441.15(3)(c)
(c) The board shall promulgate rules necessary to administer this section, including the establishment of appropriate limitations on the scope of the practice of nurse-midwifery, the facilities in which such practice may occur and the granting of temporary permits to practice nurse-midwifery pending qualification for certification.
441.15(4)
(4) A nurse-midwife who discovers evidence that any aspect of care involves any complication which jeopardizes the health or life of a newborn or mother shall consult with the collaborating physician under
sub. (2) (b) or the physician's designee, or make a referral as specified in a written agreement under
sub. (2) (b).
441.15(5)(a)(a) Except for any of the following, no person may practice nurse-midwifery unless he or she has in effect malpractice liability insurance in an amount that is at least the minimum amount specified in rules promulgated under
par. (bm):
441.15(5)(a)1.
1. A federal, state, county, city, village, or town employee who practices nurse-midwifery within the scope of his or her employment.
441.15(5)(a)2.
2. A person who is considered to be an employee of the federal public health service under
42 USC 233 (g).
441.15(5)(a)3.
3. A person whose employer has in effect malpractice liability insurance that provides coverage for the person in an amount that is at least the minimum amount specified in the rules.
441.15(5)(bm)
(bm) The board shall promulgate rules establishing the minimum amount of malpractice liability insurance that is required for a person to practice nurse-midwifery, which shall be the same as the amount established by the board under
s. 441.16 (3) (e).
441.15 Cross-reference
Cross-reference: See also ch.
N 5, Wis. adm. code.
441.16
441.16
Prescription privileges of nurses. 441.16(2)
(2) Subject to
s. 441.07 (1g), the board shall grant a certificate to issue prescription orders to an advanced practice nurse who meets the education, training, and examination requirements established by the board for a certificate to issue prescription orders, and who pays the fee specified under
s. 440.05 (1). An advanced practice nurse certified under this section may provide expedited partner therapy in the manner described in
s. 448.035.
441.16(3)
(3) The board shall promulgate rules necessary to administer this section, including rules for all of the following:
441.16(3)(a)
(a) Establishing the education, training or experience requirements that a registered nurse must satisfy to be an advanced practice nurse. The rules promulgated under this paragraph shall require a registered nurse to have education, training or experience that is in addition to the education, training or experience required for licensure as a registered nurse.
441.16(3)(am)
(am) Establishing the appropriate education, training and examination requirements that an advanced practice nurse must satisfy to qualify for a certificate to issue prescription orders.
441.16(3)(b)
(b) Defining the scope of practice within which an advanced practice nurse may issue prescription orders.
441.16(3)(c)
(c) Specifying the classes of drugs, individual drugs or devices that may not be prescribed by an advanced practice nurse.
441.16(3)(cm)
(cm) Specifying the conditions to be met for a registered nurse to do the following:
441.16(3)(cm)1.
1. Administer a drug prescribed by an advanced practice nurse who is certified to issue prescription orders.
441.16(3)(cm)2.
2. Administer a drug at the direction of an advanced practice nurse who is certified to issue prescription orders.
441.16(3)(d)
(d) Establishing procedures for maintaining a certificate to issue prescription orders, including requirements for continuing education and a requirement to complete the nursing workforce survey and submit the fee required under
s. 441.01 (7).
441.16(3)(e)
(e) Establishing the minimum amount of malpractice liability insurance coverage that an advanced practice nurse shall have if he or she is certified to issue prescription orders. The board shall promulgate rules under this paragraph in consultation with the commissioner of insurance.
441.16(4)
(4) Every advanced practice nurse who is certified to issue prescription orders shall annually submit to the board evidence satisfactory to the board that he or she has in effect malpractice liability insurance coverage in the minimum amounts required by the rules of the board.
441.16(5)
(5) An advanced practice nurse who is certified to issue prescription orders may not delegate the act of issuing a prescription order to any nurse who is not certified to issue prescription orders.
441.16(6)
(6) Nothing in this section prohibits a nurse from issuing a prescription order as an act delegated by a physician.
441.16 Cross-reference
Cross-reference: See also ch.
