TWENTY-SEVENTH LEGISLATURE, 2014
STATE OF HAWAII
A BILL FOR AN ACT
RELATING TO CONTINUING COMPETENCY FOR NURSES.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. The legislature finds that to ensure public health, candidates for initial nurse licensure are required to pass a national examination that measures the minimum competencies needed to perform safely and effectively as newly licensed, entry-level registered or practical nurses. In today's health care environment, because technology and practice are continually changing and new health care systems are emerging, the challenge of licensure boards is to assure consumers that nurses are competent throughout their practice careers. Research shows that continuing education alone is not enough to ensure competency in post-entry nurses. According to the Institute of Medicine, "[A]n emerging concept ... includes components of [continuing education] but has a broader focus, such as teaching how to identify problems and apply solutions, and allowing health professionals to tailor the learning process, setting, and curriculum to their needs."
The legislature further finds that continuing competency that ensures continued patient health and safety requires lifelong learning and ongoing redefinition based on the individual's experience, change in practice setting, and educational advancement. Each nurse must maintain and augment the necessary knowledge and skills to be current in practice. To do this, each nurse needs a self-assessment tool that enables the nurse to: assess and adapt to their learning needs; stretch learning from the classroom to the point of care; match the need for continuing education to the learning for competence; and support increased personal accountability for lifelong learning to ensure safe practice.
The legislature therefore finds that the Hawaii nurse continued competency program, which contains these elements and learning activity options, must be established for nurses licensed in Hawaii.
Accordingly, the purpose of this Act is to require licensed registered nurses and licensed practical nurses to submit evidence of continuing competency at each renewal period, beginning with the July 1, 2017 biennium.
SECTION 2. Chapter 457, Hawaii Revised Statutes, is amended by a new section to be appropriately designated and to read as follows:
"§457- Continuing competence requirements; learning activities; audit. (a) In addition to the requirements of section 457-9, beginning on July 1, 2017, each registered nurse and practical nurse shall complete the following continuing competence requirements in the two years prior to the renewal of the nurse's license:
(1) Complete a board approved self-assessment of practice, including the dimensions of professional responsibility, knowledge based practice, legal and ethical practice, and collaboration with others;
(2) Develop a plan for continued learning; and
(3) Select and complete one of the following learning activity options:
(A) Thirty contact hours of continuing education from a board approved provider for a registered nurse or twenty contact hours for a licensed practical nurse;
(B) A board approved refresher course;
(C) A minimum of two semester hours of post-licensure academic education from an accredited nursing program related to the practice of nursing;
(D) Fifteen contact hours of board approved continuing education activity and completion of one of the following:
(i) A nursing research or evidence-based practice project as principal or co-principal investigator;
(ii) Authoring or co-authoring a peer reviewed published nursing or health-related article, paper, book, or book chapter;
(iii) Developing and conducting a nursing education presentation or presentations totaling a minimum of five contact hours;
(iv) Six hundred forty hours of active practice within the previous two years; or
(v) Completion of a board recognized nurse residency program.
(b) The following are exempt from the continuing competence requirements:
(1) Registered nurses licensed in this State who also maintain active advanced practice registered nurse licenses in accordance with this chapter and maintain a current national certification;
(2) Registered nurses licensed in this State who also maintain a current national certification for the nurses' practice role from a recognized national certifying body;
(3) First-time nurse licensees; provided that the initial license was issued twelve months or less prior to the renewal date. First-time nurse licensees having a license initially issued more than twelve months prior to the renewal date shall not be eligible for this exemption and shall be required to complete the following for the first renewal period:
(A) Fifteen units of approved continuing education from a board approved provider if the nurse is a registered nurse licensee; or
(B) Ten units of approved continuing education from a board approved provider if the nurse is a licensed practical nurse.
(c) The board may extend the deadline for compliance with the continuing competency requirements. Prior to the expiration of a license, a nurse licensee may submit a written request to the board for approval of an extension of the continuing competency requirements. An extension may be granted on the following grounds:
(1) Illness, as certified by a physician or osteopathic physician licensed under chapter 453, advanced practice registered nurse licensed under this chapter, or a physician, osteopathic physician, or advanced practice registered nurse licensed in the jurisdiction in which the nurse licensee was treated;
(2) Extended active duty military service with the United States armed forces;
(3) Lack of access to continuing education courses due to the practice of nursing in geographically isolated areas; and
(4) Inability to undertake the continuing competency requirements due to incapacity, undue hardship, or other extenuating circumstances.
