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TITLE 24

Professions and Occupations

CHAPTER 19. NURSING

§ 1901. Declaration of legislative intent.

The General Assembly hereby declares the practice of nursing by competent persons is necessary for the protection of the public health, safety and welfare and further finds that the levels of practice within the profession of nursing should be regulated and controlled in the public interest. In order to safeguard life and health, the general administration and supervision of the education, examination, licensing and regulation of professional and practical nursing is declared essential, and such general administration and supervision is vested in the Board of Nursing.

24 Del. C. 1953, § 1901; 54 Del. Laws, c. 153, § 1; 64 Del. Laws, c. 26, § 1; 69 Del. Laws, c. 319, § 2.;

§ 1902. Definitions.

(a) "Administration of medications" means a process whereby a single dose of a prescribed drug or biological is given to a patient by an authorized licensed person by 1 of several routes, oral, inhalation, topical, or parenteral. The person verifies the properly prescribed drug order, removes the individual dose from a previously dispensed, properly labeled container (including a unit dose container), assesses the patient's status to assure that the drug is given as prescribed to the patient for whom it is prescribed and that there are no known contraindications to the use of the drug or the dosage that has been prescribed, gives the individual dose to the proper patient, records the time and dose given and assesses the patient following the administration of medication for possible untoward side effects.

(b)(1) "Advanced practice nurse" means an individual whose education and certification meet criteria established by the Board of Nursing who is currently licensed as a registered nurse and has a master's degree or a postbasic program certificate in a clinical nursing specialty with national certification. When no national certification at the advanced level exists, a master's degree in a clinical nursing specialty will qualify an individual for advanced practice nurse licensure. "Advanced practice nurse" shall include, but not be limited to, nurse practitioners, certified registered nurse anesthetists, certified nurse midwives or clinical nurse specialists. Advanced practice nursing is the application of nursing principles, including those described in subsection (o) of this section, at an advanced level and includes:

a. For those advanced practice nurses who do not perform independent acts of diagnosis or prescription, the authority as granted within the scope of practice rules and regulations promulgated by the Board of Nursing; and

b. For those advanced practice nurses performing independent acts of diagnosis and/or prescription with the collaboration of a licensed physician, dentist, podiatrist or licensed Delaware health care delivery system without written guidelines or protocols and within the scope of practice as defined in the rules and regulations promulgated by the Joint Practice Committee and approved by the Board of Medical Licensure and Discipline.

Nothing in this act is to be construed to limit the practice of nursing by advanced practice nurses as is currently being done or allowed including nursing diagnosis as pursuant to subsection (o)(2) of this section.

Advanced practice nurses shall operate in collaboration with a licensed physician, dentist, podiatrist, or licensed Delaware health care delivery system to cooperate, coordinate, and consult with each other as appropriate pursuant to a collaborative agreement defined in the rules and regulations promulgated by the Board of Nursing, in the provision of health care to their patients. Advanced practice nurses desiring to practice independently or to prescribe independently must do so pursuant to § 1906(20) of Title 24.

(2) Those individuals who wish to engage in independent practice without written guidelines or protocols and/or wish to have independent prescriptive authority shall apply for such privilege or privileges to the Joint Practice Committee and do so only in collaboration with a licensed physician, dentist, podiatrist or licensed Delaware health care delivery system. This does not include those individuals who have protocols and/or waivers approved by the Board of Medical Licensure and Discipline.

(c) "Assistance with medications" means a situation where a designated care provider functioning in a setting authorized by § 1921 of this title, who has taken a Board approved medication training program, or a designated care provider who is otherwise exempt from the requirement of having to take the Board approved self administration with medication training programs, assists the patient in the self-administration of a medication other than by injection, provided that the medication is in the original container, with a proper label and directions. The designated care provider may hold the container for the patient, assist with the opening of the container and assist the patient in taking the medication.

(d) The "Compact Administrator" shall be the Executive Director of the Delaware Board of Nursing who shall be designated as the Compact Administrator by the President of the Board.

(e) "Dispensing" means providing medication according to an order of a practitioner duly licensed to prescribe medication. The term shall include both the repackaging and labeling of medications from bulk to individual dosages.

(f) The "Head of the Nursing Licensing Board" shall be the President of the Delaware Board of Nursing; and

(g) "Independent practice by an advanced practice nurse" shall include those advance practice nurses who practice and prescribe without written guidelines or protocols but with a collaborative agreement with a licensed physician, dentist, podiatrist or licensed Delaware health care delivery system and with the approval of the Joint Practice Committee.

(h) "Licensure" means the authorization to practice nursing within this State granted by the Delaware Board of Nursing and includes the authorization to practice in Delaware under the Interstate Nurse Licensure Compact.

(i) "Nurse educator" is a registered nurse who is a faculty member or director of a Delaware board-approved nursing education program preparing individuals at the registered nurse entry level.

(j) "Nursing diagnosis" means the description of the individual's actual or potential health needs which are identified through a nursing assessment and are amenable to nursing intervention. The focus of the nursing diagnosis is on the individual's response to illness or other factors that may adversely affect the attainment/or maintenance of wellness. These diagnostic acts are distinct from medical, osteopathic and dental diagnosis.

(k) "Nursing education program" means a course of instruction offered and conducted to prepare persons for licensure as a registered or licensed practical nurse, and/or a course of instruction offered and conducted to increase the knowledge and skills of the nurse and leads to an academic degree in nursing, and/or refresher courses in nursing.

(l) "Standards of nursing practice" means those standards of practice adopted by the Board that interpret the legal definitions of nursing, as well as provide criteria against which violations of the law can be determined. Such standards of nursing practice shall not be used to directly or indirectly affect the employment practices and deployment of personnel by duly licensed or accredited hospitals and other duly licensed or accredited health care facilities and organizations. In addition, such standards shall not be assumed the only evidence in civil malpractice litigation, nor shall they be given a different weight than any other evidence.

(m) "Substantially related" means the nature of the criminal conduct, for which the person was convicted, has a direct bearing on the fitness or ability to perform 1 or more of the duties or responsibilities necessarily related to the practice of nursing.

(n) "The practice of practical nursing" as a licensed practical nurse means the performance for compensation of nursing services by a person who holds a valid license pursuant to the terms of this chapter and who bears accountability for nursing practices which require basic knowledge of physical, social and nursing sciences. These services, at the direction of a registered nurse or a person licensed to practice medicine, surgery or dentistry, include:

(1) Observation;

(2) Assessment;

(3) Planning and giving of nursing care to the ill, injured and infirm;

(4) The maintenance of health and well being;

(5) The administration of medications and treatments prescribed by a licensed physician, dentist, podiatrist or advanced practice nurse; and

(6) Additional nursing services and supervision commensurate with the licensed practical nurse's continuing education and demonstrated competencies; and

(7) Dispensing activities only as permitted in the Board's Rules and Regulations.

Nothing contained in this chapter shall be deemed to permit acts of surgery or medical diagnosis; nor shall it be deemed to permit dispensing of drugs, medications or therapeutics independent of the supervision of a physician who is licensed to practice medicine and surgery, or those licensed to practice dentistry or podiatry.

(o) "The practice of professional nursing" as a registered nurse means the performance of professional nursing services by a person who holds a valid license pursuant to the terms of this chapter, and who bears primary responsibility and accountability for nursing practices based on specialized knowledge, judgment and skill derived from the principles of biological, physical and behavioral sciences. The registered nurse practices in the profession of nursing by the performance of activities, among which are:

(1) Assessing human responses to actual or potential health conditions;

(2) Identifying the needs of the individual and/or family by developing a nursing diagnosis;

(3) Implementing nursing interventions based on the nursing diagnosis;

(4) Teaching health care practices. Nothing contained herein shall limit other qualified persons or agencies from teaching health care practices without being licensed under this chapter;

(5) Advocating the provision of health care services through collaboration with other health service personnel;

(6) Executing regimens, as prescribed by a licensed physician, dentist, podiatrist or advanced practice nurse, including the dispensing and/or administration of medications and treatments;

(7) Administering, supervising, delegating and evaluating nursing activities.

(8) Nothing contained in this chapter shall be deemed to permit acts of surgery or medical diagnosis; nor shall it be deemed to permit dispensing of drugs, medications or therapeutics independent of the supervision of a physician who is licensed to practice medicine and surgery, or those licensed to practice dentistry or podiatry.

A registered nurse shall have the authority, as part of the practice of professional nursing, to make a pronouncement of death; provided, however, that this provision shall only apply to attending nurses caring for terminally ill patients or patients who have "do not resuscitate" orders in the home or place of residence of the deceased as a part of a hospice program or a certified home health care agency program; in a skilled nursing facility; in a residential community associated with a skilled nursing facility; any licensed assisted living community; in an extended care facility; or in a hospice; and provided that the attending physician of record has agreed in writing to permit the attending registered nurse to make a pronouncement of death in that case.

(p) "The profession of nursing" is an art and process based on a scientific body of knowledge. The practitioner of nursing assists patients in the maintenance of health, the management of illness, injury or infirmity or in the achieving of a dignified death.

24 Del. C. 1953, § 1902; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1; 67 Del. Laws, c. 5, § 2; 67 Del. Laws, c. 434, § 2; 68 Del. Laws, c. 152, § 2; 68 Del. Laws, c. 161, § 2; 69 Del. Laws, c. 319, §§ 3-7, 13; 71 Del. Laws, c. 283, § 2; 71 Del. Laws, c. 478, § 1; 72 Del. Laws, c. 334, § 2; 73 Del. Laws, c. 285, §§ 1, 2; 73 Del. Laws, c. 316, §§ 1, 2; 74 Del. Laws, c. 262, § 34; 77 Del. Laws, c. 319, § 1; 77 Del. Laws, c. 420, § 2.;

§ 1903. Delaware Board of Nursing -- Appointments; qualifications; terms of office; vacancies; suspension or removal.

(a) The Delaware Board of Nursing (hereafter referred to as the Board) shall consist of 15 members. The term of office of every member appointed to the Board, except those appointed to fill vacancies occurring during any term of office, is 3 years. The Board shall be composed of 5 registered nurses, 3 licensed practical nurses, 1 advanced practice nurse, 1 registered nurse educator, and 5 public members.

Registered nurse appointees shall have a diploma or an earned degree in nursing, nursing education or education, and at least 3 years active practice as a registered nurse in nursing service, administration or teaching.

Practical nurse appointees shall be licensed practical nurses, who are graduates of an approved school of practical nursing, with at least 3 years active practice as a practical nurse.

The public members shall be residents of Delaware for a minimum of 3 years, shall be knowledgeable about the health needs of Delaware, but shall not be licensees of any health occupation board, employees of a health care occupational board, employees of a health care facility or agency, or engaged in governance or administration of a health care facility or agency.

(b) The nursing experience referred to in this section shall have been within the last 5 years preceding appointment and said appointee must be currently licensed in Delaware.

(c) The Governor shall appoint all members to the Board of Nursing.

(d) Sixty days prior to the expiration of the term of any member of the Board, a successor shall be appointed by the Governor. A list of at least 3 nominees for each registered nurse vacancy may be furnished to the Governor by the Delaware Nurses' Association and other professional organizations in order to aid the Governor in the appointment of new members of the Board. A list of at least 3 nominees for each licensed practical nurse vacancy may be furnished to the Governor by the Delaware Licensed Practical Nurses' Association and others in the practical nursing community in order to aid the Governor in the appointment of new members of the Board. The Governor shall not be limited to the recommendations of the professional organizations in making appointments of registered or practical nurses to the Board. The Governor shall seek nominees from the consumer population for the public members appointees. Vacancies occurring for any cause other than expiration of term shall be filled by the Governor for the unexpired term as provided in this subsection.

(e) At least 1 of the professional nurse members of the Board shall be a resident of New Castle County, 1 a resident of Kent County and 1 a resident of Sussex County. Licensed practical nurse members shall be representatives of at least 2 counties simultaneously. If there is no qualified person available in the geographical subdivision, then appointments shall be made from qualified persons available in any of the other geographical subdivisions.

(f) Each member shall serve for a term of 3 years, and may successively serve for 1 additional term; provided, however, that where a member was initially appointed to fill a vacancy, such member may successively serve for only 1 additional full term. Any person appointed to fill a vacancy on the Board shall hold office for the remainder of the unexpired term of the former member.

(g) A person who has never served on the Board may be appointed to the Board 2 consecutive times, but no such person shall thereafter be eligible for 2 consecutive appointments. No person who has been twice appointed to the Board, or who has served on the Board for 6 years within any 9-year period, shall again be appointed to the Board until an interim period of at least 1 term has expired since such person last served.

(h) Any act or vote by a person appointed in violation of subsection (g) of this section shall be invalid. An amendment or revision of this chapter is not sufficient cause for any appointment or attempted appointment in violation of subsection (g) of this section, unless such amendment or revision amends this section to permit such an appointment.

(i) A member of the Board shall be suspended or removed by the Governor for misfeasance, nonfeasance or malfeasance. A member subject to disciplinary proceedings shall be disqualified from Board business until the charge is adjudicated or the matter is otherwise concluded. A Board member may appeal any suspension or removal to the Superior Court.

(j) No member of the Board shall hold any elective office in, nor be a representative of, any local, state, regional or national nursing association.

(k) The provisions set forth for "employees" in Chapter 58 of Title 29 shall apply to all members of the Board, and to all agents appointed or otherwise employed by the Board.

24 Del. C. 1953, § 1903; 54 Del. Laws, c. 153; 57 Del. Laws, c. 668, §§ 1, 12, 13; 64 Del. Laws, c. 26, § 1; 67 Del. Laws, c. 366, § 5; 67 Del. Laws, c. 368, § 10; 68 Del. Laws, c. 162, § 1; 70 Del. Laws, c. 186, § 1; 70 Del. Laws, c. 482, §§ 1, 2; 72 Del. Laws, c. 121, § 1; 77 Del. Laws, c. 420, § 1.;

§ 1904. Delaware Board of Nursing -- Election of officers; quorum; rules and regulations; special meetings; compensation; seal.

(a) The Board shall elect, annually, from its members a President and Vice-President. In the event of a vacancy in 1 of the offices, a replacement shall be elected at the next Board meeting or at a meeting called for that purpose.

(b) Eight members of the Board, including 1 officer, shall constitute a quorum.

(c) The Board may adopt and promulgate such rules and regulations as may be necessary to govern its proceedings, to define the duties of its officers and to effectuate the intent and purpose of this chapter.

(d) The members of the Board shall receive compensation for each day, or part thereof, actually engaged in service and shall be reimbursed for all proper and necessary expenses.

(e) The Board shall adopt a seal and may use that seal on official documents.

24 Del. C. 1953, § 1904; 54 Del. Laws, c. 153; 57 Del. Laws, c. 668, § 2; 64 Del. Laws, c. 26, § 1; 67 Del. Laws, c. 366, § 6; 70 Del. Laws, c. 482, §§ 3, 25.;

§ 1905. Delaware Board of Nursing -- Executive Director.

The Executive Director shall be a registered nurse with at least 5 years experience in an administrative or teaching position, have earned a master's degree in nursing, nursing education, education or a related health field.

24 Del. C. 1953, § 1905; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1; 67 Del. Laws, c. 144, § 2.;

§ 1906. Delaware Board of Nursing -- Powers and duties.

(a) The Board shall:

(1) Adopt and, from time to time, revise such rules and regulations and standards not inconsistent with the law as may be necessary to enable it to carry into effect this chapter;

(2) Approve curricula and develop criteria and standards for evaluating educational programs preparing persons for license under this chapter;

(3) Provide for surveys of such programs at such times as it may deem necessary;

(4) Approve such programs as meet the requirements of this chapter and of the Board;

(5) Deny or withdraw approval from educational programs for failure to meet approved curricula or other criteria;

(6) Examine, license and renew licenses of duly qualified applicants, including applicants for conducting nursing educational programs and shall also prescribe the procedures for subsequent examinations of applicants who fail an examination;

(7) Establish categories of advanced practice nurses which shall include, but not be limited to, pediatric nurse practitioner, family nurse practitioner, maternal-gynecological nurse practitioner, clinical specialist in psychiatric-mental health nursing, nurse anesthetist and gerontological nurse practitioner and standards for the advanced practice nurse in each category. Such standards shall take into account the type of advanced levels of nursing practice which are or may be performed and the clinical and didactic education, experience or both needed to practice safely at those levels. In setting such standards, the Board shall consult with advanced practice nurses and physicians and health care organizations utilizing advanced practice nurses. The standards shall be consistent with the national certifying organization standards of practice recognized by the Board in its rules and regulations;

(8) Issue a temporary permit to practice nursing to applicants who apply for licensure by endorsement and to new graduates awaiting results of the first licensing examination;

(9) Conduct hearings upon charges calling for discipline of a licensee or revocation of a license;

(10) Have the power to issue subpoenas and compel the attendance of witnesses, and administer oaths to persons giving testimony at hearings;

(11) Cause the prosecution of all persons violating this chapter and have the power to incur such necessary expenses therefor;

(12) Keep a record of all its proceedings;

(13) Make an annual report to the Governor;

(14) Have all of the duties, powers and authority necessary to the enforcement of this chapter, as well as such other duties, powers and authority as it may be granted from time to time by appropriate statute;

(15) Appoint advisory committees as the Board deems desirable;

(16) Maintain a system of statistics related to nursing education programs and registered nurse and licensed practical nurse licensure in the State;

(17) Participate in and pay fees to the national organization of state boards of nursing, the National Council of State Boards of Nursing, Inc.;

(18) By regulation, establish requirements for mandatory continuing education;

(19) Create a regulatory committee entitled "Joint Practice Committee" to develop rules and regulations regarding the independent practice and prescriptive authority of "advance practice nurses." The Committee shall consist of 9 members and shall be as follows:

a. The Board of Nursing shall appoint 1 public member and 5 advanced practice nurses.

b. The Board of Pharmacy shall appoint 1 pharmacist.

c. The Board of Medical Licensure and Discipline shall appoint 2 physicians;

(20) The "Joint Practice Committee" with the approval of the Board of Medical Licensure and Discipline shall have the authority to grant, restrict, suspend or revoke practice or independent prescriptive authority and the Joint Practice Committee with the approval of the Board of Medical Licensure and Discipline shall be responsible for promulgating rules and regulations to implement the provisions of this chapter regarding "advanced practice nurses" who have been granted authority for independent practice and/or independent prescriptive authority;

(21) The rules and regulations and the granting, restricting, suspension or revocation of the independent practice and/or independent prescriptive authority shall be subject to the approval of the Board of Medical Licensure and Discipline.

