April 22, 2010

January 28, 2010

October 22, 2009

May 7, 2009

February 5, 2009

July 31, 2008

The committee meeting was called to order on July 31, 2008, by Chris Sansom, BSN, RN, Director of Operations at 9:05 a.m. via videoconference at the Nevada State Board of Nursing, 2500 W. Sahara Ave, #207, Las Vegas, and the Nevada State Board of Nursing, 5011 Meadowood Mall Way, #300, Reno, Nevada.

MEMBERS PRESENT

                 Chris Sansom, BSN, RN, Director of Operations, Chair   

                 Carrie McMurray, CNA, Board Member Liaison

                 Jean Allen, RN                           Cheryl Becerra, RN

                 Mary Brann, RN                         Barbara Cavanagh, RN

                 Leslee Hoffler                              Elizabeth Mongeau, RN 

                 Carla Wright, RN              

MEMBERS ABSENT  

Terri Shoemaker, CNA

OTHERS PRESENT

                Debra Scott, MSN, RN, APN, Executive Director 

                Fred Olmstead, General Counsel

                Roseann Colosimo, PhD, RN, Education Consultant

                Linda Aure, BSN, RN-BC, Sr. Nurse Investigator

                Lark Muncy, RN, Nurse Investigator

                Amy Clark, RN, BSN, Nurse Investigator

             

CALL TO ORDER: The meeting was called to order at 9:05 a.m.  

PUBLIC COMMENT: There was no public comment.

A.  APPROVAL OF MINUTES – The minutes of the May 1, 2008, CNA Advisory Committee meeting were approved as written.

B.  OLD BUSINESS

1.  Report on Board meeting outcomes: D. Scott reported the Board is developing an on-line initial application process.  D. Scott and C. Sansom reported on end of year statistics presented to the Board at its July business meeting.  Statistics relevant to CNAs were highlighted and will be featured in the Board’s Nursing News and in the Board’s Annual Report. R. Colosimo reported the Board was in support of the CNA Instructor’s Conference. A request was made to explore offering CE credit to the instructors. A date has not been determined, but staff are anticipating sometime in late October or early November. The Board approved several CNA Training Program site surveys. 

C.  NEW BUSINESS

1. Legislative update: D. Scott informed the committee that there continues to be legislative committee meetings regarding the roles of various occupational health boards, the Hepatitis C outbreak in Southern Nevada, and other healthcare related concerns. Legislators have stated that there will be changes in these areas during the 2009 session.  Committee members were provided with information regarding accessing bill draft requests that are available on the state website so they may keep informed of issues related to the practice of nursing, and provide any feedback to their legislators. In addition to the above, topics most likely to be addressed during the session are: Medication aides; Increase of CNA training program hours; Increase in the fee range of licensed nurses; Reorganization of the Health Division; Reorganization of healthcare boards.

2. Review, discussion and action regarding proposed revision to the CNA Skills Examination to include foot care and ambulation: R. Colosimo reported that she, D. Scott, and C. Sansom participated in a telephone conference with Prometric to discuss this proposal.  Currently, Nevada is using the 2004 standardization and cut scores and could choose to move to the 2007 standardization for the skills test.  The committee was in support of recommending the addition of the two skills to the exam and review of the current cut scores.  This issue will be addressed at the CNA Training Program Instructor’s Conference and will be presented to the Board for final approval..

3. Update on Nursing Assistant Training Program Instructor’s Conference:  R. Colosimo stated that a date has not been reached due to calendar conflicts.  Committee members will be given the opportunity to attend the conference. 

4. Quarterly program reports from Prometric:  R. Colosimo and C. Sansom provided the report and discussed the pass rates.  Each program will be receiving their report within the next few weeks.  Recommended revisions to the next quarterly report include the addition of the overall pass rate for each program. The committee was informed that Evergreen Carson City will be completing their current class but then will be removed from the approved program list due to Bureau of Licensure and Certification sanctions. 

5. Discussion on certified medication aides: C. Sansom reported that a review of National Council of State Boards of Nursing (NCSBN) member Board profiles indicates that the Arkansas, Arizona, Idaho, Kentucky, New Mexico, and North Dakota Board of Nursing either currently regulate MA-Cs or are establishing taskforces to work on the issue. The MA-Cs are working in a variety of settings including long term care, prisons and schools. Committee members reported that the Southern Nevada School District has created a position for the elementary and middle schools to provide first aid, triage, and act as a liaison to the school nurse. Training is provided by the school district in conjunction with the school nurse. The committee was also reminded that this topic is being addressed as mandated by the Nevada State Legislature during the last session. Medication aides are anticipated to be a topic during the 2009 Legislative Session.

6.       Suggested items for future CNA agendas:

   *  Report on legislative issues

   *  Discussion of certified medication aides

   *  Report on Board meeting outcomes

   *  Update on Nursing Assistant Training Program Instructors conference

    

ADJOURNMENT:  The meeting was adjourned at 10:10 a.m.

May 1, 2008

The committee meeting was called to order on May 1, 2008, by Chris Sansom, BSN, RN, Director of Operations at 9:01 a.m. via videoconference at the Nevada State Board of Nursing, 2500 W. Sahara Ave, #207, Las Vegas, and the Nevada State Board of Nursing, 5011 Meadowood Mall Way, #300, Reno, Nevada.

MEMBERS PRESENT

                 Chris Sansom, BSN, RN, Director of Operations, Chair   

                 Carrie McMurray, CNA, Board Member Liaison

                 Jean Allen, RN                           Cheryl Becerra, RN

                 Mary Brann, RN                         Barbara Cavanagh, RN

                 Leslee Hoffler                              Elizabeth Mongeau, RN 

                 Terri Shoemaker, CNA               Carla Wright, RN

MEMBERS ABSENT

OTHERS PRESENT

                Doreen Begley, MS, RN, Board Member

                Leah Doke, Home Health Services of Nevada

                Debra Scott, MSN, RN, APN, Executive Director

                Roseann Colosimo, PhD, RN, Education Consultant

                Patty Towler, Sr. Certification Specialist

                Lark Muncy, RN, Nurse Investigator

             

CALL TO ORDER: The meeting was called to order at 9:00 a.m.  C. Sansom introduced Carrie McMurray, CNA, as a new Board member and liaison to the committee.

PUBLIC COMMENT: M. Stubbs asked the committee if glass thermometers are currently being used in facilities and if there could be a discussion regarding whether their use should be on the CNA Skills Guidelines.  In addition, Ms. Stubbs asked if the use of temporal artery temperature devices by CNAs should be discussed and added to the list.  The committee will place these items on the next meeting agenda for review and discussion.

A.  APPROVAL OF MINUTES – C. Sansom gave the committee copies of revised minutes from the February 7, 2008 meeting.  Agenda items C.6. and C.7. were inadvertently omitted on the previous draft minutes sent to the committee.  The minutes of the February 7, 2008, CNA Advisory Committee were approved as revised.

B.  OLD BUSINESS

1.  Report meeting outcomes:  C. Sansom, D. Scott, and R. Colosimo reported the Board granted conditional approval to Purrfect Nursing Assistant Training Program upon a full survey being completed within six months.  First Step Nursing Assistant Training Program was granted a 2-year approval.  The committee was informed that the new regulations have now been adopted and became effective on April 17, 2008.  The committee was thanked for their work on revising some of the regulations related to CNAs.  Each new regulation was reviewed with the committee and are available on the Board's website.  The NSBN News will have an article on them.

C.  NEW BUSINESS

1. Legislative update:  D. Scott informed the committee that there has been approximately one meeting a week of a legislative committee regarding the roles of various occupational health boards, the Hepatitis C outbreak in southern Nevada, and other healthcare related concerns.  Legislators have stated that there will be changes in these areas during the 2009 session.  Committee members were provided with the information regarding accessing these meetings live on the legislative website, and are encouraged to stay informed regarding issues that may affect nursing.

2. Review, discussion and action regarding request for revision to the CNA Skills Guidelines, including a request by M. Stubbs to review CNA use of glass thermometers, CNA use of temporal artery temperature devices, and CNA use of oral brush tips: There was no one present to speak to this request and this item was tabled to a future committee meeting.

3. Discussion on certified medication aides: C. Sansom reported that a new article has been published in JONA's Healthcare Law, Ethics, and Regulation titled, "Development of a Standardized Medication Assistant Curriculum."  Highlights from the article were discussed that included: 14 Boards of Nursing now regulate MA-Cs; Nurses are delegating medication administration, are responsible for calculations/conversions, nursing assessment and judgment, and supervision of the MA-C; Nurses need to be educated regarding delegation issues.  There is limited research available, but there is evidence that MA-Cs are able to safely administer medications without proper mechanisms in place for education and oversight.  C. Sansom further reported that during a National Council of State Boards of Nursing (NCSBN) Practice Consultant Call, a discussion of MA-Cs was held and included: New Hampshire and Alabama indicated they allow delegation of medication administration to MA-Cs, but do not allow injectables to be administered by anyone but a nurse; Colorado has medication aides in residential settings where RNs teach medication administration but cannot supervise it; Oklahoma has MA-Cs that are regulated by the Okalahoma Department of Health and give medications in long term care and correctional settings.  The committee and guests were also reminded that the committee is addressing this issue as mandated by the Nevada State Legislature during the last session.  D. Scott reported that medication aides are anticipated to be a topic during the 2009 Legislative session.

