PERMANENT RULES
(Nursing Care Quality Assurance Commission)
Date of Adoption: November 19, 1999.
Purpose: Amend WAC 246-840-730 Mandatory reporting, to make this rule more clear, easier to understand and follow.
Citation of Existing Rules Affected by this Order: Amending WAC 246-840-730.
Statutory Authority for Adoption: RCW 18.79.110.
Adopted under notice filed as WSR 99-18-082 on August 31, 1999.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 1, Repealed 0.
Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0. Effective Date of Rule: Thirty-one days after filing.
November 19, 1999
Cheryl Payseno, RN, MPA, Chair
Nursing Care Quality Assurance Commission
OTS-3098.1
AMENDATORY SECTION(Amending WSR 97-13-100, filed 6/18/97,
effective 7/19/97)
WAC 246-840-730
Mandatory reporting ((defined)).
((The
nursing commission does not intend to cause every nursing error
to be reported or that mandatory reporting take away the
disciplinary ability and responsibility from the employer of the
licensed practical nurse or registered nurse.
FOR PRACTICAL NURSES:
(1) Any person, including health care facilities and
agencies and state or local government, who is aware of a
conviction or has made a determination or finding that a
practical nurse has committed an act constituting unprofessional
conduct as defined in RCW 18.130.180, including violation of
chapter 246-840 WAC, shall report such conviction, determination
or finding to the commission.
(2) Any person, including health care facilities and agencies and state or local government, who has information that a practical nurse may not be able to practice with reasonable skill and safety as a result of a mental or physical condition, shall report such information to the commission.
FOR REGISTERED NURSES:
(3) Any person, including nurses, health care facilities and
agencies, and state or local government agencies, who has
knowledge or concern that a registered nurse has committed an act
which constitutes unprofessional conduct as provided in RCW 18.130.180, including violations of chapter 246-840 WAC, or
failed to meet accepted standards for the level at which the
registered nurse is licensed, or is unable to practice with
reasonable skill or safety as the result of a physical or mental
condition shall report or cause a report to be made to the
commission. Failure of any nurse to comply with the reporting
requirements may in itself constitute a violation of nursing
standards.
(4) The decision to report a suspected violation of chapter 18.130 or 18.79 RCW or the rules adopted thereunder shall be based on, but not limited to the following:
(a) The past history of the registered nurse's performance.
(b) A demonstrated pattern of unsafe practice or conduct in violation of the standards of nursing.
(c) The magnitude of any single occurrence for actual or potential harm to the public health and safety.
(5) The following shall always be reported to the nursing commission:
(a) A nurse impostor. As used herein "nurse impostor" means an individual who is ineligible for registered nursing licensure or advanced registered nurse practitioner licensure and who practices or offers to practice registered nursing or advanced nursing or uses any title, abbreviation, card, or device to indicate that the individual is licensed to practice in Washington.
(b) A person who is practicing registered nursing when the license has become void due to nonpayment of fees.
(c) A person who is practicing registered nursing as defined in chapter 18.79 RCW unless licensed as a registered nurse or practical nurse, or a person who is practicing as a nurse practitioner as defined in WAC 246-840-300 while not licensed as an advanced registered nurse practitioner.
(d) A registered nurse who has been convicted of a crime which relates to the practice of nursing.
(e) A registered nurse who has been dismissed from employment due to unsafe practice or conduct in violation of the standards of nursing.
(f) Client abuse by a registered nurse.
(g) A demonstrated pattern of conduct in violation of the standards of nursing as defined by the rules of the commission or a single occurrence that creates serious harm or risk to the client.
(h) Any violation of a disciplinary sanction imposed on a registered nurse's license by the commission.
(i) Substance abuse as defined in RCW 18.130.180 (6) and (23). Nursing professionals counseling impaired registered nurses for substance abuse are exempt from the reporting requirements except as provided in chapter 5.62 RCW.
