Every state and territory in the U.S. is responsible for enforcing a set of laws, known as Nurse Practice Acts, which promote safe and competent nursing care. In Hawaii, Nurse Practice Act (NPA) provisions are overseen by the state's Board of Nursing (BON). This gives the BON the authority to hold nursing professionals accountable for the care that they deliver and penalize any nurses who pose a danger to patients and the public.
As a facility leader, understanding your state's NPA is crucial for promoting quality care and maintaining professional integrity among your care teams. In this article, we'll summarize key provisions of the Hawaii NPA and share tips on how to apply them to promote a culture of safety at your facility.
Hawaii State Nurse Practice Act at a Glance
Nursing licensure requirements, scope of practice guidelines, and delegation rules can all be found in the Nurse Practice Act. Hawaii nursing professionals are responsible for learning and adhering to all rules and regulations in the NPA to ensure they're fully qualified to carry out their roles. As a facility leader, you can enforce protocols that support compliance by staying up to date on some of the key provisions summarized below.
| Hawaii Nurse Practice ActSummary | |
|---|---|
| Hawaii Board of Nursing Rules and Regulations | Hawaii Revised Statutes, Volume 10, Chapter 457:Sections 457-1 to 457-17Hawaii Administrative Rules:Chapter 89 |
| Nursing Licensure Requirements | To obtain a registered nurse (RN) license in Hawaii, applicants must either pass the NCLEX examination or submit an endorsement application to the BON.Steps to receive licensure by examination:Complete an accredited nursing program.Pass the NCLEX exam.Submit an applicationonlineor viamail.Submit a background check and fingerprints.Steps to receive licensure by endorsement:Submit proof of any prior licenses issued on or after July 1, 2017.Submit aself-query report(if licensed in another state).Submit a background check and fingerprints.Submit an applicationonlineor via mail to address: Board of Nursing P.O. Box 3469 Honolulu, HI 96801.More information about license renewal processes can be found on theHawaii BON website. |
| Scope of Practice Guidelines | According to sections457-2.5through457-2.7, RNs, licensed practical nurses (LPNs), and advanced practice registered nurses (APRNs) should reference the National Council of State Boards of Nursing (NCSBN)model NPAandmodel rulesto determine which duties fall inside and outside of their scope of practice. The sections of the model NPA and rules that apply to each level of nursing are outlined below.LPN scope of practice:NCSBN Model NPA, Article II, Section 3NCSBN Model Rules, Chapter 2, Sections 2.3.1 through 2.3.3RN scope of practice:NCSBN Model NPA, Article II, Section 2NCSBN Model Rules, Chapter 2, Section 2.2.2 through 2.2.6APRN scope of practice:NCSBN Model NPA, Article II, Section 4NCSBN Model Rules, Chapter 2, Section 2.4.1 |
| Delegation Rules | Delegation and supervision rules for nursing professionals are outlined insection 457-7.5of the NPA. Here is a summary of some of the key rules to keep in mind:An RN may delegate nursing care tasks, functions, and activities to unlicensed assistive personnel in a way that is appropriate to the level of knowledge and skill of the unlicensed assistive personnel.The delegation of tasks, functions, and activities must comply with applicable federal and state laws.The delegating nurse is responsible for individually assessing the patient, circumstances, and competence of the person to whom the tasks are being delegated.When delegating a task, function, or activity, a delegating nurse should use theNCSBN delegationdecision-making process. |
| Violations and Penalties | Penalties and violations are outlined insection 457.14of the NPA. Examples of violations include but are not limited to:Fraudulently selling or obtaining any nursing diploma, license, renewal, or record.Practicing nursing under a fraudulently signed or unlawfully obtained diploma, license, or record.Practicing nursing with a suspended or revoked license.Conducting a nursing education program that hasn’t been accredited by the BON.Any of these misdemeanors or violations of the NPA can result in a fine of up to $500, with each subsequent offense resulting in a fine of up to $1,000 and imprisonment for up to 1 year. The BON can also impose other penalties, such aslicense suspension and revocation, on a case-by-case basis. |
| Nurse Licensure Compact (NLC) State? | Hawaii isnotcurrentlypart of the NLC, meaning that:In-state nurses must obtain additional licensure to practice out-of-state; andOut-of-state nurses can’t practice in Hawaii without applying for endorsement.However, pending legislation was carried into 2026 that would establish HI’s participation in the NLC if passed. Depending on the outcome ofHouse Bill 897, Hawaii may yet become a compact state. |
Improving NPA Compliance: 3 Tips for Facilities
With this overview of the Hawaii Nurse Practice Act, you're probably wondering how to take steps to ensure your staff are meeting all professional standards. Here are three tips that can help you better enforce these provisions at your facility.
1. Remain Adaptable to Regulatory Changes
The healthcare landscape is constantly evolving, and the NPA is often updated to reflect new advancements in nursing practice. It's important to stay up to date on amendments to Hawaii's NPA and remain adaptable to any changes that must be implemented at your facility. You can stay informed of any pertinent news affecting your staff through the BON's website.
2. Thoroughly Screen and Vet All Nursing Candidates
The Hawaii Nurse Practice Act prohibits individuals from practicing nursing without valid credentials and training. To avoid legal repercussions and keep your patients safe, it's important to thoroughly screen and vet all candidates during the hiring process. In addition to watching out for resume red flags, you can request an official license verification from all of your nursing candidates. Any suspicious behavior should be reported to the Hawaii BON in a timely manner.
3. Send Out Regular Licensure Renewal Reminders
You should also regularly remind your staff to renew their licenses before they expire. In Hawaii, nursing licenses must be renewed on June 30th of every odd-numbered year. All nursing professionals must also keep up with the state's continuing education requirements in order to renew their licenses. You can find more information about these competency requirements in Hawaii's continuing competency guidance booklet.
Discover More Ways to Maintain Regulatory Compliance
Learning about the Hawaii Nurse Practice Act is one of many ways to help your staff maintain compliance. Seeking a practical way to keep up with other regulations? Get even more expert-written insights into facility management and nursing practice delivered straight to your inbox.
Legal Disclaimer: This article contains general legal information, but it is not intended to constitute professional legal advice for any particular situation and should not be relied on as professional legal advice. Any references to the law may not be current, as laws regularly change through updates in legislation, regulation, and case law at the federal and state level. Nothing in this article should be interpreted as creating an attorney-client relationship. If you have legal questions, you should seek the advice of an attorney licensed to practice in your jurisdiction.