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New regs for APRNs, MA

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The Massachusetts Board of Registration in Nursing (Board) is pleased to announce the implementation of revised regulations governing the practice of the Advanced Practice Registered Nurse (APRN). The amended regulations at 244 CMR 4.00 are intended to reflect the enactment of new laws as well as to make the regulation of APRN practice more consistent with the national APRN Consensus Model.

Effective immediately, the revised regulations at 244 CMR 4.00: Massachusetts Regulations Governing Advanced Practice Registered Nursing [1] includes, but is not limited to:

- New or amended definitions;

- New APRN titles for Certified Nurse Practitioners (CNP), Certified Registered Nurse Anesthetists (CRNA), Psychiatric Clinical Nurse Specialists (PCNS) and Certified Nurse Midwives (CNM). Current APRNs who renew their authorization after 8/1/14 will have the new title printed on the wallet size document the Board mails to APRNs upon renewal;

- The creation of the non-psychiatric Clinical Nurse Specialist (CNS) category of APRN practice:

  • Includes grandfather clause effective until 12/31/16 for those Registered Nurses who are currently certified as a CNS by a Board recognized certifying organization,
  • Detailed information regarding the creation of the CNS category is available in the News and Alerts section of the Board's web home page,
  • Applications for CNS authorization available at www.pcshq.com,
  • Effective immediately, qualified CNS must apply for Board authorization in order to practice in the CNS category. Without Board authorization, a nurse may not use the CNS title;

- Clarification that guideline and physician supervision requirements are required only for an APRN who registers for prescriptive practice, with the exception of the CNM, who is no longer required by law to have guidelines or a supervising physician; and

- Requires professional malpractice Liability Insurance for all APRNs with direct patient care responsibilities.

All APRNs are accountable for practicing in accordance with the revised regulations. Upon initial Board authorization for APRN practice and at subsequent authorization renewals, every APRN attests by signature to compliance with Board laws and regulations. Please invest the time to review 244 CMR 4.00 in its entirety.

Visit the Board's website at www.mass.gov/dph/boards/rn or contact the Board if you have questions.


[1] It may take up to a week for the revised regulations to be posted on the Board's web site.

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