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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

90-36 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, effective August 3, 2023

110-18 Interpretation of "administer" to include preparation for administration, reaffirmed December 9, 2019


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 Scope of practice for registered nurses and licensed practical nurses, effective September 28, 2023

90-23 Decision-making Model for Determining RN/LPN Scope of Practice, 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

90-52  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, effective July 7, 2022

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, reaffirmed September 14 2021

90-14 Continued Full Approval of Nursing Education Program, adopted March 22, 2016, reaffirmed September 14, 2021

90-22 Requests for Accommodations for Nurse, Nurse Aide and Medication Aide Testing, effective January 19, 2023

Discipline & Compliance

90-3 Continued competency violations for nurses and licensed massage therapists, effective September 28, 2023

90-7 Sanctioning Reference Points Manual, effective October 13, 2022

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 Practitioners Practicing on Expired Licenses or Registrations, effective August 3, 2023

Advanced Practice Registered Nurses/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 (Advanced Practice Registered Nurses), effective February 2, 2023

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 January 4, 2024

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
Cynthia M. Swineford, MSN, RN, CNE, President