The Nurse Practice Act (NPA) is the body of law that governs the practice of nursing within each state and U.S. territory. This legislative framework establishes the legal parameters under which all licensed nurses must operate to ensure public safety. The NPA provides the structure for regulation, education, and licensure, defining the professional boundaries for individuals who hold a nursing title. Every nurse, from the Licensed Practical Nurse (LPN) to the Advanced Practice Registered Nurse (APRN), is bound by the specific statutes and regulations of the state where they practice.
Defining the Nurse Practice Act
The Nurse Practice Act is a statutory law, formally enacted by the state legislature. This legal foundation serves one focused purpose: protecting the consumer from unsafe or unqualified nursing practice. The Act defines what nursing is and sets the minimum educational and competency requirements for initial licensure and continued practice.
The NPA applies to every level of licensed nursing personnel, including Registered Nurses (RNs), Licensed Practical Nurses (LPNs) or Vocational Nurses (VNs), and Advanced Practice Nurses (APNs). While specifics of APN practice, such as prescriptive authority, may be detailed in separate regulations, these are linked to the foundational NPA. By defining the standards of care and professional conduct, the Act holds all practitioners accountable.
State Boards of Nursing and Enforcement
The NPA creates the State Board of Nursing (SBN), the administrative body tasked with interpreting and enforcing the Act’s provisions. The SBN translates the broad statutory law into detailed rules and regulations that govern day-to-day nursing practice. The Board manages the entire licensing process, including issuing new licenses, managing renewals, and ensuring compliance with continuing education requirements.
The SBN has the authority to investigate complaints against a nurse’s practice, initiated by patients, employers, or other professionals. If an investigation confirms a violation of the NPA, the SBN can take disciplinary actions against the nurse’s license. These actions range from issuing a public reprimand or fine to imposing probation, license suspension, or permanent revocation. The SBN also establishes specific regulations for prescriptive authority, dictating which Advanced Practice Nurses can legally write prescriptions.
Determining the Scope of Nursing Practice
The Nurse Practice Act establishes the “scope of practice,” defining the procedures and actions a nurse is legally permitted to perform. The NPA differentiates roles and responsibilities between various levels of nursing, such as distinguishing the independent functions of an RN from the more dependent functions of an LPN. This differentiation ensures that nurses only perform tasks aligned with their specific education, training, and licensure level.
Since the NPA is state-based legislation, the exact scope of practice varies significantly between states. For example, the degree of autonomy granted to an Advanced Practice Nurse regarding independent practice and prescription writing is determined by the individual state’s NPA. The Act also regulates the process of delegation, which is the transfer of authority for specific nursing tasks. Nurses must adhere to state delegation rules, maintaining accountability for patient care even when tasks are assigned to others.