STATE OF WISCONSIN
Board of Nursing
IN THE MATTER OF RULE-MAKING PROCEEDINGS BEFORE THE
BOARD OF NURSING
ORDER OF THE BOARD OF NURSING
(CLEARINGHOUSE RULE 17-095)
An order of the Board of Nursing to repeal 1.08 (5) (a) 2., 1.08 (5) (a) 3.a., and 1.08 (5) (d) 2. and 3.; to amend N 1.08 (4) (intro.) and (c) 3., 1.08 (5) (a) (intro.) and 1., 1.08 (5) (a) 3., 1.08 (5) (a) 4. and 5., 1.08 (5) (b) and 1.08 (5) (d) 1.; to repeal and recreate N 1.08 (5) (a) 3. b. and d.; and to create N 1.02 (13), 1.08 (5) (d) 5. and 1.08 (5m) relating to schools of nursing curriculum and clinicals.
Analysis prepared by the Department of Safety and Professional Services.
Explanation of agency authority:
The board shall promulgate rules for its own guidance and for the guidance of the profession to which it pertains.
Specifically, the board may establish minimum standards for schools for professional nurses and schools for licensed practical nurses, including all related clinical units and facilities, and make and provide periodic surveys and consultations to such schools. It may also establish rules to prevent unauthorized persons from practicing professional nursing. It shall approve all rules for the administration of chapter 441, Wis. Stats.
Plain language analysis:
This rule specifically addresses the requirements for schools of nursing curriculum and clinical experiences, including simulation.
Section 1 defines “simulation”. Simulation uses patient simulation in an environment and conditions that create a realistic clinical situation in order to develop clinical judgment and assess learning.
Section 2 clarifies that curriculum can be developed by more than one faculty member and if for a graduate level by doctorally prepared faculty. Curriculum should be designed to teach students how to approach clinical decision making and safe patient care. The second provision amends the didactic content and supervised clinical experiences to be across the lifespan only in prelicensure programs.
Sections 3 and 4 clarify the patient experiences shall be at the level of licensure and removes redundant language.
Sections 5, 6 and 7 cleanup the language related to providing patient-centered culturally competent care. It removes the provision relating to respecting the patient. It recreates a provision that the patient or designee is in control and a partner in care and that education is to be at a level the patient understands.
Section 8 clarifies terminology by changing “quality” to “safe and effective” and “participating in” to “experience”.
Section 9 changes “cooperating agencies” to “entities” to better reflect the diversity of placements. It also clarifies that the entities must adhere to standards rather than just having standards.
Section 10 clarifies that development of skills takes place in the provision of direct patient care.
Section 11 repeals a redundant provision relating to making clinical judgments. It also repeals the requirement that the clinical practice is across the lifespan and recognizes that not all clinical experiences are preparing the student to care for populations across the lifespan.
Section 12 creates a requirement clinical practice include effective application of the nursing process.
Section 13 creates a new section pertaining to simulation. Simulation may be used to meet clinical requirements if all of the following are met: nursing faculty with education and training in the use of simulation develop, implement and evaluate the simulation experiences; faculty with subject matter expertise and simulation training conduct prebriefing and postbriefing; and each student has an opportunity to participate in the role of a nurse and not just watch. Simulation can’t be used for more than 50% of the clinical learning requirements.