N 8, Wis. adm. code.
441.18
441.18
Prescriptions for and delivery of opioid antagonists. 441.18(2)(a)(a) An advanced practice nurse certified to issue prescription orders under
s. 441.16 may, directly or by the use of a standing order, prescribe an opioid antagonist to a person in a position to assist an individual at risk of undergoing an opioid-related drug overdose and may deliver the opioid antagonist to that person. A prescription order under this paragraph need not specify the name and address of the individual to whom the opioid antagonist will be administered, but shall instead specify the name of the person to whom the opioid antagonist will be delivered.
441.18(2)(b)
(b) An advanced practice nurse who prescribes or delivers an opioid antagonist under
par. (a) shall ensure that the person to whom the opioid antagonist will be delivered has the knowledge and training necessary to safely administer the opioid antagonist to an individual undergoing an opioid-related overdose and that the person demonstrates the capacity to ensure that any individual to whom the person further delivers the opioid antagonist has or receives that knowledge and training.
441.18(3)
(3) An advanced practice nurse who, acting in good faith, prescribes or delivers an opioid antagonist in accordance with
sub. (2), or who, acting in good faith, otherwise lawfully prescribes or dispenses an opioid antagonist, shall be immune from criminal or civil liability and may not be subject to professional discipline under
s. 441.07 for any outcomes resulting from prescribing, delivering, or dispensing the opioid antagonist.
441.18 History
History: 2013 a. 200.
NURSE LICENSURE COMPACT
441.50
441.50
Nurse licensure compact. 441.50(1)
(1)
Article I — Findings and Declaration of Purpose. 441.50(1)(a)1.
1. That the health and safety of the public are affected by the degree of compliance with and the effectiveness of enforcement activities related to state nurse licensure laws.
441.50(1)(a)2.
2. That violations of nurse licensure and other laws regulating the practice of nursing may result in injury or harm to the public.
441.50(1)(a)3.
3. That the expanded mobility of nurses and the use of advanced communication technologies as part of our nation's health care delivery system require greater coordination and cooperation among states in the areas of nurse licensure and regulation.
441.50(1)(a)4.
4. That new practice modalities and technology make compliance with individual state nurse licensure laws difficult and complex.
441.50(1)(a)5.
5. That the current system of duplicative licensure for nurses practicing in multiple states is cumbersome and redundant to both nurses and states.
441.50(1)(b)
(b) The general purposes of this compact are as follows:
441.50(1)(b)1.
1. To facilitate the states' responsibility to protect the public's health and safety.
441.50(1)(b)2.
2. To ensure and encourage the cooperation of party states in the areas of nurse licensure and regulation.
441.50(1)(b)3.
3. To facilitate the exchange of information between party states in the areas of nurse regulation, investigation and adverse actions.
441.50(1)(b)4.
4. To promote compliance with the laws governing the practice of nursing in each jurisdiction.
441.50(1)(b)5.
5. To invest all party states with the authority to hold a nurse accountable for meeting all state practice laws in the state in which the patient is located at the time care is rendered through the mutual recognition of party state licenses.
441.50(2)
(2) Article II — Definitions. As used in this compact:
441.50(2)(a)
(a) "Adverse action" means a home or remote state action.
441.50(2)(b)
(b) "Alternative program" means a voluntary, nondisciplinary monitoring program approved by a nurse licensing board.
441.50(2)(c)
(c) "Coordinated licensure information system" means an integrated process for collecting, storing and sharing information on nurse licensure and enforcement activities related to nurse licensure laws, which is administered by a nonprofit organization composed of and controlled by state nurse licensing boards.
441.50(2)(d)
(d) "Current significant investigative information" means any of the following:
441.50(2)(d)1.
1. Investigative information that a licensing board, after a preliminary inquiry that includes notification and an opportunity for the nurse to respond if required by state law, has reason to believe is not groundless and, if proved true, would indicate more than a minor infraction.
441.50(2)(d)2.
2. Investigative information that indicates that the nurse represents an immediate threat to public health and safety regardless of whether the nurse has been notified and had an opportunity to respond.
