STANDARDS OF COMPETENCY FOR RNs
[This section covers subsections (A) thru (K) of the OAC 4723-4-03, Standards relating to competent practice as a registered nurse.]
Registered nurses (A) provide nursing care within the scope of practice described in the Ohio Revised Code and the rules of the Ohio Board of Nursing and (B) maintain current knowledge of the duties, responsibilities, and accountabilities of safe nursing practice.
RNs must (C) be competent and accountable in all areas of practice, including consistent performance of all aspects of nursing care and appropriate recognition, referral or consultation, and intervention when complications arise.
RNs may (D) provide nursing care beyond basic nursing preparation for an RN provided they:
- Obtain additional education
- Demonstrate appropriate knowledge, skills, and abilities
- Maintain documentation of their additional education and training
- Have a specific current order from an authorized individual acting within their professional practice
- Do not carry out a function or procedure prohibited by any law or rule
RNs must (E) implement any order in a timely manner unless they believe or have reason to believe the order is:
- Inaccurate
- Not properly authorized
- Not current or valid
- Harmful or potentially harmful to a patient
- Contraindicated by other documented information
RNs must (E) clarify an order that meets any of the above criteria by consulting with an appropriate licensed practitioner.
When RNs (F) decide not to follow an order or prescribed medication or treatment after consulting with an appropriate licensed practitioner, the RN must:
- Notify the ordering practitioner of the decision not to follow the order
- Document that the practitioner was notified and state the reason for not following the direction
- Take any other action to ensure the safety of the patient
RNs (G) report to and consult with other nurses or members of the healthcare team and make referrals as necessary in a timely manner.
RNs must (H) maintain the confidentiality of patient information, communicating patient information with other members of the healthcare team for healthcare purposes only and accessing patient information only for patient care purposes or for fulfilling nursing responsibilities. This includes not disseminating patient information through social media, texting, emailing, or any other form of communication for purposes other than patient care.
To the maximum extent feasible, RNs must (I) not disclose identifiable patient healthcare information unless the patient has consented to such disclosure and must report individually identifiable patient information without written consent in limited circumstances only and in accordance with authorized laws and rules.
RNs must (J) use acceptable standards of safe nursing care as a basis for any observation, advice, instruction, teaching, or evaluation and communicate information that is consistent with acceptable standards of safe nursing care.
When RNs (K) give direction to LPNs, they must first assess:
- Condition and stability of the patient who needs nursing care
- The type of nursing care required
- The complexity and frequency of the care required
- The training, skill, and ability of the LPN who is to perform the specific function or procedure
- The availability and accessibility of resources needed to safely perform the function or procedure
The tasks assigned to LPNs must also be within the licensed practical nurse’s legal scope of practice.