(b) The Board of Nursing shall promulgate regulations specifically identifying those crimes which are substantially related to the practice of nursing.

24 Del. C. 1953, § 1906; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1; 65 Del. Laws, c. 380, § 2; 67 Del. Laws, c. 10, § 1; 67 Del. Laws, c. 144, § 3; 69 Del. Laws, c. 319, §§ 8, 9; 70 Del. Laws, c. 482, §§ 4, 26; 74 Del. Laws, c. 262, § 35; 77 Del. Laws, c. 319, § 1.;

§ 1907. Delaware Board of Nursing -- Revenue and expenses.

(a) All fees and other money received by the Board shall be paid over to the State Treasurer, in accordance with Chapter 61 of Title 29.

(b) Expenses of the Board, within the limits of appropriations made to it, shall be paid by the State Treasurer upon warrants signed by the proper officers of the Board.

24 Del. C. 1953, § 1907; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1.;

§ 1908. Delaware Board of Nursing -- Meetings; examinations for licensing; nursing education programs; fees.

(a) The Board shall meet as often as necessary to carry out its responsibilities as defined in this chapter.

(b) Special meetings of the Board may be called by the Executive Director upon the request of the President or any 2 members.

(c) The Board shall consider and act upon applications to conduct a nursing education program.

(d) The amount charged for each fee imposed under this chapter shall approximate and reasonably reflect all costs necessary to defray the expenses of the Board and the proportional expenses incurred by the Division of Professional Regulation in its services on behalf of the Board. There shall be a separate fee charged for each service or activity, but no fee shall be charged for a purpose not specified in this chapter. The application fee shall not be combined with any other fee or charge. At the beginning of each calendar year, the Division of Professional Regulation, or any other state agency acting on its behalf, shall compute for each separate service or activity the appropriate Board fees for the coming year.

24 Del. C. 1953, § 1908; 54 Del. Laws, c. 153; 57 Del. Laws, c. 668, § 3; 63 Del. Laws, c. 84, § 1; 64 Del. Laws, c. 26, § 1; 70 Del. Laws, c. 482, §§ 5, 6.;

§ 1909. License requirement.

No unlicensed person, except those persons issued a temporary permit by the Board, shall practice advanced practice, professional or practical nursing. Upon request, any person engaged in the practice of advanced practice, professional or practical nursing shall exhibit a license authorizing such practice.

24 Del. C. 1953, § 1909; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1; 69 Del. Laws, c. 319, § 10.;

§ 1910. Qualifications for registered nurse.

An applicant for a license to practice as a registered nurse shall submit to the Board written evidence, verified by oath, that the applicant:

(1) Is a graduate of and holds a certificate from a State Board of Nursing approved nursing education program that is authorized to prepare persons for licensure as a registered nurse;

(2) Demonstrates competence in English related to nursing;

(3) Must show evidence of an earned high school diploma or its equivalent;

(4) Is of such satisfactory physical and mental health as is consistent with the Americans with Disabilities Act [42 U.S.C. § 12101 et. seq.];

(5) Has committed no acts which are grounds for disciplinary action as set forth in 1922(a) of this title; however, after a hearing or review of documentation demonstrating that the applicant meets the specified criteria for a waiver, the Board, by an affirmative vote of a majority of the quorum may waive § 1922(a)(2) of this title, herein, if it finds all of the following:

a. More than 5 years have elapsed since the applicant has fully discharged all imposed sentences. As used herein, the term "sentence" includes, but is not limited to, all periods of modification of a sentence, probation, parole or suspension. However, "sentence" does not include fines, restitution or community service, as long as the applicant is in substantial compliance with such fines, restitution and community service.

b. The applicant is capable of practicing nursing in a competent and professional manner.

c. The granting of a waiver will not endanger the public health, safety or welfare; and

(6) If seeking licensure by endorsement, demonstrates active employment in professional nursing in the past 5 years, or satisfactory completion of a professional nursing refresher program with an approved agency within 2 years prior to filing an application. In the event no refresher course is available the Board may consider alternate methods of evaluating current knowledge in professional nursing.

24 Del. C. 1953, § 1910; 54 Del. Laws, c. 153; 57 Del. Laws, c. 668, §§ 4, 5; 64 Del. Laws, c. 26, § 1; 70 Del. Laws, c. 482, §§ 7-9; 75 Del. Laws, c. 436, § 16; 77 Del. Laws, c. 199, § 14.;

§ 1910A. Criminal background checks of registered nurses.

The version of this statute, regarding criminal background checks of registered nurses, enacted as § 1910A of this title, by 75 Del. Laws, c. 325, § 1, was redesignated as § 1928 of this title.

§ 1911. Licensure by examination for registered nurse.

The applicant shall be required to pass the standard national examination for professional nursing. The passing score shall be as recommended by the National Council of State Boards of Nursing. Every applicant who shall pass the prescribed examination shall receive a license to practice nursing as a registered nurse.

24 Del. C. 1953, § 1911; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1; 70 Del. Laws, c. 482, § 10.;

§ 1912. Reciprocity for registered nurse.

(a) The Board may, by endorsement, without written examination, license as a registered nurse an applicant who, on or after July 1, 1983, is duly licensed as a registered nurse or is entitled to perform similar services under a different title under the laws of another state, territory or foreign country if, in the opinion of the Board, the applicant meets the qualifications specified by this chapter for registered nurses in this State.

(b) In the event the applicant has not been actively employed in professional nursing in the past 5 years, the applicant will be required to give evidence of satisfactory completion of a professional nursing refresher program with an approved agency within 2 years prior to endorsement before licensure by endorsement will be granted. In the event no refresher course is available the Board may consider alternate methods of evaluating current knowledge in professional nursing.

(c) Verification of current Delaware license is provided upon request to other state boards of nursing.

24 Del. C. 1953, § 1912; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1; 70 Del. Laws, c. 482, § 11.;

§ 1913. Registered nurses licensed under previous law.

(a) Any person holding a license to practice nursing as a registered nurse that is valid on July 1, 1983, shall be deemed to be licensed as a registered nurse under this chapter and shall be eligible for renewal of such license under the conditions and standards prescribed by § 1918 of this title.

(b) Any person eligible for reactivation or reinstatement of a license to practice nursing as a registered nurse in this state on or after July 1, 1983, shall be deemed to be eligible to be licensed as a registered nurse under this chapter and shall be eligible for renewal of such license under the conditions and standards prescribed by § 1918 of this title.

(c) Any person whose license to practice nursing as a registered nurse has lapsed in this State on or after July 1, 1983, because of failure to renew may become licensed as a registered nurse under this chapter by applying for reinstatement according to the rules and regulations established by the Board of Nursing.

(d) Any person who was licensed to practice nursing as a registered nurse and who had requested to be placed on inactive status in this State on or after July 1, 1983, may become licensed as a registered nurse under this chapter by applying for reactivation according to the rules and regulations established by the Board of Nursing.

24 Del. C. 1953, § 1916; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1.;

§ 1914. Qualifications for licensed practical nurse.

An applicant for a license to practice as a licensed practical nurse shall submit to the Board written evidence, verified by oath, that such applicant:

(1) Is a graduate of and holds a certificate from a State Board of Nursing approved practical nursing education program. The Board may, by an affirmative vote of a majority of a quorum of the Board, waive this requirement for application for licensure by endorsement if it finds clear and convincing evidence that the applicant's education, training, experience and conduct have been sufficient to overcome the deficiency in meeting this requirement;

(2) Demonstrates competence in English related to nursing;

(3) Must show evidence of an earned high school diploma or its equivalent;

(4) Is of such satisfactory physical and mental health as is consistent with the Americans with Disabilities Act [42 U.S.C. § 12101 et. seq.];

(5) Has committed no acts which are grounds for disciplinary action as set forth in § 1922(a) of this title; however, after a hearing or review of documentation demonstrating that the applicant meets the specified criteria for a waiver, the Board, by an affirmative vote of a majority of the quorum may waive § 1922(a)(2) of this title, herein, if it finds all of the following:

a. More than 5 years have elapsed since the applicant has fully discharged all imposed sentences. As used herein, the term "sentence" includes, but is not limited to, all periods of modification of a sentence, probation, parole or suspension. However, "sentence" does not include fines, restitution or community service, as long as the applicant is in substantial compliance with such fines, restitution and community service.

b. The applicant is capable of practicing nursing in a competent and professional manner.

c. The granting of a waiver will not endanger the public health, safety or welfare; and

(6) If seeking licensure by endorsement, demonstrates active employment in practical nursing in the past 5 years, or satisfactory completion of a practical nursing refresher program with an approved agency within 2 years prior to filing an application. In the event no refresher course is available the Board may consider alternate methods of evaluating current knowledge in practical nursing.

24 Del. C. 1953, § 1913; 54 Del. Laws, c. 153; 57 Del. Laws, c. 668, §§ 6, 7; 64 Del. Laws, c. 26, § 1; 70 Del. Laws, c. 482, §§ 12-14; 75 Del. Laws, c. 436, § 17; 77 Del. Laws, c. 199, § 15; 77 Del. Laws, c. 420, § 4.;

§ 1914A. Criminal background checks of licensed practical nurses [Redesignated as § 1929 of this title, effective July 1, 2007]

The version of this statute, regarding criminal background checks of licensed practical nurses, enacted by 75 Del. Laws, 325, § 2, effective July 1, 2007, was redesignated as § 1929 of this title.

§ 1915. Licensure by examination for licensed practical nurse.

The applicant shall be required to pass the standard national examination for practical nursing. The passing score shall be as recommended by the National Council of State Boards of Nursing. Every applicant who shall pass the prescribed examination shall receive a license to practice as a licensed practical nurse.

24 Del. C. 1953, § 1914; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1; 70 Del. Laws, c. 482, § 15.;

§ 1916. Reciprocity for licensed practical nurse.

(a) The Board may, by endorsement, without written examination, license as a practical nurse an applicant who, as of July 1, 1983, is duly licensed as a practical nurse or is entitled to perform similar services under a different title under the laws of another state, territory or foreign country, if in the opinion of the Board, the applicant meets the qualifications specified by this chapter for licensed practical nurses in this State.

(b) In the event the applicant has not been actively employed in practical nursing in the past 5 years, the applicant will be required to give evidence of satisfactory completion of a practical nursing refresher program within an approved agency within 2 years prior to endorsement before licensure by endorsement will be granted. In the event no refresher course is available the Board may consider alternate methods of evaluating current knowledge in practical nursing.

(c) Verification of current Delaware license is provided upon request to other state boards of nursing.

24 Del. C. 1953, § 1915; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1; 70 Del. Laws, c. 482, § 16.;

§ 1917. Licensed practical nurses licensed under previous law.

(a) Any person holding a license to practice nursing as a licensed practical nurse that is valid on July 1, 1983, shall be deemed to be licensed as a licensed practical nurse under this chapter and shall be eligible for renewal of such license under the conditions and standards prescribed by § 1918 of this title.

(b) Any person eligible for reactivation or reinstatement of a license to practice nursing as a licensed practical nurse in this State on or after July 1, 1983, shall be deemed to be eligible to be licensed as a licensed practical nurse under this chapter and shall be eligible for renewal of such license under the conditions and standards prescribed by § 1918 of this title.

(c) Any person whose license to practice nursing as a licensed practical nurse has lapsed in this State on or after July 1, 1983, because of failure to renew may become licensed as a licensed practical nurse under this chapter by applying for reinstatement according to the rules and regulations established by the Board of Nursing.

(d) Any person who was licensed to practice nursing as a licensed practical nurse and who had requested to be placed on inactive status in this State on July 1, 1983, may become licensed as a licensed practical nurse under this chapter by applying for reactivation according to the rules and regulations established by the Board of Nursing.

24 Del. C. 1953, § 1916; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1.;

§ 1918. Renewal of license; lapse of license; penalties; retirement from practice; temporary permit to practice.

(a) Every advanced practice nurse, registered or licensed practical nurse licensed under this chapter shall reregister biennially by filing an application; provided however, that the license of any licensee who is on active military duty with the armed forces of the United States and serving in a theater of hostilities on the date such application or reregistration is due shall be deemed to be current and in full compliance with this chapter until the expiration of 60 days after such licensee is no longer on active military duty in a theater of hostilities. The advanced practice nurses' independent practice and/or independent prescriptive authority shall be subject to biennial renewal upon application made to the "Joint Practice Committee." In the event the applicant has not been actively employed in professional practical nursing in the past 5 years, the applicant will be required to give evidence of satisfactory completion of a professional or practical nursing refresher program within an approved agency within 2 years prior to renewal before licensure by renewal will be granted.

(b) Upon receipt of the application and fee, the Board shall verify the accuracy of the information set forth in the application and issue to the applicant a certificate of renewal of license for 2 years, provided that the applicant has successfully completed continuing education requirements as may be established by the Board. Such certificate shall entitle the holder to engage in the practice of professional or practical nursing for the period stated therein. Any licensee whose license lapses for failure to renew the license may be reinstated by the Board upon satisfactory evidence of active employment in professional or practical nursing within the past 5 years or satisfactory completion of a refresher program in professional or practical nursing within an approved agency within a 1-year period prior to renewal and upon satisfactory explanation for the failure to renew the license and payment of a penalty fee to be determined.

(c) After a license has lapsed or been inactive for 5 or more years and the applicant has not been in active practice in professional or practical nursing in the past 5 years, the applicant will be required to give evidence of satisfactory completion of a professional or practical nursing refresher program within an approved agency within 2 years prior to reinstatement before licensure by reinstatement will be granted. In the event no refresher course is available the Board may consider alternate methods of evaluating current knowledge in professional or practical nursing.

(d) Any person practicing nursing during the time that person's license has lapsed shall be considered an illegal practitioner and shall be subject to the penalties provided for violations of this chapter.

(e) Any person licensed under this chapter who desires to retire from practice in this State shall so notify the Board. Upon receipt of such notice, the Board shall place the name of such person on a nonpracticing list. While on this list, such person shall not be required to pay any license fee, and shall not practice nursing in this State. When such person desires to resume practice, application for renewal shall be made under subsection (a) of this section and the license shall be reactivated if the requirements of the Board are met.

(f) Temporary permits to practice nursing may be issued by the Board to persons who have requested reinstatement of their license, if they have practiced nursing within the past 5 years.

(g) Every registered or licensed practical nurse licensed under this chapter primarily engaged in the practice of electrolysis shall be exempt from the requirement in subsection (a) of this section that states in the event the applicant has not been actively employed in professional practical nursing in the past 5 years, the applicant will be required to give evidence of satisfactory completion of a professional or practical nursing refresher program within 2 years prior to renewal before licensure by renewal will be granted.

24 Del. C. 1953, § 1917; 54 Del. Laws, c. 153; 57 Del. Laws, c. 668, § 8; 64 Del. Laws, c. 26, § 1; 65 Del. Laws, c. 221, § 2; 65 Del. Laws, c. 466, § 2; 69 Del. Laws, c. 319, § 11; 69 Del. Laws, c. 372, § 1; 70 Del. Laws, c. 186, § 1; 70 Del. Laws, c. 482, §§ 17-20, 27, 28.;

§ 1919. Nursing educational programs.

(a) An institution desiring to conduct a nursing education program shall apply to the Board and submit satisfactory evidence that it is ready and qualified to instruct students in the prescribed basic curriculum for educating nurses and that it is prepared to meet other standards which may be established by the Board. The Board may authorize the temporary operation of a nursing education program pending evaluation for approval. The Board shall grant approval in writing. The Board may visit and survey any nursing education program at any reasonable time.

(b) If the Board determines that any approved nursing education program is not maintaining the standards required by this chapter and by the Board, written notice thereof, specifying the deficiency and the time within which the same shall be corrected, shall immediately be given to the program. The Board shall withdraw such program's approval if it fails to correct the specified deficiency, and such nursing education program shall discontinue its operation; provided, however, that the Board shall grant a hearing to such program upon written application and extend the period for correcting specified deficiency upon good cause being shown.

(c) An approved nursing education program which plans substantive changes, as defined in the Board's rules and regulations, shall obtain the written approval of the Board prior to the date of the change.

(d) Any nursing education program in the State that is recognized as an approved program by the Board of Nursing on or after July 1, 1983, shall be deemed to be an approved education program for the purpose of this chapter.

24 Del. C. 1953, § 1918; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1.;

§ 1920. License requirements; use of abbreviations.

(a) No person shall engage in the practice of professional nursing in Delaware without being licensed by the Board, except those persons issued a temporary permit by the Board.

