VOLUME 48, ISSUE 11
June 6, 2016
Law and Public Safety
Division of Consumer Affairs
New Jersey Board of Nursing
Proposed Amendments: N.J.A.C. 13:37-9.5, 9.6, and 9.10
FN-CSA Education Programs; Clinical Education; Endorsement
Authorized By: State Board of Nursing, Joanne Leone, Acting Executive Director.
Authority: N.J.S.A. 45:11-24, 45:11-67, and 52:14B-5.1; and P.L. 2001, c. 81.
Proposal Number: PRN 2016-087.
Submit written comments by August 5, 2016, to:
Joanne Leone, Acting Executive Director
State Board of Nursing
PO Box 45010
Newark, New Jersey 07101
The agency proposal follows:
N.J.A.C. 13:37-9.5 establishes course content for forensic nurse-certified sexual assault (FN-CSA) education programs. These programs prepare nurses to obtain certification as FN-CSAs and to collect forensic evidence from patients who have been sexually assaulted. The existing rule sets forth specific topics that must be included in a course. The Board of Nursing (Board) proposes to amend the existing rule to delete these specific topics and to require that FN-CSA education programs meet the requirements of the International Association of Forensic Nurses' (IAFN) Sexual Assault Nurse Examiner Education Guidelines, which are incorporated by reference, as amended and supplemented into the rule. In keeping with IAFN's guidelines, the Board proposes to amend N.J.A.C. 13:37-9.5 to increase the required numbers of didactic instruction from 40 to 64. The Board also proposes to delete provisions that establish who may teach specific portions of FN-CSA education programs and which require programs to have an administrator. The specific portions referenced in the rule are proposed for deletion as the IAFN Guidelines establish who may teach specific topics and establish administrator requirements for programs.
N.J.A.C. 13:37-9.6 establishes course content for FN-CSA clinical education programs. The Board proposes to amend this rule to delete the specific course content and to require that FN-CSA clinical education programs meet IAFN Sexual Assault Nurse Examiner Education Guidelines, which are incorporated by reference, as amended and supplemented into the rule. The Board also proposes to amend the rule to allow a Forensic Nurse Coordinator or an FN-CSA with a master's degree in nursing and at least two years working experience as an FN-CSA to supervise clinical education.
N.J.A.C. 13:37-9.10 sets forth requirements for FN-CSAs who are certified in another state and seek New Jersey certification. The rule currently sets forth specific courses enumerated in N.J.A.C. 13:37-9.5 that an applicant must complete. As the Board is amending N.J.A.C. 13:37-9.5 to remove specific course content, the Board proposes to amend N.J.A.C. 13:37-9.10 to remove references to specific course content that had been set forth at N.J.A.C. 13:37-9.5.
The Board has determined that the comment period for this notice of proposal will be 60 days; therefore, pursuant to N.J.A.C. 1:30-3.3(a)5, this notice is excepted from the rulemaking calendar requirement.
The Board anticipates that the proposed amendments will have a positive social impact. Following IAFN Guidelines will ensure that New Jersey FN-CSA programs match education programs in other states, making it easier for FN-CSAs certified in other states to obtain certification in New Jersey. This will increase the pool of nurses able to collect forensic evidence from patients who have been sexually assaulted.
The proposed amendments will not have any economic impact.
Federal Standards Statement
A Federal standards analysis is not required because there are no Federal laws or standards applicable to the proposed amendments.
The Board does not believe that the proposed amendments will increase or decrease the number of jobs in New Jersey.
Agriculture Industry Impact
The Board does not believe that the proposed amendments will have any impact on the agriculture industry of this State.
Regulatory Flexibility Analysis
Since FN-CSA education programs are individually approved by the Board under the Regulatory Flexibility Act (the Act), N.J.S.A. 52:14B-16 et seq., they may be considered "small businesses" for the purposes of the Act.
The proposed amendments will not impose any costs and the Board does not believe that FN-CSA education programs will need to employ any professional services to comply with the requirements of the proposed amendments. The proposed amendments impose no reporting or recordkeeping requirements, but will impose compliance requirements as detailed in the Summary.
The Board believes that the proposed amendments will ensure that all FN-CSA programs are following national standards, which help to ensure that FN-CSAs are adequately prepared to provide services in a safe and effective manner. Therefore, the proposed amendments must be applied uniformly to all FN-CSA education programs regardless of their size.
Housing Affordability Impact Analysis
The proposed amendments will have an insignificant impact on the affordability of housing in New Jersey and there is an extreme unlikelihood that the rules would evoke a change in the average costs associated with housing because the proposed amendments concern standards for FN-CSA education programs.
Smart Growth Development Impact Analysis
The proposed amendments will have an insignificant impact on smart growth and there is an extreme unlikelihood that the rules would evoke a change in housing production in Planning Areas 1 or 2, or within designated centers, under the State Development and Redevelopment Plan in New Jersey because the proposed amendments concern standards for FN-CSA education programs.
Full text of the proposal follows (additions indicated in boldface thus; deletions indicated in brackets [thus]):
SUBCHAPTER 9. FORENSIC NURSE-CERTIFIED SEXUAL ASSAULT PROGRAM
13:37-9.5 FN-CSA education programs
(a)-(b) (No change.)
(c) A course in FN-CSA education shall be completed within a six-month period. A course shall contain a minimum of  64 hours of didactic instruction [in the following:] that meets the requirements of the 2015 edition of the International Association of Forensic Nurses' [page=948] Sexual Assault Nurse Examiner Education Guidelines, incorporated herein by reference, as amended and supplemented, published by the International Association of Forensic Nurses, 6755 Business Parkway, Suite 303, Elkridge, MD, 21075.
