Volume 41 - Issue 39 - September 29, 2022
State of Kansas
Board of Nursing
Permanent Administrative Regulations
Article 11.—ADVANCED PRACTICE REGISTERED NURSES (APRN)
60-11-101. Definition of expanded role. Each “advanced practice registered nurse” (APRN), as defined by K.S.A. 65-1113 and amendments thereto, shall function in an expanded role to provide primary, secondary, and tertiary health care in the APRN’s role of advanced practice. Each APRN shall be authorized to make independent decisions about advanced practice nursing needs of families, patients, and clients and medical decisions. Each APRN shall be directly accountable and responsible to the consumer. (Authorized by and implementing K.S.A. 2021 Supp. 65-1113 and K.S.A. 65-1130, as amended by 2022 S Sub for HB 2279, sec. 1; effective May 1, 1984; amended March 31, 2000; amended Sept. 4, 2009; amended May 18, 2012; amended, T-60-7-18-22, July 18, 2022; amended Oct. 14, 2022.)
60-11-103. Licensure and educational requirements for advanced practice registered nurses. (a) Licensure as an advanced practice registered nurse. Each applicant for licensure as an advanced practice registered nurse shall meet the following requirements:
(1) File with the board a completed application on a form adopted by the board and pay the application fee prescribed by K.A.R. 60-11-119;
(2) be fingerprinted and submit to a state and national criminal history record check;
(3) submit proof of APRN certification in the applicant’s specific role and population focus granted by a national certifying organization that is recognized by the board and whose certification standards are approved by the board as equal to or greater than the corresponding standards established by the board for initial licensure applications submitted on and after July 1, 2023;
(4) submit proof of malpractice insurance coverage if the applicant renders professional clinical services as an APRN, unless the advanced practice registered nurse meets one of the exceptions listed in K.S.A. 65-1130 as amended by 2022 S Sub for HB 2279, sec. 1, and amendments thereto; and
(5) within 180 days after the board’s receipt of the application, submit proof that all qualifications for licensure, as specified in K.S.A. 65-1130 and K.S.A. 65-1131 and amendments thereto, have been met. If the applicant does not meet this requirement, the application shall be deemed abandoned and closed.
(b) Licensure in the roles of clinical nurse specialist, nurse anesthetist, nurse-midwife, and nurse practitioner. To be issued a license as an advanced practice registered nurse in any of the roles of advanced practice, as identified in K.A.R. 60-11-102, each applicant shall meet at least one of the following requirements:
(1) Complete a formal, post-basic nursing education program located or offered in Kansas that has been approved by the board and prepares the nurse to function in the advanced role for which application is made;
(2) complete a formal, post-basic nursing education program that is not located or offered in Kansas but is determined by the board to meet the standards for program approval established by K.A.R. 60-17-101 through 60-17-108;
(3) have completed a formal, post-basic nursing education program that is no longer in existence but is determined by the board to meet standards at least as stringent as those required for program approval by the board at the time of graduation;
(4) hold a current license to practice as an advanced practice registered nurse in the role for which application is made and demonstrate to the board’s satisfaction that both of the following requirements are met:
(A) The license was issued by a nursing licensing authority of another jurisdiction; and
(B)(i) The licensee completed a program meeting standards equal to or greater than those established by K.A.R. 60-17-101 through 60-17-108; or
(ii) the applicant has met the requirements for licensure pursuant to K.S.A. 48-3406, and amendments thereto; or
(5) complete a formal educational program of post-basic study and clinical experience that can be demonstrated by the applicant to have sufficiently prepared the applicant for practice in the role of advanced practice for which application is made. The applicant shall show that the curriculum of the program is consistent with public health and safety policy and that the program prepared individuals to perform acts generally recognized by the nursing profession as capable of being performed by persons with post-basic education in nursing.
(c) Licensure in the roles of clinical nurse specialist and nurse practitioner. Each applicant for a license as an advanced practice registered nurse in a role other than anesthesia or midwifery shall meet one of the following requirements:
(1) Have met one of the requirements of subsection (b) before July 1, 1994;
(2) if none of the requirements in subsection (b) were met before July 1, 1994, meet one of the requirements of subsection (b) and hold a baccalaureate or higher degree in nursing; or
(3) if none of the requirements in subsection (b) were met before July 1, 2002, meet one of the requirements of subsection (b) and hold a master’s or higher degree in a clinical area of nursing.
