RN Scope of Practice Clarification Regarding Partial Administrations & Conflicts in Clinical Judgment (Board Of Nursing)

Dear Bailey Pillon:

This email is to confirm receipt of your public records request. If this request requires extensive use of resources, this office will contact you again once an estimate of the costs associated with producing the records you seek is prepared. The tracking number associated with your request is in the subject line of this email. If you have any questions, please let me know. Your request was received in this office on 2/26/2024 and given the reference number P113723-022624 for tracking purposes.
Records Requested: To Whom It May Concern:

Pursuant to the Florida Sunshine Law, s. 286.011, F.S., I hereby request the following records:

Within the time frame of 2019-2024, to be on the date this request is processed, I request the following according to the below criteria:

1. Any opinion issued that mentions or includes the keywords "partial administration" or "partial medication administration" either as a formal opinion or other formal document specific to Registered Nurses.
2. Any an email sent by the person or person(s) with the authority to opine and clarify nuances and specificity referring specifically to RN scope of practice such as by the DON, ADON, CNO (if an available position at your agency), or a similar high-ranking nursing professional of a different title OR non-nursing professional if such person(s) exist that can issue authoritative opinions on the matter, whichever appropriate person(s) exist within your agency. If specificity is required for this criterion, please refer to the keywords above. I'm aware of the ANA Scope of Practice and it does not opine on partial administrations with any degree of specificity or nuance. I request emails where such person(s) are either sender, recipient, cc, or bcc, but please exclude baileypillon@gmail dot com as sender and/or recipient in the responsive records unless noted in a response (I apologize in advance) to this email.
3. Regarding (1) and (2), I request to know the specific contexts in which a partial medication administration is permissible, if at all, and if it is specific to the setting, if it is the case. If so, please specify what contexts it is permissible and when nursing judgment and critical thinking reasonably applies when considering the reasonable, prudent legal standard that RNs are held to.
4. The titles of the person(s) that typically work on EMR/EHRs and the percentage of those persons who are medical professionals that hold an active license from 2019-2024, if it is known to our agency. Please breakdown by year, if possible.
5. If there is a differentiation regarding partial administrations (assuming it is within scope at all) between RNs and LPNs and if it varies depending on the setting and/or context within this specific criterion (5).
6. If a partial medication administration is indeed within the scope of practice within RNs, I wish to know in what manner a healthcare facility may limit or entirely restrict partial administrations, if instructed nursing leadership or noted in the facility policies/procedures.
7. The precise policies/procedures taken by your agency in the event that legal action (in the form of a civil or criminal suit specifically by your agency) is taken against a licensed nursing or other medical professional, including the titles of the person(s) involved.
8. Any documents, if it is the case that a rare, one time partial administration is not within the scope of practice for RNs, that state the rationale as to why it is not within scope according to your agency.
9. Any documents or opinions issued by your agency that set forth an opinion, guidelines, or other type of document wherein there is a clinical disagreement between the RN and MD/DO/ARNP/PA regarding an order, according to clinical judgment, if it conflicts between the RN and provider.
10. Any documents wherein a non-nursing medical professional (specifically an MD/DO) can decide (and if it is legal) what is or isn't within the scope of practice for an RN, given that the provider is not an RN.

If responsive records for the above criteria exceed 200 records, please provide the number of responsive records by each criterion so that I can narrow the scope and/or time frame of this request. I sincerely appreciate it.

I also request that, if appropriate, fees be waived as I believe this request is in the public interest. The requested documents will be made available to the general public free of charge and such documents made in the process of news gathering and not for commercial usage.

In the event that fees cannot be waived, I grant permission for fees up to $50. If the fees are still in excess of $50, please let me know as well as the number of results produced and I will further revise the criteria. I would prefer the request filled electronically, by e-mail attachment if available or CD-ROM if not.

If you deny any part of this request, please cite each specific exemption you think justifies your refusal to release the information and notify me of appeal procedures available under the law.

Thank you in advance for your anticipated cooperation in this matter. I look forward to receiving your response to this request within 20 business days. Please provide an estimated completion date for the above responsive records.

