Ohio Nurse Practice Act (2 Hours)
Law and Rules – Category A

CONTACT HOURS: 2

BY: 

Adrianne E. Avillion, DEd, MSN, RN; Persis Mary Hamilton, EdD, MSN, BSN, PHN, PMHN

LEARNING OUTCOME AND OBJECTIVES:  Upon completion of this continuing education course, you will have increased your knowledge of the standards of safe nursing practice as outlined in the Ohio Nurse Practice Act and the rules of the Ohio Administrative Code as written by the Ohio Board of Nursing in accordance with Section 4723 of the Ohio Revised Code. Specific learning objectives to address potential knowledge gaps include:

  • Describe the Ohio Scope of Practice Decision-Making Model.
  • Compare the roles of the Ohio Board of Nursing and Ohio professional associations.
  • Discuss the standards for competent nursing practice of RNs and LPNs in Ohio.
  • Explain standards for the promotion of patient safety by licensed nurses in Ohio.
  • Summarize the RN and LPN standards for applying the nursing process in Ohio.
  • Describe violations of nursing laws and rules that may result in disciplinary action.

TABLE OF CONTENTS

  • Ohio Board of Nursing and Ohio Administrative Code
  • Professional Organizations
  • Standards of Competency for RNs
  • Standards of Competency for LPNs
  • Standards of Competency for Advanced Practice Nurses
  • Standards that Promote Patient Safety
  • Standards for Applying the Nursing Process for RNs
  • Standards for Applying the Nursing Process for LPNs
  • Specialty Certification
  • Discipline Related to Nursing Practice
  • Conclusion
  • Resources
  • References

The establishment of standards for nursing education and practice is the result of efforts by nursing associations that began over 100 years ago. Currently in each state or territory, a law known as the Nurse Practice Act designates an authoritative body that defines and regulates the nursing practice of every nurse in every role. This authoritative body, known as a board of nursing, is responsible for ensuring that nurses who practice in the state for which they have responsibility are competent, safe, skilled, and knowledgeable about the standards set forth in that state’s scope of practice for nurses (NCSBN, 2018). This course presents those standards for the state of Ohio written by the Ohio Board of Nursing in accordance with the Nurse Practice Act.

OHIO BOARD OF NURSING AND OHIO ADMINISTRATIVE CODE


All licensed medical professionals work under accepted standards derived from local, state, and federal laws as well as professional guidelines. Licensed nurses are no exception. Their scope of practice is defined by the Nurse Practice Act (NPA) of the state in which they practice. In Ohio, the NPA is codified in Section 4723 of the Ohio Revised Code (ORC). It establishes an Ohio Board of Nursing (OBN) and defines its structure and function.

Ohio Board of Nursing (OBN)

The Nurse Practice Act (ORC 4723) authorizes the OBN to make and enforce rules and regulations for registered nurses, licensed practical nurses, advanced practice nurses (certified nurse-midwives, certified nurse practitioners, certified nurse specialists, and certified registered nurse anesthetists), dialysis technicians, and community health workers. The board regulates over 300,000 licenses and certificates. Its top priorities are to efficiently license the nursing workforce and remove dangerous practitioners from practice in a timely manner to protect Ohio patients (OH BON, 2021).

MEMBERSHIP

Board members are public officials and meetings are open to the public. The board is made up of thirteen members: eight registered nurses, four licensed practical nurses, and one consumer appointed by the governor. At least two of the registered nurses shall hold a current, valid license issued under the ORC that authorizes the practice of nursing as an advanced practice registered nurse. The board has the legal authority to administer and enforce all provisions of the NPA. It must review each rule within the Ohio Administrative Code (OAC) at least once every five years. The board is funded and supported by mandatory licensure fees paid by nurses wishing to practice legally in the state of Ohio. The board does not have authority over employers (ORC 4723.02).

SCOPE OF PRACTICE

Because nursing is a dynamic practice, questions may arise about whether certain tasks are within the nurse’s scope of practice. All nursing care should be consistent with the nurse’s preparation, education, experience, knowledge, and demonstrated competency.

The Ohio Board of Nursing has developed a Scope of Practice Decision-Making Model to help nurses determine whether a task is within their scope of practice. The model uses a decision tree with references and is based on legality, competency, safety, and accountability.