(d) Licensure in the role of nurse anesthetist. Each applicant for a license as an advanced practice registered nurse in the role of anesthesia shall meet one of the following requirements:
(1) Have met one of the requirements of subsection (b) before July 1, 2002; or
(2) if none of the requirements in subsection (b) were met before July 1, 2002, meet one of the requirements of subsection (b) and hold a master’s degree or a higher degree in nurse anesthesia or a related field.
(e) Licensure in the role of nurse-midwife. Each applicant for a license as an advanced practice registered nurse in the role of midwifery shall meet one of the following requirements:
(1) Have met one of the requirements of subsection (b) before July 1, 2000;
(2) if none of the requirements in subsection (b) were met before July 1, 2000, meet one of the requirements of subsection (b) and hold a baccalaureate degree in nursing; or
(3) if none of the requirements in subsection (b) were met before January 1, 2010, meet one of the requirements of subsection (b) and hold a master’s degree or a higher degree in nursing, midwifery, or a related field.
(f) National nursing organization certification for licensure. National nursing organizations with certification standards that meet the standard specified in paragraph (a)(3) shall be identified by the board, and a current list of national nursing organizations with certification standards approved by the board shall be maintained by the board. Any licensee may request that a certification program be considered by the board for approval and, if approved, included by the board on its list of national nursing organizations with approved certification standards.
(g) Advanced pharmacology education requirement. Each applicant who completes an advanced practice registered nurse program after January 1, 1997 shall have completed three college hours in advanced pharmacology or the equivalent.
(h) Advanced pathophysiology and advanced health assessment education requirement. Each applicant who completes an advanced practice registered nurse program after January 1, 2001 in a role other than anesthesia or midwifery shall have completed three college hours in advanced pathophysiology or its equivalent and three college hours in advanced health assessment or its equivalent.
(i) Advanced pathophysiology and advanced health assessment education requirement after July 1, 2009. Each applicant who completes an advanced practice registered nurse program after July 1, 2009 shall have completed three college hours in advanced pathophysiology or its equivalent and three college hours in advanced health assessment or its equivalent.
(j) Refresher course requirement. In spite of the provisions of subsections (b) through (i), each applicant for a license as an advanced practice registered nurse who has not gained 1,000 hours of advanced nursing practice during the five years preceding the date of application shall be required to successfully complete a refresher course as defined by the board.
(k) Verification of current Kansas license. Verification of a current Kansas license shall be provided to other state boards upon the applicant’s request and payment of the fee prescribed by K.A.R. 60-4-101.
(l) Licensure for endorsement pursuant to K.S.A. 48-3406, and amendments thereto.
(1) The applicant shall demonstrate scope of practice as defined in K.S.A. 65-1130 and amendments thereto, K.A.R. 60-11-104, K.A.R. 60-11-104a, K.A.R. 60-11-105, and K.A.R. 60-11-106.
(2) “Active practice” shall mean that in a calendar year, the applicant worked for at least 1,000 hours in the scope of practice for which licensure is sought.
(m) Temporary emergency licensure. Each applicant for a temporary emergency license shall submit an application on a form adopted by the board to practice advanced nursing during a state of emergency declared by the legislature and submit proof that either of the following qualifications for licensure has been met:
(1) For licensure as a registered professional nurse, the applicant is currently licensed or has been licensed as a registered professional nurse by a state licensing board within five years of the application date.
(2) For licensure as an advanced practice registered nurse, the applicant is currently licensed or has been licensed as an advanced practice registered nurse by a state licensing board within five years of the application date, passed a course in cardiopulmonary resuscitation (CPR) for humans, has a current CPR certificate, and has the skills required to practice advanced practice nursing during the state of emergency declared by the legislature. (Authorized by K.S.A. 65-1130, as amended by 2022 S Sub for HB 2279, sec. 1, K.S.A. 65-1131, and K.S.A. 2021 Supp. 48-3406; implementing K.S.A. 2021 Supp. 65-1118, K.S.A. 65-1130, as amended by 2022 S Sub for HB 2279, sec. 1, K.S.A. 65-1131, K.S.A. 2021 Supp. 48-3406, K.S.A. 2021 Supp. 74-1106, and K.S.A. 74-1112; effective May 1, 1984; amended, T-85-16, June 5, 1984; amended May 1, 1985; amended, T-60-11-14-90, Nov. 14, 1990; amended, T-60-3-14-91, March 14, 1991; amended Sept. 2, 1991; amended March 9, 1992; amended Sept. 14, 1992; amended April 26, 1993; amended Sept. 6, 1994; amended Jan. 3, 1997; amended March 31, 2000; amended Sept. 4, 2009; amended May 18, 2012; amended, T-60-1-26-22, Jan. 26, 2022; amended May 6, 2022; amended, T-60-6-30-22, July 1, 2022; amended Oct. 14, 2022.)
