DEPARTMENT OF REGULATORY AGENCIES
Division of Registrations
3 CCR 716-1

CHAPTER XIV

Rules and Regulations to Register Professional Nurses
Qualified to Engage in Advanced Practice NURSING

BASIS:  The authority for the promulgation of these rules and regulations by the State Board of Nursing (“Board”) is set forth in §§ 12-38-108(1)(j) and 12-38-111.5, C.R.S.

PURPOSE:  These rules are adopted to implement the Board’s authority to register professional nurses qualified to engage in Advanced Practice Nursing and are further adopted to set forth the requirements and procedures for being so registered.

1.	DEFINITIONS

1.1	Accrediting Body:  Any organization that establishes and maintains standards for professional nursing programs and recognizes those programs that meet these standards and is recognized by the U.S. Department of Education (USDE) and/or the Council for Higher Education Accreditation (CHEA), including the Commission on Collegiate Nursing Education (CCNE), National League for Nursing Accrediting Commission (NLNAC), Council on Accreditation of Nurse Anesthesia Education Programs (COA), Division of Accreditation of the American College of Nurse Midwives, and the National Association of Nurse Practitioners in Women’s Health Council on Accreditation.

1.2	Advanced Practice Nurse (APN): A master’s prepared nurse holding a graduate degree in nursing who has completed a graduate or post-graduate program of study in an advanced practice Role, in an accredited nursing program and has been recognized and included on the Advanced Practice Registry by the Board. APN Roles recognized by the Board are nurse practitioner (NP), certified registered nurse anesthetist (CRNA), certified nurse midwife (CNM) and clinical nurse specialist (CNS).  A nurse seeking recognition as an APN must be academically prepared for the expanded scope of practice described as Advanced Practice Nursing.

1.3	Advanced Practice Nursing:  The expanded scope of nursing practice in an advanced Role and Specialty approved by the Board.

1.4	Advanced Practice Registry:  The Board’s registry of those professional nurses who apply for, and meet the criteria for inclusion as established in accordance with C.R.S. 12-38-111.5 and these Chapter XIV Rules.

1.5	Applicant:  A professional nurse seeking inclusion on the Advanced Practice Registry as an Advanced Practice Nurse.

	1.6	Board:  The State Board of Nursing.

1.7	Certifying Body:  A non-governmental agency that validates by examination, based on pre-determined standards, an individual nurse’s qualifications and knowledge for practice in a defined functional or clinical area of nursing.

	1.8	Client:  A person receiving nursing care.

1.9	Role:  The advanced practice area or position for which the professional nurse has been prepared; Nurse Practitioner (NP) Certified Registered Nurse Anesthetist (CRNA), Certified Nurse Midwife (CNM) and Clinical Nurse Specialist (CNS).

1.10	Specialty:  A broad, population-based focus of study encompassing the common problems of that group of patients and the likely co-morbidities, interventions and response to those problems.  Examples include, but are not limited to: Neonatal, Pediatric, Women’s’ Health, Adult, Family, Mental Health, Anesthesia, Midwifery, etc.  A Specialty is not defined as a specific disease/health problem or specific intervention.

1.11	Unencumbered:  No pending disciplinary action or current restriction to practice in the state of Colorado.

2.	REQUIREMENTS FOR INCLUSION ON THE ADVANCED PRACTICE REGISTRY

2.1	Educational Requirements:  The successful completion of a graduate or post-graduate nursing degree in the Role and Specialty for which the Applicant seeks inclusion on the Advanced Practice Registry.  Verification of educational requirements shall be evidenced by receipt of a sealed, official transcript from a graduate or post-graduate Advanced Practice Nurse program accredited by a nursing Accrediting Body.  The transcript shall verify date of graduation, credential conferred, and Role and Specialty focus of the program.

2.2	Certification requirements for Certified Registered Nurse Anesthetist (CRNA):  Certified Registered Nurse Anesthetist (CRNA) must pass the national certification examination as administered by the American Association of Nurse Anesthetists (AANA) Council on Certification and Recertification of Nurse Anesthetists.  Documentation required shall be AANA verification of current certification or recertification.

2.3	Certification Requirements for Certified Nurse Midwife (CNM):  Certified Nurse Midwife must meet the standards for education and certification established by the American College of Nurse Midwives (ACNM) or its designee; American Midwifery Certification Board (AMCB).  Documentation required shall be verification of current AMCB certification.