(j) Any other cause for discipline as defined in RCW 18.130.170 and 18.130.180.)) Mandatory reporting assists the nursing care quality assurance commission (nursing commission) in protecting the public health and safety through the discovery of unsafe or substandard nursing practice or conduct. These rules are intended to define the information that is to be reported and the obligation of nurses and others to report.
The nursing commission does not intend every minor nursing error to be reported or that mandatory reporting serve as a substitute for employer-based disciplinary action.
Who must make reports and what must be reported to the nursing commission?
(1) Any person, including, but not limited to, registered nurses, practical nurses, advanced registered nurse practitioners, health care facilities and governmental agencies shall always report the following, except as provided for in subsections (2) and (3) of this section:
(a) Information that a nurse may not be able to practice with reasonable skill and safety as a result of a mental or physical condition;
(b) Information regarding a conviction, determination or finding, including employer-based disciplinary action, that a nurse has committed an act that would constitute unprofessional conduct, as defined in RCW 18.130.180, including violations of chapter 246-840 WAC, including, but not limited to:
(i) Conviction of any crime or plea of guilty, including crimes against persons as defined in chapter 43.830 RCW, and crimes involving the personal property of a patient, whether or not the crime relates to the practice of nursing;
(ii) Conduct which leads to dismissal from employment for cause related to unsafe nursing practice or conduct in violation of the standards of nursing;
(iii) Conduct which reasonably appears to be a contributing factor to the death of a patient;
(iv) Conduct which reasonably appears to be a contributing factor to the harm of a patient that requires medical intervention;
(v) Conduct which reasonably appears to violate accepted standards of nursing practice and reasonably appears to create a risk of physical and/or emotional harm to a patient;
(vi) Conduct involving a pattern of repeated acts or omissions of a similar nature in violation of the standards of nursing that reasonably appears to create a risk to a patient;
(vii) Drug trafficking;
(viii) Conduct involving the misuse of alcohol, controlled substances or legend drugs, whether or not prescribed to the nurse, where such conduct is related to nursing practice or violates any other drug or alcohol-related nursing commission law;
(ix) Conduct involving sexual contact with a patient under RCW 18.130.180(24) or other sexual misconduct in violation of nursing commission law under WAC 246-840-740;
(x) Conduct involving patient abuse, including physical, verbal and emotional;
(xi) Conduct indicating unfitness to practice nursing or that would diminish the nursing profession in the eyes of the public;
(xii) Conduct involving fraud related to nursing practice;
(xiii) Conduct involving practicing beyond the scope of the nurse's license;
(xiv) Nursing practice, or offering to practice, without a valid nursing permit or license, including practice on a license lapsed for nonpayment of fees;
(xv) Violation of a disciplinary sanction imposed on a nurse's license by the nursing commission.
(2) Persons who work in federally funded substance abuse treatment programs are exempt from these mandatory reporting requirements to the extent necessary to comply with 42 CFR Part 2.
(3) Persons who work in approved substance abuse monitoring programs under RCW 18.130.175 are exempt from these mandatory reporting rules to the extent required to comply with RCW 18.130.175(3) and WAC 246-840-780(3).
How is a report made to the nursing commission?
(4) In providing reports to the nursing commission, a person may call the nursing commission office for technical assistance in submitting a report. Reports are to be submitted in writing and include the name of the nurse, licensure identification, if available, the name of the facility, the names of any patients involved, a brief summary of the specific concern which is the basis for the report, and the name, address and telephone number of the individual submitting the report.
(5) Failure of any licensed nurse to comply with these reporting requirements may constitute grounds for discipline under chapter 18.130 RCW.
What are the criteria for whistleblower protection?
(6) Whistleblower criteria is defined in chapter 246-15 WAC and RCW 43.70.075.
[Statutory Authority: Chapter 18.79 RCW. 97-13-100, § 246-840-730, filed 6/18/97, effective 7/19/97.]