(b) No person shall engage in practice as an advanced practice nurse without a Board-issued license as an advanced practice nurse. Notwithstanding any provision to the contrary, the use of title and abbreviation for advanced practice nurses is authorized in accordance with the following:

(1) Only certified registered nurse anesthetists may use that title, the abbreviation "CRNA" or any other words, letters, signs or figures indicating that the person using the same is a certified registered nurse anesthetist.

(2) Only certified registered nurse practitioners may use that title, the abbreviation "CRNP" or any other words, letters, signs or figures indicating that the person using the same is a certified nurse practitioner.

(3) Only certified registered nurse midwives may use that title, the abbreviation "CNM" or any other words, letters, signs or figures indicating that the person using the same is a certified nurse midwife.

(4) Only clinical nurse specialists may use that title, the abbreviation "CNS" or any other words, letters, signs or figures indicating that the person using the same is a clinical nurse specialist.

(c) No person shall knowingly employ a graduate of a professional nursing program or a registered nurse to engage in the practice of professional nursing without a temporary permit or license from the Board.

(d) Only registered nurses shall use that title, the title "nurse", the abbreviation of "R.N." or any other words, letters, signs or figures indicating that the person using the same is a registered nurse.

(e) No person shall practice practical nursing in Delaware without being licensed by the Board, except those persons issued a temporary permit by the Board.

(f) No person shall knowingly employ a graduate of a practical nursing program or a licensed practical nurse to engage in the practice of practical nursing without a temporary permit or license from the Board.

(g) Only licensed practical nurses shall use that title, the title "nurse", the abbreviation "L.P.N." or any other words, letters, signs or figures indicating that the person using the same is a licensed practical nurse.

24 Del. C. 1953, § 1919; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1; 69 Del. Laws, c. 319, § 12; 77 Del. Laws, c. 234, §§ 1, 2.;

§ 1921. Applicability of chapter.

(a) This chapter shall not apply to the following situations:

(1) Nursing services rendered during an epidemic or a state or national disaster;

(2) The rendering of assistance by anyone in the case of an emergency;

(3) Emergency services rendered by ambulance personnel trained in advanced life support under a licensed physician's supervision as defined in Chapter 79 of Title 29. Advanced life support is defined in Chapter 79 of Title 29;

(4) The incidental care of the sick in private homes by members of the family, friends, domestic servants or persons primarily employed as housekeepers;

(5) Nursing services rendered by a student enrolled in a State Board of Nursing approved school of professional or practical nursing when these services are incidental to the course of study; or those nursing services rendered by a professional nurse or practical nurse enrolled in a State Board of Nursing approved refresher course pending reinstatement, reactivation or endorsement of licensure;

(6) The practice of nursing in this State by a nurse licensed in another state whose employment requires such nurse to accompany and care for a patient temporarily in this State, provided the nursing services are not rendered for more than 3 months within 1 year and such nurse does not claim to be licensed in this State;

(7) The practice of nursing by a nurse licensed in another state employed by the United States government or any bureau, division or agency thereof;

(8) The practice of nonmedical nursing in connection with healing by prayer or spiritual means in accordance with the tenets and practice of a well-recognized church or religious denomination, provided that persons practicing such nonmedical nursing do not claim to be licensed under this chapter;

(9) Auxiliary care services performed by nurse's aides, attendants, orderlies and other auxiliary workers in medical care facilities, or elsewhere by persons under the direction and supervision of a person licensed to practice nursing, medicine, dentistry or podiatry, and performing those services which are routine, repetitive and limited in scope, and that do not require the professional judgment of a registered nurse or a licensed practical nurse; provided, however, that nothing contained herein shall limit the right of any person to act pursuant to § 1703(e)(7) of this title, or persons employed in similar positions in the offices of podiatrists or dentists without being licensed under this chapter;

(10) Residential child care facilities regulated by the State under Title 31 where designated child care providers, who have successfully completed a Board-approved medication training program, assist children in the taking of medication, other than by injection, provided that the medication is in the original container, properly labeled. An annual report by the Administrator of the Program shall be made to the Board of Nursing. The report shall indicate compliance with guidelines as set forth in the approved course on "Assistance with Self Administration";

(11) Administration of prescription or nonprescription medications, other than by injection, by child care providers who have successfully completed a state-approved medication training program, to children in child day care homes or child day care centers regulated by the State under §§ 341-344 of Title 31; provided the medication and written permission for the administration of the particular medication has been obtained from the child's parent or legal guardian and further provided the medication is in its original container, properly labeled. Properly labeled medication shall include instructions for administration of the medication;

(12) Foster homes, group homes or adult day habilitation centers for individuals who are developmentally disabled regulated by the State under Chapter 55 of Title 16 where designated care providers, who have successfully completed a Board-approved medication training program, assist developmentally disabled clients in the taking of medication, other than by injection, provided that the medication is in the original container, properly labeled. An annual report by the Administrator of the Program shall be made to the Board of Nursing. The report shall indicate compliance with guidelines as set forth in the approved course on "Assistance with Self Administration";

(13) Nursing services rendered by a graduate of a State Board of Nursing approved school of professional or practical nursing working under supervision, pending results of the first licensing examination. The Board shall establish the procedure and extent to which subsequent examinations may be taken and the length of time and the character of nursing service which may be rendered pending subsequent examinations;

(14) Group homes for individuals who have psychiatric disabilities regulated by the State under Chapter 11 of Title 16 and other community support programs certified by the Division of Substance Abuse and Mental Health, where designated care providers, who have successfully completed a Board-approved medication training program, assist individuals who have psychiatric disabilities in the taking of medication, other than by injection, provided that the medication is in the original container, properly labeled. An annual report by the Administrator of the Program shall be made to the Board of Nursing. The report shall indicate compliance with guidelines as set forth in the approved course on "Assistance with Self Administration";

(15) The practice of any currently licensed registered nurse or licensed practical nurse of another state who provides or attends educational programs or provides consultative services within this State not to exceed 14 days in any calendar year. Neither the education nor consultation may include the provision of patient care, the direction of patient care or the affecting of patient care policies.

(16) Assisted Living agencies serving elderly persons and adults with physical disabilities regulated by the State under Chapter 11 of Title 16, where designated care providers, who have successfully completed a Board-approved medication training program, assist individuals residing in licensed assisted living facilities in the taking of medication, other than by injection, provided that the medication is in the original container, and properly labeled. An annual report by the Administrator of the Program shall be made to the Board of Nursing. The report shall indicate compliance with guidelines as set forth in the approved course on "Assistance with Self Administration";

(17) Educators who assist students with medications that are self-administered during school field trips that have completed a Board of Nursing approved training course developed by the Delaware Department of Education;

(18) Attendants providing basic and ancillary services defined and regulated by the Department of Health and Social Services in conformity with the Community-Based Attendant Services Act, Chapter 94 of Title 16;

(19) A competent individual who does not reside in a medical facility or a facility regulated pursuant to Chapter 11 of Title 16, may delegate to unlicensed persons performance of health care acts, unless of a nature excluded by the Board through regulations, provided:

a. The acts are those individuals could normally perform themselves but for functional limitations; and

b. The delegation decision is entirely voluntary.

Nothing contained herein shall diminish any legal or contractual entitlement to receive health care services from licensed or certified personnel;

(20) The providing of assistance with the self administration of medications to residents of group homes established for individuals with AIDS, provided that persons providing such assistance have successfully completed a medication training program approved by the Board. An annual report by the administrator of the program shall be made to the Board of Nursing. The report shall indicate compliance with guidelines as set forth in the approved course on "Assistance with Self-Administration".

(b) Persons involved in the rendering of electrolysis treatments shall be eligible for licensing under this chapter regardless of whether the applicant is in compliance with § 1910(6) of this title, or § 1914(6) of this title, so long as such applicants are in compliance with subdivisions (1) through (5) of either § 1910 or 1914 of this title.

24 Del. C. 1953, § 1920; 54 Del. Laws, c. 153; 57 Del. Laws, c. 634; 57 Del. Laws, c. 668, §§ 9, 10; 64 Del. Laws, c. 26, § 1; 65 Del. Laws, c. 466, § 1; 66 Del. Laws, c. 21, §§ 1, 2; 68 Del. Laws, c. 93, §§ 1-3; 68 Del. Laws, c. 162, § 2; 71 Del. Laws, c. 478, § 2; 73 Del. Laws, c. 32, § 1; 73 Del. Laws, c. 41, § 1; 73 Del. Laws, c. 193, § 3; 74 Del. Laws, c. 260, § 1; 77 Del. Laws, c. 220, § 1.;

§ 1922. Disciplinary proceedings; appeal.

(a) Grounds. -- The Board may impose any of the following sanctions (subsection (b) of this section) singly or in combination when it finds a licensee or former licensee is guilty of any offense described herein:

(1) Is guilty of fraud or deceit in procuring or attempting to procure a license to practice nursing; or

(2) Is convicted of a crime that is substantially related to the practice of nursing; or

(3) Is unfit or incompetent by reason of negligence, habits or other causes; or

(4) Is habitually intemperate or is addicted to the use of habit-forming drugs; or

(5) Is mentally incompetent; or

(6) Whose physical condition is such that the performance of nursing service is or may be injurious or prejudicial to patients or to the public; or

(7) Has had a license to practice as a registered nurse or licensed practical nurse suspended or revoked in any jurisdiction; or

(8) Is guilty of unprofessional conduct as shall be determined by the Board, or the wilful neglect of a patient; or

(9) Has wilfully or negligently violated this chapter.

(b) Disciplinary sanctions. --

(1) Permanently revoke a license to practice.

(2) Suspend a license.

(3) Censure a licensee.

(4) Issue a letter of reprimand.

(5) Place a licensee on probationary status and require the licensee to:

a. Report regularly to the Board upon the matters which are the basis of probation.

b. Limit practice to those areas prescribed by the Board.

c. Continue or renew professional education until satisfactory degree of skill has been attained in those areas which are the basis of the probation.

(6) Refuse a license.

(7) Refuse to renew a license.

(8) Or otherwise discipline.

(c) Procedure. --

(1) When a complaint is filed pursuant to § 8735 of Title 29, alleging a violation of this chapter, the complaint shall be received and investigated by the Division of Professional Regulation and the Division shall be responsible for issuing a final written report at the conclusion of its investigation.

(2) The Board shall cause a copy of the complaint, together with a notice of the time and place fixed for the hearing, to be served upon the practitioner at least 30 days before the date fixed for the hearing. In cases where the practitioner cannot be located or where personal service cannot be effected, substitute service shall be effected in the same manner as with civil litigation.

(3) In all proceedings herein:

a. The accused may be represented by counsel who shall have the right of examination and cross-examination.

b. The accused and the Board may subpoena witnesses. Subpoenas shall be issued by the President or the Vice-President of the Board upon written request and shall be served as provided by the rules of the Superior Court and shall have like effect as a subpoena issued by said Court.

c. Testimony before the Board shall be under oath. Any member of the Board shall have power to administer oaths for this purpose.

d. A stenographic record of the hearing shall be made by a qualified court reporter. At the request and expense of any party such record shall be transcribed with a copy to the other party.

e. The decision of the Board shall be based upon sufficient legal evidence. If the charges are supported by such evidence, the Board may refuse to issue, or revoke or suspend a license, or otherwise discipline a licensee. A suspended license may be reissued upon a further hearing initiated at the request of the suspended licensee by written application in accordance with the rules of the Board.

f. All decisions of the Board shall be final and conclusive. Where the practitioner is in disagreement with the action of the Board, the practitioner may appeal the Board's decision to the Superior Court within 30 days of service or of the postmarked date of the copy of the decision maile

State Codes and Statutes

Statutes > Delaware > Title24 > C019

TITLE 24

Professions and Occupations

CHAPTER 19. NURSING

§ 1901. Declaration of legislative intent.

The General Assembly hereby declares the practice of nursing by competent persons is necessary for the protection of the public health, safety and welfare and further finds that the levels of practice within the profession of nursing should be regulated and controlled in the public interest. In order to safeguard life and health, the general administration and supervision of the education, examination, licensing and regulation of professional and practical nursing is declared essential, and such general administration and supervision is vested in the Board of Nursing.

24 Del. C. 1953, § 1901; 54 Del. Laws, c. 153, § 1; 64 Del. Laws, c. 26, § 1; 69 Del. Laws, c. 319, § 2.;

§ 1902. Definitions.

(a) "Administration of medications" means a process whereby a single dose of a prescribed drug or biological is given to a patient by an authorized licensed person by 1 of several routes, oral, inhalation, topical, or parenteral. The person verifies the properly prescribed drug order, removes the individual dose from a previously dispensed, properly labeled container (including a unit dose container), assesses the patient's status to assure that the drug is given as prescribed to the patient for whom it is prescribed and that there are no known contraindications to the use of the drug or the dosage that has been prescribed, gives the individual dose to the proper patient, records the time and dose given and assesses the patient following the administration of medication for possible untoward side effects.

(b)(1) "Advanced practice nurse" means an individual whose education and certification meet criteria established by the Board of Nursing who is currently licensed as a registered nurse and has a master's degree or a postbasic program certificate in a clinical nursing specialty with national certification. When no national certification at the advanced level exists, a master's degree in a clinical nursing specialty will qualify an individual for advanced practice nurse licensure. "Advanced practice nurse" shall include, but not be limited to, nurse practitioners, certified registered nurse anesthetists, certified nurse midwives or clinical nurse specialists. Advanced practice nursing is the application of nursing principles, including those described in subsection (o) of this section, at an advanced level and includes:

a. For those advanced practice nurses who do not perform independent acts of diagnosis or prescription, the authority as granted within the scope of practice rules and regulations promulgated by the Board of Nursing; and

b. For those advanced practice nurses performing independent acts of diagnosis and/or prescription with the collaboration of a licensed physician, dentist, podiatrist or licensed Delaware health care delivery system without written guidelines or protocols and within the scope of practice as defined in the rules and regulations promulgated by the Joint Practice Committee and approved by the Board of Medical Licensure and Discipline.

Nothing in this act is to be construed to limit the practice of nursing by advanced practice nurses as is currently being done or allowed including nursing diagnosis as pursuant to subsection (o)(2) of this section.

Advanced practice nurses shall operate in collaboration with a licensed physician, dentist, podiatrist, or licensed Delaware health care delivery system to cooperate, coordinate, and consult with each other as appropriate pursuant to a collaborative agreement defined in the rules and regulations promulgated by the Board of Nursing, in the provision of health care to their patients. Advanced practice nurses desiring to practice independently or to prescribe independently must do so pursuant to § 1906(20) of Title 24.

(2) Those individuals who wish to engage in independent practice without written guidelines or protocols and/or wish to have independent prescriptive authority shall apply for such privilege or privileges to the Joint Practice Committee and do so only in collaboration with a licensed physician, dentist, podiatrist or licensed Delaware health care delivery system. This does not include those individuals who have protocols and/or waivers approved by the Board of Medical Licensure and Discipline.

(c) "Assistance with medications" means a situation where a designated care provider functioning in a setting authorized by § 1921 of this title, who has taken a Board approved medication training program, or a designated care provider who is otherwise exempt from the requirement of having to take the Board approved self administration with medication training programs, assists the patient in the self-administration of a medication other than by injection, provided that the medication is in the original container, with a proper label and directions. The designated care provider may hold the container for the patient, assist with the opening of the container and assist the patient in taking the medication.

(d) The "Compact Administrator" shall be the Executive Director of the Delaware Board of Nursing who shall be designated as the Compact Administrator by the President of the Board.

(e) "Dispensing" means providing medication according to an order of a practitioner duly licensed to prescribe medication. The term shall include both the repackaging and labeling of medications from bulk to individual dosages.

(f) The "Head of the Nursing Licensing Board" shall be the President of the Delaware Board of Nursing; and

(g) "Independent practice by an advanced practice nurse" shall include those advance practice nurses who practice and prescribe without written guidelines or protocols but with a collaborative agreement with a licensed physician, dentist, podiatrist or licensed Delaware health care delivery system and with the approval of the Joint Practice Committee.

(h) "Licensure" means the authorization to practice nursing within this State granted by the Delaware Board of Nursing and includes the authorization to practice in Delaware under the Interstate Nurse Licensure Compact.

(i) "Nurse educator" is a registered nurse who is a faculty member or director of a Delaware board-approved nursing education program preparing individuals at the registered nurse entry level.

(j) "Nursing diagnosis" means the description of the individual's actual or potential health needs which are identified through a nursing assessment and are amenable to nursing intervention. The focus of the nursing diagnosis is on the individual's response to illness or other factors that may adversely affect the attainment/or maintenance of wellness. These diagnostic acts are distinct from medical, osteopathic and dental diagnosis.

(k) "Nursing education program" means a course of instruction offered and conducted to prepare persons for licensure as a registered or licensed practical nurse, and/or a course of instruction offered and conducted to increase the knowledge and skills of the nurse and leads to an academic degree in nursing, and/or refresher courses in nursing.

(l) "Standards of nursing practice" means those standards of practice adopted by the Board that interpret the legal definitions of nursing, as well as provide criteria against which violations of the law can be determined. Such standards of nursing practice shall not be used to directly or indirectly affect the employment practices and deployment of personnel by duly licensed or accredited hospitals and other duly licensed or accredited health care facilities and organizations. In addition, such standards shall not be assumed the only evidence in civil malpractice litigation, nor shall they be given a different weight than any other evidence.