4. Suggested items for future CNA agendas:

   • Report on legislative issues

   • Discussion of certified medication aides

   • Report on Board meeting outcomes

   • Update on Nursing Assistant Training Program Instructors conference

   • Quarterly program reports generated from Prometric

   • Review, discussion and possible action regarding proposed revision to the CNA Skills Guidelines regarding:

     - Oral Brush Tip

     - Glass Thermometers

     - Temporal artery temperature devices

5. Review, discussion and action regarding proposal for a Nursing Assistant Training Program (NATP) Instructors conference: R. Colosimo and P. Towler presented their concept for a NATP Instructors conference to be held in the Board offices to discuss areas of concern identified by R. Colosimo during program surveys.  The committee fully supported the concept and would like areas of discussion to include: CNA Skills Guidelines check-off lists; Instructor-to-student rations; Documentation of training to include critical skills.  Board staff will work toward a target date in the fall and will report progress to the committee at its next meeting.

ADJOURNMENT:  The meeting was adjourned at 10:00 a.m.

February 7, 2008

The committee meeting was called to order on February 7, 2008, by Chris Sansom, BSN, RN, Director of Operations at 9:00 a.m. via videoconference at the Nevada State Board of Nursing, 2500 W. Sahara Ave, #207, Las Vegas, and the Nevada State Board of Nursing, 5011 Meadowood Mall Way, #300, Reno, Nevada.

MEMBERS PRESENT

                 Chris Sansom, BSN, RN, Director of Operations, Chair   

                 Carrie McMurray, CNA, Board Member Liaison

                 Jean Allen, RN                           Cheryl Becerra, RN

                 Barbara Cavanagh, RN              Leslee Hoffler, RN

                 Elizabeth Mongeau, RN              Terri Shoemaker, CNA 

                 Carla Wright, RN   

MEMBERS ABSENT

                Mary Brann, RN                                                 

  

OTHERS PRESENT

                Mary Stubbs, RN, Coordinator - TMCC Nursing Assistant Program

                Debra Scott, MSN, RN, APN, Executive Director, NSBN

                Roseann Colosimo, PhD, RN, Education Consultant, NSBN

                Patty Towler, Sr. Certification Specialist, NSBN

                Linda Aure, RN, Sr. Nurse Investigator, NSBN

                Lark Muncy, RN, Nurse Investigator, NSBN

                Marilyn Schmit, RN, Application Coordinator, NSBN

CALL TO ORDER: The meeting was called to order at 9:00 a.m.  C. Sansom introduced Carrie McMurray, CNA, as a new Board member and liaison to the committee.

PUBLIC COMMENT: M. Stubbs asked the committee if glass thermometers are currently being used in facilities and if there could be a discussion regarding whether their use should be on the CNA Skills Guidelines.  In addition, Ms. Stubbs asked if the use of temporal artery temperature devices by CNAs should be discussed and added to the list.  The committee will place these items on the next meeting agenda for review and discussion.

A.  APPROVAL OF MINUTES – The minutes of the November 7, 2007 CNA Advisory Committee meeting were approved as written.

B.  OLD BUSINESS

1.  Report on Board meeting outcomes: C. Sansom reported the Board elected a new vice president, Doreen Begley, MS, RN.  The Board meeting documents have been converted from paper to laptop computers and flash drives.

C.  NEW BUSINESS

1. Update on the CNA testing contract: C. Sansom reported that a Request for Proposal was issued for the CNA testing contract with two companies responding.  The proposals were reviewed and a determination was made to enter into a contract with Prometric.  The contract is scheduled to be approved at the Board of Examiners meeting on March 11, 2008.

2. Legislative update: D. Scott informed the committee that the Board held its final hearing regarding several proposed regulation changes that have been submitted to the Legislative Counsel Bureau for approval/disapproval.  Certified medication aides are anticipated to be a topic during the next legislative session.  The Interim Health Care Committee and sub-committees are being monitored.  There is a current study being conducted regarding the roles of various occupational health boards.  The Board of Nursing is providing templates and documents to other boards, when requested, to help them establish policy and procedures.

3. Discussion on certified medication aides: C. Sansom reported that the Idaho Board of Nursing was granted authority in March 2007 to regulate and certify medication aides.  The committee member response to whether they support or oppose CMAs, and general discussion of role and scope of practice indicated: Six members present indicated they have some concerns and reservations regarding the practice of CMAs but overall felt they could be a benefit to nurses in long term care.  One member was opposed to CMAs and felt it was placing too much responsibility on the CMA, and would require more training than available models indicate.  One member was neutral.  Some members thought the National Council of State Board of Nursing's CMA Model Curriculum was a good starting point for discussions regarding the role and scope of practice.  Concerns expressed by the committee are:

   1. The amount and type of training required to be a CMA;

   2. The scope of practice would need to be limited by type and route of medication;

   3. The need to ensure a CMA would not be expected or allowed to practice as a CNA while working as a CMA.  The CMA should not be counted in staffing skill mix in a facility;

   4. Registered Nurses supervising CMAs would require education regarding scope of practice of the CMA and their role and responsibilities as supervisor;

   5. Change of the current culture of the nursing process would need to occur and be supported.

   The committee was encouraged to send all e-mails articles, and information they find regarding medication assistants to the chair for discussion at future meetings.  The committee and guests were also reminded that the committee is addressing this issue as mandated by the Nevada State Legislature during the last session.

4. Report on resignation of committee member and committee openings: C. Sansom reported that Kathie Wilcox, LPN, home health, has resigned her position due to a job change.  The committee thanks her for her participation and wishes her much success with her new role.  The committee has two positions currently open: one from long term care, and one from home health, An LPN is needed for the committee from one of these two settings.

5. Suggested items for future CNA agendas:

   • Report on legislative issues

   • Discussion of certified medication aides

   • Report on Board meeting outcomes

   • Review, discussion and possible action regarding proposed revision to the CNA Skills Guidelines regarding:

     - Oral Brush Tip

     - Glass Thermometers

     - Temporal artery temperature devices

ADJOURNMENT:  The meeting was adjourned at 10:30 a.m.

November 1, 2007

The committee meeting was called to order on November 1, 2007, by Chris Sansom, BSN, RN, Director of Operations at 9:00 a.m. via videoconference at the Nevada State Board of Nursing, 2500 W. Sahara Ave, #207, Las Vegas, and the Nevada State Board of Nursing, 5011 Meadowood Mall Way, #300, Reno, Nevada.

MEMBERS PRESENT

                 Chris Sansom, RN, Director of Operations, Chair   

                 Dorothy Perkins, CNA, Board Member Liaison

                 Mary Brann, RN                        Leslee Hoffler, RN

                 Barbara Cavanagh, RN              Terri Shoemaker, CNA

                 Elizabeth Mongeau, RN              Kathie Wilcox, LPN

 

MEMBERS ABSENT

                Jean Allen, RN                                                     

    Cheryl Becerra, RN

    Carla Wright, RN

 

OTHERS PRESENT

                Diane Stein, RN

                Fred Olmstead, Board General Counsel

                Roseann Colosimo, RN, Board Education Consultant

                Lark Muncy, RN, Board Investigator

                Patty Towler, Board Sr. Certification Specialist

CALL TO ORDER: The meeting was called to order at 9:00 a.m.

PUBLIC COMMENT: C. Sansom presented a request from the Centers for Medicaid & State Operations (CMS), Survey & Certification regarding CNA training.  Specifically, CMS is requesting examples of best practices for nurse aide training for any quality of care area such as pressure ulcers, incontinence, and hydration.  If any committee members have examples they would like to have forwarded to CMS please mail or fax them to the chair by November 20, 2007.

A.  APPROVAL OF MINUTES – The minutes of the August 2, 2007 CNA Advisory Committee meeting were approved as written.

B.  OLD BUSINESS

1.  Report on Board meeting outcomes: C. Sansom reported the Board elected new officers for the coming year. They are H. Vos, president, D. Burgio, vice-president, and B. McKay, secretary. The Board approved concept and wording regarding several proposed regulation changes. Workshops for regulation changes will be held via videoconference on November 30, 2007; they are open to the public to attend and make comment. R. Colosimo reported that the Board approved two site surveys of CNA programs, Nevada Healthcare, and Sierra Nevada Job Corps. The Board also approved a new CNA training program being offered by First Step Nursing.

C.  NEW BUSINESS

1. Report by F. Olmstead regarding the contact process the Board must go through regarding the CNA testing service. The Prometric contact runs through January 2008, and the Board anticipates a settled contract prior to that time.

2. Report from Diane Stein, RN, regarding the Prometric National Examination Council Meeting she attended in August 2007 as a representative from Nevada. The meeting consisted of test question development, exam scores and cut scores. The new exam questions are not expected to be in use for 2-3 years while they are verified, validated and psychometrically tested.  The focus of the new questions includes pressure ulcers, hydration, feeding, turning and body mechanics. Environmental issues will also be included such as restraints, safety, and fires.  he committee thanked Diane for attending the meeting and her report.

3. Legislative update: C. Sansom informed the committee there were no new issues to report at this time. The Interim Health Care Committee met yesterday, however nursing was not a topic of discussion at the meeting.

4. Discussion on certified medication aides: C. Sansom reported that a new research paper was received titled, “Nursing Home Error and Level of Staff Credentials,” Jill Scott-Cawiezell, et al, published by Clinical Nursing Research, Volume 16, Number 1, February 2007. The article could not be copied for the members, however C. Sansom reported the research indicates that interruption has a significant impact on medication error rate for RNs and LPNs. The report stated there was no significant difference in medication errors among licensed nurses versus CMAs when wrong time errors were removed. There is initial evidence based on the limited study to suggest that CMAs can be safe and effective. C. Sansom reported on a survey conducted by the Arkansas Board of Nursing regarding UAP (CMA) administration of injectable medications. Of the 30 states reporting, 14 do not allow subcutaneous injections; 22 do not allow intramuscular; 23 do not allow intravenous; and 25 do not allow central line administration. The committee was encouraged to send all e-mails, articles, and information they find regarding medication assistants to the chair for discussion at future meetings. The committee was also reminded that the committee is addressing this issue as mandated by the Nevada State Legislature during the last session.

