Current through Register Vol. 47, No. 17, September 10, 2024
A.
BASIS: The authority for the
promulgation of these rules and regulations by the State Board of Nursing is
set forth in sections
12-20-202(3),
12-20-204(1),
12-255-107(1)(b),(d) and
(j),
12-255-109,
12-255-110,
12-255-114,
12-255-115, and
12-255-121, C.R.S.
B.
PURPOSE: To specify
requirements for obtaining and maintaining professional and practical nursing
licensure.
C.
DEFINITIONS:
For the purposes of Rule 1.1 , the following terms have the
indicated meaning:
1. Applicant: Any
individual seeking a license to practice as a professional or practical nurse
in the State of Colorado.
2.
Approved Nursing Education Program (Approved Professional Nursing Education
Program/Approved Practical Nursing Education Program): A course of study which
implements the basic professional or practical nursing curriculum prescribed
and approved by the Board.
3.
Board: The Colorado State Board of Nursing.
4. Clinical Experience for Continuing
Competency: Any relevant experience accumulated as a practical or professional
nurse, including paid or unpaid work experience, volunteer work, or student
work. The gratuitous care of friends or members of the family is not included
in Clinical Experience.
5. Clinical
Supervision: The on-site guidance, direction, and review by a professional
nurse designated as an instructor/preceptor of the nursing care provided by a
holder of a special or student permit pursuant to Sections (H) and (I) of Rule
1.1 . This supervision includes assigning nursing responsibilities for patient
care appropriately and evaluating the competency of the individual
nurse.
6. Encumbered: Any current
form of discipline against a professional or practical license that restricts
the ability to practice, including but not limited to, fine, probation,
suspension, revocation, restriction, condition, or limitation imposed on a
license.
7. Executive Officer: The
executive administrator of the Board appointed by the Director of the Division
of Professions and Occupations pursuant to section
12-255-106, C.R.S. The Executive
Officer has been delegated authority to administer examinations, issue licenses
by endorsement and examination, renew licenses, reinstate licenses, inactivate
and reactivate licenses, and issue temporary licenses and permits to qualified
Applicants, and other delegated functions as stated and set forth in Board
rules and policies.
8. Graduate: An
individual who has successfully completed the requirements for a degree,
diploma, or certificate from an Approved Nursing Education Program or United
States armed services traditional nursing education program gained in military
service outlined in section
12-20-202(4),
C.R.S.
9. Licensee: An individual
licensed to practice as a professional or practical nurse by the
Board.
10. NCLEX: The National
Council Licensure Examination maintained, owned, and created by the National
Council of State Boards of Nursing.
11. Nontraditional Nursing Education Program:
A program with curricula that does not include a faculty supervised
teaching/learning component in clinical settings taught concurrently with
theoretical content.
12. Practice:
Any role which requires nursing skill and judgment.
13. Unencumbered: No current restriction on a
license to practice on any professional or practical nursing license.
D.
REQUIREMENTS FOR ALL
APPLICANTS
1. Must apply in a manner
approved by the Board.
2. Pay
application fee.
3. Submit proof of
successful completion of an Approved Nursing Education Program, as set forth in
Sections (E) and (F) of Rule 1.1.
4. Submit proof of having passed:
a. The NCLEX RN or NCLEX PN examination for
professional or practical nurses; or
b. The State Board Test Pool Examination for
Professional Nurses given between 1951 and 1982/1983; or
c. The State Board Test Pool Examination for
Practical Nurses given between 1952 and 1982/1983; or
d. A state licensing examination for
professional nurses given prior to 1951 or a state licensing examination for
practical nurses given prior to 1952.
e. In the event that Applicant examination
results are lost or destroyed through circumstances beyond the control of the
Board, the matter will be addressed and resolved by the Board on a case by case
basis.
