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Guidance Documents

The Code of Virginia requires annual publication of lists of guidance documents from state agencies. A guidance document is defined as "...any document developed by a state agency or staff that provides information or guidance of general applicability to the staff or public to interpret or implement statutes or the agency's rules or regulations..." Agencies are required to maintain a complete, current list of all guidance documents and make the full text of such documents available to the public.

Copies of the following documents may be viewed during regular work days from 8:15 a.m. until 5 p.m. at the offices of the Department of Health Professions, 9960 Mayland Drive, Suite 300, Henrico Virginia 23233-1463.  Copies may also be downloaded by clicking on the links below or from the Regulatory Townhall at or requested by email at  Questions regarding implementation of these documents or requests for copies may be directed to Jay P. Douglas, MSM, RN, CSAC, FRE, Executive Director of the Board, at the address above or by telephone at (804) 367-4515.  Copies are free of charge.

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Medication Administration and Training:

90-2 Transmittal of Orders by Authorized Agents, effective April 3, 2019

90-9 Guidelines for Prescription Drug Administration Training Program for Child Day Programs, Reaffirmed September 17, 2019

90-16 Evaluation form for adult immunization protocols, developed by staff, August 1996, revised December 2020

90-31 Whether a Nurse May Administer a Medication That Has Been Transmitted Orally Or In Writing By a Pharmacist Acting as the Prescriber’s Agent, effective April 3, 2019

90-36 Guidelines for the training of public school employees in the administration of insulin and glucagon, effective December 10, 2020

90-46 Administration of over-the counter drugs by certified nurse aides, reaffirmed November 13, 2018

90-62 Medication administration training curriculum, reaffirmed November 16, 2021

110-18 Interpretation of "administer" to include preparation for administration, revised September 29, 2015


Standard of Care/Scope of Practice:

90-1 Policy statement on Registered Nurses or Licensed Practical Nurses as first assistants in surgery, revised November 13, 2018

90-5 Guidance on practice of conversion therapy, effective December 10, 2020

90-4 Opinion on how licensure as a nurse relates to service on a volunteer rescue squad, effective July 8, 2021

90-6 Guidance statement by board regarding peripherally inserted central catheters, reaffirmed November 16, 2021

90-15 Insertion of Prostaglandin E2 Gel by Registered Nurses, revised by Board motion, reaffirmed November 13, 2018

90-17 Opinion of cutting of corns and warts with a scalpel by Licensed RN/LPN, reaffirmed November 13, 2018

90-19 Board interpretative statement on bolusing epidural anesthesia by Registered Nurses, reaffirmed December 2, 2020

90-23 Decision-making Model for Determining RN/LPN Scope of Practice, reaffirmed November 13, 2018

90-40 Surveillance Activities Required by the OSHA Respiratory Standards, reaffirmed November 13, 2018

90-41 Board motion adopting article on patient abandonment by Dr. Shelley Conroy in the Spring 2001 Nursing Notes, effective May 16, 2019

90-43 Board opinion on attachment of scalp leads for internal fetal monitoring, adopted October 22, 1983, revised by Board motion on November 18, 2003, reaffirmed November 19, 2019

90-52  Board opinion on delegation of the removal of venous and arterial sheaths to unlicensed personnel, effective May 16, 2019

90-63 Registered nurses and procedural sedation, effective July 8, 2021


90-10 Guidelines for Processing Applications for Licensure: Examination, Endorsement and Reinstatement, revised February 24, 2017

90-42 Reinstatement following Mandatory Suspension, reaffirmed November 13, 2018

90-55 Joint statement of the Department of Health and the Department of Health Professions on Impact of Criminal Convictions on Nursing Licensure or Certification and Employment in Virginia, effective February 4, 2021

90-59 Impact of Criminal Convictions on Registration of Medication Aides and Licensure of Massage Therapist in Virginia, effective February 4, 2021

Education & Testing

90-13 Application for Initial Approval of Nursing Education Program, adopted March 22, 2016, revised February 22, 2017

90-14 Continued Full Approval of Nursing Education Program, adopted March 22, 2016, revised February 22, 2017

90-21 Clinical Learning Experience in Nursing Education Programs, revised February 24, 2017

90-22 Requests for Accommodations for NCLEX and NNAAP Testing and Medication Aide Examination for Registration, effective April 3, 2019

90-34 Board motion on review and challenge of NCLEX, effective May 16, 2019

Discipline & Compliance

90-3 Continuing Competency Violations for Nurses, effective April 3, 2019

90-7 Sanctioning Reference Points Manual, revised January 2017

90-12 Delegation of Authority to Board of Nursing RN Education and Discipline Staff, effective April 3, 2019

90-35 Noncompliance with Board Orders by Individual Licensees, effective April 3, 2019

90-38 Disposition of Disciplinary Cases against Nurses and Massage Therapists Practicing on Expired Licenses, effective April 3, 2019

90-39 Indefinite Suspension Timeframes, reaffirmed January 29, 2019

90-54  Guidance for Conduct of an Informal Conference by an Agency Subordinate of a Health Regulatory Board at the Department of Health Professions, adopted September 21, 2004, reaffirmed September 17, 2019

90-61 Disposition of Disciplinary Cases against CNA’s and RMA’s Practicing on Expired Certificates or Registrations, effective April 3, 2019

Licensed Nurse Practitioners/Joint Board:

90-11 Continuing Competency Violations for Nurse Practitioners, effective February 4, 2021

90-33 Authority of Licensed Nurse Practitioners to write Do Not Resuscitate Orders (DNR Orders)effective May 16, 2019

90-56 Practice Agreement Requirements for Licensed Nurse Practitioners, effective September 30, 2021

90-64 Telemedicine for Nurse Practitioners, revised by the Board of Medicine June 22, 2017, revised by the Board of Nursing July 18, 2017, edited August 11, 2021

110-8 Information on prescriptive authority in Virginia, effective Autust 6, 2020

Massage Therapist

90-47 Guidance on Massage Therapy Practice, revised September 17, 2019

90-58 By-Laws of the Advisory Board on Massage Therapy, revised September 17, 2019

Board Administration

90-57 By-Laws of the Board of Nursing, effective March 18, 2020


Virginia Board of Nursing
Jay P. Douglas, MSM, RN, CSAC, FRE, Executive Director
Marie Gerardo, MS, RN, ANP-BC, President