5. Review, discussion and action regarding proposed committee meeting dates for 2008: The committee approved February 7, 2008, May 1, 2008,  July 31, 2008, and November 4, 2008.

6. Suggested items for future CNA agendas:

·    Report on legislative issues

·    Discussion of certified medication aides to include:

o   Committee member response to whether they support or oppose CMAs with rationale

o   General discussion of CMA role and scope

·    Report on Board meeting outcomes

ADJOURNMENT:  The meeting was adjourned at 9:35 a.m.

August 2, 2007

The committee meeting was called to order on August 2, 2007 by Chris Sansom, BSN, RN, Director of Operations at 9:00 a.m. via videoconference at the Nevada State Board of Nursing, 2500 W. Sahara Ave, #207, Las Vegas, and the Nevada State Board of Nursing, 5011 Meadowood Mall Way, #300, Reno, Nevada.

MEMBERS PRESENT

Chris Sansom, RN, Director of Operations, Chair

Dorothy Perkins, CNA, Board Member Liaison

Jean Allen, RN

Cheryl Becerra, RN

Barbara Cavanagh, RN

Leslee Hoffler, RN

Elizabeth Mongeau, RN

Kathie Wilcox, LPN

Carla Wright, RN

MEMBERS ABSENT

Mary Brann, RN

Terri Shoemaker, CNA

OTHERS PRESENT

Debra Scott, MSN, RN, APN, Executive Director

Roseann Colosimo, RN, Education Consultant

Karen Winter, RN

Jen Richards, RN

Dee Riley, RN, nursing student

CALL TO ORDER: The meeting was called to order at 9:00 a.m.

PUBLIC COMMENT: None 

A.   APPROVAL OF MINUTES – The minutes of the May 3, 2007 CNA Advisory Committee meeting were approved as written.

B.  OLD BUSINESS

1. Report on Board meeting outcomes: C. Sansom reported the Board revised the concept and wording the committee proposed regarding NAC 632.193 Renewal of certificate, to state the CNA must have 40 hours of employment within the last two years under the direction of a licensed nurse to be eligible to renew. Workshops for regulation changes will be held at a future date. The Board withdrew approval of Nevada Care Nursing Institute as a CNA training program. There are currently approximately 6,321 active CNAs in the state. The Board reviewed CNA testing reports from Prometric and approved staff sending the reports to training programs semi-annually.

C.   NEW BUSINESS

1. Review, discussion and action regarding request for review and revision of the CNA Skills Guidelines, including a request by Renown Medical Center to include emptying and measuring surgical drainage collection devices: Karen Winter and Jen Richards were present from Renown Medical Center to present the request and the results of their research. There is no research specifically available regarding this procedure being performed by a CNA. J. Richards reported the research indicated the most common source of postoperative complications is urinary tract infections usually originating from an indwelling urinary catheter. CNAs currently perform the skill of emptying urinary catheter bags and catheter care. K. Richards provided research indicating the licensed nurse should not delegate assessment of wound drainage and maintenance of drains and the drainage system; however, delegation of emptying, measuring and recording output from a closed drainage system is appropriate delegation. The committee discussed the proposed practice decision and voted to recommend it be brought to the Board for approval as a delegable task from an RN to a CNA who has the documented competence to perform it. The committee did not support adding the skill to the CNA Model Curriculum due to the burden that would be placed on training programs, primarily long-term care based, to teach a skill that most CNAs would not be performing in their daily practice. 

2. Legislative update: D. Scott updated the committee on the Board related bills that had been passed and those which died during the legislative session including certified medication aides, the Nurse Licensure Compact, education requirements for nursing program faculty, and student clinical privileging.

3. Report on long-term care conference: R. Colosimo discussed the long-term care director of nursing conference she attended and the Clinical Practice Guidelines she obtained from the conference. She will provide copies of the guidelines to anyone who would like them.

4. Update on Prometric sale, and testing reports: C. Sansom reported that Prometric has been sold to Educational Testing Services (ETS). There has not been any change noted in services, and the company has indicated all services will remain the same. The CNA testing reports were presented to the Board at its annual business meeting. A copy of the format was given to committee members. Actual reports will be sent to each training program semi-annually with a projected start date of January 2008. Diane DeLucia-Stein, RN. from the College of Southern Nevada is going to attend Prometric’s National Examination Council Meeting as a representative for Nevada to review and write items for the CNA exam.

5. Discussion on certified medication aides: C. Sansom reported that an e-mail from the California Nurses Association was received regarding medication aides, and that CNAs with 51 months of experience in an acute care facility may take a few courses and become an LVN and administer medications. They acknowledged these LVNs would not be eligible for licensure in any other state. The committee was encouraged to send all e-mails, articles, and information they find regarding medication assistants to the chair for discussion at future meetings.

6. Suggested items for future CNA agendas:

¬       Report from D. Stein regarding the Prometric conference.

¬       Discussion on certified medication aides.

ADJOURNMENT:  The meeting was adjourned at 10:20 a.m.

May 3, 2007

The committee meeting was called to order on May 3, 2007 by Chris Sansom, BSN, RN, Director of Operations at 9:00 a.m. via videoconference at the Nevada State Board of Nursing, 2500 W. Sahara Ave, #207, Las Vegas, and the Nevada State Board of Nursing, 5011 Meadowood Mall Way, #300, Reno, Nevada.

MEMBERS PRESENT

Chris Sansom, BSN, RN, Director of Operations, Chair

Dorothy Perkins, CNA, Board Member Liaison

Jean Allen, BSN, RN

Cheryl Becerra, RN

Barbara Cavanagh, BSN, RN, CCM

Leslee Hoffler, RN

Elizabeth Mongeau, BS, RN

Terri Shoemaker, CNA

Carla Wright, RN

MEMBERS ABSENT

Mary Brann, MSN, RN

Kathie Wilcox, LPN

OTHERS PRESENT

Roseann Colosimo, PhD, MSN, RN

Lark Muncy, RN, Investigator

Patty Towler, Sr. Certification Specialist

CALL TO ORDER: The meeting was called to order at 9:00 a.m.

PUBLIC COMMENT: None

A.  APPROVAL OF MINUTES: The minutes of February 15, 2007 CNA Advisory Committee meeting were approved as written.

 B. OLD BUSINESS

1.  Report on Board meeting outcomes: C. Sansom reported that two new members of the CNA Advisory Committee were appointed at the March Board meeting, Cheryl Becerra, and Carla Wright. The new members were welcomed to the committee. The Reno office of the Board has moved to suite 300 at the same street address. The committee was reminded that the proposed concept and wording revision to the regulation regarding hours of employment for renewal of certificate is being presented at the May 9, 2007 Board meeting and all members are welcome to attend or submit a letter to the Board regarding their position on this issue. The committee clarified that they requested 8 hours of employment as a CNA within the previous twenty-four months under the direction of a licensed nurse for renewal of a certificate. The proposed concept and wording will be amended at the Board meeting to reflect this clarification.

C.  NEW BUSINESS

1.   Legislative update: C. Sansom informed the committee of issues related to nursing that are being reviewed during this legislative session including: AB491 to create a certificate of clinical privileging for nursing students based on a criminal background checks has passed out of the Assembly Committee.  If approved, the Board of Nursing would be conducting these checks; SB412 regarding the Nurse Licensure Compact, and allowing RNs with a bachelors degree and five years nursing experience to teach clinical portions of a nursing education program passed out of committee. The Board of Nursing continues to have concerns regarding criminal background checks not being conducted by all compact states. If this bill passes, the nurse educator portion would sunset in 2012. The Medication Aides bill, the staffing ratios bill, and the mandatory gerontology education bill did not pass out of committee. The committee will be updated at future meetings regarding these and any other relevant issues that arise during the current legislative session.

2.   Report by R. Colosimo regarding the status of CNA training programs in the state. There are currently 22 approved training programs. Some of the programs have not graduated a class in almost two years. If a program does not graduate students within two years they will not be eligible to renew, but would have to submit a request for approval of a new program. Currently, Mesquite and Berryman in Reno may not run CNA training programs or be clinical sites due to BLC sanctions. Roseann reported that she is reinforcing the importance of hand washing when conducting surveys because many students appear to have difficulty with this skill and some sites have limited hand washing resources available.

3.   Update on Prometric sale and testing reports: C. Sansom reported that as of yesterday, Prometric was still not able to provide information regarding their sale. The testing reports are being presented to the Board at the annual business meeting in July, and with their approval, the reports will be made available to training programs on a quarterly basis. There continue to be some “unknowns” under “instructors” in the reports, but these appear to be dropping off as Prometric is loading more complete information and data continues to be updated.

4.   Suggested items for future CNA agendas:

·        R. Colosimo report on status of CNA training programs

·        Update on the Prometric sale and testing reports

·        Legislative update

·        Medication aides

·        Review of the CNA Skills Guidelines

·        Scope of practice decision request by Renown Healthcare regarding drainage collection devices

5.  Discussion on certified medication aides: C. Sansom reported that as previously stated, the medication aide bill did not pass out of committee. The legislature did request that the CNA Advisory Committee take this issue under advisement and conduct research to be able to present findings to the Interim Healthcare Committee prior to the next legislative session. Committee members were encouraged to be alert for articles and resources regarding this issue and bring them before the committee for discussion and review. This topic will become a standard agenda item for this committee.