(m) "Substantially related" means the nature of the criminal conduct, for which the person was convicted, has a direct bearing on the fitness or ability to perform 1 or more of the duties or responsibilities necessarily related to the practice of nursing.

(n) "The practice of practical nursing" as a licensed practical nurse means the performance for compensation of nursing services by a person who holds a valid license pursuant to the terms of this chapter and who bears accountability for nursing practices which require basic knowledge of physical, social and nursing sciences. These services, at the direction of a registered nurse or a person licensed to practice medicine, surgery or dentistry, include:

(1) Observation;

(2) Assessment;

(3) Planning and giving of nursing care to the ill, injured and infirm;

(4) The maintenance of health and well being;

(5) The administration of medications and treatments prescribed by a licensed physician, dentist, podiatrist or advanced practice nurse; and

(6) Additional nursing services and supervision commensurate with the licensed practical nurse's continuing education and demonstrated competencies; and

(7) Dispensing activities only as permitted in the Board's Rules and Regulations.

Nothing contained in this chapter shall be deemed to permit acts of surgery or medical diagnosis; nor shall it be deemed to permit dispensing of drugs, medications or therapeutics independent of the supervision of a physician who is licensed to practice medicine and surgery, or those licensed to practice dentistry or podiatry.

(o) "The practice of professional nursing" as a registered nurse means the performance of professional nursing services by a person who holds a valid license pursuant to the terms of this chapter, and who bears primary responsibility and accountability for nursing practices based on specialized knowledge, judgment and skill derived from the principles of biological, physical and behavioral sciences. The registered nurse practices in the profession of nursing by the performance of activities, among which are:

(1) Assessing human responses to actual or potential health conditions;

(2) Identifying the needs of the individual and/or family by developing a nursing diagnosis;

(3) Implementing nursing interventions based on the nursing diagnosis;

(4) Teaching health care practices. Nothing contained herein shall limit other qualified persons or agencies from teaching health care practices without being licensed under this chapter;

(5) Advocating the provision of health care services through collaboration with other health service personnel;

(6) Executing regimens, as prescribed by a licensed physician, dentist, podiatrist or advanced practice nurse, including the dispensing and/or administration of medications and treatments;

(7) Administering, supervising, delegating and evaluating nursing activities.

(8) Nothing contained in this chapter shall be deemed to permit acts of surgery or medical diagnosis; nor shall it be deemed to permit dispensing of drugs, medications or therapeutics independent of the supervision of a physician who is licensed to practice medicine and surgery, or those licensed to practice dentistry or podiatry.

A registered nurse shall have the authority, as part of the practice of professional nursing, to make a pronouncement of death; provided, however, that this provision shall only apply to attending nurses caring for terminally ill patients or patients who have "do not resuscitate" orders in the home or place of residence of the deceased as a part of a hospice program or a certified home health care agency program; in a skilled nursing facility; in a residential community associated with a skilled nursing facility; any licensed assisted living community; in an extended care facility; or in a hospice; and provided that the attending physician of record has agreed in writing to permit the attending registered nurse to make a pronouncement of death in that case.

(p) "The profession of nursing" is an art and process based on a scientific body of knowledge. The practitioner of nursing assists patients in the maintenance of health, the management of illness, injury or infirmity or in the achieving of a dignified death.

24 Del. C. 1953, § 1902; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1; 67 Del. Laws, c. 5, § 2; 67 Del. Laws, c. 434, § 2; 68 Del. Laws, c. 152, § 2; 68 Del. Laws, c. 161, § 2; 69 Del. Laws, c. 319, §§ 3-7, 13; 71 Del. Laws, c. 283, § 2; 71 Del. Laws, c. 478, § 1; 72 Del. Laws, c. 334, § 2; 73 Del. Laws, c. 285, §§ 1, 2; 73 Del. Laws, c. 316, §§ 1, 2; 74 Del. Laws, c. 262, § 34; 77 Del. Laws, c. 319, § 1; 77 Del. Laws, c. 420, § 2.;

§ 1903. Delaware Board of Nursing -- Appointments; qualifications; terms of office; vacancies; suspension or removal.

(a) The Delaware Board of Nursing (hereafter referred to as the Board) shall consist of 15 members. The term of office of every member appointed to the Board, except those appointed to fill vacancies occurring during any term of office, is 3 years. The Board shall be composed of 5 registered nurses, 3 licensed practical nurses, 1 advanced practice nurse, 1 registered nurse educator, and 5 public members.

Registered nurse appointees shall have a diploma or an earned degree in nursing, nursing education or education, and at least 3 years active practice as a registered nurse in nursing service, administration or teaching.

Practical nurse appointees shall be licensed practical nurses, who are graduates of an approved school of practical nursing, with at least 3 years active practice as a practical nurse.

The public members shall be residents of Delaware for a minimum of 3 years, shall be knowledgeable about the health needs of Delaware, but shall not be licensees of any health occupation board, employees of a health care occupational board, employees of a health care facility or agency, or engaged in governance or administration of a health care facility or agency.

(b) The nursing experience referred to in this section shall have been within the last 5 years preceding appointment and said appointee must be currently licensed in Delaware.

(c) The Governor shall appoint all members to the Board of Nursing.

(d) Sixty days prior to the expiration of the term of any member of the Board, a successor shall be appointed by the Governor. A list of at least 3 nominees for each registered nurse vacancy may be furnished to the Governor by the Delaware Nurses' Association and other professional organizations in order to aid the Governor in the appointment of new members of the Board. A list of at least 3 nominees for each licensed practical nurse vacancy may be furnished to the Governor by the Delaware Licensed Practical Nurses' Association and others in the practical nursing community in order to aid the Governor in the appointment of new members of the Board. The Governor shall not be limited to the recommendations of the professional organizations in making appointments of registered or practical nurses to the Board. The Governor shall seek nominees from the consumer population for the public members appointees. Vacancies occurring for any cause other than expiration of term shall be filled by the Governor for the unexpired term as provided in this subsection.

(e) At least 1 of the professional nurse members of the Board shall be a resident of New Castle County, 1 a resident of Kent County and 1 a resident of Sussex County. Licensed practical nurse members shall be representatives of at least 2 counties simultaneously. If there is no qualified person available in the geographical subdivision, then appointments shall be made from qualified persons available in any of the other geographical subdivisions.

(f) Each member shall serve for a term of 3 years, and may successively serve for 1 additional term; provided, however, that where a member was initially appointed to fill a vacancy, such member may successively serve for only 1 additional full term. Any person appointed to fill a vacancy on the Board shall hold office for the remainder of the unexpired term of the former member.

(g) A person who has never served on the Board may be appointed to the Board 2 consecutive times, but no such person shall thereafter be eligible for 2 consecutive appointments. No person who has been twice appointed to the Board, or who has served on the Board for 6 years within any 9-year period, shall again be appointed to the Board until an interim period of at least 1 term has expired since such person last served.

(h) Any act or vote by a person appointed in violation of subsection (g) of this section shall be invalid. An amendment or revision of this chapter is not sufficient cause for any appointment or attempted appointment in violation of subsection (g) of this section, unless such amendment or revision amends this section to permit such an appointment.

(i) A member of the Board shall be suspended or removed by the Governor for misfeasance, nonfeasance or malfeasance. A member subject to disciplinary proceedings shall be disqualified from Board business until the charge is adjudicated or the matter is otherwise concluded. A Board member may appeal any suspension or removal to the Superior Court.

(j) No member of the Board shall hold any elective office in, nor be a representative of, any local, state, regional or national nursing association.

(k) The provisions set forth for "employees" in Chapter 58 of Title 29 shall apply to all members of the Board, and to all agents appointed or otherwise employed by the Board.

24 Del. C. 1953, § 1903; 54 Del. Laws, c. 153; 57 Del. Laws, c. 668, §§ 1, 12, 13; 64 Del. Laws, c. 26, § 1; 67 Del. Laws, c. 366, § 5; 67 Del. Laws, c. 368, § 10; 68 Del. Laws, c. 162, § 1; 70 Del. Laws, c. 186, § 1; 70 Del. Laws, c. 482, §§ 1, 2; 72 Del. Laws, c. 121, § 1; 77 Del. Laws, c. 420, § 1.;

§ 1904. Delaware Board of Nursing -- Election of officers; quorum; rules and regulations; special meetings; compensation; seal.

(a) The Board shall elect, annually, from its members a President and Vice-President. In the event of a vacancy in 1 of the offices, a replacement shall be elected at the next Board meeting or at a meeting called for that purpose.

(b) Eight members of the Board, including 1 officer, shall constitute a quorum.

(c) The Board may adopt and promulgate such rules and regulations as may be necessary to govern its proceedings, to define the duties of its officers and to effectuate the intent and purpose of this chapter.

(d) The members of the Board shall receive compensation for each day, or part thereof, actually engaged in service and shall be reimbursed for all proper and necessary expenses.

(e) The Board shall adopt a seal and may use that seal on official documents.

24 Del. C. 1953, § 1904; 54 Del. Laws, c. 153; 57 Del. Laws, c. 668, § 2; 64 Del. Laws, c. 26, § 1; 67 Del. Laws, c. 366, § 6; 70 Del. Laws, c. 482, §§ 3, 25.;

§ 1905. Delaware Board of Nursing -- Executive Director.

The Executive Director shall be a registered nurse with at least 5 years experience in an administrative or teaching position, have earned a master's degree in nursing, nursing education, education or a related health field.

24 Del. C. 1953, § 1905; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1; 67 Del. Laws, c. 144, § 2.;

§ 1906. Delaware Board of Nursing -- Powers and duties.

(a) The Board shall:

(1) Adopt and, from time to time, revise such rules and regulations and standards not inconsistent with the law as may be necessary to enable it to carry into effect this chapter;

(2) Approve curricula and develop criteria and standards for evaluating educational programs preparing persons for license under this chapter;

(3) Provide for surveys of such programs at such times as it may deem necessary;

(4) Approve such programs as meet the requirements of this chapter and of the Board;

(5) Deny or withdraw approval from educational programs for failure to meet approved curricula or other criteria;

(6) Examine, license and renew licenses of duly qualified applicants, including applicants for conducting nursing educational programs and shall also prescribe the procedures for subsequent examinations of applicants who fail an examination;

(7) Establish categories of advanced practice nurses which shall include, but not be limited to, pediatric nurse practitioner, family nurse practitioner, maternal-gynecological nurse practitioner, clinical specialist in psychiatric-mental health nursing, nurse anesthetist and gerontological nurse practitioner and standards for the advanced practice nurse in each category. Such standards shall take into account the type of advanced levels of nursing practice which are or may be performed and the clinical and didactic education, experience or both needed to practice safely at those levels. In setting such standards, the Board shall consult with advanced practice nurses and physicians and health care organizations utilizing advanced practice nurses. The standards shall be consistent with the national certifying organization standards of practice recognized by the Board in its rules and regulations;

(8) Issue a temporary permit to practice nursing to applicants who apply for licensure by endorsement and to new graduates awaiting results of the first licensing examination;

(9) Conduct hearings upon charges calling for discipline of a licensee or revocation of a license;

(10) Have the power to issue subpoenas and compel the attendance of witnesses, and administer oaths to persons giving testimony at hearings;

(11) Cause the prosecution of all persons violating this chapter and have the power to incur such necessary expenses therefor;

(12) Keep a record of all its proceedings;

(13) Make an annual report to the Governor;

(14) Have all of the duties, powers and authority necessary to the enforcement of this chapter, as well as such other duties, powers and authority as it may be granted from time to time by appropriate statute;

(15) Appoint advisory committees as the Board deems desirable;

(16) Maintain a system of statistics related to nursing education programs and registered nurse and licensed practical nurse licensure in the State;

(17) Participate in and pay fees to the national organization of state boards of nursing, the National Council of State Boards of Nursing, Inc.;

(18) By regulation, establish requirements for mandatory continuing education;

(19) Create a regulatory committee entitled "Joint Practice Committee" to develop rules and regulations regarding the independent practice and prescriptive authority of "advance practice nurses." The Committee shall consist of 9 members and shall be as follows:

a. The Board of Nursing shall appoint 1 public member and 5 advanced practice nurses.

b. The Board of Pharmacy shall appoint 1 pharmacist.

c. The Board of Medical Licensure and Discipline shall appoint 2 physicians;

(20) The "Joint Practice Committee" with the approval of the Board of Medical Licensure and Discipline shall have the authority to grant, restrict, suspend or revoke practice or independent prescriptive authority and the Joint Practice Committee with the approval of the Board of Medical Licensure and Discipline shall be responsible for promulgating rules and regulations to implement the provisions of this chapter regarding "advanced practice nurses" who have been granted authority for independent practice and/or independent prescriptive authority;

(21) The rules and regulations and the granting, restricting, suspension or revocation of the independent practice and/or independent prescriptive authority shall be subject to the approval of the Board of Medical Licensure and Discipline.

(b) The Board of Nursing shall promulgate regulations specifically identifying those crimes which are substantially related to the practice of nursing.

24 Del. C. 1953, § 1906; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1; 65 Del. Laws, c. 380, § 2; 67 Del. Laws, c. 10, § 1; 67 Del. Laws, c. 144, § 3; 69 Del. Laws, c. 319, §§ 8, 9; 70 Del. Laws, c. 482, §§ 4, 26; 74 Del. Laws, c. 262, § 35; 77 Del. Laws, c. 319, § 1.;

§ 1907. Delaware Board of Nursing -- Revenue and expenses.

(a) All fees and other money received by the Board shall be paid over to the State Treasurer, in accordance with Chapter 61 of Title 29.

(b) Expenses of the Board, within the limits of appropriations made to it, shall be paid by the State Treasurer upon warrants signed by the proper officers of the Board.

24 Del. C. 1953, § 1907; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1.;

§ 1908. Delaware Board of Nursing -- Meetings; examinations for licensing; nursing education programs; fees.

(a) The Board shall meet as often as necessary to carry out its responsibilities as defined in this chapter.

(b) Special meetings of the Board may be called by the Executive Director upon the request of the President or any 2 members.

(c) The Board shall consider and act upon applications to conduct a nursing education program.

(d) The amount charged for each fee imposed under this chapter shall approximate and reasonably reflect all costs necessary to defray the expenses of the Board and the proportional expenses incurred by the Division of Professional Regulation in its services on behalf of the Board. There shall be a separate fee charged for each service or activity, but no fee shall be charged for a purpose not specified in this chapter. The application fee shall not be combined with any other fee or charge. At the beginning of each calendar year, the Division of Professional Regulation, or any other state agency acting on its behalf, shall compute for each separate service or activity the appropriate Board fees for the coming year.

24 Del. C. 1953, § 1908; 54 Del. Laws, c. 153; 57 Del. Laws, c. 668, § 3; 63 Del. Laws, c. 84, § 1; 64 Del. Laws, c. 26, § 1; 70 Del. Laws, c. 482, §§ 5, 6.;

§ 1909. License requirement.

No unlicensed person, except those persons issued a temporary permit by the Board, shall practice advanced practice, professional or practical nursing. Upon request, any person engaged in the practice of advanced practice, professional or practical nursing shall exhibit a license authorizing such practice.

24 Del. C. 1953, § 1909; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1; 69 Del. Laws, c. 319, § 10.;

§ 1910. Qualifications for registered nurse.

An applicant for a license to practice as a registered nurse shall submit to the Board written evidence, verified by oath, that the applicant:

(1) Is a graduate of and holds a certificate from a State Board of Nursing approved nursing education program that is authorized to prepare persons for licensure as a registered nurse;

(2) Demonstrates competence in English related to nursing;

(3) Must show evidence of an earned high school diploma or its equivalent;

(4) Is of such satisfactory physical and mental health as is consistent with the Americans with Disabilities Act [42 U.S.C. § 12101 et. seq.];

(5) Has committed no acts which are grounds for disciplinary action as set forth in 1922(a) of this title; however, after a hearing or review of documentation demonstrating that the applicant meets the specified criteria for a waiver, the Board, by an affirmative vote of a majority of the quorum may waive § 1922(a)(2) of this title, herein, if it finds all of the following:

a. More than 5 years have elapsed since the applicant has fully discharged all imposed sentences. As used herein, the term "sentence" includes, but is not limited to, all periods of modification of a sentence, probation, parole or suspension. However, "sentence" does not include fines, restitution or community service, as long as the applicant is in substantial compliance with such fines, restitution and community service.

b. The applicant is capable of practicing nursing in a competent and professional manner.

c. The granting of a waiver will not endanger the public health, safety or welfare; and

(6) If seeking licensure by endorsement, demonstrates active employment in professional nursing in the past 5 years, or satisfactory completion of a professional nursing refresher program with an approved agency within 2 years prior to filing an application. In the event no refresher course is available the Board may consider alternate methods of evaluating current knowledge in professional nursing.

24 Del. C. 1953, § 1910; 54 Del. Laws, c. 153; 57 Del. Laws, c. 668, §§ 4, 5; 64 Del. Laws, c. 26, § 1; 70 Del. Laws, c. 482, §§ 7-9; 75 Del. Laws, c. 436, § 16; 77 Del. Laws, c. 199, § 14.;

§ 1910A. Criminal background checks of registered nurses.

The version of this statute, regarding criminal background checks of registered nurses, enacted as § 1910A of this title, by 75 Del. Laws, c. 325, § 1, was redesignated as § 1928 of this title.

§ 1911. Licensure by examination for registered nurse.

The applicant shall be required to pass the standard national examination for professional nursing. The passing score shall be as recommended by the National Council of State Boards of Nursing. Every applicant who shall pass the prescribed examination shall receive a license to practice nursing as a registered nurse.

