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 [Effective until fulfillment of the contingency in 85 Del. Laws, c. 459, § 4]. (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) “Advanced practice registered nurse” (“APRN”) means an individual with knowledge and skills in basic nursing education; licensure as a registered nurse (“RN”); and graduation from or completion of a graduate-level APRN program accredited by a national accrediting body and current certification by a national certifying body in the appropriate APRN role and at least 1 population focus. “Advanced practice registered nurse” includes certified nurse practitioners, certified registered nurse anesthetists, certified nurse midwives, or clinical nurse specialist. Advanced practice nursing is an expanded scope of nursing licensed as an independent licensed practitioner in a role and population focus approved by the Board of Nursing, with or without compensation or personal profit, and includes the RN scope of practice. The scope of an APRN includes performing acts of advanced assessment, diagnosing, prescribing, and ordering. Advanced practice nursing is the application of nursing principles, including those described in subsection (t) of this section. (c) “Compact Administrator” means the Executive Director of the Delaware Board of Nursing who is designated as the compact Administrator under Chapters 19A and 19B of this title. (d) “Conversion therapy” means any practice or treatment that seeks to change an individual’s sexual orientation or gender identity, as “sexual orientation” and “gender identity” are defined in § 710 of Title 19, including any effort to change behaviors or gender expressions or to eliminate or reduce sexual or romantic attractions or feelings toward individuals of the same gender. “Conversion therapy” does not mean any of the following: (1) Counseling that provides assistance to an individual who is seeking to undergo a gender transition or who is in the process of undergoing gender transition. (2) Counseling that provides an individual with acceptance, support, and understanding without seeking to change an individual’s sexual orientation or gender identity. (3) Counseling that facilitates an individual’s coping, social support, and identity exploration and development, including counseling in the form of sexual orientation-neutral interventions or gender identity-neutral interventions provided for the purpose of preventing or addressing unlawful conduct or unsafe sexual practices, without seeking to change an individual’s sexual orientation or gender identity. (e) “Dispensing” means providing medication according to an order of a practitioner duly licensed to prescribe medication. The term includes both the repackaging and labeling of medications from bulk to individual dosages. (f) “Division” means the Delaware Division of Professional Regulation. (g) “Electronic prescription” means a prescription that is generated on an electronic application and transmitted as an electronic data file. (h) “Full-practice authority,” as granted to an advanced practice registered nurse, means the collection of state practice and licensure laws that allow APRNs to evaluate patients, diagnose, order and interpret diagnostic tests, initiate and manage treatments, including prescribing medications, under exclusive licensure authority of the Delaware Board of Nursing and includes: (1) Practicing within standards established or recognized by the Board of Nursing. (2) Being accountable to patients, the nursing profession, and the Board of Nursing for complying with the requirements of this chapter and the quality of advanced nursing care rendered. (3) Recognizing limits of knowledge and experience. (4) Planning for the management of situations beyond the APRN’s expertise. (5) Consultation with or referring patients to other health-care providers as appropriate. (i) “Head of the Nursing Licensing Board” means the President of the Delaware Board of Nursing. (j) “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 [Chapter 19A of this title]. (k) “Limited lay administration of medications (LLAM)” means a process by which LLAM trained unlicensed assistive personnel, functioning in a setting authorized by § 1932 of this title, give a prescribed medication to clients, patients, residents, or students as ordered by a licensed practitioner authorized to prescribe medications or gives a nonprescription medication pursuant to the Delacare regulations. ( l ) “LLAM trained unlicensed assistive personnel (UAP)” means an individual who has successfully completed the Board of Nursing approved LLAM course, including the core course and any program specific specialized training modules required. (m) “Nurse educator” means 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. (n) “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. (o) “Nursing education program” means a course of instruction offered and conducted to prepare persons for licensure as a registered or licensed practical nurse, 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, or refresher courses in nursing. (p) “Reproductive health services” means as defined in § 1702 of this title. (q) “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 may 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 may not be assumed the only evidence in civil malpractice litigation, nor may they be given a different weight than any other evidence. (r) “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. (s) “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 registered nurse; and (6) Additional nursing services and supervision commensurate with the licensed practical nurse’s continuing education and demonstrated competencies; (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; and (8) [Repealed.] (t) “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 or family by developing a nursing diagnosis; (3) Implementing nursing interventions based on the nursing diagnosis; (4) Teaching health-care practices. Nothing contained in this subsection limits 