5. Applicant must
submit fingerprints for the purpose of obtaining criminal history record
information from the Federal Bureau of Investigation and the Colorado Bureau of
Investigation responsible for retaining the state's criminal records set forth
in section
24-60-380(III)(c)(6),
C.R.S.
E.
LICENSURE BY EXAMINATION
1. A
Graduate of a Colorado Approved Professional Nursing Education Program is
eligible to take the NCLEX examination for professional or practical nursing,
provided that:
a. An official school
transcript reflecting completion of institutional requirements for the
degree/diploma/certificate and the date of completion is provided to the Board
in a secure manner;
b. All other
requirements of state law and Rule 1.1 are met.
2. A Graduate of a Colorado Approved
Practical Nursing Education Program is eligible to take the NCLEX examination
for practical nursing, provided that:
a. An
official school transcript reflecting completion of institutional requirements
for the degree/diploma/certificate and the date of completion is provided to
the Board in a secure manner;
b.
All other requirements of state law and Rule 1.1 are met.
3. A Graduate of a nursing education program
approved by a board of nursing of another state or territory of the United
States is eligible to take the NCLEX examination for professional or practical
nursing, provided that:
a. The applicant
graduated from a traditional nursing education program that was accredited by
an agency recognized by the United States Department of Education and/or
Council for Higher Education Accreditation and approved by a board of nursing
of a state or territory of the United States;
b. An official school transcript reflecting
completion of institutional requirements for the degree/diploma/certificate and
the date of completion is provided in a manner approved by the Board;
and
c. All other requirements of
state law and Rule 1.1 are met.
4. A Graduate of a United States armed
services traditional nursing education program gained in military service as
provided for in section
12-20-202(4),
C.R.S., that is determined to be substantially equivalent to the criteria set
forth in Sections (E)(1) through (E)(3) of Rule 1.1 is eligible to take the
NCLEX examination for professional or practical nursing provided that:
a. An official transcript reflecting
completion of institutional requirements for the degree/ diploma/certificate
and the date of completion is provided in a manner approved by the Board; or
satisfactory evidence of the education provided and assessed on a case by case
basis; and
b. All other
requirements of state law and Rule 1.1 are met.
5. A Graduate of a Non-traditional Nursing
Education Program may take the NCLEX if the requirements as outlined in Section
(I) of Rule 1.1 are met.
6. A
Graduate of a foreign nursing education program is eligible to take the NCLEX
examination only after:
a. Board review of
nursing education credentials as evaluated by a Board-recognized educational
credentialing agency; and
b. Having
met the standards set by the United States Department of Education on the
English competency exam.
7. Applicants must provide official school
transcripts in a manner approved by the Board. Applicants of foreign nursing
education programs must provide official school transcripts to a
Board-recognized educational credentialing agency.
8. Notwithstanding the requirements of
Section (I) of Rule 1.1 , Graduates of a Nontraditional Nursing Education
Program that were enrolled in the program on or before January 1, 2006, and
with continuous enrollment are deemed to be Graduates of an Approved Nursing
Education Program and are eligible to take the NCLEX pursuant to Section (E)(1)
of Rule 1.1. If the Graduate is unable to establish continuous enrollment, the
Graduate must comply with Section (I) of Rule 1.1.
9. Applicants once approved may take the
NCLEX a maximum of three times within three years of the date the Applicant
first took the NCLEX in any state or territory of the United States, or foreign
country. Any applicant who wishes to take the NCLEX a fourth time must:
a. Evaluate his/her deficiencies;
b. Educate and prepare him/herself
appropriately, such as, but not limited to, completing appropriate coursework,
NCLEX review, or a didactic portion of a refresher course; and
c. Submit, in writing, a petition for a
waiver to take the NCLEX a fourth time, documenting evidence of successful
completion of Sections (E)(9)(a) and (E)(9)(b) of Rule 1.1. The applicant may
also include any circumstances they wish the Board to consider. The decision to
grant or deny any such waiver is at the sole discretion of the Board. It is
anticipated that such waivers will be rare.
d. All requirements of Section (E)(9) of Rule
1.1 must be completed within two years of the date of the third NCLEX
examination date. If not completed, the application file will be
purged.
e. An applicant who has not
met criteria as set forth in Sections (E)(9)(a-d) of Rule 1.1, is not eligible
for application by examination in Colorado.