24 Del. C. 1953, § 1911; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1; 70 Del. Laws, c. 482, § 10.;

§ 1912. Reciprocity for registered nurse.

(a) The Board may, by endorsement, without written examination, license as a registered nurse an applicant who, on or after July 1, 1983, is duly licensed as a registered nurse or is entitled to perform similar services under a different title under the laws of another state, territory or foreign country if, in the opinion of the Board, the applicant meets the qualifications specified by this chapter for registered nurses in this State.

(b) In the event the applicant has not been actively employed in professional nursing in the past 5 years, the applicant will be required to give evidence of satisfactory completion of a professional nursing refresher program with an approved agency within 2 years prior to endorsement before licensure by endorsement will be granted. In the event no refresher course is available the Board may consider alternate methods of evaluating current knowledge in professional nursing.

(c) Verification of current Delaware license is provided upon request to other state boards of nursing.

24 Del. C. 1953, § 1912; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1; 70 Del. Laws, c. 482, § 11.;

§ 1913. Registered nurses licensed under previous law.

(a) Any person holding a license to practice nursing as a registered nurse that is valid on July 1, 1983, shall be deemed to be licensed as a registered nurse under this chapter and shall be eligible for renewal of such license under the conditions and standards prescribed by § 1918 of this title.

(b) Any person eligible for reactivation or reinstatement of a license to practice nursing as a registered nurse in this state on or after July 1, 1983, shall be deemed to be eligible to be licensed as a registered nurse under this chapter and shall be eligible for renewal of such license under the conditions and standards prescribed by § 1918 of this title.

(c) Any person whose license to practice nursing as a registered nurse has lapsed in this State on or after July 1, 1983, because of failure to renew may become licensed as a registered nurse under this chapter by applying for reinstatement according to the rules and regulations established by the Board of Nursing.

(d) Any person who was licensed to practice nursing as a registered nurse and who had requested to be placed on inactive status in this State on or after July 1, 1983, may become licensed as a registered nurse under this chapter by applying for reactivation according to the rules and regulations established by the Board of Nursing.

24 Del. C. 1953, § 1916; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1.;

§ 1914. Qualifications for licensed practical nurse.

An applicant for a license to practice as a licensed practical nurse shall submit to the Board written evidence, verified by oath, that such applicant:

(1) Is a graduate of and holds a certificate from a State Board of Nursing approved practical nursing education program. The Board may, by an affirmative vote of a majority of a quorum of the Board, waive this requirement for application for licensure by endorsement if it finds clear and convincing evidence that the applicant's education, training, experience and conduct have been sufficient to overcome the deficiency in meeting this requirement;

(2) Demonstrates competence in English related to nursing;

(3) Must show evidence of an earned high school diploma or its equivalent;

(4) Is of such satisfactory physical and mental health as is consistent with the Americans with Disabilities Act [42 U.S.C. § 12101 et. seq.];

(5) Has committed no acts which are grounds for disciplinary action as set forth in § 1922(a) of this title; however, after a hearing or review of documentation demonstrating that the applicant meets the specified criteria for a waiver, the Board, by an affirmative vote of a majority of the quorum may waive § 1922(a)(2) of this title, herein, if it finds all of the following:

a. More than 5 years have elapsed since the applicant has fully discharged all imposed sentences. As used herein, the term "sentence" includes, but is not limited to, all periods of modification of a sentence, probation, parole or suspension. However, "sentence" does not include fines, restitution or community service, as long as the applicant is in substantial compliance with such fines, restitution and community service.

b. The applicant is capable of practicing nursing in a competent and professional manner.

c. The granting of a waiver will not endanger the public health, safety or welfare; and

(6) If seeking licensure by endorsement, demonstrates active employment in practical nursing in the past 5 years, or satisfactory completion of a practical nursing refresher program with an approved agency within 2 years prior to filing an application. In the event no refresher course is available the Board may consider alternate methods of evaluating current knowledge in practical nursing.

24 Del. C. 1953, § 1913; 54 Del. Laws, c. 153; 57 Del. Laws, c. 668, §§ 6, 7; 64 Del. Laws, c. 26, § 1; 70 Del. Laws, c. 482, §§ 12-14; 75 Del. Laws, c. 436, § 17; 77 Del. Laws, c. 199, § 15; 77 Del. Laws, c. 420, § 4.;

§ 1914A. Criminal background checks of licensed practical nurses [Redesignated as § 1929 of this title, effective July 1, 2007]

The version of this statute, regarding criminal background checks of licensed practical nurses, enacted by 75 Del. Laws, 325, § 2, effective July 1, 2007, was redesignated as § 1929 of this title.

§ 1915. Licensure by examination for licensed practical nurse.

The applicant shall be required to pass the standard national examination for practical nursing. The passing score shall be as recommended by the National Council of State Boards of Nursing. Every applicant who shall pass the prescribed examination shall receive a license to practice as a licensed practical nurse.

24 Del. C. 1953, § 1914; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1; 70 Del. Laws, c. 482, § 15.;

§ 1916. Reciprocity for licensed practical nurse.

(a) The Board may, by endorsement, without written examination, license as a practical nurse an applicant who, as of July 1, 1983, is duly licensed as a practical nurse or is entitled to perform similar services under a different title under the laws of another state, territory or foreign country, if in the opinion of the Board, the applicant meets the qualifications specified by this chapter for licensed practical nurses in this State.

(b) In the event the applicant has not been actively employed in practical nursing in the past 5 years, the applicant will be required to give evidence of satisfactory completion of a practical nursing refresher program within an approved agency within 2 years prior to endorsement before licensure by endorsement will be granted. In the event no refresher course is available the Board may consider alternate methods of evaluating current knowledge in practical nursing.

(c) Verification of current Delaware license is provided upon request to other state boards of nursing.

24 Del. C. 1953, § 1915; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1; 70 Del. Laws, c. 482, § 16.;

§ 1917. Licensed practical nurses licensed under previous law.

(a) Any person holding a license to practice nursing as a licensed practical nurse that is valid on July 1, 1983, shall be deemed to be licensed as a licensed practical nurse under this chapter and shall be eligible for renewal of such license under the conditions and standards prescribed by § 1918 of this title.

(b) Any person eligible for reactivation or reinstatement of a license to practice nursing as a licensed practical nurse in this State on or after July 1, 1983, shall be deemed to be eligible to be licensed as a licensed practical nurse under this chapter and shall be eligible for renewal of such license under the conditions and standards prescribed by § 1918 of this title.

(c) Any person whose license to practice nursing as a licensed practical nurse has lapsed in this State on or after July 1, 1983, because of failure to renew may become licensed as a licensed practical nurse under this chapter by applying for reinstatement according to the rules and regulations established by the Board of Nursing.

(d) Any person who was licensed to practice nursing as a licensed practical nurse and who had requested to be placed on inactive status in this State on July 1, 1983, may become licensed as a licensed practical nurse under this chapter by applying for reactivation according to the rules and regulations established by the Board of Nursing.

24 Del. C. 1953, § 1916; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1.;

§ 1918. Renewal of license; lapse of license; penalties; retirement from practice; temporary permit to practice.

(a) Every advanced practice nurse, registered or licensed practical nurse licensed under this chapter shall reregister biennially by filing an application; provided however, that the license of any licensee who is on active military duty with the armed forces of the United States and serving in a theater of hostilities on the date such application or reregistration is due shall be deemed to be current and in full compliance with this chapter until the expiration of 60 days after such licensee is no longer on active military duty in a theater of hostilities. The advanced practice nurses' independent practice and/or independent prescriptive authority shall be subject to biennial renewal upon application made to the "Joint Practice Committee." In the event the applicant has not been actively employed in professional practical nursing in the past 5 years, the applicant will be required to give evidence of satisfactory completion of a professional or practical nursing refresher program within an approved agency within 2 years prior to renewal before licensure by renewal will be granted.

(b) Upon receipt of the application and fee, the Board shall verify the accuracy of the information set forth in the application and issue to the applicant a certificate of renewal of license for 2 years, provided that the applicant has successfully completed continuing education requirements as may be established by the Board. Such certificate shall entitle the holder to engage in the practice of professional or practical nursing for the period stated therein. Any licensee whose license lapses for failure to renew the license may be reinstated by the Board upon satisfactory evidence of active employment in professional or practical nursing within the past 5 years or satisfactory completion of a refresher program in professional or practical nursing within an approved agency within a 1-year period prior to renewal and upon satisfactory explanation for the failure to renew the license and payment of a penalty fee to be determined.

(c) After a license has lapsed or been inactive for 5 or more years and the applicant has not been in active practice in professional or practical nursing in the past 5 years, the applicant will be required to give evidence of satisfactory completion of a professional or practical nursing refresher program within an approved agency within 2 years prior to reinstatement before licensure by reinstatement will be granted. In the event no refresher course is available the Board may consider alternate methods of evaluating current knowledge in professional or practical nursing.

(d) Any person practicing nursing during the time that person's license has lapsed shall be considered an illegal practitioner and shall be subject to the penalties provided for violations of this chapter.

(e) Any person licensed under this chapter who desires to retire from practice in this State shall so notify the Board. Upon receipt of such notice, the Board shall place the name of such person on a nonpracticing list. While on this list, such person shall not be required to pay any license fee, and shall not practice nursing in this State. When such person desires to resume practice, application for renewal shall be made under subsection (a) of this section and the license shall be reactivated if the requirements of the Board are met.

(f) Temporary permits to practice nursing may be issued by the Board to persons who have requested reinstatement of their license, if they have practiced nursing within the past 5 years.

(g) Every registered or licensed practical nurse licensed under this chapter primarily engaged in the practice of electrolysis shall be exempt from the requirement in subsection (a) of this section that states in the event the applicant has not been actively employed in professional practical nursing in the past 5 years, the applicant will be required to give evidence of satisfactory completion of a professional or practical nursing refresher program within 2 years prior to renewal before licensure by renewal will be granted.

24 Del. C. 1953, § 1917; 54 Del. Laws, c. 153; 57 Del. Laws, c. 668, § 8; 64 Del. Laws, c. 26, § 1; 65 Del. Laws, c. 221, § 2; 65 Del. Laws, c. 466, § 2; 69 Del. Laws, c. 319, § 11; 69 Del. Laws, c. 372, § 1; 70 Del. Laws, c. 186, § 1; 70 Del. Laws, c. 482, §§ 17-20, 27, 28.;

§ 1919. Nursing educational programs.

(a) An institution desiring to conduct a nursing education program shall apply to the Board and submit satisfactory evidence that it is ready and qualified to instruct students in the prescribed basic curriculum for educating nurses and that it is prepared to meet other standards which may be established by the Board. The Board may authorize the temporary operation of a nursing education program pending evaluation for approval. The Board shall grant approval in writing. The Board may visit and survey any nursing education program at any reasonable time.

(b) If the Board determines that any approved nursing education program is not maintaining the standards required by this chapter and by the Board, written notice thereof, specifying the deficiency and the time within which the same shall be corrected, shall immediately be given to the program. The Board shall withdraw such program's approval if it fails to correct the specified deficiency, and such nursing education program shall discontinue its operation; provided, however, that the Board shall grant a hearing to such program upon written application and extend the period for correcting specified deficiency upon good cause being shown.

(c) An approved nursing education program which plans substantive changes, as defined in the Board's rules and regulations, shall obtain the written approval of the Board prior to the date of the change.

(d) Any nursing education program in the State that is recognized as an approved program by the Board of Nursing on or after July 1, 1983, shall be deemed to be an approved education program for the purpose of this chapter.

24 Del. C. 1953, § 1918; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1.;

§ 1920. License requirements; use of abbreviations.

(a) No person shall engage in the practice of professional nursing in Delaware without being licensed by the Board, except those persons issued a temporary permit by the Board.

(b) No person shall engage in practice as an advanced practice nurse without a Board-issued license as an advanced practice nurse. Notwithstanding any provision to the contrary, the use of title and abbreviation for advanced practice nurses is authorized in accordance with the following:

(1) Only certified registered nurse anesthetists may use that title, the abbreviation "CRNA" or any other words, letters, signs or figures indicating that the person using the same is a certified registered nurse anesthetist.

(2) Only certified registered nurse practitioners may use that title, the abbreviation "CRNP" or any other words, letters, signs or figures indicating that the person using the same is a certified nurse practitioner.

(3) Only certified registered nurse midwives may use that title, the abbreviation "CNM" or any other words, letters, signs or figures indicating that the person using the same is a certified nurse midwife.

(4) Only clinical nurse specialists may use that title, the abbreviation "CNS" or any other words, letters, signs or figures indicating that the person using the same is a clinical nurse specialist.

(c) No person shall knowingly employ a graduate of a professional nursing program or a registered nurse to engage in the practice of professional nursing without a temporary permit or license from the Board.

(d) Only registered nurses shall use that title, the title "nurse", the abbreviation of "R.N." or any other words, letters, signs or figures indicating that the person using the same is a registered nurse.

(e) No person shall practice practical nursing in Delaware without being licensed by the Board, except those persons issued a temporary permit by the Board.

(f) No person shall knowingly employ a graduate of a practical nursing program or a licensed practical nurse to engage in the practice of practical nursing without a temporary permit or license from the Board.

(g) Only licensed practical nurses shall use that title, the title "nurse", the abbreviation "L.P.N." or any other words, letters, signs or figures indicating that the person using the same is a licensed practical nurse.

24 Del. C. 1953, § 1919; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1; 69 Del. Laws, c. 319, § 12; 77 Del. Laws, c. 234, §§ 1, 2.;

§ 1921. Applicability of chapter.

(a) This chapter shall not apply to the following situations:

(1) Nursing services rendered during an epidemic or a state or national disaster;

(2) The rendering of assistance by anyone in the case of an emergency;

(3) Emergency services rendered by ambulance personnel trained in advanced life support under a licensed physician's supervision as defined in Chapter 79 of Title 29. Advanced life support is defined in Chapter 79 of Title 29;

(4) The incidental care of the sick in private homes by members of the family, friends, domestic servants or persons primarily employed as housekeepers;

(5) Nursing services rendered by a student enrolled in a State Board of Nursing approved school of professional or practical nursing when these services are incidental to the course of study; or those nursing services rendered by a professional nurse or practical nurse enrolled in a State Board of Nursing approved refresher course pending reinstatement, reactivation or endorsement of licensure;

(6) The practice of nursing in this State by a nurse licensed in another state whose employment requires such nurse to accompany and care for a patient temporarily in this State, provided the nursing services are not rendered for more than 3 months within 1 year and such nurse does not claim to be licensed in this State;

(7) The practice of nursing by a nurse licensed in another state employed by the United States government or any bureau, division or agency thereof;

(8) The practice of nonmedical nursing in connection with healing by prayer or spiritual means in accordance with the tenets and practice of a well-recognized church or religious denomination, provided that persons practicing such nonmedical nursing do not claim to be licensed under this chapter;

(9) Auxiliary care services performed by nurse's aides, attendants, orderlies and other auxiliary workers in medical care facilities, or elsewhere by persons under the direction and supervision of a person licensed to practice nursing, medicine, dentistry or podiatry, and performing those services which are routine, repetitive and limited in scope, and that do not require the professional judgment of a registered nurse or a licensed practical nurse; provided, however, that nothing contained herein shall limit the right of any person to act pursuant to § 1703(e)(7) of this title, or persons employed in similar positions in the offices of podiatrists or dentists without being licensed under this chapter;

(10) Residential child care facilities regulated by the State under Title 31 where designated child care providers, who have successfully completed a Board-approved medication training program, assist children in the taking of medication, other than by injection, provided that the medication is in the original container, properly labeled. An annual report by the Administrator of the Program shall be made to the Board of Nursing. The report shall indicate compliance with guidelines as set forth in the approved course on "Assistance with Self Administration";

(11) Administration of prescription or nonprescription medications, other than by injection, by child care providers who have successfully completed a state-approved medication training program, to children in child day care homes or child day care centers regulated by the State under §§ 341-344 of Title 31; provided the medication and written permission for the administration of the particular medication has been obtained from the child's parent or legal guardian and further provided the medication is in its original container, properly labeled. Properly labeled medication shall include instructions for administration of the medication;

(12) Foster homes, group homes or adult day habilitation centers for individuals who are developmentally disabled regulated by the State under Chapter 55 of Title 16 where designated care providers, who have successfully completed a Board-approved medication training program, assist developmentally disabled clients in the taking of medication, other than by injection, provided that the medication is in the original container, properly labeled. An annual report by the Administrator of the Program shall be made to the Board of Nursing. The report shall indicate compliance with guidelines as set forth in the approved course on "Assistance with Self Administration";

(13) Nursing services rendered by a graduate of a State Board of Nursing approved school of professional or practical nursing working under supervision, pending results of the first licensing examination. The Board shall establish the procedure and extent to which subsequent examinations may be taken and the length of time and the character of nursing service which may be rendered pending subsequent examinations;

(14) Group homes for individuals who have psychiatric disabilities regulated by the State under Chapter 11 of Title 16 and other community support programs certified by the Division of Substance Abuse and Mental Health, where designated care providers, who have successfully completed a Board-approved medication training program, assist individuals who have psychiatric disabilities in the taking of medication, other than by injection, provided that the medication is in the original container, properly labeled. An annual report by the Administrator of the Program shall be made to the Board of Nursing. The report shall indicate compliance with guidelines as set forth in the approved course on "Assistance with Self Administration";

(15) The practice of any currently licensed registered nurse or licensed practical nurse of another state who provides or attends educational programs or provides consultative services within this State not to exceed 14 days in any calendar year. Neither the education nor consultation may include the provision of patient care, the direction of patient care or the affecting of patient care policies.

