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[Mazie Machain]

Full Practice

State practice and licensure laws permit all NPs to evaluate patients; diagnose, order and interpret diagnostic tests; and initiate and manage treatments, including prescribing medications and controlled substances, under the exclusive licensure authority of the state board of nursing. This is the model recommended by the National Academy of Medicine, formerly called the Institute of Medicine, and the National Council of State Boards of Nursing.

Reduced Practice

State practice and licensure laws reduce the ability of NPs to engage in at least one element of NP practice. State law requires a career-long regulated collaborative agreement with another health provider in order for the NP to provide patient care, or it limits the setting of one or more elements of NP practice.

Restricted Practice

State practice and licensure laws restrict the ability of NPs to engage in at least one element of NP practice. State law requires career-long supervision, delegation or team management by another health provider in order for the NP to provide patient care.

DISCLAIMER: The material contained in this is offered as information only and not as practice, financial, accounting, legal or other professional advice. Correspondents must contact their own professional advisors for such advice.

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UNLV PRACTICE does not refuse services to any individual on the basis of: race/ethnicity; gender; age; physical or mental disability unlikely to affect the therapeutic process; an unfavorable discharge from military service; veteran, marital, or parental status; source of income; religious/spiritual beliefs or practices; sexual orientation; immigration status; or nationality.

The MPH practicum requirement provides each student the opportunity to engage in applied practice activities aligned with their career goals and interest areas. All public health professional degree students (MPH, MSPH, DrPH) are required to complete a practicum experience.* MPH students may meet this requirement either through courses with a practicum component or through a self-designed practicum.

The Office of Public Health Practice and Training recognizes faculty, staff, and students each year for outstanding public health practice contributions. Learn about a few of our award-winning practice projects here.

Following a 2.5-hour choir practice attended by 61 persons, including a symptomatic index patient, 32 confirmed and 20 probable secondary COVID-19 cases occurred (attack rate = 53.3% to 86.7%); three patients were hospitalized, and two died. Transmission was likely facilitated by close proximity (within 6 feet) during practice and augmented by the act of singing.

The choir, which included 122 members, met for a 2.5-hour practice every Tuesday evening through March 10. On March 15, the choir director e-mailed the group members to inform them that on March 11 or 12 at least six members had developed fever and that two members had been tested for SARS-CoV-2 and were awaiting results. On March 16, test results for three members were positive for SARS-CoV-2 and were reported to two respective local health jurisdictions, without indication of a common source of exposure. On March 17, the choir director sent a second e-mail stating that 24 members reported that they had developed influenza-like symptoms since March 11, and at least one had received test results positive for SARS-CoV-2. The email emphasized the importance of social distancing and awareness of symptoms suggestive of COVID-19. These two emails led many members to self-isolate or quarantine before a delegated member of the choir notified SCPH on March 17.

In total, 78 members attended the March 3 practice, and 61 attended the March 10 practice (Table 1). Overall, 51 (65.4%) of the March 3 practice attendees became ill; all but one of these persons also attended the March 10 practice. Among 60 attendees at the March 10 practice (excluding the patient who became ill March 7, who also attended), 52 (86.7%) choir members subsequently became ill. Some members exclusively attended one practice; among 21 members who only attended March 3, one became ill and was not tested (4.8%), and among three members who only attended March 10, two became ill (66.7%), with one COVID-19 case being laboratory-confirmed.

SCPH provided March 10 practice attendees with isolation and quarantine instructions by telephone, email, and postal mail. Contacts of patients were traced and notified of isolation and quarantine guidelines. At initial contact, 15 attendees were quarantined, five of whom developed symptoms during quarantine and notified SCPH.

The findings in this report are subject to at least two limitations. First, the seating chart was not reported because of concerns about patient privacy. However, with attack rates of 53.3% and 86.7% among confirmed and all cases, respectively, and one hour of the practice occurring outside of the seating arrangement, the seating chart does not add substantive additional information. Second, the 19 choir members classified as having probable cases did not seek testing to confirm their illness. One person classified as having probable COVID-19 did seek testing 10 days after symptom onset and received a negative test result. It is possible that persons designated as having probable cases had another illness.

United States district courts and courts of appeals often prescribe local rules governing practice and procedure. Such rules must be consistent with both Acts of Congress and the Federal Rules of Practice and Procedure, and may only be prescribed after notice and an opportunity for public comment. A court's authority to prescribe local rules is governed by both statute and the Federal Rules of Practice and Procedure. See 28 U.S.C. 2071(a)-(b); Fed. R. App. P. 47; Fed. R. Bankr. P. 9029; Fed. R. Civ. P. 83; Fed. R. Crim. P. 57.

AASLD develops evidence-based practice guidelines, practice guidances, and patient guidances to share recommended approaches to the diagnostic, therapeutic, and preventive aspects of care. View the AASLD Policy here.

AASLD strives to review and update its practice guidelines every five (5) years, as necessary. Users are cautioned that in the interim, scientific and medical developments may supersede or invalidate, in whole or in part, specific recommendations in any guideline. A guideline is considered to be "inactive" if it has not been updated by AASLD in at least five (5) years, and for this reason particular care must be exercised in placing reliance on an inactive guideline.

AASLD commissions and provides financial support for the formulation and production of practice guidelines/guidances by volunteer experts. Financial support from commercial entities or the pharmaceutical industry is not accepted for the development of AASLD practice guidelines or guidances.

Permission is required to reproduce more than one figure, table, or section over 400 words or complete practice guidelines and guidances for systematic redistribution. Re-sale and posting AASLD practice guidelines and guidances on other websites are not allowed; however, linking to these documents is permitted. Contact jcastano aasld.org for assistance.

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