6.   Review, discussion and action regarding revision to the CNA Skills Guidelines to include starting and stopping a tube feeding when providing care: Deborah Cline, RN, MS presented the practice decision request to the committee. Ms. Cline provided the committee with a written request and rationale. Rationale included the following: Allowing CNAs to stop the feeding prior to lowering the head of the bed for care would assist in preventing ventilator associated pneumonia associated with aspiration; Placing a tube feeding pump on hold is not unsafe practice; Feeding of patients is already within the scope of practice of a CNA; CNAs placing tube feeding pumps on hold is a common practice; and two Boards of Nursing - New Hampshire and Oregon - include sections on feeding tubes within the CNA scope of practice. The committee members clarified that the request included the tube feeding pumps be restarted by CNAs, and included all types of tubes. The committee expressed concerns regarding who would check for tube placement prior to the restarting the feeding and were advised that no one would. The committee discussed the benefit of a CNA being able to provide care to the patient without waiting for the nurse who may be overburdened to come and turn off or restart the feeding. The central issue for most committee members was restarting the tube feeding pump by a CNA, and that the risk outweighed the benefit. The committee voted to not recommend the Board approve starting and stopping a tube feeding pump as within the scope of practice of a CNA.

ADJOURNMENT: The meeting was adjourned at 10:40 a.m.

February 15, 2007

The committee meeting was called to order on February 15, 2007 by Chris Sansom, BSN, RN, Director of Operations at 9:00 a.m. via videoconference at the Nevada State Board of Nursing, 2500 W. Sahara Ave, #207, Las Vegas, and the Nevada State Board of Nursing, 5011 Meadowood Mall Way, #201, Reno, Nevada.

MEMBERS PRESENT

                 Chris Sansom, BSN, RN, Director of Operations, Chair          

                 Dorothy Perkins, CNA, Board Member Liaison     

                 Jean Allen, RN

                 Mary Brann, MSN, RN                 

                 Barbara Cavanagh, BSN, RN, CCM      
    Leslee Hoffler, RN    

                 Elizabeth Mongeau, BS, RN   

                 Terri Shoemaker, CNA   

MEMBERS ABSENT

              Sandra Collier, RN                                        Tonya Evans-Poole, CNA

              Linda Toombs, CNA                                     Kathie Wilcox, LPN

OTHERS PRESENT

              Debra Scott, MSN, RN, Executive Director

              Frederick Olmstead, General Counsel

              Linda Aure, BSN, RN, Sr. Investigator

              Patty Towler, Sr. Certification Specialist

CALL TO ORDER: The meeting was called to order at 9:00 a.m.

PUBLIC COMMENT: No one was present for public comment although D. Scott discussed a bill draft that would require gerontology education for nurses and CNAs both in their original nursing education programs and continuing education.

A. APPROVAL OF MINUTES: The minutes of November 2, 2006 CNA Advisory Committee meeting were approved as amended.

B. OLD BUSINESS

1.    Review, discussion, and action regarding the CNA Skills Guidelines to include placement and care of fecal incontinence collection devices, and emptying and measuring a wound/surgical drainage collection device: The committee voted at the previous meeting that emptying and measuring a wound/surgical drainage collection device is not within the scope of practice as a CNA. There was no one present to speak on behalf of the placement and care of fecal incontinence collection devices and there was no action taken by the committee.

2.    Review, discussion and action regarding updated Train the Trainer Manual reviewed by a subcommittee of D. Perkins, K. Wilcox, and T. Shoemaker: The subcommittee made the following findings and recommendations. The new format is easier to read and the manual should be single page documents, not two sided. The subcommittee recommended an updated training program list, and the Model Curriculum be included with the manual. It was moved and seconded the committee approve the revised Train the Trainer Manual with the revisions recommended by the subcommittee. The subcommittee was thanked for their time and effort that went into the review.

C.  NEW BUSINESS

1.   Report on Board meeting outcomes: C. Sansom and D. Scott reported that D. Perkins has been reappointed as the Board liaison to the committee. There was a review of the statutory requirements for the composition of the committee and why the applications to serve on the committee were not presented at the Board meeting for consideration in January.               

2.   Legislative update: D. Scott informed the committee of issues related to nursing that will be reviewed during this legislative session including: The board will not seek an increase in the fee range at this time; There is a bill draft for criminal background checks for nursing students prior to allowing them to proceed in clinicals. If passed, the Board of Nursing would be conducting these checks; There is potential legislation regarding mandatory overtime; There is a movement to have Medication Aides - Certified in Nevada to serve primarily in long term care. If given the authority the Board of Nursing would be actively involved in drafting regulation for these MA-Cs because nurses would be delegating to them; There has been and continues to be a movement to eliminate temporary licenses/certificates due to concerns about fingerprint background checks; The Nurse Licensure Compact may be presented to the legislature. The Board of Nursing has some concerns regarding criminal background checks not being conducted by all compact states as mandated by the compact. The NLC is not a solution to the nursing shortage in Nevada, as some have perceived it. The committee will be updated at future meetings regarding these and any other relevant issues that arise during the current legislative session.

3.   Review, discussion, and action regarding proposed revision of NAC 632.193 (1)(b) Renewal of certificate, specifically the requirement for 400 hours of employment as a CNA to renew: The committee reviewed current Nevada statutes and regulations regarding this issue as well as the Code of Federal Regulations. An overview of the CNA program origins and federal oversight was presented to the committee. A survey was conducted with 21 state responses indicating that 13 states require 7 or 8 hours every two years to renew, 3 require 160 hours or more every two years to renew, and 5 require the CNA to work for compensation in the two year renewal period. The committee discussed competency measures for CNAs, the employer’s responsibility, and the disparity of renewal hours for licensed nurses versus CNAs and the levels of scope of practice. It was moved and seconded the committee recommend that NAC 632.193 (1)(b) be revised to state, “The nursing assistant must be employed for monetary compensation since their last renewal by the Board under the direct supervision of a licensed nurse” in accordance with federal regulations. Motion failed. It was moved and seconded the committee recommend that NAC 632.193 (1)(b) be revised to state, “The nursing assistant must have worked 8 hours for compensation during the 24 month recertification period under the direction of a licensed nurse, or must complete a new training and competency evaluation program or a new competency evaluation program.” Motion carried. The committee requested this item be presented to the Board for consideration at the May 2007 meeting to allow members who cannot attend the March meeting to be present.

4.   Review, discussion and action regarding request for removal of L. Toombs, CNA from the committee: The committee was advised that Ms. Toombs has submitted a written resignation and that applications for openings on the committee will be presented at the March 2007 Board meeting.

5.      Suggested items for future CNA agendas:

·        R. Colosimo report on status of CNA training programs

·        Update on the Prometric sale, and testing reports

·        Legislative update

ADJOURNMENT: The meeting was adjourned at 10:10 a.m.                            

November 2, 2006

The committee meeting was called to order on November 2, 2006 by Chris Sansom, RN, Director of Operations at 9:02 a.m. via videoconference at the Nevada State Board of Nursing, 2500 W. Sahara Ave, #207, Las Vegas, and the Nevada State Board of Nursing, 5011 Meadowood Mall Way, #201, Reno, Nevada.

MEMBERS PRESENT

                  Chris Sansom, BSN, RN, Board Director of Operations, Chair

                          Dorothy Perkins, CNA, Board Member Liaison

                              Jean Allen, BSN, RN             Terri Shoemaker, CNA

                              Mary Brann, MSN, RN         Kathie Wilcox, LPN  

                              Barbara Cavanagh, BSN, RN, CCM 

MEMBERS ABSENT

Sandra Collier, RN

Tonya Evans-Poole, CNA

Barbara Fraser, MS, RN

Linda Toombs, CNA

Diane Schlapkohl, RN, RAC-C

OTHERS PRESENT

Debra Scott, MS, RN, APN, Board Executive Director

Frederick Olmstead, Board General Counsel

Roseann Colosimo, PhD, MSN, RN, Education Consultant

Linda Aure, BSN, RN, Board Sr. Investigator

Lark Muncy, RN, Investigator

Patty Towler, Board Sr. Certification Specialist 

CALL TO ORDER: The meeting was called to order at 9:02 a.m.

PUBLIC COMMENT:  None 

A.         APPROVAL OF MINUTES: The minutes of August 24, 2006, CNA Advisory Committee meeting were approved as revised.

B.        OLD BUSINESS

1.      C. Sansom is now the chair of the committee. R. Colosimo was introduced to committee members as the Board’s Education Consultant. The committee welcomed M. Brann as a new member.

2.      Review, discussion and action regarding recommendation of proposed concept and wording change to NAC 632.726 Determinations required before approval, and NAC 632.785 Duties of coordinator of approved program.  The committee discussed the role of a CNA training program coordinator based on the duties outlined in regulation.  The committee agreed that the program coordinator should be a registered nurse and recommended a concept and wording change as follows:

NAC 632.726 Determinations required before approval. 3. Coordinated by a registered nurse person who has the qualifications required by the Federal Government and is qualified to perform the duties set forth in NAC 632.785.

NAC 632.785 Duties of coordinator of approved program. (NRS 632.120,632.2856)  The registered nurse coordinator of an approved program shall:

C.        NEW BUSINESS

1.      Review, discussion and action regarding proposed revision to the CNA Skills Guidelines: The committee was asked if placement and care of fecal incontinence collection devices is within the scope of practice of a CNA.  The committee requested this item be continued to the next meeting so further information and specifics could be presented for consideration. The committee was asked if it is within the scope of practice for a CNA to empty and measure a wound/surgical drainage collection device. The members expressed concerns that this procedure requires an assessment of the drainage, dressing and/or wound site by a registered nurse. The committee decided that this is not within the scope of practice of a CNA. 