OBN SCOPE OF PRACTICE DECISION-MAKING MODEL

The Scope of Practice Decision-Making Model includes the following steps:

  • Define/describe the activity or task: Is the activity or task within the scope of practice and not prohibited or precluded by any other law or rule?
  • Can the nurse perform the activity or task and meet the standards of safe nursing practice as defined in OAC, chapter 4723-4? Can the nurse demonstrate and document current knowledge, skills, and abilities?
  • Is this activity or task safe and appropriate to perform with this patient at this time?
  • The nurse may perform the activity/task according to acceptable and prevailing standards of safe nursing care and prepare to accept accountability for the nursing actions.

Each of these steps must be answered with a “yes” before proceeding to the next step. If at any point an answer is “no,” the nurse must not perform the action (OBN, 2019).

CASE
Scope of Practice Decision-Making

Mycee is a licensed practical nurse (LPN) with five years of experience who has recently moved from Indiana to Ohio. This is her first shift on a surgical floor following orientation, and she is responsible for five patients who are 1 to 4 days post-op. A new order has been written for Mr. Hansen, who is receiving patient-controlled analgesia (PCA). The order is for a change in PCA dosage.

In Indiana, Mycee was not restricted from performing this task, but she does not recall whether she is allowed to do so in Ohio. Since she can’t look up the Ohio Administrative Code right now to see if the task is within her scope of practice, she consults with her charge nurse. The charge nurse tells Mycee that this is not within the scope of the LPN in Ohio. As a registered nurse (RN), the charge nurse addresses the new order.

Later, when Mycee has a break, she refers to “Using the Scope of Practice Decision-Making Model” and then visits the Ohio Administrative Code website indicated in that document. She reads Chapter 4723-17-03 (A) (4) of the code, which describes the role of the LPN in intravenous therapy procedures. There she finds that an LPN may not “program or set any function of a patient-controlled analgesic,” thereby confirming that the task is not within her legal scope of practice in Ohio.

Applying the Model Yourself

Take a moment to think of a situation that could arise in your practice. Then ask yourself the following questions. If you cannot answer yes to each question, you should not undertake the action.

  1. Is this activity or task within my scope of practice and not prohibited or precluded by any other law or rule?
  2. Can I perform the activity or task and meet the standards of safe nursing practice as defined in OAC, chapter 4723-4? Can I demonstrate and document current knowledge, skills, and abilities?
  3. Is this activity or task safe and appropriate to perform with this patient at this time?
  4. Can I perform the activity or task according to acceptable and prevailing standards of safe nursing care and prepare to accept accountability for the nursing actions?

Ohio Administrative Code

The rules of the Board of Nursing regulate nursing practice in Ohio and are contained in Section 4723 of the Ohio Administrative Code (OAC). This course reviews those chapters in Section 4723 that set forth the standards of competency, safe nursing practice, delegation, application of the nursing process, and discipline for registered nurses and licensed practical nurses in the state of Ohio.

OHIO ADMINISTRATIVE CODE, SECTION 4723, BOARD OF NURSING

Chapter 4723-1     Board Organization and Records
Chapter 4723-21     Public Notice
Chapter 4723-31     Definitions
Chapter 4723-41     Standards of Practice Relative to Registered Nurse or Licensed Practical Nurse
Chapter 4723-51     Nursing Education Program
Chapter 4723-61     Alternative Program for Substance Use Disorder Monitoring
Chapter 4723-71     Examination and Licensure
Chapter 4723-81     Advanced Practice Nurse Certification and Practice
Chapter 4723-91     Prescriptive Authority
Chapter 4723-131     Delegation of Nursing Tasks
Chapter 4723-141     Continuing Nursing Education
Chapter 4723-161     Hearings
Chapter 4723-171     Intravenous Therapy Courses for Licensed Practical Nurses
Chapter 4723-181     Practice Intervention and Improvement Program (PIIP)
Chapter 4723-201     Prevention of Disease Transmission
Chapter 4723-231     Dialysis Technicians
Chapter 4723-251     Nurse Education Grant Program
Chapter 4723-261     Community Health Workers
Chapter 4723-271     Medication Administration by Certified Medication Aide

CONTINUING EDUCATION FOR RENEWAL FOR RNs and LPNs

For the period immediately following Ohio licensure by NCLEX examination, the nurse is not required to complete any contact hours of CE for the first license renewal. Other than the first renewal immediately following licensure by exam, nurses must complete at least 24 contact hours of CE that includes at least one contact hour of Category A CE for each renewal. A nurse who has been licensed in Ohio by reciprocity for less than or equal to one year prior to the first Ohio license renewal must complete at least 12 contact hours, rather than 24 (OBN, 2020).