Washington Nurse Practice Act: Facility Guide
Every nurse undergoes rigorous training to ensure they’re qualified to deliver safe patient care. Once they enter the workforce, they must continue to deliver care that falls within the scope of this training. Each state establishes its own set of laws to enforce these standards and regulate the profession at large. In Washington, these laws are outlined in the Washington Nurse Practice Act (NPA)
It’s important for facility leaders to familiarize themselves with their state’s specific nursing laws in order to appropriately enforce them within their care teams. In this article, we’ll provide an overview of the Washington NPA and outline practical tips for promoting compliance.
The Washington State Nurse Practice Act at a Glance
The Washington State Board of Nursing oversees and enforces all state nursing regulations. The NPA in particular outlines key information on nurse credentialing, scope of practice requirements, and delegation rules for the following types of nurses:
- Registered nurses (RNs)
- Licensed practical nurses (LPNs)
- Advanced practice registered nurses (APRNs)
Below, we’ll summarize key aspects of the Washington Nurse Practice Act and link to resources that can help you apply these provisions at your facility.
| Legal Authorities | Revised Code of Washington:
Washington Administrative Code: |
| Nursing Licensure Requirements | In Washington, RNs and LPNs can get licensed by examination or endorsement.
Steps to receive licensure by examination:
Steps to receive licensure by endorsement:
More information about licensure renewal can be found directly on the Board of Nursing’s website. |
| Scope of Practice Guidelines | The Washington Nurse Practice Act broadly defines the practice of LPNs,RNs, and APRNs.
The LPN scope of practice includes:
The RN scope of practice includes:
The APRN scope of practice includes:
For more information on the LPN vs. RN scope of practice, Washington State facility leaders can refer to the Department of Health’s advisory opinion. |
| Delegation Rules | In Washington, only RNs can delegate to surgical technologists, medical assistants, non-credentialed unlicensed assistive personnel within school settings, and nursing assistants and home care aides in community-based and in-home settings.
However, both RNs and LPNs may delegate tasks to nursing assistants in other settings. In general, delegation decisions must:
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| Violations and Penalties | Anyone who breaches the NPA is subject to up to $5,000 in fines and additional penalties imposed by the Washington State Board of Nursing. Nurse Practice Act abandonment rules, practice violations, and other specific prohibited acts are outlined in WAC 246-840-710. |
| Nurse Licensure Compact (NLC) State? | Washington is part of the NLC, meaning that nurses within the state can practice according to the rules and guidelines established by the NLC. |
Improving NPA Compliance: 3 Tips for Facilities
As you familiarize yourself with the Washington Nurse Practice Act, you may be wondering how to enforce these standards at your facility. Here are three additional tips to help you improve compliance and build a better culture of safety.
1. Ensure Staff Complete Continuing Competency Requirements
In Washington state, nurses are required to complete continuing competency courses and meet 96 practice hours every year in order to renew their licenses. It’s important to ensure that your staff are keeping up with these requirements so that they can maintain active licenses without interruptions.
Each level of nursing has a different set of requirements. Send out annual email reminders that link to Board-approved courses and remind your staff to complete them before the renewal period is over.
2. Educate Your Staff About Assignment Refusals
The Washington NPA strictly prohibits patient abandonment. Sometimes, these laws get conflated with a nurse’s right to refuse an assignment. Especially when floating to new units, nurses may be asked to carry out tasks that they don’t feel qualified to perform. In these cases, refusing an assignment doesn’t necessarily equate to patient abandonment.
It’s important to educate your staff on what to do when they feel obligated to turn down an assignment. Staff should feel comfortable raising concerns when they’re unable to safely handle certain tasks, and unit leaders should be ready to collaborate with them to find an alternative solution. This can help prevent other violations of the NPA, such as patient injury that stems from poor nursing judgement.
3. Utilize Guidance From Advisory Opinions
Some provisions in the NPA may not have all the information you need to fully understand how to apply them in practice. However, the Washington Board of Nursing regularly publishes new advisory opinions to help clarify these provisions.
While advisory opinions are not legally binding, they are a professionally-vetted resource for facility leaders seeking more guidance on how to interpret the NPA. They range in topics, from making delegation decisions to the nurse’s role in infusion therapy management. For a full list of current advisory opinions, you can visit the Board of Nursing’s website.
Stay Informed on the Latest Nursing Regulations
The Washington Nurse Practice Act and related nursing regulations are constantly being amended to reflect changing care standards. Looking for practical ways to keep up with the latest nursing news? Get expert-written healthcare management tips and insights 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.