(16) Assisted Living agencies serving elderly persons and adults with physical disabilities regulated by the State under Chapter 11 of Title 16, where designated care providers, who have successfully completed a Board-approved medication training program, assist individuals residing in licensed assisted living facilities in the taking of medication, other than by injection, provided that the medication is in the original container, and properly labeled. An annual report by the Administrator of the Program shall be made to the Board of Nursing. The report shall indicate compliance with guidelines as set forth in the approved course on "Assistance with Self Administration";

(17) Educators who assist students with medications that are self-administered during school field trips that have completed a Board of Nursing approved training course developed by the Delaware Department of Education;

(18) Attendants providing basic and ancillary services defined and regulated by the Department of Health and Social Services in conformity with the Community-Based Attendant Services Act, Chapter 94 of Title 16;

(19) A competent individual who does not reside in a medical facility or a facility regulated pursuant to Chapter 11 of Title 16, may delegate to unlicensed persons performance of health care acts, unless of a nature excluded by the Board through regulations, provided:

a. The acts are those individuals could normally perform themselves but for functional limitations; and

b. The delegation decision is entirely voluntary.

Nothing contained herein shall diminish any legal or contractual entitlement to receive health care services from licensed or certified personnel;

(20) The providing of assistance with the self administration of medications to residents of group homes established for individuals with AIDS, provided that persons providing such assistance have successfully completed a medication training program approved by the Board. An annual report by the administrator of the program shall be made to the Board of Nursing. The report shall indicate compliance with guidelines as set forth in the approved course on "Assistance with Self-Administration".

(b) Persons involved in the rendering of electrolysis treatments shall be eligible for licensing under this chapter regardless of whether the applicant is in compliance with § 1910(6) of this title, or § 1914(6) of this title, so long as such applicants are in compliance with subdivisions (1) through (5) of either § 1910 or 1914 of this title.

24 Del. C. 1953, § 1920; 54 Del. Laws, c. 153; 57 Del. Laws, c. 634; 57 Del. Laws, c. 668, §§ 9, 10; 64 Del. Laws, c. 26, § 1; 65 Del. Laws, c. 466, § 1; 66 Del. Laws, c. 21, §§ 1, 2; 68 Del. Laws, c. 93, §§ 1-3; 68 Del. Laws, c. 162, § 2; 71 Del. Laws, c. 478, § 2; 73 Del. Laws, c. 32, § 1; 73 Del. Laws, c. 41, § 1; 73 Del. Laws, c. 193, § 3; 74 Del. Laws, c. 260, § 1; 77 Del. Laws, c. 220, § 1.;

§ 1922. Disciplinary proceedings; appeal.

(a) Grounds. -- The Board may impose any of the following sanctions (subsection (b) of this section) singly or in combination when it finds a licensee or former licensee is guilty of any offense described herein:

(1) Is guilty of fraud or deceit in procuring or attempting to procure a license to practice nursing; or

(2) Is convicted of a crime that is substantially related to the practice of nursing; or

(3) Is unfit or incompetent by reason of negligence, habits or other causes; or

(4) Is habitually intemperate or is addicted to the use of habit-forming drugs; or

(5) Is mentally incompetent; or

(6) Whose physical condition is such that the performance of nursing service is or may be injurious or prejudicial to patients or to the public; or

(7) Has had a license to practice as a registered nurse or licensed practical nurse suspended or revoked in any jurisdiction; or

(8) Is guilty of unprofessional conduct as shall be determined by the Board, or the wilful neglect of a patient; or

(9) Has wilfully or negligently violated this chapter.

(b) Disciplinary sanctions. --

(1) Permanently revoke a license to practice.

(2) Suspend a license.

(3) Censure a licensee.

(4) Issue a letter of reprimand.

(5) Place a licensee on probationary status and require the licensee to:

a. Report regularly to the Board upon the matters which are the basis of probation.

b. Limit practice to those areas prescribed by the Board.

c. Continue or renew professional education until satisfactory degree of skill has been attained in those areas which are the basis of the probation.

(6) Refuse a license.

(7) Refuse to renew a license.

(8) Or otherwise discipline.

(c) Procedure. --

(1) When a complaint is filed pursuant to § 8735 of Title 29, alleging a violation of this chapter, the complaint shall be received and investigated by the Division of Professional Regulation and the Division shall be responsible for issuing a final written report at the conclusion of its investigation.

(2) The Board shall cause a copy of the complaint, together with a notice of the time and place fixed for the hearing, to be served upon the practitioner at least 30 days before the date fixed for the hearing. In cases where the practitioner cannot be located or where personal service cannot be effected, substitute service shall be effected in the same manner as with civil litigation.

(3) In all proceedings herein:

a. The accused may be represented by counsel who shall have the right of examination and cross-examination.

b. The accused and the Board may subpoena witnesses. Subpoenas shall be issued by the President or the Vice-President of the Board upon written request and shall be served as provided by the rules of the Superior Court and shall have like effect as a subpoena issued by said Court.

c. Testimony before the Board shall be under oath. Any member of the Board shall have power to administer oaths for this purpose.

d. A stenographic record of the hearing shall be made by a qualified court reporter. At the request and expense of any party such record shall be transcribed with a copy to the other party.

e. The decision of the Board shall be based upon sufficient legal evidence. If the charges are supported by such evidence, the Board may refuse to issue, or revoke or suspend a license, or otherwise discipline a licensee. A suspended license may be reissued upon a further hearing initiated at the request of the suspended licensee by written application in accordance with the rules of the Board.

f. All decisions of the Board shall be final and conclusive. Where the practitioner is in disagreement with the action of the Board, the practitioner may appeal the Board's decision to the Superior Court within 30 days of service or of the postmarked date of the copy of the decision maile


State Codes and Statutes

State Codes and Statutes

Statutes > Delaware > Title24 > C019

TITLE 24

Professions and Occupations

CHAPTER 19. NURSING

§ 1901. Declaration of legislative intent.

The General Assembly hereby declares the practice of nursing by competent persons is necessary for the protection of the public health, safety and welfare and further finds that the levels of practice within the profession of nursing should be regulated and controlled in the public interest. In order to safeguard life and health, the general administration and supervision of the education, examination, licensing and regulation of professional and practical nursing is declared essential, and such general administration and supervision is vested in the Board of Nursing.

24 Del. C. 1953, § 1901; 54 Del. Laws, c. 153, § 1; 64 Del. Laws, c. 26, § 1; 69 Del. Laws, c. 319, § 2.;

§ 1902. Definitions.

(a) "Administration of medications" means a process whereby a single dose of a prescribed drug or biological is given to a patient by an authorized licensed person by 1 of several routes, oral, inhalation, topical, or parenteral. The person verifies the properly prescribed drug order, removes the individual dose from a previously dispensed, properly labeled container (including a unit dose container), assesses the patient's status to assure that the drug is given as prescribed to the patient for whom it is prescribed and that there are no known contraindications to the use of the drug or the dosage that has been prescribed, gives the individual dose to the proper patient, records the time and dose given and assesses the patient following the administration of medication for possible untoward side effects.

(b)(1) "Advanced practice nurse" means an individual whose education and certification meet criteria established by the Board of Nursing who is currently licensed as a registered nurse and has a master's degree or a postbasic program certificate in a clinical nursing specialty with national certification. When no national certification at the advanced level exists, a master's degree in a clinical nursing specialty will qualify an individual for advanced practice nurse licensure. "Advanced practice nurse" shall include, but not be limited to, nurse practitioners, certified registered nurse anesthetists, certified nurse midwives or clinical nurse specialists. Advanced practice nursing is the application of nursing principles, including those described in subsection (o) of this section, at an advanced level and includes:

a. For those advanced practice nurses who do not perform independent acts of diagnosis or prescription, the authority as granted within the scope of practice rules and regulations promulgated by the Board of Nursing; and

b. For those advanced practice nurses performing independent acts of diagnosis and/or prescription with the collaboration of a licensed physician, dentist, podiatrist or licensed Delaware health care delivery system without written guidelines or protocols and within the scope of practice as defined in the rules and regulations promulgated by the Joint Practice Committee and approved by the Board of Medical Licensure and Discipline.

Nothing in this act is to be construed to limit the practice of nursing by advanced practice nurses as is currently being done or allowed including nursing diagnosis as pursuant to subsection (o)(2) of this section.

Advanced practice nurses shall operate in collaboration with a licensed physician, dentist, podiatrist, or licensed Delaware health care delivery system to cooperate, coordinate, and consult with each other as appropriate pursuant to a collaborative agreement defined in the rules and regulations promulgated by the Board of Nursing, in the provision of health care to their patients. Advanced practice nurses desiring to practice independently or to prescribe independently must do so pursuant to § 1906(20) of Title 24.

(2) Those individuals who wish to engage in independent practice without written guidelines or protocols and/or wish to have independent prescriptive authority shall apply for such privilege or privileges to the Joint Practice Committee and do so only in collaboration with a licensed physician, dentist, podiatrist or licensed Delaware health care delivery system. This does not include those individuals who have protocols and/or waivers approved by the Board of Medical Licensure and Discipline.

(c) "Assistance with medications" means a situation where a designated care provider functioning in a setting authorized by § 1921 of this title, who has taken a Board approved medication training program, or a designated care provider who is otherwise exempt from the requirement of having to take the Board approved self administration with medication training programs, assists the patient in the self-administration of a medication other than by injection, provided that the medication is in the original container, with a proper label and directions. The designated care provider may hold the container for the patient, assist with the opening of the container and assist the patient in taking the medication.

(d) The "Compact Administrator" shall be the Executive Director of the Delaware Board of Nursing who shall be designated as the Compact Administrator by the President of the Board.

(e) "Dispensing" means providing medication according to an order of a practitioner duly licensed to prescribe medication. The term shall include both the repackaging and labeling of medications from bulk to individual dosages.

(f) The "Head of the Nursing Licensing Board" shall be the President of the Delaware Board of Nursing; and

(g) "Independent practice by an advanced practice nurse" shall include those advance practice nurses who practice and prescribe without written guidelines or protocols but with a collaborative agreement with a licensed physician, dentist, podiatrist or licensed Delaware health care delivery system and with the approval of the Joint Practice Committee.

(h) "Licensure" means the authorization to practice nursing within this State granted by the Delaware Board of Nursing and includes the authorization to practice in Delaware under the Interstate Nurse Licensure Compact.

(i) "Nurse educator" is a registered nurse who is a faculty member or director of a Delaware board-approved nursing education program preparing individuals at the registered nurse entry level.

(j) "Nursing diagnosis" means the description of the individual's actual or potential health needs which are identified through a nursing assessment and are amenable to nursing intervention. The focus of the nursing diagnosis is on the individual's response to illness or other factors that may adversely affect the attainment/or maintenance of wellness. These diagnostic acts are distinct from medical, osteopathic and dental diagnosis.

(k) "Nursing education program" means a course of instruction offered and conducted to prepare persons for licensure as a registered or licensed practical nurse, and/or a course of instruction offered and conducted to increase the knowledge and skills of the nurse and leads to an academic degree in nursing, and/or refresher courses in nursing.

(l) "Standards of nursing practice" means those standards of practice adopted by the Board that interpret the legal definitions of nursing, as well as provide criteria against which violations of the law can be determined. Such standards of nursing practice shall not be used to directly or indirectly affect the employment practices and deployment of personnel by duly licensed or accredited hospitals and other duly licensed or accredited health care facilities and organizations. In addition, such standards shall not be assumed the only evidence in civil malpractice litigation, nor shall they be given a different weight than any other evidence.

(m) "Substantially related" means the nature of the criminal conduct, for which the person was convicted, has a direct bearing on the fitness or ability to perform 1 or more of the duties or responsibilities necessarily related to the practice of nursing.

(n) "The practice of practical nursing" as a licensed practical nurse means the performance for compensation of nursing services by a person who holds a valid license pursuant to the terms of this chapter and who bears accountability for nursing practices which require basic knowledge of physical, social and nursing sciences. These services, at the direction of a registered nurse or a person licensed to practice medicine, surgery or dentistry, include:

(1) Observation;

(2) Assessment;

(3) Planning and giving of nursing care to the ill, injured and infirm;

(4) The maintenance of health and well being;

(5) The administration of medications and treatments prescribed by a licensed physician, dentist, podiatrist or advanced practice nurse; and

(6) Additional nursing services and supervision commensurate with the licensed practical nurse's continuing education and demonstrated competencies; and

(7) Dispensing activities only as permitted in the Board's Rules and Regulations.

Nothing contained in this chapter shall be deemed to permit acts of surgery or medical diagnosis; nor shall it be deemed to permit dispensing of drugs, medications or therapeutics independent of the supervision of a physician who is licensed to practice medicine and surgery, or those licensed to practice dentistry or podiatry.

(o) "The practice of professional nursing" as a registered nurse means the performance of professional nursing services by a person who holds a valid license pursuant to the terms of this chapter, and who bears primary responsibility and accountability for nursing practices based on specialized knowledge, judgment and skill derived from the principles of biological, physical and behavioral sciences. The registered nurse practices in the profession of nursing by the performance of activities, among which are:

(1) Assessing human responses to actual or potential health conditions;

(2) Identifying the needs of the individual and/or family by developing a nursing diagnosis;

(3) Implementing nursing interventions based on the nursing diagnosis;

(4) Teaching health care practices. Nothing contained herein shall limit other qualified persons or agencies from teaching health care practices without being licensed under this chapter;

(5) Advocating the provision of health care services through collaboration with other health service personnel;

(6) Executing regimens, as prescribed by a licensed physician, dentist, podiatrist or advanced practice nurse, including the dispensing and/or administration of medications and treatments;

(7) Administering, supervising, delegating and evaluating nursing activities.

(8) Nothing contained in this chapter shall be deemed to permit acts of surgery or medical diagnosis; nor shall it be deemed to permit dispensing of drugs, medications or therapeutics independent of the supervision of a physician who is licensed to practice medicine and surgery, or those licensed to practice dentistry or podiatry.

A registered nurse shall have the authority, as part of the practice of professional nursing, to make a pronouncement of death; provided, however, that this provision shall only apply to attending nurses caring for terminally ill patients or patients who have "do not resuscitate" orders in the home or place of residence of the deceased as a part of a hospice program or a certified home health care agency program; in a skilled nursing facility; in a residential community associated with a skilled nursing facility; any licensed assisted living community; in an extended care facility; or in a hospice; and provided that the attending physician of record has agreed in writing to permit the attending registered nurse to make a pronouncement of death in that case.

(p) "The profession of nursing" is an art and process based on a scientific body of knowledge. The practitioner of nursing assists patients in the maintenance of health, the management of illness, injury or infirmity or in the achieving of a dignified death.

24 Del. C. 1953, § 1902; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1; 67 Del. Laws, c. 5, § 2; 67 Del. Laws, c. 434, § 2; 68 Del. Laws, c. 152, § 2; 68 Del. Laws, c. 161, § 2; 69 Del. Laws, c. 319, §§ 3-7, 13; 71 Del. Laws, c. 283, § 2; 71 Del. Laws, c. 478, § 1; 72 Del. Laws, c. 334, § 2; 73 Del. Laws, c. 285, §§ 1, 2; 73 Del. Laws, c. 316, §§ 1, 2; 74 Del. Laws, c. 262, § 34; 77 Del. Laws, c. 319, § 1; 77 Del. Laws, c. 420, § 2.;

§ 1903. Delaware Board of Nursing -- Appointments; qualifications; terms of office; vacancies; suspension or removal.

(a) The Delaware Board of Nursing (hereafter referred to as the Board) shall consist of 15 members. The term of office of every member appointed to the Board, except those appointed to fill vacancies occurring during any term of office, is 3 years. The Board shall be composed of 5 registered nurses, 3 licensed practical nurses, 1 advanced practice nurse, 1 registered nurse educator, and 5 public members.

Registered nurse appointees shall have a diploma or an earned degree in nursing, nursing education or education, and at least 3 years active practice as a registered nurse in nursing service, administration or teaching.

Practical nurse appointees shall be licensed practical nurses, who are graduates of an approved school of practical nursing, with at least 3 years active practice as a practical nurse.

The public members shall be residents of Delaware for a minimum of 3 years, shall be knowledgeable about the health needs of Delaware, but shall not be licensees of any health occupation board, employees of a health care occupational board, employees of a health care facility or agency, or engaged in governance or administration of a health care facility or agency.

(b) The nursing experience referred to in this section shall have been within the last 5 years preceding appointment and said appointee must be currently licensed in Delaware.

(c) The Governor shall appoint all members to the Board of Nursing.

(d) Sixty days prior to the expiration of the term of any member of the Board, a successor shall be appointed by the Governor. A list of at least 3 nominees for each registered nurse vacancy may be furnished to the Governor by the Delaware Nurses' Association and other professional organizations in order to aid the Governor in the appointment of new members of the Board. A list of at least 3 nominees for each licensed practical nurse vacancy may be furnished to the Governor by the Delaware Licensed Practical Nurses' Association and others in the practical nursing community in order to aid the Governor in the appointment of new members of the Board. The Governor shall not be limited to the recommendations of the professional organizations in making appointments of registered or practical nurses to the Board. The Governor shall seek nominees from the consumer population for the public members appointees. Vacancies occurring for any cause other than expiration of term shall be filled by the Governor for the unexpired term as provided in this subsection.