441.50(2)(e)
(e) "Home state" means the party state that is the nurse's primary state of residence.
441.50(2)(f)
(f) "Home state action" means any administrative, civil, equitable or criminal action permitted by the home state's laws that are imposed on a nurse by the home state's licensing board or other authority including actions against an individual's license, such as revocation, suspension, probation or any other action that affects a nurse's authorization to practice.
441.50(2)(g)
(g) "Licensing board" means a party state's regulatory body responsible for issuing nurse licenses.
441.50(2)(h)
(h) "Multistate licensure privilege" means current, official authority from a remote state permitting the practice of nursing as either a registered nurse or a licensed practical/vocational nurse in such party state. All party states have the authority, in accordance with existing state due process law, to take actions against the nurse's privilege, such as revocation, suspension, probation or any other action that affects a nurse's authorization to practice.
441.50(2)(i)
(i) "Nurse" means a registered nurse or licensed practical/vocational nurse, as those terms are defined by each party's state practice laws.
441.50(2)(j)
(j) "Party state" means any state that has adopted this compact.
441.50(2)(k)
(k) "Remote state" means a party state, other than the home state, where the patient is located at the time nursing care is provided, or, in the case of the practice of nursing not involving a patient, in such party state where the recipient of nursing practice is located.
441.50(2)(L)
(L) "Remote state action" means any of the following:
441.50(2)(L)1.
1. Any administrative, civil, equitable or criminal action permitted by a remote state's laws that are imposed on a nurse by the remote state's licensing board or other authority including actions against an individual's multistate licensure privilege to practice in the remote state.
441.50(2)(L)2.
2. Cease and desist and other injunctive or equitable orders issued by remote states or the licensing boards thereof.
441.50(2)(m)
(m) "State" means a state, territory, or possession of the United States, the District of Columbia or the Commonwealth of Puerto Rico.
441.50(2)(n)
(n) "State practice laws" means those individual party state's laws and regulations that govern the practice of nursing, define the scope of nursing practice, and create the methods and grounds for imposing discipline. "State practice laws" does not include the initial qualifications for licensure or requirements necessary to obtain and retain a license, except for qualifications or requirements of the home state.
441.50(3)
(3) Article III — General Provisions and Jurisdiction. 441.50(3)(a)(a) A license to practice registered nursing issued by a home state to a resident in that state will be recognized by each party state as authorizing a multistate licensure privilege to practice as a registered nurse in such party state. A license to practice licensed practical/vocational nursing issued by a home state to a resident in that state will be recognized by each party state as authorizing a multistate licensure privilege to practice as a licensed practical/vocational nurse in such party state. In order to obtain or retain a license, an applicant must meet the home state's qualifications for licensure and license renewal as well as all other applicable state laws.
441.50(3)(b)
(b) Party states may, in accordance with state due process laws, limit or revoke the multistate licensure privilege of any nurse to practice in their state and may take any other actions under their applicable state laws necessary to protect the health and safety of their citizens. If a party state takes such action, it shall promptly notify the administrator of the coordinated licensure information system. The administrator of the coordinated licensure information system shall promptly notify the home state of any such actions by remote states.
441.50(3)(c)
(c) Every nurse practicing in a party state must comply with the state practice laws of the state in which the patient is located at the time care is rendered. In addition, the practice of nursing is not limited to patient care, but shall include all nursing practice as defined by the state practice laws of a party state. The practice of nursing will subject a nurse to the jurisdiction of the nurse licensing board and the courts, as well as the laws, in that party state.
441.50(3)(d)
(d) This compact does not affect additional requirements imposed by states for advanced practice registered nursing. However, a multistate licensure privilege to practice registered nursing granted by a party state shall be recognized by other party states as a license to practice registered nursing if one is required by state law as a precondition for qualifying for advanced practice registered nurse authorization.
441.50(3)(e)
(e) Individuals not residing in a party state shall continue to be able to apply for nurse licensure as provided for under the laws of each party state. However, the license granted to these individuals will not be recognized as granting the privilege to practice nursing in any other party state unless explicitly agreed to by that party state.
