AUTHORITY: Implementing the Nurse Practice Act [225 ILCS 65] and authorized by Section 2105-15(7) of the Civil Administrative Code of Illinois [20 ILCS 2105].
SOURCE: Adopted at 34 Ill. Reg. 14012, effective September 17, 2010; amended at 37 Ill. Reg. 9467, effective July 5, 2013; amended at 38 Ill. Reg. 15988, effective August 1, 2014; amended at 39 Ill. Reg. 15764, effective November 24, 2015; Subpart D recodified at 42 Ill. Reg. 17955; amended at 43 Ill. Reg. 6924, effective June 14, 2019; amended at 45 Ill. Reg. 228, effective January 4, 2021.
SUBPART A: GENERAL PROVISIONS
Section 1300.10 Definitions
The following definitions shall apply to this Part:
"Act" means the Nurse Practice Act [225 ILCS 65].
"Address of Record" means the address recorded by the Division in the applicant's or licensee's application file or license file, as maintained by the Division's licensure maintenance unit.
"Advanced Practice Registered Nurse" or "APRN" means a person who has met the qualifications for a:
certified nurse midwife (CNM);
certified nurse practitioner (CNP);
certified registered nurse anesthetist (CRNA); or
clinical nurse specialist (CNS) and has been licensed by the Division.
All advanced practice registered nurses licensed and practicing in the State of Illinois shall use the title APRN and may use specialty credentials after their name.
"APRN Practice Pending Licensure" means practice by an APRN, under a temporary permit, who is scheduled to take the National Certification Examination. This period of practice cannot exceed 6 months from date of application for the license. APRN Practice Pending Licensure does not include prescriptive authority.
"Board" means the Board of Nursing.
"Collaboration" means a process involving 2 or more health care professionals working together, each contributing one's respective area of expertise to provide more comprehensive patient care. (Section 50-10 of the Act)
"Consultation" means the process by which an advanced practice registered nurse seeks the advice or opinion of another health care professional. (Section 50-10 of the Act)
"Dentist" means a person licensed to practice dentistry under the Illinois Dental Practice Act [225 ILCS 25]. (Section 50-10 of the Act)
"Department" means the Department of Financial and Professional Regulation.
"Direction" means to give authoritative instruction to another regarding nursing interventions and/or professional responsibilities.
"Director" means the Director of the Division of Professional Regulation, with the authority delegated by the Secretary.
"Division" means the Department of Financial and Professional Regulation-Division of Professional Regulation.
"Impaired Nurse" means a nurse licensed under the Act who is unable to practice with reasonable judgment, skill and safety because of a physical or mental disability, as evidenced by a written determination or written consent based on clinical evidence, including loss of motor skills, abuse of drugs or alcohol, or a psychiatric disorder, of sufficient degree to diminish his or her ability to deliver competent patient care. (Section 50-10 of the Act)
"Licensed Practical Nurse" or "LPN" means a person who is licensed as a practical nurse under the Act and practices pratical nursing as defined by the Act. (Section 50-10 of the Act)
"Nursing Intervention" means any treatment, based on clinical nursing judgment or knowledge, that a nurse performs. An individual or entity shall not mandate that a registered professional nurse delegate a nursing intervention if the registered professional nurse determines it is inappropriate to do so. A nurse shall not be subject to disciplinary or any other adverse action for refusing to delegate a nursing intervention based on patient safety. (Section 5-10 of the Act)
"Physician" means a person licensed to practice medicine in all its branches under the Medical Practice Act of 1987 [225 ILCS 60]. (Section 50-10 of the Act)
"Physician Assistant" means a person licensed under the Physician Assistant Practice Act of 1987 [225 ILCS 95]. (Section 50-10 of the Act)
"Podiatrist" or "Podiatric Physician" means a person licensed to practice podiatry under the Podiatric Medical Practice Act of 1987 [225 ILCS 100]. (Section 50-10 of the Act)
"Professional Responsibility" includes making decisions and judgments requiring use of knowledge acquired by completion of an approved program for licensure as a practical, professional or advanced practice registered nurse.
"Registered Nurse", "Registered Professional Nurse", or "RN" means a person who is licensed as a professional nurse under the Act and practices nursing as defined by the Act.
"Secretary" means the Secretary of the Department of Financial and Professional Regulation.
(Source: Amended at 45 Ill. Reg. 228, effective January 4, 2021)
Section 1300.20 Nursing Delegation by a Registered Professional Nurse
a) For the purposes of this Section:
"Community-Based Setting" means facilities within the community where individuals, groups and populations may seek or receive assistance and/or care. These include, but are not limited to, schools, assisted living facilities, physicians' and APRNs' offices, clinics, home health, and residences where individuals receive services under the Home Health, Home Services, and Home Nursing Licensing Act [210 ILCS 55] or Hospice Program Licensing Act [210 ILCS 60]. Community-based setting does not include Home Services Agencies and Home Service Placement Agencies.