(e) At least 1 of the professional nurse members of the Board shall be a resident of New Castle County, 1 a resident of Kent County and 1 a resident of Sussex County. Licensed practical nurse members shall be representatives of at least 2 counties simultaneously. If there is no qualified person available in the geographical subdivision, then appointments shall be made from qualified persons available in any of the other geographical subdivisions.

(f) Each member shall serve for a term of 3 years, and may successively serve for 1 additional term; provided, however, that where a member was initially appointed to fill a vacancy, such member may successively serve for only 1 additional full term. Any person appointed to fill a vacancy on the Board shall hold office for the remainder of the unexpired term of the former member.

(g) A person who has never served on the Board may be appointed to the Board 2 consecutive times, but no such person shall thereafter be eligible for 2 consecutive appointments. No person who has been twice appointed to the Board, or who has served on the Board for 6 years within any 9-year period, shall again be appointed to the Board until an interim period of at least 1 term has expired since such person last served.

(h) Any act or vote by a person appointed in violation of subsection (g) of this section shall be invalid. An amendment or revision of this chapter is not sufficient cause for any appointment or attempted appointment in violation of subsection (g) of this section, unless such amendment or revision amends this section to permit such an appointment.

(i) A member of the Board shall be suspended or removed by the Governor for misfeasance, nonfeasance or malfeasance. A member subject to disciplinary proceedings shall be disqualified from Board business until the charge is adjudicated or the matter is otherwise concluded. A Board member may appeal any suspension or removal to the Superior Court.

(j) No member of the Board shall hold any elective office in, nor be a representative of, any local, state, regional or national nursing association.

(k) The provisions set forth for "employees" in Chapter 58 of Title 29 shall apply to all members of the Board, and to all agents appointed or otherwise employed by the Board.

24 Del. C. 1953, § 1903; 54 Del. Laws, c. 153; 57 Del. Laws, c. 668, §§ 1, 12, 13; 64 Del. Laws, c. 26, § 1; 67 Del. Laws, c. 366, § 5; 67 Del. Laws, c. 368, § 10; 68 Del. Laws, c. 162, § 1; 70 Del. Laws, c. 186, § 1; 70 Del. Laws, c. 482, §§ 1, 2; 72 Del. Laws, c. 121, § 1; 77 Del. Laws, c. 420, § 1.;

§ 1904. Delaware Board of Nursing -- Election of officers; quorum; rules and regulations; special meetings; compensation; seal.

(a) The Board shall elect, annually, from its members a President and Vice-President. In the event of a vacancy in 1 of the offices, a replacement shall be elected at the next Board meeting or at a meeting called for that purpose.

(b) Eight members of the Board, including 1 officer, shall constitute a quorum.

(c) The Board may adopt and promulgate such rules and regulations as may be necessary to govern its proceedings, to define the duties of its officers and to effectuate the intent and purpose of this chapter.

(d) The members of the Board shall receive compensation for each day, or part thereof, actually engaged in service and shall be reimbursed for all proper and necessary expenses.

(e) The Board shall adopt a seal and may use that seal on official documents.

24 Del. C. 1953, § 1904; 54 Del. Laws, c. 153; 57 Del. Laws, c. 668, § 2; 64 Del. Laws, c. 26, § 1; 67 Del. Laws, c. 366, § 6; 70 Del. Laws, c. 482, §§ 3, 25.;

§ 1905. Delaware Board of Nursing -- Executive Director.

The Executive Director shall be a registered nurse with at least 5 years experience in an administrative or teaching position, have earned a master's degree in nursing, nursing education, education or a related health field.

24 Del. C. 1953, § 1905; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1; 67 Del. Laws, c. 144, § 2.;

§ 1906. Delaware Board of Nursing -- Powers and duties.

(a) The Board shall:

(1) Adopt and, from time to time, revise such rules and regulations and standards not inconsistent with the law as may be necessary to enable it to carry into effect this chapter;

(2) Approve curricula and develop criteria and standards for evaluating educational programs preparing persons for license under this chapter;

(3) Provide for surveys of such programs at such times as it may deem necessary;

(4) Approve such programs as meet the requirements of this chapter and of the Board;

(5) Deny or withdraw approval from educational programs for failure to meet approved curricula or other criteria;

(6) Examine, license and renew licenses of duly qualified applicants, including applicants for conducting nursing educational programs and shall also prescribe the procedures for subsequent examinations of applicants who fail an examination;

(7) Establish categories of advanced practice nurses which shall include, but not be limited to, pediatric nurse practitioner, family nurse practitioner, maternal-gynecological nurse practitioner, clinical specialist in psychiatric-mental health nursing, nurse anesthetist and gerontological nurse practitioner and standards for the advanced practice nurse in each category. Such standards shall take into account the type of advanced levels of nursing practice which are or may be performed and the clinical and didactic education, experience or both needed to practice safely at those levels. In setting such standards, the Board shall consult with advanced practice nurses and physicians and health care organizations utilizing advanced practice nurses. The standards shall be consistent with the national certifying organization standards of practice recognized by the Board in its rules and regulations;

(8) Issue a temporary permit to practice nursing to applicants who apply for licensure by endorsement and to new graduates awaiting results of the first licensing examination;

(9) Conduct hearings upon charges calling for discipline of a licensee or revocation of a license;

(10) Have the power to issue subpoenas and compel the attendance of witnesses, and administer oaths to persons giving testimony at hearings;

(11) Cause the prosecution of all persons violating this chapter and have the power to incur such necessary expenses therefor;

(12) Keep a record of all its proceedings;

(13) Make an annual report to the Governor;

(14) Have all of the duties, powers and authority necessary to the enforcement of this chapter, as well as such other duties, powers and authority as it may be granted from time to time by appropriate statute;

(15) Appoint advisory committees as the Board deems desirable;

(16) Maintain a system of statistics related to nursing education programs and registered nurse and licensed practical nurse licensure in the State;

(17) Participate in and pay fees to the national organization of state boards of nursing, the National Council of State Boards of Nursing, Inc.;

(18) By regulation, establish requirements for mandatory continuing education;

(19) Create a regulatory committee entitled "Joint Practice Committee" to develop rules and regulations regarding the independent practice and prescriptive authority of "advance practice nurses." The Committee shall consist of 9 members and shall be as follows:

a. The Board of Nursing shall appoint 1 public member and 5 advanced practice nurses.

b. The Board of Pharmacy shall appoint 1 pharmacist.

c. The Board of Medical Licensure and Discipline shall appoint 2 physicians;

(20) The "Joint Practice Committee" with the approval of the Board of Medical Licensure and Discipline shall have the authority to grant, restrict, suspend or revoke practice or independent prescriptive authority and the Joint Practice Committee with the approval of the Board of Medical Licensure and Discipline shall be responsible for promulgating rules and regulations to implement the provisions of this chapter regarding "advanced practice nurses" who have been granted authority for independent practice and/or independent prescriptive authority;

(21) The rules and regulations and the granting, restricting, suspension or revocation of the independent practice and/or independent prescriptive authority shall be subject to the approval of the Board of Medical Licensure and Discipline.

(b) The Board of Nursing shall promulgate regulations specifically identifying those crimes which are substantially related to the practice of nursing.

24 Del. C. 1953, § 1906; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1; 65 Del. Laws, c. 380, § 2; 67 Del. Laws, c. 10, § 1; 67 Del. Laws, c. 144, § 3; 69 Del. Laws, c. 319, §§ 8, 9; 70 Del. Laws, c. 482, §§ 4, 26; 74 Del. Laws, c. 262, § 35; 77 Del. Laws, c. 319, § 1.;

§ 1907. Delaware Board of Nursing -- Revenue and expenses.

(a) All fees and other money received by the Board shall be paid over to the State Treasurer, in accordance with Chapter 61 of Title 29.

(b) Expenses of the Board, within the limits of appropriations made to it, shall be paid by the State Treasurer upon warrants signed by the proper officers of the Board.

24 Del. C. 1953, § 1907; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1.;

§ 1908. Delaware Board of Nursing -- Meetings; examinations for licensing; nursing education programs; fees.

(a) The Board shall meet as often as necessary to carry out its responsibilities as defined in this chapter.

(b) Special meetings of the Board may be called by the Executive Director upon the request of the President or any 2 members.

(c) The Board shall consider and act upon applications to conduct a nursing education program.

(d) The amount charged for each fee imposed under this chapter shall approximate and reasonably reflect all costs necessary to defray the expenses of the Board and the proportional expenses incurred by the Division of Professional Regulation in its services on behalf of the Board. There shall be a separate fee charged for each service or activity, but no fee shall be charged for a purpose not specified in this chapter. The application fee shall not be combined with any other fee or charge. At the beginning of each calendar year, the Division of Professional Regulation, or any other state agency acting on its behalf, shall compute for each separate service or activity the appropriate Board fees for the coming year.

24 Del. C. 1953, § 1908; 54 Del. Laws, c. 153; 57 Del. Laws, c. 668, § 3; 63 Del. Laws, c. 84, § 1; 64 Del. Laws, c. 26, § 1; 70 Del. Laws, c. 482, §§ 5, 6.;

§ 1909. License requirement.

No unlicensed person, except those persons issued a temporary permit by the Board, shall practice advanced practice, professional or practical nursing. Upon request, any person engaged in the practice of advanced practice, professional or practical nursing shall exhibit a license authorizing such practice.

24 Del. C. 1953, § 1909; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1; 69 Del. Laws, c. 319, § 10.;

§ 1910. Qualifications for registered nurse.

An applicant for a license to practice as a registered nurse shall submit to the Board written evidence, verified by oath, that the applicant:

(1) Is a graduate of and holds a certificate from a State Board of Nursing approved nursing education program that is authorized to prepare persons for licensure as a registered nurse;

(2) Demonstrates competence in English related to nursing;

(3) Must show evidence of an earned high school diploma or its equivalent;

(4) Is of such satisfactory physical and mental health as is consistent with the Americans with Disabilities Act [42 U.S.C. § 12101 et. seq.];

(5) Has committed no acts which are grounds for disciplinary action as set forth in 1922(a) of this title; however, after a hearing or review of documentation demonstrating that the applicant meets the specified criteria for a waiver, the Board, by an affirmative vote of a majority of the quorum may waive § 1922(a)(2) of this title, herein, if it finds all of the following:

a. More than 5 years have elapsed since the applicant has fully discharged all imposed sentences. As used herein, the term "sentence" includes, but is not limited to, all periods of modification of a sentence, probation, parole or suspension. However, "sentence" does not include fines, restitution or community service, as long as the applicant is in substantial compliance with such fines, restitution and community service.

b. The applicant is capable of practicing nursing in a competent and professional manner.

c. The granting of a waiver will not endanger the public health, safety or welfare; and

(6) If seeking licensure by endorsement, demonstrates active employment in professional nursing in the past 5 years, or satisfactory completion of a professional nursing refresher program with an approved agency within 2 years prior to filing an application. In the event no refresher course is available the Board may consider alternate methods of evaluating current knowledge in professional nursing.

24 Del. C. 1953, § 1910; 54 Del. Laws, c. 153; 57 Del. Laws, c. 668, §§ 4, 5; 64 Del. Laws, c. 26, § 1; 70 Del. Laws, c. 482, §§ 7-9; 75 Del. Laws, c. 436, § 16; 77 Del. Laws, c. 199, § 14.;

§ 1910A. Criminal background checks of registered nurses.

The version of this statute, regarding criminal background checks of registered nurses, enacted as § 1910A of this title, by 75 Del. Laws, c. 325, § 1, was redesignated as § 1928 of this title.

§ 1911. Licensure by examination for registered nurse.

The applicant shall be required to pass the standard national examination for professional nursing. The passing score shall be as recommended by the National Council of State Boards of Nursing. Every applicant who shall pass the prescribed examination shall receive a license to practice nursing as a registered nurse.

24 Del. C. 1953, § 1911; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1; 70 Del. Laws, c. 482, § 10.;

§ 1912. Reciprocity for registered nurse.

(a) The Board may, by endorsement, without written examination, license as a registered nurse an applicant who, on or after July 1, 1983, is duly licensed as a registered nurse or is entitled to perform similar services under a different title under the laws of another state, territory or foreign country if, in the opinion of the Board, the applicant meets the qualifications specified by this chapter for registered nurses in this State.

(b) In the event the applicant has not been actively employed in professional nursing in the past 5 years, the applicant will be required to give evidence of satisfactory completion of a professional nursing refresher program with an approved agency within 2 years prior to endorsement before licensure by endorsement will be granted. In the event no refresher course is available the Board may consider alternate methods of evaluating current knowledge in professional nursing.

(c) Verification of current Delaware license is provided upon request to other state boards of nursing.

24 Del. C. 1953, § 1912; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1; 70 Del. Laws, c. 482, § 11.;

§ 1913. Registered nurses licensed under previous law.

(a) Any person holding a license to practice nursing as a registered nurse that is valid on July 1, 1983, shall be deemed to be licensed as a registered nurse under this chapter and shall be eligible for renewal of such license under the conditions and standards prescribed by § 1918 of this title.

(b) Any person eligible for reactivation or reinstatement of a license to practice nursing as a registered nurse in this state on or after July 1, 1983, shall be deemed to be eligible to be licensed as a registered nurse under this chapter and shall be eligible for renewal of such license under the conditions and standards prescribed by § 1918 of this title.

(c) Any person whose license to practice nursing as a registered nurse has lapsed in this State on or after July 1, 1983, because of failure to renew may become licensed as a registered nurse under this chapter by applying for reinstatement according to the rules and regulations established by the Board of Nursing.

(d) Any person who was licensed to practice nursing as a registered nurse and who had requested to be placed on inactive status in this State on or after July 1, 1983, may become licensed as a registered nurse under this chapter by applying for reactivation according to the rules and regulations established by the Board of Nursing.

24 Del. C. 1953, § 1916; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1.;

§ 1914. Qualifications for licensed practical nurse.

An applicant for a license to practice as a licensed practical nurse shall submit to the Board written evidence, verified by oath, that such applicant:

(1) Is a graduate of and holds a certificate from a State Board of Nursing approved practical nursing education program. The Board may, by an affirmative vote of a majority of a quorum of the Board, waive this requirement for application for licensure by endorsement if it finds clear and convincing evidence that the applicant's education, training, experience and conduct have been sufficient to overcome the deficiency in meeting this requirement;

(2) Demonstrates competence in English related to nursing;

(3) Must show evidence of an earned high school diploma or its equivalent;

(4) Is of such satisfactory physical and mental health as is consistent with the Americans with Disabilities Act [42 U.S.C. § 12101 et. seq.];

(5) Has committed no acts which are grounds for disciplinary action as set forth in § 1922(a) of this title; however, after a hearing or review of documentation demonstrating that the applicant meets the specified criteria for a waiver, the Board, by an affirmative vote of a majority of the quorum may waive § 1922(a)(2) of this title, herein, if it finds all of the following:

a. More than 5 years have elapsed since the applicant has fully discharged all imposed sentences. As used herein, the term "sentence" includes, but is not limited to, all periods of modification of a sentence, probation, parole or suspension. However, "sentence" does not include fines, restitution or community service, as long as the applicant is in substantial compliance with such fines, restitution and community service.

b. The applicant is capable of practicing nursing in a competent and professional manner.

c. The granting of a waiver will not endanger the public health, safety or welfare; and

(6) If seeking licensure by endorsement, demonstrates active employment in practical nursing in the past 5 years, or satisfactory completion of a practical nursing refresher program with an approved agency within 2 years prior to filing an application. In the event no refresher course is available the Board may consider alternate methods of evaluating current knowledge in practical nursing.

24 Del. C. 1953, § 1913; 54 Del. Laws, c. 153; 57 Del. Laws, c. 668, §§ 6, 7; 64 Del. Laws, c. 26, § 1; 70 Del. Laws, c. 482, §§ 12-14; 75 Del. Laws, c. 436, § 17; 77 Del. Laws, c. 199, § 15; 77 Del. Laws, c. 420, § 4.;

§ 1914A. Criminal background checks of licensed practical nurses [Redesignated as § 1929 of this title, effective July 1, 2007]

The version of this statute, regarding criminal background checks of licensed practical nurses, enacted by 75 Del. Laws, 325, § 2, effective July 1, 2007, was redesignated as § 1929 of this title.

§ 1915. Licensure by examination for licensed practical nurse.

The applicant shall be required to pass the standard national examination for practical nursing. The passing score shall be as recommended by the National Council of State Boards of Nursing. Every applicant who shall pass the prescribed examination shall receive a license to practice as a licensed practical nurse.

24 Del. C. 1953, § 1914; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1; 70 Del. Laws, c. 482, § 15.;

§ 1916. Reciprocity for licensed practical nurse.

(a) The Board may, by endorsement, without written examination, license as a practical nurse an applicant who, as of July 1, 1983, is duly licensed as a practical nurse or is entitled to perform similar services under a different title under the laws of another state, territory or foreign country, if in the opinion of the Board, the applicant meets the qualifications specified by this chapter for licensed practical nurses in this State.

(b) In the event the applicant has not been actively employed in practical nursing in the past 5 years, the applicant will be required to give evidence of satisfactory completion of a practical nursing refresher program within an approved agency within 2 years prior to endorsement before licensure by endorsement will be granted. In the event no refresher course is available the Board may consider alternate methods of evaluating current knowledge in practical nursing.

(c) Verification of current Delaware license is provided upon request to other state boards of nursing.

24 Del. C. 1953, § 1915; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1; 70 Del. Laws, c. 482, § 16.;

§ 1917. Licensed practical nurses licensed under previous law.