[1. History and role of forensic nursing, for a minimum of two hours, including:
i. History of forensic nursing;
ii. Forensic roles and practice settings;
iii. Professional organizations; and
iv. Ethical issues of forensic practice;
2. Role and responsibility of the FN-CSA, for a minimum of two hours, including:
i. Board statutes and rules, N.J.S.A. 45:11-24 et seq. and N.J.A.C. 13:37;
ii. Job description; and
iii. Role within the Sexual Assault Response Team;
3. Sexual Assault Response Teams, for a minimum of two hours, including:
i. Role of the rape care advocate;
ii. Role of law enforcement; and
iii. Sexual Assault Response Team activation;
4. Secondary responding/interacting agencies, for a minimum of two hours, including:
i. Division of Youth and Family Services;
ii. Regional Diagnostic and Treatment Centers;
iii. Division of Developmental Disabilities; and
iv. Office of the Ombudsman for the Institutionalized Elderly;
5. Psychosocial issues of sexual assault, for a minimum of two hours, including:
i. Definition and dynamics of sexual assault;
ii. Cultural awareness;
iii. Rape Trauma Syndrome/Post Traumatic Stress Disorder; and
iv. Vicarious trauma;
6. Needs of special victim populations, for a minimum of two hours, including:
iii. Disabled; and
iv. Male victims;
7. Sexual assault offenders, for a minimum of two hours, including:
i. Offender characteristics; and
ii. Drug-facilitated sexual assault;
8. Anatomy and physiology, for a minimum of six hours, including:
i. Male and female genital anatomy-normal growth and development;
ii. Genital injury and healing; and
iii. Injury versus disease process;
9. Nursing management issues, for a minimum of two hours, including:
i. Emergency Medical Treatment and Labor Act (EMTALA) regulations and medical screening exams, as required by 43 CFR §489.24 and N.J.A.C. 8:43G;
ii. Sexually transmitted disease and pregnancy prevention;
iii. Managing/referring medical problems; and
iv. Patient discharge and referral;
10. Evidence in sexual assault cases, for a minimum of four hours, including:
i. Specialized equipment and Sexual Assault Forensic Evidence (SAFE) kits; and
ii. Lab procedures and DNA Evidence;
11. Documentation skills, for a minimum of four hours, including:
i. Forensic history taking skills;
ii. Communication skills; and
iii. Fact-based documentation;
12. Documenting injuries and evidence, for a minimum of four hours, including:
i. Body map diagrams (pediatric and adult);
ii. Physical assessment;
iii. Forensic photography; and
13. Genital exams, for a minimum of two hours;
14. Criminal justice system, for a minimum of two hours, including:
i. New Jersey sexual assault laws;
ii. Rules of evidence; and
iii. Investigation and prosecution; and
15. Trial testimony, for a minimum of two hours, including:
i. Preparing to testify; and
ii. Mock trial demonstration.]
(d) The didactic instruction required in (c) above shall be taught by an instructor who either has a masters degree in nursing from a school accredited by the New Jersey Department of Education, or another state's department of education, or who is a FN-CSA. [Didactic instruction in topics required by (c)14i and 15 above may be taught by an attorney. Didactic instruction in topics required by (c)14ii and iii above may be taught by an attorney or by an investigator or detective who is part of a New Jersey law enforcement agency. Didactic instruction in topics required by (c)1, 3, 5i, 5ii, 5iii and 6 above may be taught by an individual who is recognized as a rape care advocate pursuant to N.J.S.A. 52:4B-52.]
(e) (No change.)
[(f) Every program shall have an administrator who has direct authority for the fiscal and academic administration of the program. The administrator shall have a masters degree in nursing from a school accredited by the New Jersey Department of Education, or another state's department of education.]
[(g)] (f) (No change in text.)
13:37-9.6 Clinical education
(a) (No change.)
(b) An applicant shall complete a clinical program [consisting of:] that meets guidelines on clinical education found in the 2015 edition of the International Association of Forensic Nurses' Sexual Assault Nurse Examiner Education Guidelines, incorporated herein by reference, as amended and supplemented, published by the International Association of Forensic Nurses, 6755 Business Parkway, Suite 303, Elkridge, MD, 21075.
[1. A minimum of 10 routine gynecological genital inspections, which include speculum examinations, in a clinic or in clinical settings supervised by an advanced practice nurse or physician; and
2. A minimum of five simulated sexual assault examinations using a State of New Jersey Sexual Assault Evidence Collection Kit, in a clinical examination facility approved by the Board and the Director of the Division of Criminal Justice pursuant to N.J.A.C. 13:37-9.7 or run by the Division of Criminal Justice.]
(c) Documentation of the completed clinical education shall be dated and signed by the supervising advanced practice nurse, [or] physician, Forensic Nurse Coordinator, or FN-CSA who holds a master's degree in nursing and has been working as an FN-CSA for at least two years.
(a) A registered professional nurse, licensed in New Jersey, who is working as a FN-CSA in another state may apply for certification as a FN-CSA in New Jersey if the applicant is certified by another state as a FN-CSA, or its equivalent, and the applicant:
1. Has completed a course and clinical education substantially similar to the requirements of N.J.A.C. 13:37-9.5 and 9.6; and
[2. Takes a one-day course which covers the information required by N.J.A.C. 13:37-9.5(c)15, 16, 27 and 28; and]
[3.] 2. (No change in text.)
(b) An applicant for certification by endorsement shall submit to the Board:
1.-5. (No change.)
6. Evidence that the applicant has passed a clinical competency examination given by an approved clinical examination facility; and
[7. Evidence that the applicant has taken a one day course which reviews those topics required by N.J.A.C. 13:37-9.5(c)15, 16, 27 and 28; and]
[8.] 7. (No change in text.)
(c) (No change.)