2.      Review, discussion, and action regarding updated Train the Trainer Manual:  The subcommittee (D. Perkins, K. Wilcox, & T. Shoemaker) that was formed to review the Train the Trainer Manual and report back to the committee requested this matter be continued to the next regularly scheduled meeting to allow for further review.

3.      Review, discussion and action regarding CNA Committee meeting dates for 2007: The committee approved the following dates: February 15, May 3, August 2, and November 1.

4.      Report on Board meeting outcomes: C. Sansom reported relevant NSBN Board meeting outcomes from the September meeting. The committee was advised that the Board ratified the survey results of nine CNA training programs, and withdrew approval of one CNA training program.

5.  C. Sansom and P. Towler reported on the Prometric reports of pass/fail rates for CNA programs. For 17 programs in Nevada, pass rates included the following. 

      Clinical Exam:  80-100% = 10 programs; 70-79% = 3 programs; <69% = 5 programs. 

      Written Knowledge Exam: 80-100% = 16 programs; 70-79% = 1 program; <69% = 0 programs. 

      Oral Exams were review based on six individual results. 80-100% = 3 individuals;  51-79% = 0 individuals; < 50% = 3 individuals. 

      The committee was advised that Prometric has recently informed the Board it is being sold by Thomson. Prometric has assured Board staff that this sale will not impact CNA examinations and it does not anticipate any changes. 

            6.   Suggested items for future CNA agenda: 

·        Review, discussion and possible action regarding placement and care of fecal incontinence collection devices being added to the CNA Skills Guidelines.

·        Train the Trainer Manual revision.

·        Update on proposed regulation changes.

·        Legislative update.

·        Prometric update.

ADJOURNMENT:  The meeting was adjourned at 9:50 a.m.

August 24, 2006

The committee meeting was called to order on August 24, 2006, by Donna Cowling, MSN, RN, Education Consultant, at 9:09 a.m. via videoconference at the Nevada State Board of Nursing, 2500 W. Sahara Ave, #207, Las Vegas, and the Nevada State Board of Nursing, 5011 Meadowood Mall Way, #201, Reno, Nevada.

MEMBERS PRESENT

             Donna Cowling, MSN, RN, Chair                        Terri Shoemaker, CNA

             Dorothy Perkins, CNA, Board Member Liaison    Barbara Fraser, MS, RN

             Kathie Wilcox, RN

MEMBERS ABSENT

Barbara Cavanagh, BSN, RN, CCM

Sandra Collier, RN

Vivencio Navarro, Jr., MSN, RN

Linda Toombs, CNA

Larry Searles, RN

Diane Schlapkohl, RN, Medicaid

Jean Allen, RN, DAS

Linda Dammeyer, MS, RN

Tonya Evans-Poole, CNA

OTHERS PRESENT

Debra Scott, MS, RN, Executive Director

Linda Aure, BSN, RN, Sr. Investigator

Patty Towler, Sr. Certification Specialist

Chris Sansom, BSN, RN, Director of Operations

CALL TO ORDER: The meeting was called to order at 9:09 a.m.

PUBLIC COMMENT:  C. Sansom, discussed the possibility of sending copies of the Nurse Practice Act to new CNAs. 

A.        APPROVAL OF MINUTES: The minutes of February 16, 2006, CNA Advisory Committee meeting were approved as written.

B.        OLD BUSINESS

1.      D. Cowling reported that the Board approved the committee’s recommended changes in content and wording to NAC 632.746 at its March 2006 meeting.

2.      D. Cowling reported that the Board approved the committee’s proposed content and wording changes to NRS 632.2856 at its March 2006 meeting and will include this item in the Board’s BDR for the 2007 legislative meeting.

3.      Review, discussion and possible action regarding additions to the CNA Skill Guidelines: This item will be placed on the November 2, 2006, agenda to address specific items. 

C.        NEW BUSINESS

1.      Review, discussion, and action regarding updated Train the Trainer Manual. The format has been updated and documents added to include current regulations and forms. D. Cowling and C. Sansom reported that there have been no other substantive changes to the manual. A subcommittee (D. Perkins, K. Wilcox, and T. Shoemaker) was formed to review the Train the Trainer Manual and report back to the committee at the next regularly scheduled meeting.

2.      Review, discussion and possible action regarding qualifications required for CNA Program Coordinators (NAC 632.726 & NAC 632.785). It was moved, seconded and carried that wording of the regulation should be amended to require the NATP Coordinator be a Registered Nurse. A proposed change in concept and wording will be presented to the committee at the November meeting.

3.      Review, discussion and action regarding CPR certification for NATs. It was moved, seconded and carried that the CNA Model Curriculum be revised to include the following behavioral objective under Unit 3: Safety and Infection Control, # 14: “Attain CPR certification prior to patient contact.”

4.      Report on Board meeting outcomes: D. Cowling, D. Perkins, and D. Scott reported relevant NSBN Board meeting outcomes for the previous three meetings.

4.   Suggested items for future CNA agenda: Possible addition of placement and care of fecal incontinence collection devices to the CNA Skills Guidelines, pass/fail rates for CNA programs, and Board-required reports from NAT programs.

ADJOURNMENT:  The meeting was adjourned at 10:06 a.m.

February 16, 2006

The committee meeting was called to order on February 16, 2006 by Chris Sansom, RN, Director of Operations at 9:00 a.m. via videoconference at the Nevada State Board of Nursing, 2500 W. Sahara Ave, #207, Las Vegas, and the Nevada State Board of Nursing, 5011 Meadowood Mall Way, #201, Reno, Nevada.

MEMBERS PRESENT

             Chris Sansom, RN, Director of Operations, Chair    Tonya Evans-Poole, CNA

             Donna Cowling, MSN, RN, NSBN Staff                 Terri Shoemaker, CNA

             Dorothy Perkins, CNA, Board Member Liaison       Barbara Fraser, MS, RN

             Diane Schlapkohl, RN, Medicaid                             Jean Allen, RN, DAS

             Linda Dammeyer, MS, RN

MEMBERS ABSENT

Barbara Cavanagh, BSN, RN, CCM

Sandra Collier, RN

Vivencio Navarro, Jr., MSN, RN

Linda Toombs, CNA

Larry Searles, RN

OTHERS PRESENT

NSBN Staff

Debra Scott, MS, RN, Executive Director

Frederick Olmstead, General Counsel

Linda Aure, BSN, RN, Sr. Investigator

Patty Towler, Sr. Certification Specialist

CALL TO ORDER: The meeting was called to order at 9:00 a.m.

PUBLIC COMMENT: There was no public comment.

A.     APPROVAL OF MINUTES: The minutes of November 9, 2005, CNA Advisory Committee meeting were approved as amended.

B.    OLD BUSINESS

1. Review, discussion, and action regarding the CNA Skills Guidelines: The proposed revision to the CNA Skills Guidelines was presented to the committee.  The committee agreed that the new format more closely follows the outline of the Model Curriculum.  The committee approved the revised CNA Skills Guidelines.

C.   NEW BUSINESS

1. Review, discussion and action regarding CNA documentation per NAC 632.736, and 632.746:  D. Perkins, committee member, presented information to the committee about the difficulty CNAs have when trying to defend themselves or explain their actions while on duty because they often do not document in a patient medical record.  The committee agreed that CNAs should be allowed to document in the medical record and recommended a concept and wording change to NAC 632.746 to include the following:

NAC 632.746  Instruction in basic nursing skills.

6.      Observes, ing and reports and records changes in condition, abnormal  signs, and symptoms. such as shortness of breath, rapid respiration, fever, coughs, chills, pains in the chest, lips which are blue, pain in the abdomen, nausea, vomiting, drowsiness, excessive thirst, sweating, pus, blood or small amounts, pain or burning when urinating or urine with a dark color or strong odor.

10. Reports and records incidents.

                        11. Reports and records patient care provided.

 2. Review, discussion and action regarding CNA training program minimum hours:  Board staff reported that all but three CNA training programs in this  state have 100 or more hours of training in their programs.  The committee discussed the difficulty of teaching the skills included within the scope of practice of a CNA in a 75-hour program.  The committee agreed that the minimum CNA training program hours should be increased to 120 hours, with 40 hours of clinical, and 80 hours of theory and lab.  The committee recommended the following statute change: 

NRS 632.2856 Training programs; regulations.

1.  The training program required for certification as a nursing assistant must consist of 75 120 hours of instruction.  The program must include no less than 60 80 hours of theory and learning skills in a laboratory setting. 

3.       Report on Board meeting outcomes: C. Sansom reported that Dorothy Perkins, CNA, has been reappointed as the CNA Advisory Committee Board liaison.

4.   Suggested items for future CNA agenda:  Additions to the CNA Skills Guidelines.

ADJOURNMENT:  The meeting was adjourned at 10:30 a.m.

November 9, 2005

The meeting of the Nevada State Board of Nursing CNA Advisory Committee was called to order on November 9, 2005 by Chris Sansom, RN, Director of Operations.  The meeting began at 9:10 a.m. via videoconference at the Nevada State Board of Nursing, 2500 W. Sahara Ave., Suite 207, Las Vegas, Nevada and the Nevada State Board of Nursing, 5011 Meadowood Mall Way, No. 201, Reno, Nevada.

