H-4363              _______________________________________________

                                          SUBSTITUTE HOUSE BILL NO. 2451

                        _______________________________________________

State of Washington                               51st Legislature                              1990 Regular Session

By House Committee on Health Care (originally sponsored by Representatives Prentice, D. Sommers, Sprenkle, Rayburn, Ferguson, Day, Moyer, Rector, P. King, Wang, Spanel and Brekke)

Read first time 2/2/90.

AN ACT Relating to registered nurses; amending RCW 18.88.280; and adding a new section to chapter 18.88 RCW.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION. Sec. 1.  A new section is added to chapter 18.88 RCW to read as follows:

          The board is authorized to regulate prescriptive privileges for advanced registered nurse practitioners within their scope of practice.  Prescriptive privileges include prescribing legend drugs and controlled substances as defined in schedules II through V of the Uniform Controlled Substances Act, chapter 69.50 RCW.

          Dispensing of controlled substances under schedules II through V is limited to emergency situations.  In such an emergency, dispensing is limited to a maximum of a seventy-two hour supply of the prescribed controlled substance.

          The board shall adopt rules necessary to administer prescriptive privileges for advanced registered nurse practitioners and any other rules necessary to implement this section.  The board shall also require continuing education units in order to obtain or maintain prescriptive privileges.

          The board, in consultation with the board of pharmacy and the board of medical examiners, shall develop a monitoring system for schedules II through IV and conduct random audits, via the use of triplicate prescriptive forms for these schedules, which shall be required by the board for prescriptive authority involving these schedules.

          Prescriptive authority for schedules II through IV shall continue through June 1994.  The board shall report in January 1994 to the health care committees of both the house of representatives and the senate with the results of the random audits and monitoring system, which shall be considered by the legislature in extending prescriptive authority for schedules II through IV beyond June 1994.

        Sec. 2.  Section 28, chapter 202, Laws of 1949 as last amended by section 7, chapter 114, Laws of 1989 and RCW 18.88.280 are each amended to read as follows:

          This chapter shall not be construed as (1) prohibiting the incidental care of the sick by domestic servants or persons primarily employed as housekeepers, so long as they do not practice professional nursing within the meaning of this chapter, (2) or preventing any person from the domestic administration of family remedies or the furnishing of nursing assistance in case of emergency;  (3) nor shall it be construed as prohibiting such practice of nursing by students enrolled in approved schools as may be incidental to their course of study nor shall it prohibit such students working as nursing aides;  (4) nor shall it be construed as prohibiting auxiliary services provided by persons carrying out duties necessary for the support of nursing service including those duties which involve minor nursing services for persons performed in hospitals, nursing homes  or elsewhere under the direction of licensed physicians or the supervision of licensed, registered nurses;  (5) nor shall it be construed as prohibiting or preventing the practice of nursing in this state by any legally qualified nurse of another state or territory whose engagement requires him or her to accompany and care for a patient temporarily residing in this state during the period of one such engagement, not to exceed six months in length, if such person does not represent or hold himself or herself out as a nurse licensed to practice in this state;  (6) nor shall it be construed as prohibiting nursing or care of the sick, with or without compensation, when done in connection with the practice of the religious tenets of any church by adherents thereof so long as they do not engage in the practice of nursing as defined in this chapter;  (7) nor shall it be construed as prohibiting the practice of any legally qualified nurse of another state who is employed by the United States government or any bureau, division or agency thereof, while in the discharge of his or her official duties;  (8) permitting the measurement of the powers or range of human vision, or the determination of the accommodation and refractive state of the human eye or the scope of its functions in general, or the fitting or adaptation of lenses or frames for the aid thereof;  (9) permitting the prescribing or directing the use of, or using, any optical device in connection with ocular exercises, visual training, vision training or orthoptics;  (10) permitting the prescribing of contact lenses for, or the fitting or adaptation of contact lenses to, the human eye;  (11) prohibiting the performance of routine visual screening;  (12) permitting the practice of dentistry or dental hygiene as defined in chapters 18.32 and 18.29 RCW respectively;  (13) permitting the practice of chiropractic as defined in chapter 18.25 RCW including the adjustment or manipulation of the articulations of the spine;  (14) permitting the practice of podiatry as defined in chapter 18.22 RCW;  (15) permitting the performance of major surgery, except such minor surgery as the board may have specifically authorized by rule or regulation duly adopted in accordance with the provisions of chapter 34.05 RCW;  (16) permitting the prescribing of legend drugs and controlled substances as defined in schedules I through ((IV)) V of the Uniform Controlled Substances Act, chapter 69.50 RCW, except as provided in section 1 of this act; (17)  prohibiting the determination and pronouncement of death.