Sincerely,

Bailey Pillon RN

Upload documents directly: https://www.muckrock.com/
You can monitor the progress of your request at the link below and you'll receive an email when your request has been completed.
Florida Department of Health

--- Please respond above this line ---
02/28/2024
Bailey Pillon MuckRock News, DEPT MR159346 263 Huntington Ave Boston MA 02115
Re: Public Records Request-Tracking #P113723-022624
Dear Bailey Pillon,
The Florida Department of Health received a Public Records Request from you on 2/26/2024. Your request mentioned: To Whom It May Concern:

Pursuant to the Florida Sunshine Law, s. 286.011, F.S., I hereby request the following records:

Within the time frame of 2019-2024, to be on the date this request is processed, I request the following according to the below criteria:

1. Any opinion issued that mentions or includes the keywords "partial administration" or "partial medication administration" either as a formal opinion or other formal document specific to Registered Nurses.
2. Any an email sent by the person or person(s) with the authority to opine and clarify nuances and specificity referring specifically to RN scope of practice such as by the DON, ADON, CNO (if an available position at your agency), or a similar high-ranking nursing professional of a different title OR non-nursing professional if such person(s) exist that can issue authoritative opinions on the matter, whichever appropriate person(s) exist within your agency. If specificity is required for this criterion, please refer to the keywords above. I'm aware of the ANA Scope of Practice and it does not opine on partial administrations with any degree of specificity or nuance. I request emails where such person(s) are either sender, recipient, cc, or bcc, but please exclude baileypillon@gmail dot com as sender and/or recipient in the responsive records unless noted in a response (I apologize in advance) to this email.
3. Regarding (1) and (2), I request to know the specific contexts in which a partial medication administration is permissible, if at all, and if it is specific to the setting, if it is the case. If so, please specify what contexts it is permissible and when nursing judgment and critical thinking reasonably applies when considering the reasonable, prudent legal standard that RNs are held to.
4. The titles of the person(s) that typically work on EMR/EHRs and the percentage of those persons who are medical professionals that hold an active license from 2019-2024, if it is known to our agency. Please breakdown by year, if possible.
5. If there is a differentiation regarding partial administrations (assuming it is within scope at all) between RNs and LPNs and if it varies depending on the setting and/or context within this specific criterion (5).
6. If a partial medication administration is indeed within the scope of practice within RNs, I wish to know in what manner a healthcare facility may limit or entirely restrict partial administrations, if instructed nursing leadership or noted in the facility policies/procedures.
7. The precise policies/procedures taken by your agency in the event that legal action (in the form of a civil or criminal suit specifically by your agency) is taken against a licensed nursing or other medical professional, including the titles of the person(s) involved.
8. Any documents, if it is the case that a rare, one time partial administration is not within the scope of practice for RNs, that state the rationale as to why it is not within scope according to your agency.
9. Any documents or opinions issued by your agency that set forth an opinion, guidelines, or other type of document wherein there is a clinical disagreement between the RN and MD/DO/ARNP/PA regarding an order, according to clinical judgment, if it conflicts between the RN and provider.
10. Any documents wherein a non-nursing medical professional (specifically an MD/DO) can decide (and if it is legal) what is or isn't within the scope of practice for an RN, given that the provider is not an RN.

If responsive records for the above criteria exceed 200 records, please provide the number of responsive records by each criterion so that I can narrow the scope and/or time frame of this request. I sincerely appreciate it.

I also request that, if appropriate, fees be waived as I believe this request is in the public interest. The requested documents will be made available to the general public free of charge and such documents made in the process of news gathering and not for commercial usage.

In the event that fees cannot be waived, I grant permission for fees up to $50. If the fees are still in excess of $50, please let me know as well as the number of results produced and I will further revise the criteria. I would prefer the request filled electronically, by e-mail attachment if available or CD-ROM if not.

If you deny any part of this request, please cite each specific exemption you think justifies your refusal to release the information and notify me of appeal procedures available under the law.

Thank you in advance for your anticipated cooperation in this matter. I look forward to receiving your response to this request within 20 business days. Please provide an estimated completion date for the above responsive records.

Sincerely,

Bailey Pillon RN

Upload documents directly: https://www.muckrock.com/ The Division of Medical Quality Assurance has received your request for public records.  Upon review, we discovered this was filled when responding to your previous request dated 02/26/2024 reference number . P113719 The Department has no further records responsive to your request and this request is considered closed. Sincerely, Analyst Bellamy
Operations Analyst II Florida Department of Health Division of Medical Quality Assurance
Bureau of Operations
Public Records Team
4052 Bald Cypress Way, Bin # C-01
Tallahassee, FL 32399-3251 Phone: (850) 245-4252 , Option 4
Fax: (850) 487-9537 Department Mission : To protect, promote and improve the health of all people in Florida through integrated state, county, and community efforts.
Please note: Florida has a very broad public records law. Most written communications to or from state officials regarding state business are public records available to the public and media upon request. Your e-mail communications may therefore be subject to public disclosure. Please consider the environment before printing this e-mail.