MEMBERS PRESENT

Chris Sansom, RN, Director of Operations

Donna Cowling, MSN, RN

Dorothy Perkins, CNA, Board Member Liaison

Barbara Cavanagh, BSN, RN, CCM

Linda Dammeyer, MS, RN

Barbara Fraser, MS, RN

Vivencio Navarro, Jr., MSN, RN

Terri Shoemaker, CNA

MEMBERS ABSENT

Caroline Case, RN, Medicaid

Sandra Collier, RN

Tonya Evans-Poole, CNA

Linda Toombs, CNA

Larry Searles, RN

OTHERS PRESENT

Debra Scott, MS, RN, Executive Director

Linda Aure, BSN, RN, Sr. Investigator

Patty Towler, Sr. Certification Specialist

Malinda Baldridge, Management Assistant

CALL TO ORDER:  The meeting was called to order at 9:10 a.m.

PUBLIC COMMENTS:  There was no public comment.

A.                 APPROVAL OF MINUTES:  The minutes of August 17, 2005 were approved as amended.

B.                 OLD BUSINESS

1.      Discussion, recommendations and possible action regarding CNA Skills Guidelines:  Review of the previous meeting discussion regarding clarifications requested regarding the Skills Guidelines and Examples of Tasks or Procedures not within the CNA Scope.  The “not within scope” list was created to clarify tasks and procedures that a CNA could not perform.  These tasks are out of the CNA scope of practice and cannot be used to meet the renewal requirement of 400 hours of employment as a CNA. The committee agreed that the “not within scope” list is not all-inclusive, may be confusing, and does not account for some variance based on work setting.

     The committee approved the following revisions to the CNA Skills guidelines.  

·        Remove the Examples of Tasks or Procedures not within the CNA Scope.

·        Reformat the Guidelines into system-by-system categories to mirror the Model Curriculum.

·    On column 1, remove: “Performs as a health team member in a medical facility.”

·        Add under Reports: “Observes and reports changes in condition, abnormal vital signs, symptoms, and care provided to a licensed nurse.”

·        Change: “Uses universal standard precautions.”

·        Under “Performs Procedures”:

o       “Transports patients: by wheelchair, oxygen conversion, or gurney.

o       “Care of an established stoma on the abdomen: change bag, pouch, provide skin care.”  

o       “CPR and Heimlich Maneuver abdominal thrusts.”        

o       Add:  “Oxygen conversion.”

·        Add under, “Assists with care of patients with special needs”:

o       “Mental health conditions / suicide prevention;” and

o       “Post mortem care.”

C.  NEW BUSINESS

1.      Report on Nevada State Board of Nursing activities since the last CNA meeting:  An update of board activities and discussion included the election of new Board officers, the Board’s denial of a request for a waiver for a CNA training program to be taught by an LPN, and the Board denial of an LPN application for certification as a CNA Instructor.

2.  Discussion recommendation and action regarding JCAHO National Patient Safety Goals relevant to CNA practice:  Handouts of the 2004, 2005, 2006 Hospital National Patient Safety Goals mandated by JCAHO were provided to the committee.  Items of particular significance to CNA’s are: hand washing, infection control, pressure ulcers, fall reduction, communication, accuracy of patient identification, and list of abbreviations not to be used.  The committee would like to explore the possibility of the Board publishing an article about the standards as they relate to patient safety.  D. Scott and C. Sansom will review this request with C. Kimball, Information Officer.

3.   Discussion, recommendation and action regarding CNA training program standards: Discussion regarding the current minimum standards of CNA training program and if they meet current needs in healthcare.  The committee identified the specific issue in question is the minimum training hours due to changes in health care since the statute was enacted.  Board staff will compile statistics for the next meeting regarding other Board’s minimum training hours requirements, pass rates for various in state programs, and the minimum hours current programs are requiring. This matter was tabled to the next committee meeting in February 2006.

4.   Scheduling of 2006 CNA Advisory Committee meeting dates:  The committee approved the following meeting dates for 2006:  February 16, May 4, August 17, and November 2, 2006. MOTION CARRIED.

5.   Suggested items for the next meeting agenda:

a.      Review of the revised CNA Skill Guidelines

b.      Discussion, recommendation and action regarding CNA documentation.

c.      Discussion, recommendation and action regarding CNA training program minimum hours.

ADJOURNMENT

The meeting was adjourned at 10:40 a.m.

August 17, 2005

The meeting of the Nevada State Board of Nursing CNA Advisory Committee was called to order on August 17, 2005 by Chris Sansom, RN, Director of Operations.  The meeting began at 9:10 a.m. via videoconference at the Nevada State Board of Nursing, 2500 W. Sahara Ave., Suite 207, Las Vegas, Nevada and the Nevada State Board of Nursing, 5011 Meadowood Mall Way, No. 201, Reno, Nevada.

MEMBERS PRESENT

Chris Sansom, RN, Director of Operations

Dorothy Perkins, CNA, Board Member Liaison

Barbara Cavanagh, BSN, RN, CCM (BLC)

Linda Dammeyer, MS, RN

Barbara Fraser, MS, RN

Sandra Collier, RN

Tonya Evans-Poole, CNA

Terri Shoemaker, CNA

MEMBERS ABSENT

Caroline Case, RN, Medicaid

Linda Toombs, CNA

Vivencio Navarro, Jr., MSN, RN

Larry Searles, RN

Gilda Johnstone, DAS

OTHERS PRESENT

Debra Scott, MS, RN, Executive Director

Frederick Olmstead, General Counsel

Linda Aure, BSN, RN

Karin Maxfield, Odyssey Healthcare

Linda Hamilton, Odyssey Healthcare

CALL TO ORDER:  The meeting was called to order at 9:10 a.m.

A. APPROVAL OF MINUTES:  The minutes of May 11, 2005 were approved as presented.

B. OLD BUSINESS

1.   Discussion, recommendations and action related to the proposed skill of performing hearing tests to include neonates:  T. Evans-Poole presented her research of the skill related to training and equipment involved and provided examples of the documentation required. The committee reviewed NRS 442 in regard to the required qualifications of providers.  The committee does not endorse adding this skill to the Model Curriculum. The committee rationale is that inclusion of the skill would only benefit a very small portion of CNAs, would add a cost burden to training programs for the equipment necessary, and based on NRS 442, a person who has documented competence and training by a licensed medical facility may perform hearing tests on neonates and be in compliance with the law.

C.  NEW BUSINESS

1.      Report on Nevada State Board of Nursing activities since the last CNA meeting:  An update of board activities was provided by C. Sansom.  Discussion included an update on CNA on-line renewal process and informational flyers being sent to Chief Nurse Executives and training programs in the state regarding the process.

2.   Discussion of CNA Skills Guidelines:  Karen Maxfield and Lori Hamilton from Odyssey Healthcare were present to request clarification and direction regarding the CNA Skill Guidelines and the Examples of Tasks or Procedures not within the CNA Scope list.  Discussion and recommendations from the committee are as follows:

a.    Vacuuming and laundry – may be performed only when for the health and safety of the patient and not as part of routine house keeping duties.

b.   Grocery shopping – is not appropriate for CNAs to perform and may be a violation of professional boundaries related to money exchange with a patient.

c.    Nail care and clipping – A CNA may perform nail care, including nail clipping on patients except those with diabetes or cardiovascular disease.

d.   Role of the CNA in home care when a patient falls – A CNA may evaluate the patient for pulse, respirations and blood pressure. The CNA should not move the patient until a licensed nurse or emergency personnel is present and assisting them to do so.

e.    Oxygen conversion – clarification provided regarding changing from a portable tank to a wall unit.

Tasks or Procedures Not Within the CNA Scope of Practice – Staff will conduct research to determine the origin and intent of this list and will bring this matter back to the committee for further review at the next meeting.  

2.      Report on National Council of State Boards of Nursing CNA conference held in Washington D.C.:  Oral presentation by D. Perkins and C. Sansom. 

3.      Suggested items for the next meeting agenda:

a.      JCAHO National Patient Safety Goals – these include hand washing, approved abbreviations, falls and skin care items that are relevant to CNA practice.

b.     Minimum training program standards.

ADJOURNMENT

The meeting was adjourned at 11:05 a.m.

May 11, 2005

The meeting of the Nevada State Board of Nursing CNA Advisory Committee was called to order on May 11, 2005 by Chris Sansom, RN, Director of Operations. The meeting began at 9:00 a.m. via videoconference at the Nevada State Board of Nursing, 2500 W. Sahara Ave., Suite 207, Las Vegas, Nevada and Nevada State Board of Nursing, 5011 Meadowood Mall Way, No. 201, Reno, Nevada.

MEMBERS PRESENT

Chris Sansom, RN, Director of Operations

Caroline Case, RN, Medicaid

Barbara Cavanagh, BSN, RN, CCM (BLC)

Linda Dammeyer, MS, RN

Barbara Fraser, MS, RN

Marcedes Parsons, LPN

Terri Shoemaker, CNA

Linda Toombs, CNA

Vivencio Navarro, Jr., MSN, RN

Larry Searles, RN

MEMBERS ABSENT

Dorothy Perkins, CNA, Board Member Liaison

Sandra Collier, RN

Virginia Enns, BSN, RN

Gilda Johnstone, DAS

Tonya Evans-Poole, CNA

OTHERS PRESENT

Debra Scott, MS, RN, Executive Director

Frederick Olmstead, General Counsel

Theresa Chevalier, Thomson Prometric

Pamela Rice, Thomson Prometric

CALL TO ORDER:  The meeting was called to order at 9:00 a.m.

A.                 APPROVAL OF MINUTES:  The minutes of November 10, 2004 were approved as presented.

B.            OLD BUSINESS

1. Discussion, recommendations and action related to the proposed skill of performing hearing tests to include neonates:  Tabled for further information.  T. Evans-Poole will be contacted regarding presenting her research of the skill, related training and equipment involved, then report to the committee at the next regularly scheduled meeting.  B. Fraser will submit information regarding testing procedures utilized at Sunrise Hospital.

