North Carolina Nurse Practice Act: Facility Guide
Nursing duties and responsibilities are always adapting to changes in the healthcare industry. While this helps facilities meet heightened clinical demands, it can make it challenging for administrators to regulate the care patients receive. The North Carolina (NC) Nurse Practice Act promotes patient safety by establishing rulemaking authority and outlining the rules and regulations that govern nursing care.
What is the North Carolina Nurse Practice Act and how does it affect facilities and the patients that they serve? In this article, we’ll review the specific rules outlined in the state’s legislation, examine key laws that could affect a nursing professional’s daily practice, and outline ways healthcare leaders can improve regulatory compliance and care quality in their facility.
What Is the North Carolina Nursing Practice Act?
RNs and LPNs are required to provide care that conforms to specific rules and regulations. In North Carolina, this legislation is called the North Carolina Nurse Practice Act (NPA). These laws directly impact nursing practice by:
- Establishing NC Board of Nursing (NCBON) rules and regulations.
- Describing requirements for North Carolina nursing education programs.
- Setting minimum care standards that must be met.
- Regulating the maintenance and renewal of an NC nursing license.
- Clarifying and setting penalties for law violations.
The NC Nurse Practice Act: Laws at a Glance
The laws outlined in each state’s Nurse Practice Act contain similar information on BON regulatory functioning and licensure requirements. However, each state works independently to develop unique nursing scopes of practice and rules for delegation.
Understanding the intricacies of NC nursing practice laws can help you provide safe patient care while protecting patients and staff members. The following table reviews some of the key components unique to the NC Nurse Practice Act.
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| Legal Authorities | General Statutes of North Carolina, Chapter 90, Article 9A
North Carolina Administrative Code: |
| North Carolina State Nursing Licensure Requirements | North Carolina RN licensure applicants must qualify by either passing the NCLEX examination or getting a license endorsed from another state.
Steps for NCLEX Exam Qualification:
Steps for Endorsement Qualification:
Note: The board may grant a temporary RN license to practice for up to 6 months while their permanent license is processing and under legal review. The North Carolina Board of Nursing website also provides approximate timeframes for application processing and outlines the steps to renew a nursing license. |
| NC Nurse Practice Act Delegation of Duties | Nursing professionals are allowed to delegate when:
Nursing professionals are prohibited from delegating:
Note: The NC BON states that individual clinical tasks allowed by unlicensed personnel (patient bathing, vital sign collection, toileting, ambulation assistance, etc.) aren’t regulated by the BON, but should instead be outlined in each facility’s policies and procedures. |
| Penalties | Under Section 90-171.44, violations of the NC Nurse Practice Act can include:
Violations of the Nursing Practice Act (NC) can constitute a Class 1 misdemeanor and could result in jail time, community service, and/or fines. Additionally, the BON may initiate further investigation that could result in:
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| Nurse Licensure Compact (NLC) State? | North Carolina is involved in the NLC compact, meaning that its state Nurse Practice Act encompasses rules and guidelines established by the NLC. |
Promoting Safe Nursing Practice: 3 Strategies for Facilities
By understanding and implementing the laws outlined in the NC Nurse Practice Act, North Carolina healthcare leaders can ensure that clinicians and patients are confident in the care being provided. Looking for ways to engage your team and empower them to manage their own professional practice? Here are three ideas to get the ball rolling.
1. Encourage Staff to Complete NCBON Scope of Practice Training
The North Carolina Board of Nursing offers an online course for nursing staff to better understand the NC RN scope of practice. This 1.5 contact-hour training outlines role differences between RNs and LPNs. It also reviews delegation rules to help clinicians collaborate safely and effectively. Administrators who promote this course can ensure their staff are practicing nursing within the confines of state law.
2. Make the NC Nurse Practice Act Easy to Access
Providing staff with a copy of the Nurse Practice Act (NC) is a great way to educate them on the rules surrounding their professional practice. Upload a copy of the NPA to your nursing website and distribute hard copies to your nursing units. Review any legal updates or relevant case law during annual competency training.
The NPA isn’t just useful for clinicians — educating patients about the responsibilities and duties of their care providers can help you build a culture of safety at your facility. It can also improve patient engagement, satisfaction, and health outcomes.
3. Promote Nursing Shared Governance
Shared governance councils are committees of clinicians that work together to drive change within a healthcare facility. Nursing professionals in these leadership groups develop facility-wide policies and procedures based on the rules outlined in their state’s NPA.
This “bottom-up management” leadership style fosters collaboration, engagement, and autonomy among nursing professionals. Facility leaders who encourage the formation of these clinical teams empower their nurses to manage their own professional practice, boosting staff satisfaction and retention.
Stay Current on the Latest Healthcare Laws
Understanding the intricacies of the NC Nurse Practice Act gets your facility one step closer to ensuring safety and regulatory compliance. Looking for more ways to improve care quality and help your team perform at its best? Follow our free newsletter for additional resources on healthcare policy changes and regulatory updates, delivered straight to your inbox.
Legal Disclaimer: This article contains general legal information, but it is not intended to constitute professional legal advice for any particular situation and should not be relied on as professional legal advice. Any references to the law may not be current, as laws regularly change through updates in legislation, regulation, and case law at the federal and state level. Nothing in this article should be interpreted as creating an attorney-client relationship. If you have legal questions, you should seek the advice of an attorney licensed to practice in your jurisdiction.