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 registered nurse, including the dispensing or administration of medications and treatments; (7) Administering, supervising, delegating, and evaluating nursing activities; (8) [Repealed.] (9) 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. (u) “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 the achievement 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 ; 80 Del. Laws, c. 80, §  10 ; 80 Del. Laws, c. 171 ; 80 Del. Laws, c. 172, §  1 ; 81 Del. Laws, c. 80, § 1 ; 81 Del. Laws, c. 340, § 4 ; 82 Del. Laws, c. 75, § 4 ; 82 Del. Laws, c. 261, §§  8, 16 ; 83 Del. Laws, c. 52, § 10 ; 83 Del. Laws, c. 111, § 1 ; 83 Del. Laws, c. 327, § 2 ; 85 Del. Laws, c. 456, § 1 ; § 1902 Definitions [Effective upon fulfillment of the contingency in 85 Del. Laws, c. 459, § 4]. (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) “Advanced practice registered nurse” (“APRN”) means an individual with knowledge and skills in basic nursing education; licensure as a registered nurse (“RN”); and graduation from or completion of a graduate-level APRN program accredited by a national accrediting body and current certification by a national certifying body in the appropriate APRN role and at least 1 population focus. “Advanced practice registered nurse” includes certified nurse practitioners, certified registered nurse anesthetists, certified nurse midwives, or clinical nurse specialist. Advanced practice nursing is an expanded scope of nursing licensed as an independent licensed practitioner in a role and population focus approved by the Board of Nursing, with or without compensation or personal profit, and includes the RN scope of practice. The scope of an APRN includes performing acts of advanced assessment, diagnosing, prescribing, and ordering. Advanced practice nursing is the application of nursing principles, including those described in subsection (t) of this section. (c) “Compact Administrator” means the Executive Director of the Delaware Board of Nursing who is designated as the compact Administrator under Chapters 19A and 19B of this title. (d) “Conversion therapy” means any practice or treatment that seeks to change an individual’s sexual orientation or gender identity, as “sexual orientation” and “gender identity” are defined in § 710 of Title 19, including any effort to change behaviors or gender expressions or to eliminate or reduce sexual or romantic attractions or feelings toward individuals of the same gender. “Conversion therapy” does not mean any of the following: (1) Counseling that provides assistance to an individual who is seeking to undergo a gender transition or who is in the process of undergoing gender transition. (2) Counseling that provides an individual with acceptance, support, and understanding without seeking to change an individual’s sexual orientation or gender identity. (3) Counseling that facilitates an individual’s coping, social support, and identity exploration and development, including counseling in the form of sexual orientation-neutral interventions or gender identity-neutral interventions provided for the purpose of preventing or addressing unlawful conduct or unsafe sexual practices, without seeking to change an individual’s sexual orientation or gender identity. (e) “Dispensing” means providing medication according to an order of a practitioner duly licensed to prescribe medication. The term includes both the repackaging and labeling of medications from bulk to individual dosages. (f) “Division” means the Delaware Division of Professional Regulation. (g) “Dry needling” means an intervention that meets all of the following criteria: a. Uses a thin filiform needle to penetrate the skin and stimulate underlying muscular tissue, connective tissues, and myofascial trigger points for the management of neuromusculoskeletal pain and movement impairments. b. Is based upon Western medical concepts. c. Requires an advanced practice nursing exam and diagnosis. (h) “Electronic prescription” means a prescription that is generated on an electronic application and transmitted as an electronic data file. (i) “Full-practice authority,” as granted to an advanced practice registered nurse, means the collection of state practice and licensure laws that allow APRNs to evaluate patients, diagnose, order and interpret diagnostic tests, initiate and manage treatments, including prescribing medications, under exclusive licensure authority of the Delaware Board of Nursing and includes: (1) Practicing within standards established or recognized by the Board of Nursing. (2) Being accountable to patients, the nursing profession, and the Board of Nursing for complying with the requirements of this chapter and the quality of advanced nursing care rendered. (3) Recognizing limits of knowledge and experience. (4) Planning for the management of situations beyond the APRN’s expertise. (5) Consultation with or referring patients to other health-care providers as appropriate. (j) “Head of the Nursing Licensing Board” means the President of the Delaware Board of Nursing. (k) “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 [Chapter 19A of this title]. ( l ) “Limited lay administration of medications (LLAM)” means a process by which LLAM trained unlicensed assistive personnel, functioning in a setting authorized by § 1932 of this title, give a prescribed medication to clients, patients, residents, or students as ordered by a licensed practitioner authorized to prescribe medications or gives a nonprescription medication pursuant to the Delacare regulations. (m) “LLAM trained unlicensed assistive personnel (UAP)” means an individual who has successfully completed the Board of Nursing approved LLAM course, including the core course and any program specific specialized training modules required. (n) “Nurse educator” means 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. (o) “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. (p) “Nursing education program” means a course of instruction offered and conducted to prepare persons for licensure as a registered