The board may consider requests for extensions on a case-by-case basis. Extensions shall not be granted unless proof deemed appropriate and sufficient by the board that the applicant is capable of safe practice is submitted by the licensee. Licensees unable to complete continuing competency requirements during the two year license renewal period and after receiving an extension shall be placed on inactive status.
(d) Upon application for license renewal, each licensee shall:
(1) Attest under oath that the licensee has completed the continuing competency requirements of this section; and
(2) Submit sufficient proof, as determined by the board, of compliance with the board's requirements for continuing competency.
(e) The board may, randomly or for cause, audit a licensee's continuing competency requirements, including the licensee's completion of competency units. The board shall inform all licensee of the licensee's selection for audit. Licensees shall cooperate with all board conducted audits, including the furnishing of documentation or other evidence showing the licensee's completion of competency requirements, within sixty days of the notice of audit. The board may establish guidelines for random audit and notice procedures necessary to effectuate the intent of this subsection."
SECTION 3. Section 457-2, Hawaii Revised Statutes, is amended by adding three new definitions to be appropriately inserted and to read as follows:
""Competence" means the ability of a nurse to integrate knowledge, skills, judgment, and personal attributes to practice safely and ethically in a designated role or setting in accordance with the scope of nursing practice.
"Continuing competence" means the lifelong process of maintaining and documenting competence through ongoing self-assessment, development, and implementation of a personal learning plan, and subsequent reassessment.
"Unit" means a relative value assigned to continuing competence activities in which one continuing competence unit is equivalent to at least fifty minutes of classroom or hands on instruction."
SECTION 4. Section 457-12, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:
"(a) In addition to any other actions authorized by law, the board shall have the power to deny, revoke, limit, or suspend any license to practice nursing as a registered nurse or as a licensed practical nurse applied for or issued by the board in accordance with this chapter, and to fine or to otherwise discipline a licensee for any cause authorized by law, including but not limited to the following:
(1) Fraud or deceit in procuring or attempting to procure a license to practice nursing as a registered nurse or as a licensed practical nurse;
(2) Gross immorality;
(3) Unfitness or incompetence by reason of negligence, habits, or other causes;
(4) Habitual intemperance, addiction to, or dependency on alcohol or other habit-forming substances;
(5) Mental incompetence;
(6) Unprofessional conduct as defined by the board in accordance with its own rules;
(7) Wilful or repeated violation of any of the provisions of this chapter or any rule adopted by the board;
(8) Revocation, suspension, limitation, or other disciplinary action by another state of a nursing license for reasons as provided in this section;
(9) Conviction, whether by nolo contendere or otherwise, of a penal offense substantially related to the qualifications, functions, or duties of a nurse, notwithstanding any statutory provision to the contrary;
(10) Failure to report to the board any disciplinary action taken against the licensee in another jurisdiction within thirty days after the disciplinary action becomes final;
(11) Submitting to or filing with the board any
notice, statement, or other document required under this chapter, which is
false or untrue or contains any material misstatement of fact[
including a false attestation of compliance with the continuing competency
(12) Violation of the conditions or limitations upon which any license is issued."
SECTION 5. The department of commerce and consumer affairs, in collaboration with the center for nursing, shall convene a stakeholder group to address any outstanding issues associated with the implementation of the continuing competence requirements pursuant to this Act and shall report to the legislature no later than twenty days prior to the convening of the regular sessions of 2015 and 2016.
SECTION 6. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 7. This Act shall take effect on July 1, 2014, and section 457- , Hawaii Revised Statutes, shall apply to the licensing biennium for registered nurses and practical nurses beginning on July 1, 2017.
Nurses; Registered Nurses; Practical Nurses; Continuing Competency; Licensing; Registration
Requires licensed registered nurses and licensed practical nurses to submit evidence of continuing competency at each renewal period, beginning on July, 2017. Requires the department of commerce and consumer affairs, in collaboration with the center for nursing, to convene a stakeholder group to address any outstanding issues associated with the implementation of the continuing competence requirements for nurses and report to the legislature. (SB2490 HD1)
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.