C.  NEW BUSINESS

1.      Discussion of actions taken at Nevada State Board of Nursing meetings of January and March 2005:  An update of board actions provided by C. Sansom and D. Scott.

2.      Report on legislative activities:  Presentation by D. Scott and F. Olmstead.

3.      Report from Thomson Prometric regarding the CNA certification testing service:  Presentation by T. Chevalier, and P. Rice, representatives from Thomson Prometric.  They thanked all of the test centers, and Patty Towler, Board staff, for their cooperation, professionalism and enthusiasm during the transition to their service. A general discussion regarding the testing process ensued. To date there have been 277 clinical exams given with an 87% pass rate, and 250 knowledge exams given with a 90% pass rate. Significant statistical data will be available at the end of one year of testing, but ongoing statistical reports will be provided to the Board.  Discussion ensued with those present regarding the dress code for clinical testing.  It was reported that some candidates have appeared for testing in inappropriate attire. There was a consensus that wearing appropriate attire will aid in preparing the candidate to assume the role as a caregiver during the testing process, and will reinforce the expectation of professional conduct as they enter the practice. Board staff will send a memo to all training programs regarding implementation of this requirement effective June 1, 2005. 

4.      Suggested items for the next meeting agenda:  Report regarding other states CNA practices from a CNA national conference to be held in Washington, D.C., on June 3, 2005 to be attended by D. Perkins, P. Towler, and C. Sansom.

ADJOURNMENT

The meeting was adjourned at 11:00 a.m.

November 10, 2004

The meeting of the Nevada State Board of Nursing CNA Advisory Committee was called to order on November 10, 2004 by Associate Executive Director, Donald Rennie, MSN, RN.  The meeting began at 9:00 a.m. via videoconference at the Community College of Southern Nevada, Cheyenne Campus, 3200 E. Cheyenne Avenue, Conference Room A (#2638), Las Vegas, Nevada and Truckee Meadows Community College, Meadowood Center, 5270 Neil Road, South Building Room 104, Reno, Nevada.

MEMBERS PRESENT

Donald Rennie, MSN, RN, AED, Licensure and Certification

Dorothy Perkins, CNA, Board Member Liaison

Barbara Cavanagh, BSN, RN, CCM (BLC)

Sandra Collier, RN

Linda Dammeyer, MS, RN

Tonya Evans-Poole, CNA

Barbara Fraser, MS, RN

Margaret Hanson, RN

Marcedes Parsons, LPN

Terri Shoemaker, CNA

MEMBERS ABSENT

Caroline Case, RN, Medicaid

Virginia Enns, BSN, RN

Gilda Johnstone, DAS

Vivencio Navarro, Jr., MSN, RN

Larry Searles, RN

Linda Toombs, CNA

OTHERS PRESENT

Cindy Kimball, Information Officer

CALL TO ORDER:  The meeting was called to order at 9:00 a.m.

A.                 APPROVAL OF MINUTES:  The minutes of May 12, 2004 were approved as presented.

B.                 OLD BUSINESS

1.      Discussion of actions taken at Nevada State Board of Nursing meeting of September 2004:  An update of Board actions was provided by D. Rennie and C. Kimball.

2.      Discussion, recommendations and action related to the proposed skill of performing hearing tests to include neonates:  Tabled for further information.  T. Evans-Poole will research the skill, related training and equipment involved then report to the committee at the next regularly scheduled meeting.

C.  NEW BUSINESS

1.      Discussion of issues and misconceptions related to training programs and instructors:  Presentation by D. Rennie.  Issues related to training programs:  1.  Training programs are approved for facilities, not instructors.  2.  The approved facility program is the program that must be taught unless a request for revision is approved by the Board.  3.  Facilities that lose their training program, based on a Bureau finding, may request a waiver if the facility meets Bureau criteria.  The approved program, brought into a facility on waiver, must be taught using the curriculum and number of hours of that approved program.  The certificate of completion must be issued in the name of the approved program, not the facility on waiver.  4.  A training program may only issue the certificate of completion that was approved by the Board as part of the initial training program or most current renewal.  5.  Approved program training records are the property of the facility conducting the training and may be destroyed four (4) years after the completion of a course.  6.  Facilities with approved training programs may not change Academic Administrators without Board approval.  7.  The use of instructors not certified by the Board is not authorized.  

Issues related to instructors:  1.  Approved training program records are not the property of the instructor teaching the program.  2. Training programs are approved based on the facility, NOT on the instructor.  3.  Instructors who teach in multiple approved training programs must teach the curriculum of the program in which they are teaching.  Instructors may not modify a facility’s approved curriculum based on what they teach at another facility.  4.  It is the responsibility of the applicant to answer certification application Eligibility Questions; instructors should not advise students to answer “NO” to the questions when the student is unsure.  5.  Instructors may not change a program in progress without Board approval.  6.  Instructors should not submit certificates of completion prior to the completion of training, nor should they hold them for extended periods after the training has been completed.  The committee concluded theses concerns and issues should again be sent to all approved training programs and instructors.

2.      Discussion, recommendations and action related to instructor ratio of 1:15 in Practice Decision and NAC 632.770:  Presentation by D. Rennie and C. Kimball.  At its July business meeting, the board reviewed the current listing of practice decisions found in the Nurse Practice Act.  It was noted that some of the practice decisions had been converted into regulations (e.g. the practice decision related to the instructor ratio of 1:15, in clinical laboratory instruction and clinical experiences, has been superseded by NAC 632.770.)  The committee concurred the practice decision was no longer valid nor needed since it has been superseded.  The committee recommended the Board rescind the practice decision based on this information.

3.      Discussion of information regarding Nurse Aide Testing security incident in Colorado:  Presentation by D. Rennie.   The news media had reported there was a security breech in the Colorado NATP testing that allowed the manual skills examination to become public information.  Per the test vendor, there was not a breech in examination security.  There was a procedural error at the time of a manual skills examination.  The rater of this particular examination noted the error and properly reported it to the test vendor.  No action was taken on part of the test vendor staff.  This resulted in the dismissal of certain test vendor staff. Reassurances have been made by the test vendor confirming no disruption in test security. 

4.      Discussion, recommendations and action related to NATP certification examination accommodations:  Presentation by L. Dammeyer.  Currently there are no accommodations to the NATP manual skills examination for an applicant with a disability, e.g. hearing impairment.  It was noted the professional licensure examination (NCLEX) does have an accommodation process involving both the board of nursing and National Council State Boards of Nursing.  The committee concluded there should be a similar process for applicants completing the manual skills examination.  The committee recommended this issue be researched by Board staff and the Board’s General Counsel.  The committee further recommended the test vendor, when selected for the new contract for written and manual skills examination, also be queried about this concern.

5.      Discussion and action related to schedule for 2005 committee meetings:  The committee accepted the dates of February 2, 2005; May 11, 2005; August 17, 2005; and November 9, 2005.  The meetings will be conducted by videoconference, when available.

       D.  ITEMS FOR NEXT AGENDA:  No items were presented. 

ADJOURNMENT

The meeting was adjourned at 10:30 a.m.

May 12, 2004

The meeting of the Nevada State Board of Nursing’s CNA Advisory Committee was called to order on May 12, 2004 by Associate Executive Director, Donald Rennie.  The meeting began at 9:30 a.m. via videconference at CCSN, Cheyenne Campus, Conference Room A2638, 3200 E. Cheyenne Blvd, Las Vegas and TMCC Meadwood Center, 5270 Neil Road, South Building, Room 104, Reno.

MEMBERS PRESENT

Donald Rennie, MSN, RN, Associate Executive Director

Linda Dammeyer, RN, MS, RN Member

Virginia Enns, RN, Retired, Northern Member

Tanya Evans-Poole, CNA Member

Barbara Fraser, MS, RN, Acute Care Member

Margaret Hansen, RN, Retired, Southern Member

Vincencio Navarro, MSN, RN, Long-term Care Member

Terri Shoemaker, CNA Member

MEMBERS ABSENT

Caroline Case, RN, Medicaid Member

Catherine Johnson, RN, MSN, Health Division Member

Gilda Johnstone, Aging Services Member

Marcedes Parsons, LPN, LPN Member

Larry Searles, RN, Acute Care Member

OTHERS PRESENT

Fred Olmstead, JD, General Counsel

A.        CALL TO ORDER:  The meeting was called to order at 9:30 a.m. due to technically difficulties at the TMCC videoconference site.

B.        PUBLIC COMMENTS:  There were no public comments offered.

C.        APPROVAL OF MINUTES:  The minutes of February 4, 2004 meeting were approved.

D.        OLD BUSINESS

     1.     Discussion of actions taken at recent Nevada State Board of Nursing meeting of March 2004:  The board approved the Education Advisory Committee’s proposed concept and wording changes to regulations related to nursing program faculty education requirements, accreditation, provisional approval, administrator duties and program composition.  The Board approved the Advanced Practice Advisory Committee’s proposed concept and wording changes to NAC 632.257 (2.b.) related to the 1000 hours requirement for prescriptive privileges.  Curriculum changes were approved for Community College of Southern Nevada RN and PN programs, Nevada State College and Truckee Meadows Community College nursing programs.  Practice decisions were approved related to Sexual Assault Nurse Examiners and activities not considered “providing patient care”.  Board members and staff reported on the National Council of State Boards of Nursing (NCSBN) Mid-Year meeting, which covered topics such as global issues of nursing and the federal visa screening requirement for certain Trade NAFTA nurses currently working in the United States.  The board approved the NCSBN proposed revisions to the NCLEX-PN test plan to be implemented in Spring 2005.