or licensed practical nurse, 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, or refresher courses in nursing. (q) “Reproductive health services” means as defined in § 1702 of this title. (r) “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 may 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 may not be assumed the only evidence in civil malpractice litigation, nor may they be given a different weight than any other evidence. (s) “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. (t) “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 registered nurse; and (6) Additional nursing services and supervision commensurate with the licensed practical nurse’s continuing education and demonstrated competencies; (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; and (8) [Repealed.] (u) “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 or family by developing a nursing diagnosis; (3) Implementing nursing interventions based on the nursing diagnosis; (4) Teaching health-care practices. Nothing contained in this subsection limits 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 registered nurse, including the dispensing or administration of medications and treatments; (7) Administering, supervising, delegating, and evaluating nursing activities; (8) [Repealed.] (9) 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. (v) “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 the achievement of a dignified death. (w) “Trigger points” means hyperirritable spots in skeletal muscle that are associated with palpable nodules in taut bands of muscle fibers. They can give rise to local or referred pain, autonomic phenomenon, and can cause limitations in range of motion and muscle activation. 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 ; 80 Del. Laws, c. 80, §  10 ; 80 Del. Laws, c. 171 ; 80 Del. Laws, c. 172, §  1 ; 81 Del. Laws, c. 80, § 1 ; 81 Del. Laws, c. 340, § 4 ; 82 Del. Laws, c. 75, § 4 ; 82 Del. Laws, c. 261, §§  8, 16 ; 83 Del. Laws, c. 52, § 10 ; 83 Del. Laws, c. 111, § 1 ; 83 Del. Laws, c. 327, § 2 ; 85 Del. Laws, c. 456, § 1 ; 85 Del. Laws, c. 459, § 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, 1 licensed practical nurse, 1 nurse at-large which shall be either a registered nurse or licensed practical nurse, 2 advanced practice registered nurses representing different practice roles, 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. Each practical nurse appointee shall be a licensed practical nurse, who is a graduate 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 ; 79 Del. Laws, c. 368, §  1 ; 81 Del. Laws, c. 80, § 2 ; § 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) Each member of the Board shall be reimbursed for all expenses involved in each meeting, including travel, and in addition shall receive compensation per meeting attended in an amount determined by the Division in accordance with Del. Const. art. III, §  9. (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 ; 81 Del. Laws, c. 85, § 9 ; § 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 registered nurses in the roles of certified nurse practitioner (CNP), certified registered nurse anesthetist (CRNA), certified nurse midwife (CNM), and clinical nurse specialist (CNS) and in the population foci of family/individual across the lifespan, adult-gerontology, neonatal, pediatrics, women’s health/gender-related, or psychiatric/mental health. Each APRN must use the designation “APRN” plus role title as a minimum for purposes of identification and documentation. When providing nursing care, the APRN must provide clear identification that indicates their APRN designation. (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, known as the National Council of State Boards of Nursing, Inc. (18) By regulation, establish requirements for mandatory continuing education. Such requirements must mandate that all nursing professionals renew their license on or after October 1, 2025, and must complete at least 1 hour of continuing education in each reporting period on the recognition of and response to suspected or known sexual abuse, physical abuse, exploitation, trafficking, or domestic violence of vulnerable persons including, but not limited to, children, elders, or persons with intellectual, physical and developmental disabilities, or on the reporting obligations under the rules and regulations promulgated by the Board of Nursing, reporting of known or suspected child abuse or neglect under § 903 of Title 16, and any successors thereto, and any other mandatory reporting obligations required by the Board. Licensees under this chapter should consider the Delaware Child Protection Accountability Commission a resource for continuing education programming relating to child abuse, exploitation, and trafficking. (19) Administer the Advanced Practice Registered Nurse Committee. (20) Have the authority to grant, restrict, suspend, or revoke practice or prescriptive authority and be responsible for promulgating rules and regulations to implement the provisions of this chapter regarding advanced practice registered nurses who have been granted authority for independent practice or prescriptive authority. (21) Have the authority to limit the ability of APRNs to prescribe and order nonpharmacological interventions. (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. 186, §  1 ; 70 Del. Laws, c. 482, §§  4, 26 ; 74 Del. Laws, c. 262, §  35 ; 77 Del. Laws, c. 319, §  1 ; 80 Del. Laws, c. 171 ; 80 Del. Laws, c. 172, §  2 ; 83 Del. Laws, c. 422, § 2 ; 84 Del. Laws, c. 194, § 2 ; 84 Del. Laws, c. 503, § 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. 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 ; 85 Del. Laws, c. 456, § 1 ; § 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) Has earned a 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, if after consideration of the factors set forth under § 8735(x)(3) of Title 29 through a hearing or review of documentation the Board determines that granting a waiver would not create an unreasonable risk to public safety, the Board by an affirmative vote of a majority of the quorum, shall waive § 1922(a)(2) of this title. A waiver may not be granted for a conviction of a felony sexual offense; a.