OAR 851-006-0011: Definitions

(1) “ Advanced Practice Registered Nurse (APRN)” means a clinical nurse specialist, nurse practitioner, or certified registered nurse anesthetist. (2) “ Appropriate resources ” means the human and material support necessary to perform an activity, intervention, or role safely. (3) “Assessment” means the first step in the practice of nursing in which a registered nurse, or advanced practice registered nurse, independently collects, validates, and analyzes, data relevant to their client. (4) “Assign” means the action of directing and distributing the work that each practice team member is already authorized by license or certification and organizational position description to perform. (5) “Board ” means the Oregon State Board of Nursing. The Board is a nine (9) member Governor-appointed public body legislatively authorized to regulate nursing education, licensure and practice per ORS 678.010 through 678.448. (6) “Client” for the nurse means an individual, family, facility resident or group engaged in a professional relationship with a licensee and the recipient of nursing services. For the certified nursing assistant (CNA) and certified medication aid (CMA), means the person for whom the CNA or CMA is carrying out authorized duties as assigned by a nurse. (7) “Clinical component” means the component of a nursing education program curriculum where students refine competencies in real practice settings or through the use of simulation. The clinical component can occur in any setting where students may impact a health outcome. (8) “Clinical direction” means the direction provided to a licensed practical nurse by a registered nurse plan of care, or by a health care provider treatment plan. (9) “Clinical judgment” means the observed outcome of critical thinking and decision making. It is the result of an iterative process in which the nurse applies nursing knowledge to observe and assess presenting situations, identify a prioritized client concern and generate the best possible evidence-based solution to promote client health and safety. (10) “Clinical preceptor ” means a health care professional who is qualified by specific education and clinical competency to provide supervision of the clinical component of pre-licensure or advanced practice nursing students. (11) “Cohort placement” means placement of nursing education program students where a nursing faculty member guides the selection of student experiences. (12) “Community-based setting” means a setting that does not exist primarily for the purposes of providing nursing or medical services, but where nursing services could be required intermittently. These settings include adult foster homes, assisted living facilities, child foster homes, schools, and 24-hour residential care facilities. (13) “Competency” means possessing specified levels of knowledge, technical skill, ability, ethical principle, and clinical reasoning that are relevant to the practice role, practice setting, prevailing standards, and client safety. For the purposes of these rules this definition is also applicable with the terms “competence” and “competencies”. (14) “Context of care” means the environment where a licensee’s practice of nursing occurs. Defining a specific context of care includes factors such as the location where the nurse’s client receives nursing services, the licensee’s practice role within the setting, regulations of the setting, policies and procedures of the setting, professional and specialty nursing practice standards applicable to the nurse’s practice role, and the ability of the client to self-direct the nursing strategies or interventions to which they have given their consent. (15) “Conviction” means that a court of law has entered a final judgment on a verdict or finding of guilty, a plea of guilty, a plea of nolo contendere (no contest) or any determination of guilt entered by a court of law against a subject individual (SI) in a criminal case, unless that judgment has been reversed or set aside by a subsequent court decision. (16) “Delegation process” means the process used by an RN in a community-based setting to delegate the performance of a plan of care nursing procedure to an unregulated assistive person per OAR Chapter 851 Division 47. (17) “Facility-based program” means an approved nursing assistant or medication aide training program offered by an Oregon Department of Human Services- licensed nursing facility. (18) “Focused assessment” means the collection, validation, and analysis of data, by the licensed practical nurse (LPN), as directed by a registered nurse plan of care or health care provider treatment plan, for the purpose of the LPN identifying their client’s priority condition. (19) “Focused plan of care” means the licensed practical nurse’s prioritization of interventions from the RN plan of care or the health care provider treatment plan, to be carried out by the LPN with the client. (20) “Full-time” means at least 32 hours of regularly scheduled work each week. (21) “Hand off ” means a transfer and acceptance of nursing services responsibility for a client achieved through effective communication. It is a process of passing client-specific information from one nurse to another for the purpose of ensuring continuity of services and the safety of the client. (22) “ Health care provider” means a clinical nurse specialist, certified registered nurse anesthetist, nurse practitioner, medical doctor, doctor of osteopathic medicine (DO), doctor of podiatric medicine, dentist, naturopathic physician, optometrist, doctor of chiropractic, MD volunteer emeritus, DO volunteer emeritus, and physician associate. (23) “ In good standing ” means a license or certificate without current discipline, conditions, or restrictions. (24) “Independent third-party evaluator” means an individual who is approved by the Board, who is not an employee or contractor of the Board, to evaluate, diagnose, and offer treatment options for substance use disorders, mental disorders, or co-occurring disorders. (25) “Individual scope of practice” means an individual licensee’s known set of activities, interventions, and roles, occurring within their practice of nursing for which they possess the competencies necessary to perform safely in their context of care. (26) “ Interim consent order (ICO)” means a voluntary agreement in which a licensee voluntarily