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<regulation prefix="Regulation" num=".01" citation="COMAR 10.27.09.01" title_num="10" subtitle_num="27" chapter_num="09" heading="Definitions.">
  <paragraph num="A.">
    <text>In this chapter, the following terms have the meanings indicated.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Terms Defined.</text>
    <paragraph num="(1)">
      <text>“Accountability” means being answerable for the actions of self and others.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>“Aggregate” means the sum total of nursing care the client received.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>“Assessment” means a systematic, dynamic process by which the nurse, through interaction with the client, family, significant others, and other health care providers, collects and analyzes data.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>“Assign” means the transfer of responsibility from one nurse to another with each nurse having the legal authority to perform the function as permitted by the licensee's scope of practice.</text>
    </paragraph>
    <paragraph num="(5)">
      <text>“Client” means an individual, family, group, or community under the licensee's direct or indirect care.</text>
    </paragraph>
    <paragraph num="(6)">
      <text>“Continuity of care” means an interdisciplinary process that:</text>
      <paragraph num="(a)">
        <text>Includes the client, family, and significant other in the development and communication of a coordinated plan of care; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Based on changing needs and available resources, facilitates the client's:</text>
        <paragraph num="(i)">
          <text>Care within a setting, and</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Transition between settings.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(7)">
      <text>“Criteria” means relevant, measurable indicators of the standards of registered nurse practice.</text>
    </paragraph>
    <paragraph num="(8)">
      <text>“Delegate” means the registered nurse:</text>
      <paragraph num="(a)">
        <text>Invests authority to act on behalf of the registered nurse to an unlicensed person;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Authorizes the unlicensed person to augment and supplement the care the registered nurse provides; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Retains the accountability and responsibility for the delegated act.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(9)">
      <text>“Evaluation” means the review and analysis of the extent to which the assessment, nursing diagnosis, planning, and implementation is effective in resolving the client's health problems or progress toward the attainment of expected outcomes.</text>
    </paragraph>
    <paragraph num="(10)">
      <text>Health Care Providers.</text>
      <paragraph num="(a)">
        <text>“Health care provider” means an individual with special expertise who provides health care services or assistance to clients.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>“Health care provider” includes:</text>
        <paragraph num="(i)">
          <text>Nurses;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Physicians;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Psychologists;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Social workers;</text>
        </paragraph>
        <paragraph num="(v)">
          <text>Nutritionists/dietitians; and</text>
        </paragraph>
        <paragraph num="(vi)">
          <text>Various therapists.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(11)">
      <text>“Health care team” means a group of individuals, which includes health care providers and unlicensed personnel, working in collaboration with the client, family, and significant others to achieve identified outcomes.</text>
    </paragraph>
    <paragraph num="(12)">
      <text>Health Status Data.</text>
      <paragraph num="(a)">
        <text>“Health status data” means information obtained through nursing assessment of the client.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>“Health status data” includes but is not limited to:</text>
        <paragraph num="(i)">
          <text>Growth and development;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Biophysical status;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Emotional status;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Cultural, religious, and socioeconomic background;</text>
        </paragraph>
        <paragraph num="(v)">
          <text>Activities of daily living and instrumental activities of daily living;</text>
        </paragraph>
        <paragraph num="(vi)">
          <text>Patterns of coping;</text>
        </paragraph>
        <paragraph num="(vii)">
          <text>Interaction patterns;</text>
        </paragraph>
        <paragraph num="(viii)">
          <text>Client perception of and degree of satisfaction with health status;</text>
        </paragraph>
        <paragraph num="(ix)">
          <text>Client health goals;</text>
        </paragraph>
        <paragraph num="(x)">
          <text>Physical, social, emotional, and ecological environments; and</text>
        </paragraph>
        <paragraph num="(xi)">
          <text>Access to and availability of human and material resources.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(13)">
      <text>“Implementation” means the process of performing, delegating, assigning, supervising, and coordinating interventions.</text>
    </paragraph>
    <paragraph num="(14)">
      <text>“Instrumental activities of daily living” means home management skills such as shopping for food and personal items, preparing meals, or handling money.</text>
    </paragraph>
    <paragraph num="(15)">
      <text>“Multistate licensure privilege” has the meaning set forth in COMAR 10.27.01.01B.</text>
    </paragraph>
    <paragraph num="(16)">
      <text>“Nursing diagnosis” means a description of the actual or potential, overt or covert health problems which registered nurses are licensed to treat.</text>
    </paragraph>
    <paragraph num="(17)">
      <text>“Outcomes” means measurable, expected, client-focused goals which translate into observable behaviors.</text>
    </paragraph>
    <paragraph num="(18)">
      <text>“Plan of care” means designing methods to solve identified problems and to attain outcomes by means of establishing priorities, setting goals, and defining interventions.</text>
    </paragraph>
    <paragraph num="(19)">
      <text>“Process” means the delivery of care and the fulfillment of the practice standards.</text>
    </paragraph>
    <paragraph num="(20)">
      <text>“Quality of care” means the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.</text>
    </paragraph>
    <paragraph num="(21)">
      <text>“Recipients of nursing care” means individuals, families, groups, communities, or populations.</text>
    </paragraph>
    <paragraph num="(22)">
      <text>“Registered nurse (RN)” means an individual who:</text>
      <paragraph num="(a)">
        <text>Is licensed by the Board to practice registered nursing; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Has a multistate licensure privilege to practice registered nursing.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(23)">
      <text>“Responsibility” means the obligation and duty to perform.</text>
    </paragraph>
    <paragraph num="(24)">
      <text>“Scientific principles” means a fundamental belief or reason for action derived from an organized system of study.</text>
    </paragraph>
    <paragraph num="(25)">
      <text>“Standards of care” means a minimum level of competent nursing practice demonstrated through assessment, analysis, formulation of nursing diagnosis, outcome identification, planning, implementation, and evaluation.</text>
    </paragraph>
    <paragraph num="(26)">
      <text>Standards of Registered Nurse Practice.</text>
      <paragraph num="(a)">
        <text>“Standards of registered nurse practice” means the minimum criteria the registered nurse shall adhere to in the practice of registered nursing.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>“Standards of registered nurse practice” includes both standards of care and standards of professional performance.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(27)">
      <text>Standards of Professional Performance.</text>
      <paragraph num="(a)">
        <text>“Standards of professional performance” means a competent level of behavior in the professional role.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>“Standards of professional performance” includes activities related to:</text>
        <paragraph num="(i)">
          <text>Quality of care;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Performance appraisal;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Education;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Collegiality;</text>
        </paragraph>
        <paragraph num="(v)">
          <text>Ethics;</text>
        </paragraph>
        <paragraph num="(vi)">
          <text>Collaboration;</text>
        </paragraph>
        <paragraph num="(vii)">
          <text>Research;</text>
        </paragraph>
        <paragraph num="(viii)">
          <text>Resource utilization;</text>
        </paragraph>
        <paragraph num="(ix)">
          <text>Assignment;</text>
        </paragraph>
        <paragraph num="(x)">
          <text>Delegation and supervision; and</text>
        </paragraph>
        <paragraph num="(xi)">
          <text>Refusal.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(28)">
      <text>“Structure” means:</text>
      <paragraph num="(a)">
        <text>The environment in which care is provided; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Resources available to provide care including but not limited to finances, staffing, supplies, equipment, and medical records.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(29)">
      <text>“Technology assessment” means a review of drugs, devices, procedures, and systems in relationship to their safety, effectiveness, and economic and social impact.</text>
    </paragraph>
  </paragraph>
</regulation>