E.  NEW BUSINESS

1.          Discussion of recent Promissor NATP examination pilot project at Community College of Southern Nevada:  Presentation by L.Dammeyer and D. Rennie.  The April 2004 written and clinical skills examination utilized score sheets and registration forms designed specifically for fax processing.  Issues identified included:  •excessive volume of documents to fax for reading and scoring; •training concurrent with examination; •non-tested skills not removed from the clinical scenarios used; •candidates unfamiliar with “bubble” forms; •need for a U.S. Social Security Number as a registration requirement; •additional time for testing staff to provide “bubble” form instructions and to fax documents; •and high number of rejected registration forms.  The pilot project provided valuable information in preparation for a July statewide implementation at the three examination sites (GBC, CCSN, TMCC).  

2.          Discussion, Recommendation and Actions related to the proposed skill of re-setting oxygen flow rates at the direction of the nurse:  Presentation by L. Dammeyer.  Currently a CNA may convert oxygen from wall to tank and do pulse oximetry, but is precluded from adjusting the flow rate at the direction of the nurse.  Discussion ensued.  It was noted CNA training includes exposure to various types of oxygen regulation equipment. The committee concluded it would be in the interest of patient safety for the CNA to perform this task.  The committee approved a recommendation to the board stipulating CNAs adjusting the oxygen flow rate at the direction of the nurse be incorporated into the NATP training and become part of CNA scope of practice.  The committee further recommended this skill could be taught to currently certified CNAs at the facility using the following guidelines:

a.     Instruction must follow the content of the NSBN Model Curriculum;

            b.    The instructor must be an RN who has at least two years experience in nursing, one year of which must be in the care of the elderly or chronically ill; and

            c.     Training must be documented.

3.          Discussion, Recommendations and Actions related to the proposed skill of performing hearing tests to include neonates:  Tabled for further research related to required training and reporting procedures of test results.

4.          Discussion, Recommendations and Actions related to the proposed terminology of “Forfeiture of Certificate” for certain CNA discipline issues:  Certain CNAs, with board- ordered probation agreements, may no longer desire to practice.  An “inactive” status is not available for CNA certification; the CNA must comply with the probation agreement requirements until the certificate expires even if he/she is no longer working as a CNA.  Failure to comply with the probation requirements may result in further disciplinary action.   Allowing the CNA to forfeit the certificate would prevent further disciplinary actions for non-compliance.  If the person with a forfeited certificate desired to reinstate, the terms of the probation agreement would need to be satisfied.  Per federal law, if two or more years has elapsed since forfeiture, the CNA would be required to re-train.  The committee supported development of a “forfeiture’ status for CNAs in this situation.  The committee further recommended board staff pursue this through the appropriate board processes.

ADJOURNMENT

The meeting was adjourned at 10:30 a.m.

February 4, 2004

The meeting of the Nevada State Board of Nursing CNA Advisory Committee was called to order on February 4, 2004 by Associate Executive Director, Donald Rennie.  The meeting began at 9:30 a.m. via videconference at CCSN, Cheyenne Campus Conference Room A2638, 3200 E. Cheyenne Blvd, Las Vegas, Nevada and TMCC Meadowood Center, 5270 Neil Road, South Bldg, Room 104, Reno, Nevada.

MEMBERS PRESENT

Donald Rennie, RN, MSN, AED, Licensure and Certification

Barbara Fraser, RN, MS, Sunrise Hospital

Caroline Case, RN, Medicaid

Linda Dammeyer, RN, MS, Community College of Southern Nevada

Virginia Enns, RN, Retired, Northern Member

Catherine Johnson, RN, MSN, Bureau of Licensure and Certification

Gilda Johnstone, Division of Aging Services

Vincencio Navarro, RN, MSN, Community College of South Nevada

Marcedes Parsons, LPN

MEMBERS ABSENT

Margaret Hansen, RN, Retired, Southern Member

Larry Searles, RN, Valley Health System

OTHERS PRESENT

Fred Olmstead, JD, General Counsel

Neena Laxalt, Legislative Lobbyist, NNA

CCSN NATP Students

CALL TO ORDER:  The meeting was called to order at 9:30 a.m.

PUBLIC COMMENTS:  There were no public comments offered.

A.   APPROVAL OF MINUTES:  The minutes of November 5, 2003 meeting were approved.

B.  OLD BUSINESS

            1.            Discussion of requested revisions to NATP training programs

a.      Placement of monitor leads:  Presentation by Noel Banks on behalf of Jennifer Richards.  Discussion ensued related to theoretical instruction, clinical experiences, and revision of the NSBN Model Curriculum needed to support this skill.  The committee approved a recommendation to the board that placement of monitor leads be incorporated into the NATP training and become part of CNA scope of practice.  The committee further recommended this skill be taught to currently certified CNAs at a facility using the following guidelines:

1.                  Instruction must follow the content of the NSBN Model Curriculum;

2.      The instructor must be an RN who has at least 2 years of experience in nursing, 1 year of which must be in the care of the elderly or chronically ill; and

3.                  Training must be documented.   

b.      Bladder scans:  Presentation by N. Banks.  Discussion ensued related to the focus of bladder training currently performed in facilities caring for the elderly, the value of documentation of bladder residual and its relation to incontinence, and invasive versus non-invasive procedures to determine bladder residual.  The committee approved a recommendation to the board that bladder scans be incorporated into the NATP training and become part of CNA scope of practice.  The committee further recommended this skill be taught to currently certified CNAs at a facility using the following guidelines:

1.                  Instruction must follow the content of the NSBN Model Curriculum;

2.      The instructor must be an RN who has least 2 years of experience in nursing, 1 year of which must be in the care of the elderly or chronically ill; and

3.                  Training must be documented.    

c.      Application of dry sterile dressings:  Presentation by L. Dammeyer.  Discussion ensued concerning the need for CNAs to replace or reinforce a dry sterile dressing, particularly after resident bathing.  It was noted that currently wounds may be covered with non-sterile items which is contradictory to infection control standards.  The committee approved a recommendation to the board that application or reinforcement of a dry sterile dressing be incorporated into the NATP training and become part of CNA scope of practice.  The committee further recommended this skill be taught to currently certified CNAs at a facility using the following guidelines:

1.      Instruction must follow the content of the NSBN Model Curriculum;

2.      The instructor must be an RN who has at least 2 years of experience in nursing, 1 year of which must be in the care of the elderly or chronically ill; and

3.      Training must be documented.  

                  d.            Automated External Defibrillation:  Presentation by D. Rennie.  Although CPR is not a requirement of NATP training, most facilities require CNAs to be CPR certified by an American Heart Association health care provider.  This training includes the use of automated External Defibrillation (AED).  The committee approved a recommendation to the board that training in CPR with AED become part of CNA scope of practice.  The committee recommended the training be either the American Heart Association Health Care Provider CPR or a comparable program that includes AED.  

e.      Performing EKG:  Presentation by D. Rennie.  The performance of an EKG is a non-invasive procedure that is currently taught to unlicensed assistive persons as an “on-the-job” skill.  Discussion ensued concerning the performance of single-lead versus multiple-lead EKG, and the need for the EKG to be given to the nurse for interpretation.  The committee approved a recommendation to the board that performance of EKG be incorporated into the NATP training and become part of CNA scope of practice.  The committee further recommended this skill be taught to currently certified CNAs at a facility using the following guidelines:

1.                  Instruction must follow the content of the NSBN Model Curriculum;

2.      The instructor must be an RN who has at least 2 years of experience in nursing, one year of which must be in the care of the elderly or chronically ill; and

3.                  Training must be documented.   

            2.      Discussion of use of PCA and other non-traditional CNA position hours to meet CNA renewal requirements:  Presentation by D. Rennie.  To renew certification a CNA must have 400 hours of employment in a position with a CNA scope of practice and under the direct supervision of a licensed nurse.  The CNA must have also completed 24 hours of continuing education (inservice) related to the CNA scope of practice.  Some CNAs working in non-CNA positions are seeking renewal through the use of these non-CNA hours.   F. Olmstead stated the board only has regulatory authority to renew certification of CNAs who meet renewal requirements and has none over other unlicensed assistive persons.  In its January meeting the board approved a revision to the CNA renewal application that includes the attachment of the CNA Skills Guidelines and a clarification of the information in the employment verification section related to employment hours used for renewal and attested to by the supervising licensed nurse.

            3.      Discussion of CNA certification testing services:  Presentation by D. Rennie.  Additional information has been obtained from Headmaster describing their processes related to conducting certification testing in rural areas.  Board staff will visit a Headmaster testing center to observe the in-facility process and the computer-based test analyses processes.

C.  NEW BUSINESS

1.      Report on NATP surveys:  Since the November 2003 committee meeting, one survey was conducted at Great Basin College.  Evergreen at Pahrump Health and Rehabilitation Center has recently established an NATP program.  There are currently 26 board approved NATP training programs:  12 in southern Nevada and 14 in northern Nevada. 

2.      Report on number of NATP instructors:  There are currently 86 certified instructors available to teach NATP.

3.      Highlights from November 2003 and January 2004 board meetings:  At the November 2003 meeting elections were conducted with the following results:  President: Patty Shutt, LPN; Vice President: Mary Ann Lambert, MSN, RN; and Secretary: Helen Vos, MS, RN.  The board approved an increase of all CNA-related fees effective December 1, 2003.

At the January 2004 meeting, the board approved a policy revision related to the auditing of CE as it relates to RN/LPN online renewal.  A curriculum revision reducing credit hours from 76 to 72 was approved for CCSN’s ADN program.  Presentations were made related to foreign MD-to-BSN nursing programs, nursing program faculty education requirements, and the actions of the California RN Board of Nursing related to Excelsior College of New York.

ADJOURNMENT

The meeting was adjourned at 11:30 a.m.