(a) Any person holding a license to practice nursing as a licensed practical nurse that is valid on July 1, 1983, shall be deemed to be licensed as a licensed practical nurse under this chapter and shall be eligible for renewal of such license under the conditions and standards prescribed by § 1918 of this title.

(b) Any person eligible for reactivation or reinstatement of a license to practice nursing as a licensed practical nurse in this State on or after July 1, 1983, shall be deemed to be eligible to be licensed as a licensed practical nurse under this chapter and shall be eligible for renewal of such license under the conditions and standards prescribed by § 1918 of this title.

(c) Any person whose license to practice nursing as a licensed practical nurse has lapsed in this State on or after July 1, 1983, because of failure to renew may become licensed as a licensed practical nurse under this chapter by applying for reinstatement according to the rules and regulations established by the Board of Nursing.

(d) Any person who was licensed to practice nursing as a licensed practical nurse and who had requested to be placed on inactive status in this State on July 1, 1983, may become licensed as a licensed practical nurse under this chapter by applying for reactivation according to the rules and regulations established by the Board of Nursing.

24 Del. C. 1953, § 1916; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1.;

§ 1918. Renewal of license; lapse of license; penalties; retirement from practice; temporary permit to practice.

(a) Every advanced practice nurse, registered or licensed practical nurse licensed under this chapter shall reregister biennially by filing an application; provided however, that the license of any licensee who is on active military duty with the armed forces of the United States and serving in a theater of hostilities on the date such application or reregistration is due shall be deemed to be current and in full compliance with this chapter until the expiration of 60 days after such licensee is no longer on active military duty in a theater of hostilities. The advanced practice nurses' independent practice and/or independent prescriptive authority shall be subject to biennial renewal upon application made to the "Joint Practice Committee." In the event the applicant has not been actively employed in professional practical nursing in the past 5 years, the applicant will be required to give evidence of satisfactory completion of a professional or practical nursing refresher program within an approved agency within 2 years prior to renewal before licensure by renewal will be granted.

(b) Upon receipt of the application and fee, the Board shall verify the accuracy of the information set forth in the application and issue to the applicant a certificate of renewal of license for 2 years, provided that the applicant has successfully completed continuing education requirements as may be established by the Board. Such certificate shall entitle the holder to engage in the practice of professional or practical nursing for the period stated therein. Any licensee whose license lapses for failure to renew the license may be reinstated by the Board upon satisfactory evidence of active employment in professional or practical nursing within the past 5 years or satisfactory completion of a refresher program in professional or practical nursing within an approved agency within a 1-year period prior to renewal and upon satisfactory explanation for the failure to renew the license and payment of a penalty fee to be determined.

(c) After a license has lapsed or been inactive for 5 or more years and the applicant has not been in active practice in professional or practical nursing in the past 5 years, the applicant will be required to give evidence of satisfactory completion of a professional or practical nursing refresher program within an approved agency within 2 years prior to reinstatement before licensure by reinstatement will be granted. In the event no refresher course is available the Board may consider alternate methods of evaluating current knowledge in professional or practical nursing.

(d) Any person practicing nursing during the time that person's license has lapsed shall be considered an illegal practitioner and shall be subject to the penalties provided for violations of this chapter.

(e) Any person licensed under this chapter who desires to retire from practice in this State shall so notify the Board. Upon receipt of such notice, the Board shall place the name of such person on a nonpracticing list. While on this list, such person shall not be required to pay any license fee, and shall not practice nursing in this State. When such person desires to resume practice, application for renewal shall be made under subsection (a) of this section and the license shall be reactivated if the requirements of the Board are met.

(f) Temporary permits to practice nursing may be issued by the Board to persons who have requested reinstatement of their license, if they have practiced nursing within the past 5 years.

(g) Every registered or licensed practical nurse licensed under this chapter primarily engaged in the practice of electrolysis shall be exempt from the requirement in subsection (a) of this section that states in the event the applicant has not been actively employed in professional practical nursing in the past 5 years, the applicant will be required to give evidence of satisfactory completion of a professional or practical nursing refresher program within 2 years prior to renewal before licensure by renewal will be granted.

24 Del. C. 1953, § 1917; 54 Del. Laws, c. 153; 57 Del. Laws, c. 668, § 8; 64 Del. Laws, c. 26, § 1; 65 Del. Laws, c. 221, § 2; 65 Del. Laws, c. 466, § 2; 69 Del. Laws, c. 319, § 11; 69 Del. Laws, c. 372, § 1; 70 Del. Laws, c. 186, § 1; 70 Del. Laws, c. 482, §§ 17-20, 27, 28.;

§ 1919. Nursing educational programs.

(a) An institution desiring to conduct a nursing education program shall apply to the Board and submit satisfactory evidence that it is ready and qualified to instruct students in the prescribed basic curriculum for educating nurses and that it is prepared to meet other standards which may be established by the Board. The Board may authorize the temporary operation of a nursing education program pending evaluation for approval. The Board shall grant approval in writing. The Board may visit and survey any nursing education program at any reasonable time.

(b) If the Board determines that any approved nursing education program is not maintaining the standards required by this chapter and by the Board, written notice thereof, specifying the deficiency and the time within which the same shall be corrected, shall immediately be given to the program. The Board shall withdraw such program's approval if it fails to correct the specified deficiency, and such nursing education program shall discontinue its operation; provided, however, that the Board shall grant a hearing to such program upon written application and extend the period for correcting specified deficiency upon good cause being shown.

(c) An approved nursing education program which plans substantive changes, as defined in the Board's rules and regulations, shall obtain the written approval of the Board prior to the date of the change.

(d) Any nursing education program in the State that is recognized as an approved program by the Board of Nursing on or after July 1, 1983, shall be deemed to be an approved education program for the purpose of this chapter.

24 Del. C. 1953, § 1918; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1.;

§ 1920. License requirements; use of abbreviations.

(a) No person shall engage in the practice of professional nursing in Delaware without being licensed by the Board, except those persons issued a temporary permit by the Board.

(b) No person shall engage in practice as an advanced practice nurse without a Board-issued license as an advanced practice nurse. Notwithstanding any provision to the contrary, the use of title and abbreviation for advanced practice nurses is authorized in accordance with the following:

(1) Only certified registered nurse anesthetists may use that title, the abbreviation "CRNA" or any other words, letters, signs or figures indicating that the person using the same is a certified registered nurse anesthetist.

(2) Only certified registered nurse practitioners may use that title, the abbreviation "CRNP" or any other words, letters, signs or figures indicating that the person using the same is a certified nurse practitioner.

(3) Only certified registered nurse midwives may use that title, the abbreviation "CNM" or any other words, letters, signs or figures indicating that the person using the same is a certified nurse midwife.

(4) Only clinical nurse specialists may use that title, the abbreviation "CNS" or any other words, letters, signs or figures indicating that the person using the same is a clinical nurse specialist.

(c) No person shall knowingly employ a graduate of a professional nursing program or a registered nurse to engage in the practice of professional nursing without a temporary permit or license from the Board.

(d) Only registered nurses shall use that title, the title "nurse", the abbreviation of "R.N." or any other words, letters, signs or figures indicating that the person using the same is a registered nurse.

(e) No person shall practice practical nursing in Delaware without being licensed by the Board, except those persons issued a temporary permit by the Board.

(f) No person shall knowingly employ a graduate of a practical nursing program or a licensed practical nurse to engage in the practice of practical nursing without a temporary permit or license from the Board.

(g) Only licensed practical nurses shall use that title, the title "nurse", the abbreviation "L.P.N." or any other words, letters, signs or figures indicating that the person using the same is a licensed practical nurse.

24 Del. C. 1953, § 1919; 54 Del. Laws, c. 153; 64 Del. Laws, c. 26, § 1; 69 Del. Laws, c. 319, § 12; 77 Del. Laws, c. 234, §§ 1, 2.;

§ 1921. Applicability of chapter.

(a) This chapter shall not apply to the following situations:

(1) Nursing services rendered during an epidemic or a state or national disaster;

(2) The rendering of assistance by anyone in the case of an emergency;

(3) Emergency services rendered by ambulance personnel trained in advanced life support under a licensed physician's supervision as defined in Chapter 79 of Title 29. Advanced life support is defined in Chapter 79 of Title 29;

(4) The incidental care of the sick in private homes by members of the family, friends, domestic servants or persons primarily employed as housekeepers;

(5) Nursing services rendered by a student enrolled in a State Board of Nursing approved school of professional or practical nursing when these services are incidental to the course of study; or those nursing services rendered by a professional nurse or practical nurse enrolled in a State Board of Nursing approved refresher course pending reinstatement, reactivation or endorsement of licensure;

(6) The practice of nursing in this State by a nurse licensed in another state whose employment requires such nurse to accompany and care for a patient temporarily in this State, provided the nursing services are not rendered for more than 3 months within 1 year and such nurse does not claim to be licensed in this State;

(7) The practice of nursing by a nurse licensed in another state employed by the United States government or any bureau, division or agency thereof;

(8) The practice of nonmedical nursing in connection with healing by prayer or spiritual means in accordance with the tenets and practice of a well-recognized church or religious denomination, provided that persons practicing such nonmedical nursing do not claim to be licensed under this chapter;

(9) Auxiliary care services performed by nurse's aides, attendants, orderlies and other auxiliary workers in medical care facilities, or elsewhere by persons under the direction and supervision of a person licensed to practice nursing, medicine, dentistry or podiatry, and performing those services which are routine, repetitive and limited in scope, and that do not require the professional judgment of a registered nurse or a licensed practical nurse; provided, however, that nothing contained herein shall limit the right of any person to act pursuant to § 1703(e)(7) of this title, or persons employed in similar positions in the offices of podiatrists or dentists without being licensed under this chapter;

(10) Residential child care facilities regulated by the State under Title 31 where designated child care providers, who have successfully completed a Board-approved medication training program, assist children in the taking of medication, other than by injection, provided that the medication is in the original container, properly labeled. An annual report by the Administrator of the Program shall be made to the Board of Nursing. The report shall indicate compliance with guidelines as set forth in the approved course on "Assistance with Self Administration";

(11) Administration of prescription or nonprescription medications, other than by injection, by child care providers who have successfully completed a state-approved medication training program, to children in child day care homes or child day care centers regulated by the State under §§ 341-344 of Title 31; provided the medication and written permission for the administration of the particular medication has been obtained from the child's parent or legal guardian and further provided the medication is in its original container, properly labeled. Properly labeled medication shall include instructions for administration of the medication;

(12) Foster homes, group homes or adult day habilitation centers for individuals who are developmentally disabled regulated by the State under Chapter 55 of Title 16 where designated care providers, who have successfully completed a Board-approved medication training program, assist developmentally disabled clients in the taking of medication, other than by injection, provided that the medication is in the original container, properly labeled. An annual report by the Administrator of the Program shall be made to the Board of Nursing. The report shall indicate compliance with guidelines as set forth in the approved course on "Assistance with Self Administration";

(13) Nursing services rendered by a graduate of a State Board of Nursing approved school of professional or practical nursing working under supervision, pending results of the first licensing examination. The Board shall establish the procedure and extent to which subsequent examinations may be taken and the length of time and the character of nursing service which may be rendered pending subsequent examinations;

(14) Group homes for individuals who have psychiatric disabilities regulated by the State under Chapter 11 of Title 16 and other community support programs certified by the Division of Substance Abuse and Mental Health, where designated care providers, who have successfully completed a Board-approved medication training program, assist individuals who have psychiatric disabilities in the taking of medication, other than by injection, provided that the medication is in the original container, properly labeled. An annual report by the Administrator of the Program shall be made to the Board of Nursing. The report shall indicate compliance with guidelines as set forth in the approved course on "Assistance with Self Administration";

(15) The practice of any currently licensed registered nurse or licensed practical nurse of another state who provides or attends educational programs or provides consultative services within this State not to exceed 14 days in any calendar year. Neither the education nor consultation may include the provision of patient care, the direction of patient care or the affecting of patient care policies.

(16) Assisted Living agencies serving elderly persons and adults with physical disabilities regulated by the State under Chapter 11 of Title 16, where designated care providers, who have successfully completed a Board-approved medication training program, assist individuals residing in licensed assisted living facilities in the taking of medication, other than by injection, provided that the medication is in the original container, and properly labeled. An annual report by the Administrator of the Program shall be made to the Board of Nursing. The report shall indicate compliance with guidelines as set forth in the approved course on "Assistance with Self Administration";

(17) Educators who assist students with medications that are self-administered during school field trips that have completed a Board of Nursing approved training course developed by the Delaware Department of Education;

(18) Attendants providing basic and ancillary services defined and regulated by the Department of Health and Social Services in conformity with the Community-Based Attendant Services Act, Chapter 94 of Title 16;

(19) A competent individual who does not reside in a medical facility or a facility regulated pursuant to Chapter 11 of Title 16, may delegate to unlicensed persons performance of health care acts, unless of a nature excluded by the Board through regulations, provided:

a. The acts are those individuals could normally perform themselves but for functional limitations; and

b. The delegation decision is entirely voluntary.

Nothing contained herein shall diminish any legal or contractual entitlement to receive health care services from licensed or certified personnel;

(20) The providing of assistance with the self administration of medications to residents of group homes established for individuals with AIDS, provided that persons providing such assistance have successfully completed a medication training program approved by the Board. An annual report by the administrator of the program shall be made to the Board of Nursing. The report shall indicate compliance with guidelines as set forth in the approved course on "Assistance with Self-Administration".

(b) Persons involved in the rendering of electrolysis treatments shall be eligible for licensing under this chapter regardless of whether the applicant is in compliance with § 1910(6) of this title, or § 1914(6) of this title, so long as such applicants are in compliance with subdivisions (1) through (5) of either § 1910 or 1914 of this title.

24 Del. C. 1953, § 1920; 54 Del. Laws, c. 153; 57 Del. Laws, c. 634; 57 Del. Laws, c. 668, §§ 9, 10; 64 Del. Laws, c. 26, § 1; 65 Del. Laws, c. 466, § 1; 66 Del. Laws, c. 21, §§ 1, 2; 68 Del. Laws, c. 93, §§ 1-3; 68 Del. Laws, c. 162, § 2; 71 Del. Laws, c. 478, § 2; 73 Del. Laws, c. 32, § 1; 73 Del. Laws, c. 41, § 1; 73 Del. Laws, c. 193, § 3; 74 Del. Laws, c. 260, § 1; 77 Del. Laws, c. 220, § 1.;

§ 1922. Disciplinary proceedings; appeal.

(a) Grounds. -- The Board may impose any of the following sanctions (subsection (b) of this section) singly or in combination when it finds a licensee or former licensee is guilty of any offense described herein:

(1) Is guilty of fraud or deceit in procuring or attempting to procure a license to practice nursing; or

(2) Is convicted of a crime that is substantially related to the practice of nursing; or

(3) Is unfit or incompetent by reason of negligence, habits or other causes; or

(4) Is habitually intemperate or is addicted to the use of habit-forming drugs; or

(5) Is mentally incompetent; or

(6) Whose physical condition is such that the performance of nursing service is or may be injurious or prejudicial to patients or to the public; or

(7) Has had a license to practice as a registered nurse or licensed practical nurse suspended or revoked in any jurisdiction; or

(8) Is guilty of unprofessional conduct as shall be determined by the Board, or the wilful neglect of a patient; or

(9) Has wilfully or negligently violated this chapter.

(b) Disciplinary sanctions. --

(1) Permanently revoke a license to practice.

(2) Suspend a license.

(3) Censure a licensee.

(4) Issue a letter of reprimand.

(5) Place a licensee on probationary status and require the licensee to:

a. Report regularly to the Board upon the matters which are the basis of probation.

b. Limit practice to those areas prescribed by the Board.

c. Continue or renew professional education until satisfactory degree of skill has been attained in those areas which are the basis of the probation.

(6) Refuse a license.

(7) Refuse to renew a license.

(8) Or otherwise discipline.

(c) Procedure. --

(1) When a complaint is filed pursuant to § 8735 of Title 29, alleging a violation of this chapter, the complaint shall be received and investigated by the Division of Professional Regulation and the Division shall be responsible for issuing a final written report at the conclusion of its investigation.

(2) The Board shall cause a copy of the complaint, together with a notice of the time and place fixed for the hearing, to be served upon the practitioner at least 30 days before the date fixed for the hearing. In cases where the practitioner cannot be located or where personal service cannot be effected, substitute service shall be effected in the same manner as with civil litigation.

(3) In all proceedings herein:

a. The accused may be represented by counsel who shall have the right of examination and cross-examination.

b. The accused and the Board may subpoena witnesses. Subpoenas shall be issued by the President or the Vice-President of the Board upon written request and shall be served as provided by the rules of the Superior Court and shall have like effect as a subpoena issued by said Court.

c. Testimony before the Board shall be under oath. Any member of the Board shall have power to administer oaths for this purpose.

d. A stenographic record of the hearing shall be made by a qualified court reporter. At the request and expense of any party such record shall be transcribed with a copy to the other party.

e. The decision of the Board shall be based upon sufficient legal evidence. If the charges are supported by such evidence, the Board may refuse to issue, or revoke or suspend a license, or otherwise discipline a licensee. A suspended license may be reissued upon a further hearing initiated at the request of the suspended licensee by written application in accordance with the rules of the Board.

f. All decisions of the Board shall be final and conclusive. Where the practitioner is in disagreement with the action of the Board, the practitioner may appeal the Board's decision to the Superior Court within 30 days of service or of the postmarked date of the copy of the decision maile