60-11-104. Functions of the advanced practice registered nurse in the role of nurse practitioner. Each advanced practice registered nurse in the role of nurse practitioner shall function in an advanced role at a specialized level, through the application of advanced knowledge and skills and shall be authorized to perform the following:
(a) Provide health promotion and maintenance, disease prevention, and independent nursing diagnosis, as defined in K.S.A. 65-1113 and amendments thereto, and treatment, as defined in K.S.A. 65-1113 and amendments thereto, of acute and chronic diseases;
(b) develop and manage the medical plan of care for patients or clients;
(c) provide health care services for which the nurse practitioner is educationally prepared and for which competency has been established and maintained. Educational preparation may include academic coursework, workshops, institutes, and seminars if theory or clinical experience, or both, are included;
(d) provide health care for individuals by managing health problems encountered by patients and clients; and
(e) provide innovation in evidence-based nursing practice based upon advanced clinical expertise, decision making, and leadership skills and serve as a consultant, researcher, and patient advocate for individuals, families, groups, and communities to achieve quality, cost-effective patient outcomes and solutions. (Authorized by and implementing K.S.A. 2021 Supp. 65-1113 and K.S.A. 65-1130, as amended by 2022 S Sub for HB 2279, sec. 1; effective May 1, 1984; amended, T-85-16, June 5, 1984; amended May 1, 1985; amended Sept. 4, 2009; amended May 18, 2012; amended, T-60-7-18-22, July 18, 2022; amended Oct. 14, 2022.)
60-11-104a. Prescription orders. (a) Any advanced practice registered nurse may perform the following:
(1) Prescribe durable medical equipment;
(2) prescribe, procure, and administer any drug consistent with the licensee’s specific role and population focus, except any drug that is intended to cause an abortion; and
(3) prescribe, procure, or administer any drug that is a controlled substance in accordance with the uniform controlled substances act as specified in K.S.A. 65-4101, and amendments thereto.
(b) Each prescription order in written form shall meet the following requirements:
(1) Include the name, address, and telephone number of the practice location of the advanced practice registered nurse;
(2) be signed by the advanced practice registered nurse with the letters A.P.R.N.; and
(3) contain the D.E.A. registration number issued to the advanced practice registered nurse when a controlled substance, as defined in K.S.A. 65-4101 and amendments thereto, is prescribed.
(c) Nothing in this regulation shall be construed to prohibit any registered nurse or licensed practical nurse or advanced practice registered nurse from conveying a prescription order orally or administering a drug if acting under the lawful direction of a person licensed to practice either medicine and surgery or dentistry or licensed as an advanced practice registered nurse.
(d) When used in this regulation, terms shall be construed to have the meanings specified in K.S.A. 65-1626, and amendments thereto. (Authorized by and implementing K.S.A. 65-1130, as amended by 2022 S Sub for HB 2279, sec. 1; effective, T-60-9-12-88, Sept. 12, 1988; effective Feb. 13, 1989; amended May 7, 1990; amended Jan. 3, 1995; amended March 31, 2000; amended May 18, 2012; amended, T-60-6-30-22, July 1, 2022; amended Oct. 14, 2022.)
60-11-105. Functions of the advanced practice registered nurse in the role of nurse-midwife. Each advanced practice registered nurse in the role of nurse-midwife shall function in an advanced role through the application of advanced skills and knowledge of women’s health care through the life span and shall be authorized to perform the following:
(a) Provide independent nursing diagnosis, as defined in K.S.A. 65-1113 and amendments thereto, and treatment, as defined in K.S.A. 65-1113 and amendments thereto;
(b) develop and manage the medical plan of care for patients or clients;
(c) provide health care services for which the nurse-midwife is educationally prepared and for which competency has been established and maintained. Educational preparation may include academic coursework, workshops, institutes, and seminars if theory or clinical experience, or both, are included;
(d) in a manner consistent with subsection (c), provide health care for women, focusing on gynecological needs, pregnancy, childbirth, the postpartum period, care of the newborn, and family planning, including indicated partner evaluation, treatment, and referral for infertility and sexually transmitted diseases; and
(e) provide innovation in evidence-based nursing practice based upon advanced clinical expertise, decision making, and leadership skills and serve as a consultant, researcher, and patient advocate for individuals, families, groups, and communities to achieve quality, cost-effective patient outcomes and solutions. (Authorized by and implementing K.S.A. 2021 Supp. 65-1113 and K.S.A. 65-1130, as amended by 2022 S Sub for HB 2279, sec. 1; effective May 1, 1984; amended, T-85-16, June 5, 1984; amended May 1, 1985; amended Sept. 4, 2009; amended May 18, 2012; amended, T-60-7-18-22, July 18, 2022; amended Oct. 14, 2022.)