F.
LICENSURE BY ENDORSEMENT
1. Pursuant to the Occupational Credential
Portability Program under section
12-20-202(3),
C.R.S., an applicant is entitled to licensure as a professional or practical
nurse by endorsement in Colorado if the applicant has met the requirements of
Sections (D)(1), (2) and (5) of Rule 1.1 is currently licensed in good standing
in another state or U.S. territory, or through the federal government, or holds
a military occupational specialty, as defined in section
24-4-201, C.R.S., and has
submitted satisfactory proof under penalty of perjury that:
a. The applicant:
(1) Has substantially equivalent experience
or credentials that are required by Article
255 of Title
12, C.R.S.; or
(2) Has held for at least one year a current
and valid license as a professional or practical nurse in a jurisdiction with a
scope of practice that is substantially similar to the scope of practice for
professional and practical nurses specified in Article
255 of Title
12, C.R.S.
2. The Board may deny such license
if:
a. The Board demonstrates by a
preponderance of evidence, after notice and opportunity for a hearing, that the
applicant:
(1) Lacks the requisite
substantially equivalent education, experience, or credentials for a license;
or
(2) Has committed an act that
would be grounds for disciplinary action under Article
255 of Title
12, C.R.S.
3. An applicant who is not
currently licensed in good standing in another state or U.S. territory or
through the federal government is eligible for licensure as a professional or
practical nurse by endorsement in Colorado if the applicant has met the
requirements of Section (D) of Rule 1.1 (D) and:
a. Has been previously licensed in another
state or territory of the United States or through the federal government,
graduated from an Approved Nursing Education Program or a recognized military
education program approved by a board of nursing of a state or territory of the
United States, passed the NCLEX exam, and has demonstrated competency as
defined in section
12-20-202(3),
C.R.S.; or
b. Has been previously
licensed as a professional nurse in another state or territory of the United
States or through the federal government, graduated from a Nontraditional
Nursing Education Program, and has worked a minimum of 2,000 hours as a
professional nurse and has provided evidence of demonstrated continued
competency requirements as defined in section
12-20-202(3),
C.R.S.; or
c. Has an encumbered
license in another state or territory of the United States or through the
federal government, only after review and approval by the Board.
G.
REINSTATEMENT
AND REACTIVATION
1. A licensee who
does not renew his or her license within the sixty day grace period, as set
forth in section
12-20-202(1)(e),
C.R.S., will have an expired license and is ineligible to practice until such
license is reinstated.
2. A
licensee may elect inactive status in accordance with section
12-255-122, C.R.S. A licensee may
not apply for inactive status to avoid disciplinary action. Upon inactivation,
any and all authorities attached to that license will be cancelled.
3. The licensee must apply for reinstatement
or reactivation in a manner approved by the Board.
4. The licensee applying for reinstatement or
reactivation must pay an application fee.
5. A licensee who has practiced on an expired
or inactive license may be subject to disciplinary action.
6. A licensee whose license has been expired
or inactive less than two years must comply with requirements of Sections
(G)(3) and (G)(4) of Rule 1.1.
7.
An individual whose professional or practical nursing license has been inactive
or expired for two or more but less than five years must demonstrate
competency. The Program Director or designee may accept proof of competency
through 20 contact hours of continuing education for each two years without an
active license. Hours of clinical experience for clinical competency may also
be considered.