steps away from practice during the investigation and until further order of the Board. (27) “Licensee” means the person licensed as a registered nurse (RN), registered nurse emeritus (RN-E), licensed practical nurse (LPN), licensed practical nurse emeritus (LPN-E), nurse practitioner (NP), clinical nurse specialist (CNS), certified registered nurse anesthetist (CRNA), and nurse intern (NI), pursuant to ORS Chapter 678.010 through 678.448. (28) "Limited license” means a registered nurse or practical nurse license with conditions which specifically limit its duration and generally used for short term educational experiences for international nurses. (29) “Monitored practice” means a licensee’s practice of nursing under the direct supervision of a worksite monitor by agreement or Board order. (30) “Name of record” means the name to which the applicant is legally entitled, submitted on the initial application, or changed at the written request of the applicant with documentation of the legal basis for the change. (31) “National board certification” means the certificate granted to an advanced practice registered nurse (APRN) for an APRN role and population focus by a professional nursing practice organization accredited by the National Commission on Certifying Agencies or the American Boards of Nursing Specialties. (32) “Nurse Practice Act” means Oregon Revised Statute (ORS) 678.010 through 678.448 and Oregon Administrative Rules (OAR) Chapter 851 inclusive of all divisions. (33) “ Nursing procedure” means a health-related procedure identified within the registered nurse plan of care. (34) “Plan of care ” means the plan authored by the registered nurse that communicates the client’s prioritized problems or risks, identifies measurable client outcomes related to the problems or risks; and identifies the nursing strategies and interventions chosen to address the identified problems or risks. (35) “Professional boundaries ” means the nurse and client therapeutic relationship limitations that guide appropriate and professional interactions. The licensee or certificate holder and the client establish a relationship where the client depends on the licensee or certificate holder to have the knowledge, skills, abilities, and competencies to provide the care needed by the client. This relationship has a space between the needs of the client and the ability of the licensee or certificate holder to provide that care. That space is a professional boundary and is applicable in and out of the practice setting. The licensee or certificate holder has power in that the client is dependent upon the provision of care and the client is vulnerable to the influences of this power. Violation of this space between power and vulnerability through the blending of the personal and professional relationship constitutes a boundary violation. (36) “ Public discipline ” means Board action against a licensee or certificate holder resulting in public reporting of the discipline, including posting on the Oregon State Board of Nursing (OSBN) website and in the OSBN publications. Public discipline is a permanent document that remains publicly displayed for the life of the license or certificate even after all requirements of the Board order are met. (37) “Reasoned conclusion ” means the registered nurse’s interpretation or judgment about a client’s needs or risks reached through the application of scientific evidence, clinical experience, and nursing knowledge to assessment data. Reasoned conclusions are also known as nursing diagnostic statements. (38) “Representative of the Board ” means a Board staff member or Board designee who has been delegated by the authority of the Board to perform the necessary responsibilities as allowed by statute or rule. (39) " Self-referred licensee ” means a licensee who entered participation in the Health Professional Services Program without referral from the Board. (40) “Stable and predictable condition ” means a situation where the client's clinical and behavioral state is known, not characterized by rapid changes, and does not require frequent reassessment and evaluation. This includes clients whose deteriorating condition is expected such as the client receiving hospice services. (41) “Statewide need” means the assessment and documentation of the need for a nursing education program in relation to plans for total state resources and the need for entry level nurses in the state. (42) “ Stipulated agreement ” means the documented terms and conditions of public discipline agreed to by the licensee and approved by Board order. (43) “ Substantial non-compliance ” means that a licensee is in violation of the terms of the monitoring agreement or Board Order. (44) “ Substantive change ” means a significant modification or expansion in the nature or scope of a nursing education program. This may include change in program structure, outcomes, or length; change in method of instructional delivery; opening or closing of new educational tracks at the same level of licensure; or a change that modifies 25% or more of the credit hours of the nursing education program curriculum. (45) “ Total pass rate ” means a calculation that includes all first time and repeat test takers. For nursing programs, this includes all graduates who pass the NCLEX® examination within 12 months of program completion. (46) “ Unregulated assistive person (UAP) ” means the practice team member whose position description or job within an organization does not require licensure or certification by a state of Oregon health related licensing agency. The UAP includes, but is not limited to, the person working as a: medical assistant, certified medical assistant, registered medical assistant, home care worker, emergency department technician, labor and delivery technician, direct care staff, direct support professional, traditional health worker, volunteer. The term applies to those who have state of Oregon issued health-related licensure or certification but who hold a position where their license or certificate is not a requirement. The term does not apply to practice team members who are family members of the client. (47) “Unstable condition” means a situation where the client's clinical and behavioral status is of a serious nature, critical, fluctuating, expected to rapidly change, and in need of the continuous reassessment and evaluation of a licensed nurse.