Ohio Nurse Practice Act & Rules of Board of Nursing Presented by Terri Durkin Williams, RN

objectives Upon completion the learner will be able to relate the process of nursing law and rule formation in the State of Ohio. Upon completion the learner will be able to relate the essential components of the Nurse Practice Act and Rules of the Board. Upon completion the learner will be able to discuss Section 4723.28 of the ORC, offenses.

Board of Nursing Members appointed by governor 8 Registered Nurses One RN must hold a Certificate of Authority 4 Licensed Practical Nurses 1 Consumer Serve 4 year terms and may be reappointed one time

Regulate pre-licensure educational/training programs Board of Nursing Regulate pre-licensure educational/training programs Issues credentials to qualified individuals Disciplinary action

Given rule-making authority Board of Nursing Given rule-making authority Must promulgate rules according to statutory process Requires public input

Laws Chapter 4723 of the Ohio Revised Code (ORC) General Assembly, the State Legislature. Nurse Practice Act Laws regulating nursing practice

Chapter 4723-1 through 4723-27 of the Ohio Administrative Code (OAC) Rules Chapter 4723-1 through 4723-27 of the Ohio Administrative Code (OAC) Rules of the Board of Nursing

Renewal of License Must renew license every two years Must complete continuing education Keep CEU’s for 6 years Need 24 hours for each licensing period One hour must be directly related to the laws and rules pertaining to nursing practice, Category A

17 South High Street, Suite 400 Board notification Change of address Name change May contact the Board electronically www.nursing.ohio.gov 17 South High Street, Suite 400 Columbus, Ohio 43215-7410 614-466-3947

Section 4723.28 Orc offenses Practice without a license Misdemeanor committed in the course of practice Any felony or any crime involving gross immorality or moral turpitude Selling, giving away, of administrating drugs other then legally

Offenses Habitual or excessive use of controlled substances, habit-forming drugs, alcohol Impairment of the ability to practice according to acceptable and prevailing standards of safe nursing care Assaulting or causing harm to a patient

Offenses Misappropriation of money or anything of value Failure to use universal and standard precautions Activities that exceed the practice of nursing Sexual contact

offenses Verbal behavior that is sexually demeaning Assisting in suicide

Mandatory reporting section 4723.34 ORC Must report the name of any current of former nurse who engages in conduct that would be grounds for disciplinary action. Who Must Report: Nurses Prosecutors Nursing Associations

Nursing board Must investigate all complaints Investigations are confidential Has Subpoena Authority No statute of limitations Action is public

Practice of Nursing RN LPN Specialized knowledge Judgment Skill derived from principles of biological, physical, behavioral, social, and nursing science Application of basic knowledge of the biological, physical, behavioral, social and nursing science at the direction of a licensed physician, dentist, podiatrist, optometrist, chiropractor, or RN

RN Scope of Practice Identifying patterns of human responses to actual or potential health problems amenable to a nursing regimen; Executing a nursing regimen through the selection, performance, management, and evaluation of nursing actions; Assessing health status for the purpose of providing nursing care;

RN Scope of Practice Providing health counseling and health teaching; Administering medications, treatments, and executing regimens authorized by an individual who is authorized to practice in the state and is actin within the course of the individual’s professional practice;

Rn scope of practice Teaching, administering, supervising, delegating, and evaluating nursing practice. RN is authorized to engage in all aspects of nursing practice. RN determines the data to be collected to determine the patient’s health status. RN determines the nursing care that should be provided.

Lpn scope of practice Observation, patient teaching, and care in a diversity of health care settings; Contributions to the planning, implementation, and evaluation of nursing; Delegation of nursing tasks as directed by a registered nurse;

LPN scope of practice Administration of medications and treatment authorized by an individual who is authorized t practice in this state and is acting within the course of the individual’s professional practice on the condition that the licensed practical nurse is authorized under section 4723.17 of the Revised Code to administer medications

Lpn scope of practice Administration to an adult of intravenous therapy authorized by an individual who is authorized to practice in this state and is acting within the course of the individual’s professional practice, on the condition that the licensed practical nurse is authorized under section 4723.18 or 4723.181 of the Revised Code to perform intravenous therapy and performs intravenous therapy only in accordance with those sections;

Lpn scope of practice Teaching nursing tasks to licensed practice nurses and Individuals to whom the licensed practical nurse is authorized to delegate nursing tasks as directed by a registered nurse. LPN has a dependent role and may provide nursing care only at the direction of a RN, physician, dentist, podiatrist, optometrist or chiropractor.

Supervision of nursing practice The RN is supervising the “practice” of nursing as stated in (Section 4723.01(B)(6), ORC). Supervision of employee performance and other employment requirements are established by the employer. RN is not required to be on-site to supervise.

Is the activity or task within the scope of practice of the nurse and NOT prohibited or precluded by any other law of rule? legality Scope of Practice Decision Making Model

Can the nurse perform the activity or task and meet the standards of safe nursing practice as defined in Chapter 4723-4 of Ohio Administrative Code? Competency Scope of Practice Decision Making Model

Is this activity or task safe and appropriate to perform with this patient/client at this time? Safety Scope of Practice Decision Making Model

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 action. Accountability Scope of Practice Decision Making Model

Definition of delegation The transfer of responsibility for the performance of a selected nursing task from a licensed nurse authorized to perform the task to an individual who does not otherwise have the authority to perform the task.

Delegating Nurse The nurse who delegates a nursing task or assumes responsibility for individuals who are receiving delegated nursing care.

Direction Communicating a plan of care to a licensed practical nurse. Direction by a registered nurse is not meant to imply the registered nurse is supervising the licensed practical nurse in the employment context.

Nursing task Those activities that constitute the practice of nursing as a licensed nurse and may include: Assistance with ADL’s that are performed to maintain or improve the client’s well-being, when the clients are unable to perform that activity themselves.

Key Points for delegation Chapter 4723-13 OAC That the nursing task is within the training, ability, and skill of the unlicensed person who will be performing the task. Appropriate resources and support are available Appropriate supervision

Key points for delegation The nursing task requires no judgment based on nursing knowledge and expertise. The task can be safely performed according to exact, unchanging directions. The task does not require repeated performance of nursing assessments.

Key points for delegation The consequences of performing the nursing task improperly are minimal and not life-threatening. No person to whom a nursing task is delegated shall delegate the nursing task to any other person. The delegating nurse shall be accountable for the decision to delegate nursing tasks.

Professional boundaries Inspire confidence in patients and families Professional Promote independence Respect patient’s dignity No personal gain No personal relationship

Evaluation of professional boundaries Talk about personal life Give address and phone number Complain Accept gifts Buy or sell items Feel compelled to “fix” problems more so than patient

National council of state boards of nursing Free Brochure A Nurse’s Guide to Professional Boundaries Web site www.ncsbn.org To order e-mail: communications@ncsbn.org

Social networking definition Web-based services that allow individuals to: Construct a public or semi-public profile within a bounded system Articulate a list of other users with whom they share a connection View and traverse their lists of connections by others in the system

Tips to avoid problems Use standards of professionalism online Do not share or post information or photos gained through the nurse-patient relationship Maintain professional boundaries online.

Tips to avoid problems Do not make disparaging remarks about patients, employers of co-workers. Do not take photos or videos of patients on personal devices. Promptly report a breach of confidentiality or privacy.

Questions

Terri Durkin Williams, RN, LNHA Contact Information Terri Durkin Williams, RN, LNHA terri.williams@omnicare.com 330-203-8372