8. An individual
whose professional or practical nursing license has been expired or inactive
for five or more years must demonstrate competency. The Program Director or
designee may accept proof of competency through successful completion of
remedial or refresher courses under a restricted license as defined in (a) and
(b), below. "Successful completion" means achieving a grade of "C" or better or
the equivalent in each course. The Program Director or designee may refer any
case to an Inquiry Panel for review.
a. The
remedial or refresher courses must have medical/surgical focus, must clearly
differentiate knowledge and skill level for RNs and LPNs, and have the
following minimum content:
(1) Physical
assessment, history taking, documentation, and health information
technologies;
(2) Pharmacology,
medication administration, and IV therapy;
(3) Nursing knowledge and skills update,
based on best evidence;
(4) Legal,
ethical, and professional issues;
(5) Manage patient conditions effectively in
order to minimize sentinel events;
(6) Rapid response to critical
incidents;
(7) Prioritize cares
when caring for multiple patients; and
(8) Critical reasoning for clinical decision
making.
b. The number of
successfully completed contact hours required of each individual to demonstrate
competency prior to reinstatement, reactivation, or endorsement will be
determined by the number of years that his or her license has been inactive or
expired, as follows:
5-10 years
|
Contact Hours:
|
120 Theory (including lab) and 120 Clinical
(one-hundred percent may be conducted in a simulation environment)
|
more than 10 years
|
Contact Hours:
|
120 Theory (including lab) and 120 Clinical
(seventy-five percent may be conducted in a simulation environment); and
possible additional hours as determined by the Board on a case-by-case
basis.
|
9. Upon a petition by the licensee, and with
due consideration of the need to protect the public, the Board may accept an
alternative method for establishing competency, to include hours worked under a
temporary emergency license. The decision to accept an alternative method for
establishing competency is at the sole discretion of the Board.
10. An Applicant for reinstatement or
reactivation of advanced practice authorities must provide proof that the
licensee has maintained national certification in each Role/Specialty and
Population Focus or meets the current requirements in accordance with Rule 1.14
, or meets current requirements for prescriptive authority in accordance with
Rule 1.15.
11. An Applicant for
reinstatement or reactivation of practical nurse IV authority must meet the
current requirements for practical nurse IV authority in accordance with Rule
1.9.
H.
SPECIAL
PERMITS
1. Permits may be granted, in
the Board's discretion, to individuals possessing active and unencumbered
licenses to practice professional or practical nursing in other states or
territories of the United States, to allow for occasional nursing practice
which is patient- or procedure-specific for educational purposes and/or
clinical practice of professional development. However, if such nurse has any
established or regularly used healthcare agency connections in this state for
the provision of such services, the nurse must possess a license to practice
nursing in Colorado, except as otherwise provided in these Rules.
2. All individuals seeking a permit must
apply in a manner approved by the Board.
3. A permit may be denied if the Applicant
has committed any of the acts that would be grounds for discipline under
section 12-255-120, C.R.S.
I.
STUDENT PERMITS
1. Student permits are intended for students
in Nontraditional Nursing Education Programs who must obtain in-state clinical
training and experience.
2.
Eligibility.
a. An individual who is a
Graduate of a Nontraditional Nursing Education Program is eligible for a
student permit if:
(1) The program is
physically located in another state or territory of the United States;
and
(2) The program is accredited
by the United States Department of Education and is approved by a board of
nursing of a state or territory of the United States.
b. A student permit is not required for
persons actively enrolled in an Approved Nursing Education Program in Colorado
and who participate in clinical training as defined in Section (C)(5) of Rule
1.2 for Approval of Nursing Education Programs.
3. Nontraditional Nursing Education Program
Graduate Requirements to take the NCLEX Examination.
a. The Applicant is able to demonstrate
satisfactory completion of 750 hours of supervised clinical experience in the
role of a professional nurse; or
b.
The Applicant has an active license to practice as a practical nurse in any
state and is able to demonstrate satisfactory completion of 350 hours of
supervised clinical experience in the role of a professional nurse.
c. The required elements for satisfactory
completion of the supervised clinical experience are as follows:
(1) Acceptable clinical sites that take place
in acute care or subacute care settings, skilled nursing facilities, or other
sites as approved by the Board.