60-11-107. Functions of the advanced practice registered nurse in the role of clinical nurse specialist. Each advanced practice registered nurse in the role of clinical nurse specialist shall function in an advanced role to provide evidence-based nursing practice within a specialty area focused on specific patients or clients, populations, settings, and types of care. Each clinical nurse specialist shall be authorized to perform the following:
(a) Provide independent nursing diagnosis, as defined in K.S.A. 65-1113 and amendments thereto, and treatment, as defined in K.S.A. 65-1113 and amendments thereto;
(b) develop and manage the medical plan of care for patients or clients;
(c) provide health care services for which the clinical nurse specialist is educationally prepared and for which competency has been established and maintained. Educational preparation may include academic coursework, workshops, institutes, and seminars if theory or clinical experience, or both, are included;
(d) provide care for specific patients or clients or specific populations, or both, utilizing a broad base of advanced scientific knowledge, nursing theory, and skills in assessing, planning, implementing, and evaluating health and nursing care; and
(e) provide innovation in evidence-based nursing practice based upon advanced clinical expertise, decision making, and leadership skills and serve as a consultant, researcher, and patient advocate for individuals, families, groups, and communities to achieve quality, cost-effective patient outcomes and solutions. (Authorized by and implementing K.S.A. 2021 Supp. 65-1113 and K.S.A. 65-1130, as amended by 2022 S Sub for HB 2279, sec. 1; effective May 1, 1984; amended, T-85-16, June 5, 1984; amended May 1, 1985; amended Sept. 4, 2009; amended May 18, 2012; amended, T-60-7-18-22, July 18, 2022; amended Oct. 14, 2022.)
60-11-113. License renewal. (a) Advanced practice registered nurse licenses shall be renewed on the same biennial cycle as the cycle for the registered professional nurse licensure renewal, as specified in K.A.R. 60-3-108.
(b) On and after January 1, 2013, each individual renewing a license shall have completed the required 30 contact hours of approved continuing nursing education (CNE) related to the advanced practice registered nurse role during the most recent prior license period. Proof of completion of 30 contact hours of approved CNE in the advanced practice nurse role may be requested by the board. Contact hours accumulated in excess of the 30-hour requirement shall not be carried over to the next renewal period.
(c) The number of contact hours assigned to any offering that includes a recognized standard curriculum shall be determined by the board.
(d) Any individual attending any offering not previously approved by the board may submit an application for an individual offering approval (IOA). Credit may be given for offerings that the licensee demonstrates as having a relationship to the practice of the advanced practice registered nursing role. Each separate offering shall be approved before the individual submits the license renewal application.
(e) Approval shall not be granted for identical offerings completed within the same license renewal period.
(f) Any individual renewing a license may accumulate 15 contact hours of the required CNE from instructor credit. Each presenter shall receive instructor credit only once for the preparation and presentation of each course. The provider shall issue a certificate listing the number of contact hours earned and clearly identifying the hours as instructor credit.
(g) Fractions of contact hours may be accepted for offerings over 30 minutes.
(h) All CNE accumulated for APRN license renewal shall also be applicable to the renewal of the registered professional nurse license.
(i) Any APRN whose initial licensure is before July 1, 2023 may submit evidence of APRN certification to the board upon license renewal.
(j) An APRN shall provide proof of malpractice insurance coverage when renewing the license if the APRN renders professional clinical services, unless the advanced practice registered nurse meets one of the exceptions listed in K.S.A. 65-1130 as amended by 2022 S Sub for HB 2279, sec. 1, and amendments thereto. (Authorized by K.S.A. 2021 Supp. 65-1117, K.S.A. 65-1129, and K.S.A. 65-1130, as amended by 2022 S Sub for HB 2279, sec. 1; implementing K.S.A. 2021 Supp. 65-1117, K.S.A. 65-1130, as amended by 2022 S Sub for HB 2279, sec. 1, and K.S.A. 65-1132; effective Sept. 2, 1991; amended May 9, 1994; amended July 29, 2005; amended May 18, 2012; amended, T-60-6-30-22, July 1, 2022; amended Oct. 14, 2022.)
Carol Moreland, MSN, RN
Executive Director
Doc. No. 050546
