewal period, a plan to demonstrate competency for these areas of interest or goals based on the standards in paragraph (1).8. Having performed activities including, but not limited to: (i) Satisfactory volunteer work in a position using nursing knowledge, skills, and abilities. Examples are: (ii) Service relevant to nursing on local, state, or national boards, commissions, foundations, or agencies.9. Having participated in the education of students in a program leading to licensure as a Registered Nurse or to an advanced degree in nursing.10. Having successfully completed five (5) contact hours of continuing education / in-service education applicable to the licensee's practice.11. Having had an article published relevant to nursing.12. Having successfully completed a two (2) week Board-approved nursing refresher program.13. Having successfully completed a two (2) week Board-approved comprehensive orientation program offered by a prospective nursing employer.14. Having enrolled in an approved/accredited nursing program leading to licensure as a Registered Nurse or to an advanced degree in nursing. (i) The individual must have satisfactorily completed two (2) hours of nursing credits or equivalent during the past five (5) years.(ii) An official transcript verifying the completion of nursing courses shall be maintained.15. Having retaken and successfully completed the examination required in Rule .01 of this chapter.(c) For Registered Nurses who wish to maintain an active license who are not practicing full-time, part-time, or are not self employed, attesting to any of the following activities which require the expertise of the Registered Nurse shall be considered proof of sufficient competence to constitute compliance with this rule. 1. Having performed Board-approved activities including, but not limited to: (i) Satisfactory volunteer work in a position using nursing knowledge, skills, and abilities. Examples are: (ii) Service relevant to nursing on local, state, or national boards, commissions, foundations, or agencies.2. Having participated in the education of students in a program leading to licensure as a Registered Nurse or to an advanced degree in nursing.3. Having successfully completed five (5) contact hours of continuing education for each year of inactivity.4. Having had an article published during the period of inactivity in a professional journal acceptable to the Board.5. Having successfully completed a two (2) week Board-approved nursing refresher program.6. Having successfully completed a two (2) week Board-approved comprehensive orientation program offered by a prospective nursing employer.7. Having enrolled in an approved/accredited nursing program leading to licensure as a Registered Nurse or to an advanced degree in nursing. (i) The individual must have satisfactorily completed two (2) hours of nursing credits or equivalent during the past five (5) years.(ii) An official transcript verifying the completion of nursing courses shall be submitted.8. Having retaken and successfully completed the examination required in Rule .01 of this chapter.(d) For Registered Nurses who have not practiced for more than five (5) years and do not intend to practice in the future, compliance with this subparagraph is not required. For Registered Nurses who have not practiced for more than five (5) years and are applicants for licensure, renewal of license, reactivation of license, or reinstatement of license, the appropriate application and one (1) of the following shall be submitted as evidence of continued nursing competence: 1. Proof of successful completion of five (5) contact hours of continuing education for each year of inactivity.2. Proof of having had an article published during the period of inactivity in a professional journal acceptable to the Board.3. Proof of successful completion of a two (2) week Board-approved nursing refresher program.4. Proof of successful completion of a two (2) week Board-approved comprehensive orientation program offered by a prospective nursing employer.5. Proof of enrollment in an approved/accredited nursing program leading to licensure as a Registered Nurse or to an advanced degree in nursing. (i) The individual must have satisfactorily completed two (2) hours of nursing credits or equivalent during the past five (5) years.(ii) An official transcript verifying the completion of nursing courses shall be submitted.6. Proof of current certification in an appropriate nursing specialty area.7. Proof of retaking and successfully completing the examination required in Rule .01 of this chapter.(e) Documentation of compliance 1. Each licensee must retain documentation of completion of all continued competence requirements of this rule for a period of four (4) years from when the requirements were completed. This documentation must be produced for inspection and verification, if requested in writing by the Board during its verification process.2. The licensee must, within thirty (30) days of a request from the Board, provide evidence of continued competence activities.3. Any licensee who fails to complete the continued competence activities or who falsely certifies completion of continued competence activities may be subject to disciplinary action pursuant to T.C.A. §§ 63-7-115, 63-7-116, 63-7-120, and 637-207.Tenn. Comp. R. & Regs. 1000-01-.14
Original rule filed February 28, 1983; effective March 30, 1983. Amendment filed January 31, 1985; effective March 2, 1985. Amendment filed August 31, 2001; effective November 14, 2001. Amendments filed October 18, 2004; effective January 1, 2005.Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-7-101, 63-7-103, 63-7-114, 63-7-115, 63-7-116, 63-7-120, and 63-7-207.