-e. [Repealed.] (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; and (7) Has passed the standard national examination for registered nursing. The National Council of State Boards of Nursing shall establish the passing score. 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 ; 78 Del. Laws, c. 35, §§  1, 2 ; 78 Del. Laws, c. 44, §§  28, 29 ; 81 Del. Laws, c. 80, § 3 ; 83 Del. Laws, c. 433, § 13 ; § 1911 Licensure by examination for registered nurse [Repealed]. 24 Del. C. 1953, §  1911; 54 Del. Laws, c. 153 ; 64 Del. Laws, c. 26, §  1 ; 70 Del. Laws, c. 482, §  10 ; repealed by 81 Del. Laws, c. 80, § 4, effective July 17, 2017. ; § 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 or territory of the United States or a 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 ; 81 Del. Laws, c. 80, § 5 ; § 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) Has earned a 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, the Board, by an affirmative vote of a majority of the quorum, shall waive § 1922(a)(2) of this title if, after considering the factors set forth in § 8735(x)(3) of Title 29, that the granting of a waiver would not create an unreasonable risk to public safety. A waiver may not be granted for a conviction of a felony sexual offense and a felony sexual offense shall be considered by the Board notwithstanding the time limitation set forth in § 8735(x)(4) of Title 29; a.-e. [Repealed.] (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; and (7) Has passed the standard national examination for practical nursing. The National Council of State Boards of Nursing shall establish the passing score. 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 ; 78 Del. Laws, c. 35, §§  3, 4 ; 78 Del. Laws, c. 44, §§  30, 31 ; 81 Del. Laws, c. 80, § 6 ; 81 Del. Laws, c. 425, § 16 ; 83 Del. Laws, c. 433, § 13 ; § 1915 Licensure by examination for licensed practical nurse [Repealed]. 24 Del. C. 1953, §  1914; 54 Del. Laws, c. 153 ; 64 Del. Laws, c. 26, §  1 ; 70 Del. Laws, c. 482, §  15 ; repealed by 81 Del. Laws, c. 80, § 7, effective July 17, 2017. ; § 1916 Reciprocity for licensed practical nurse. (a) The Board may, by endorsement, without written examination, license as a practical nurse an applicant who, on or after 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 or a territory of the United States or a 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 ; 81 Del. Laws, c. 80, § 8 ; § 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; late renewal; penalties; retirement from practice; temporary permit to practice; inactive status. (a) Every advanced practice registered nurse or 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 registered nurses’ licensure or prescriptive authority is subject to biennial renewal coinciding with RN license renewal. In the event the applicant has not been actively employed in professional, practical, or advanced practice registered nursing in the past 5 years, the applicant must provide evidence of satisfactory completion of an appropriate board-approved nursing refresher program within 1 year before licensure by reinstatement. APRNs who have been out of active clinical practice more than 2 years but less than 5 years must submit 24 hours of CE with 12 hours in pharmacotherapeutics and 12 hours in the clinical management of patients taken within 1 year before application. APRNs who have been out of active clinical practice more than 5 years must submit 45 hours of pharmacotherapeutics CE taken within 1 year before application and the advanced practice refresher program. In the event no advanced practice refresher program is available, the applicant must complete 600 hours of supervised clinical experience in the appropriate advanced practice role and population focus, with a qualified preceptor within 1 year before licensure by reinstatement. A qualified APRN preceptor must hold an active unencumbered license or privilege to practice as an APRN or be a physician who has an active unencumbered license and practices in a comparable practice focus in the clinical setting. (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, practical, or advanced practice registered 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, practical, or advanced practice registered nursing within the past 5 years or satisfactory completion of a refresher program 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) A license may be renewed up to 60 days past the license’s expiration date, by submitting to the Division of Professional Regulation payment of the penalty fee referred to in subsection (b) of this section and proof of completion of continuing education requirements. The license of a nurse who fails to renew on time is considered lapsed and the nurse is not permitted to work until the license is renewed. Licensees who fail to renew during the renewal period or during the 60-day late renewal period must apply for reinstatement. (d) 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 1 year 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. (e) 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. (f) 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. (g) 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. (h) 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. (i) An individual licensed under this chapter may, upon written request to the Board, be placed in an inactive status in accordance with the Board’s rules and regulations. An individual may reenter practice from inactive status if the individual provides written notification to the Board of the individual’s intent and complies with any relevant provisions of this chapter and the Board’s regulations. 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 ; 78 Del. Laws, c. 122, §§  1, 2 ; 80 Del. Laws, c. 171 ; 81 Del. Laws, c. 80, § 9 ; § 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, s