"Delegation" means transferring to a specific individual the authority to perform a specific nursing intervention, in a specific situation.
"Predictability of outcomes" means that a registered professional nurse or advanced practice registered nurse has determined that the patient's or individual's clinical status is stable and expected to improve or the patient's or individual's deteriorating condition is expected to follow a known or expected course."
"Stability" means a registered professional nurse or advanced practice registered nurse has determined that the individual's clinical status and nursing care needs are consistent. (Section 50-75(a) of the Act)
b) A registered professional nurse may:
1) Delegate nursing interventions to other registered professional nurses, licensed practical nurses, and other unlicensed personnel. The delegation should be based on the comprehensive nursing assessment that includes, but is not limited to:
A) The stability and condition of the patient;
B) The potential for harm;
C) The complexity of the nursing intervention to be delegated;
D) The predictability of outcomes; and
E) The competency of the person to whom the nursing intervention is delegated. To ensure competency, the RN may have to provide instruction to the individual or evaluate the individual's experience, training and/or education.
2) Delegate medication administration to other licensed nurses.
3) Refuse to delegate, stop, or rescind a previously authorized delegation. (Section 5-75(b) of the Act)
c) In community-based or in-home care settings, an RN may:
1) Delegate medication administration (limited to oral or subcutaneous dosage and topical or transdermal application) to unlicensed personnel, if the conditions of delegations set forth in subsection (b) are met.
2) Delegate, guide and evaluate the implementations of nursing interventions as a component of patient care coordination after completion of the comprehensive patient assessment based on analysis of the comprehensive nursing assessment data. Care coordination may occur in person, by telecommunication, or by electronic communication. (Section 5-75(b) of the Act)
d) The following actions are prohibited by this Section:
1) Mandating an RN to delegate nurse interventions when the RN has determined that it is not appropriate to do so.
2) Delegating medication administration to unlicensed personnel in any institutional or long-term facility, including but not limited to those facilities licensed by the Hospital Licensing Act [210 ILCS 85], the University of Illinois Hospital Act [110 ILCS 330], State-operated mental health hospitals, or State-operated developmental centers.
3) Delegating nursing judgement, the comprehensive patient assessment, development of a plan of care, and evaluations of care to licensed or unlicensed personnel;
4) Allowing a licensed practical nurse or unlicensed personnel to re‑delegate a nursing intervention that had been delegated to him or her by the RN. (Section 50-75(b) of the Act)
e) Practice in End Stage Renal Dialysis Facilities
1) For the purposes of this Section only, an individual working as a dialysis technician in a Medicare-certified End Stage Renal Dialysis Facility or a facility regulated under the End Stage Renal Disease Facility Act [210 ILCS 62] shall be considered a licensed individual for the purposes of delegation only under Section 50-75 of the Act. A person working to acquire the experience necessary to obtain certification under subsection (e)(2) may practice in accordance with this subsection (e) for a period of no more than 18 months so long as his or her practice is in compliance with the experience standards set forth by the entities listed in subsection (e)(2).
2) Delegation under this subsection (e) shall only be allowed if the individual receiving delegation currently holds, or is in the process of acquiring, the necessary experience to apply for and achieve one of the following certifications:
A) Certified Clinical Hemodialysis Technician (CCHT) by the Nephrology Nursing Certification Commission (NNCC);
B) Certified Hemodialysis Technician (CHT) by the Board of Nephrology Examiners Nursing and Technology (BONENT);
C) Certified in Clinical Nephrology Technology (CCNT) by the National Nephrology Certification Organization (NNCO).
3) Delegation under this subsection (e) shall not include medication administration except for saline flushes and application of topical anesthetics. All patient care provided by a certified dialysis technician practicing under this subsection (e) shall be under the direct and immediate on-site supervision of a licensed physician, advanced practice registered nurse, physician assistant or registered nurse.
4) Delegation under this subsection (e) shall also comply with any rules adopted under the End Stage Renal Disease Facility Act.
5) Nothing in this subsection (e) shall be construed to apply to any other facility or practice setting. This subsection (e) shall not be construed as granting a license under the Act and shall not allow individuals receiving delegation under this subsection (e) to use any title regulated by the Act.
f) The delegation of medication administration in a community-based setting shall be rescinded upon the discharge of the patient from the home health, home nursing, or hospice agency, or when the nurse who delegated the nursing intervention is no longer providing or coordinating the nursing clinical care.
g) An RN who has delegated a nursing intervention does not have to be physically present while the individual is performing the delegation so long as the RN has satisfied the conditions of delegation set forth in subsection (b) and is available to assist in person or by telecommunications.
(Source: Amended at 45 Ill. Reg. 228, effective January 4, 2021)