2.4	Applicants must possess an active, Unencumbered Colorado or multi-state compact professional nurse license.

2.5	For each Role and Specialty for which the Applicant applies for inclusion on the Advanced Practice Registry, the Applicant shall be required to:

A.	Submit an Advanced Practice Registry application on the current Board approved form;

B.	Provide a sealed, official transcript from the graduate or post graduate Advanced Practice Nurse program; and

C.	Pay the current application fee.

2.6	CRNA and CNM Applicants must request verification of current certification, as outlined in section 2.2 and 2.3, be sent to the Board directly from the AANA or AMCB.

3.	SCOPE OF ADVANCED PRACTICE NURSING

3.1	Advanced Practice Nurses are expected to practice within the standards established by the appropriate nursing organization and have, including, but not limited to, a safe mechanism for consultation or collaboration with a physician, or when appropriate, referral to a physician.

	3.2	The scope of Advanced Practice Nursing is based on:

A.	The professional nurse’s scope of practice within the Advanced Practice Nurse’s Role;

B.	Graduate or post-graduate nursing education in the Role and Specialty for which the Advanced Practice Nurse has been recognized by the Board for inclusion on the Advanced Practice Registry.

3.3	The scope of Advanced Practice Nursing may include, but is not limited to:  performing acts of advanced assessment, diagnosing, treating, prescribing, selecting, administering, and dispensing diagnostic and therapeutic measures.

3.4	Prescribing medication is not within the scope of practice of Advanced Practice Nurses unless the Advanced Practice Nurse has applied for and been granted Prescriptive Authority by the Board.

	3.5	Each Advanced Practice Nurse is accountable to the nurse’s Clients and the Board for:

A.	Complying with the requirements of the Colorado Nurse Practice Act, Board rules, and Board policies;

		B.	For the quality of advanced nursing care rendered;

		C.	For recognizing limits of knowledge and experience;

D.	For planning for the management of situations beyond the Advanced Practice Nurse’s expertise; and

E.	For consulting with, or referring Clients to other health care providers as appropriate.

4.	WITHDRAWAL OF ADVANCED PRACTICE REGISTRATION

4.1	An Advanced Practice Nurse may request to voluntarily withdraw the nurse’s registration as an Advanced Practice Nurse in each Role or Specialty in which the nurse was granted inclusion on the Advanced Practice Registry by the Board.

4.2	The Board may withdraw an Advanced Practice Nurse’s registration from the Advanced Practice Registry in one or more of the Roles or Specialties the Advanced Practice Nurse was granted recognition, if the Board has reasonable cause to believe that the Advanced Practice Nurse no longer meets the requirements as set forth in section 2 of these Chapter XIV Rules.  Such withdrawal shall be in accordance with the procedures set forth in section 12-38-116.5, C.R.S.

4.3	The Board may withdraw an Advanced Practice Nurse’s registration from the advanced Practice Registry in one or more of the Roles or Specialties the Advanced Practice Nurse was granted recognition, if the Board has reasonable cause to believe that the Advanced Practice Nurse is unable to practice Advanced Practice Nursing with reasonable skill and safety.  Such withdrawal shall be in accordance with the procedures set forth in section 12-38-116.5, C.R.S.

5.	RENEWAL AND REINSTATEMENT OF ADVANCED PRACTICE REGISTRATION

5.1	Renewal of an Adavanced Practice Nurse’s registration on the Advanced Practice Registry is required at the time of the Advanced Practice Nurse’s Colorado professional nurse license renewal.  Multi-state compact licensed professional nurses granted inclusion on the Advanced Practice Registry shall be required to renew their registration every two years and the registration shall be issued with a specific expiration date.

5.2	An APN who has failed to timely renew the Advanced Practice Nurse registration may apply to reinstate such registration.  The nurse shall submit an application on the current Board approved application forms, pay the current application fee, and submit required documentation as set forth in section 2 of these rules for each Role and Specialty in which the Applicant wishes to practice Advanced Practice Nursing.

5.3	The Applicant may be required to demonstrate continued competency in each Role or Specialty in which the Applicant wishes to be included on the Advanced Practice Registry at the time of the reinstatement application.

5.4	Reinstatement of Advanced Practice registration following disciplinary action requires compliance with all requirements set forth in section 2 of these Chapter XIV Rules and any requirements set forth by the Board.

6.	DISCIPLINE OF ADVANCED PRACTICE NURSES

6.1	Advanced Practice Nurse disciplinary procedures shall be the same as set forth in sections 12-38-116.5 and 12-38-117, C.R.S.

Adopted: October 22, 2008

Effective:  December 30, 2008