(2)
Clinical Supervision may be provided either in a traditional format with one
instructor directly overseeing a group of students or as a preceptorship
experience where a direct ongoing 1:1 relationship is established.
(3) Qualified instructor/preceptor is
educated at or above the level of the Applicant with at least two years of
experience in a practice setting and has an active, unencumbered license to
practice as a professional registered nurse in Colorado. The Applicant must
provide documentation that the instructor/preceptor meets these requirements
when he/she applies for a permit and must also provide a written agreement
between the Applicant, the preceptor, the faculty, and the facility where the
Clinical Supervision will occur.
(4) Required components of the supervised
clinical experience include:
(a) Clinical
decision making and critical thinking;
(b) Patient assessment as part of the nursing
process;
(c) Interdisciplinary
collaboration and evaluation of care evidenced in caring for multiple patients
with both predictable and unpredictable outcomes across the variety of learning
options appropriate for contemporary nursing; and
(d) Nursing delegation and
supervision.
(e) A signed, original
checklist and instructor/preceptor agreement, provided by the Board, must be
completed by the primary instructor/preceptor, documenting the Applicant's
satisfactory completion of the required components in a manner approved by the
Board.
4. Limitations of student permits.
a. Individuals practicing under a student
permit are subject to the Nurse and Nurse Aide Practice Act.
b. Student permit holders may not supervise
Licensees or other permit holders.
c. Individuals practicing under a student
permit are responsible for arranging and obtaining their own clinical
hours.
d. Individuals practicing
under a student permit may not exceed the terms of the permit.
e. A student permit may be issued for a
period of twelve consecutive months.
J.
CHANGE OF NAME AND ADDRESS
1. The licensee must supply to the Board
legal evidence of a name change within thirty days of the effective date of the
name change.
2. The licensee must
notify the Board within thirty days of any change of address. This notification
may be submitted in writing or through the Board's on-line system.
3. Any notification by the Board to licensees
required or permitted under the Nurse and Nurse Aide Practice Act, sections
12-255-101 to
134, C.R.S., or the State
Administrative Procedure Act, sections
24-4-101 to
108, C.R.S., will be addressed to the
last address provided in writing to the Board by the Licensee and any such
mailing will be deemed proper service on said licensee.
K.
INCOMPLETE APPLICATIONS
1. Any application not completed within one
year of the date of receipt of the original application expires and will be
purged.
L.
VOLUNTEER NURSE LICENSURE
1.
Applicants for Volunteer Licensure must meet all requirements of section
12-255-115, C.R.S.
a. An applicant who at the time the
application is received holds an emergency active license shall be deemed to
satisfy the requirement of holding an active license pursuant to section
12-255-115, C.R.S.
2. A licensee on volunteer status
in accordance with section
12-255-115, C.R.S., may apply to
reinstate to active status. The reinstatement application must be submitted as
described in Section (G) of Rule 1.1 and the applicant must demonstrate
competency by one of the following:
a. Proof
they have actively volunteered as a nurse during the two year period
immediately preceding application.
b. Proof they meet the Board's requirements
for demonstrated competency as defined in section
12-20-202(2),
C.R.S. Experience under an emergency active license may be considered as
evidence of competency.
M.
LICENSURE AS MILITARY SPOUSE
1. The spouse of a person who is actively
serving the in the United States Armed forces and who is stationed in Colorado
in accordance with military orders shall be entitled to a temporary license as
set forth in section
12-20-202, C.R.S.
Adopted: October 21, 2009
Revised: April 26, 2012
Effective: July 1, 2012
Revised: October 24, 2012
Effective: December 15, 2012
Revised: January 22, 2013
Effective: March 18, 2013
Revised: January 23, 2019
Effective: March 17, 2019
Revised: October 27, 2021
Effective: December 30, 2021