Nursing Law and Rules in Ohio: An Overview

 This independent study has been developed for nurses who wish to learn more about nursing law and rules in Ohio. The study was designed to be utilized with both Section 4723 of the Ohio Revised Code (ORC), (commonly known as the Nurse Practice Act) and Chapter 4723 of the Ohio Administrative Code (commonly known as Board rules).

This independent study meets the Ohio Board of Nursing requirement for 1 contact hour of approved continuing education directly related to the law and rules governing nursing practice in Ohio.

1.3 contact hour of Category A (Law and Rules) will be awarded for successful completion of this independent study.

The Ohio Nurses Association (OBN-001-91) is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Expires 6/9/2017.

DIRECTIONS

1. Please read the below article carefully.

2. Complete the post-test, evaluation form and the registration form.

The post-test will be reviewed. If a score of 70 percent or better is achieved, a certificate will be sent to you. If a score of 70 percent is not achieved, a letter of notification of the final score and a second post-test will be sent to you. We recommend that this independent study be reviewed prior to taking the second post-test. If a score of 70 percent is achieved on the second post-test, a certificate will be issued.

If you have any questions, please feel free to call Zandra Ohri, MA, MS, RN, Director, Continuing Education, zohri@ohnurses.org, 614-448-1027, or Sandy Swearingen, sswearingen@ohnurses.org. 614-448-1030, Ohio Nurses Association at (614) 237-5414.

OBJECTIVES:

  1. Describe the difference in the role of the Ohio Board of Nursing and professional nursing associations in Ohio.
  2. Describe the role of the Ohio General Assembly in establishing the Nurse Practice Act in Ohio.
  3. Describe selected functions of the Ohio Board of Nursing.
  4. Describe selected portions of the Nurse Practice Act and Board rules.

This independent study was developed by: Carol Roe, JD, RN, Centers for Dialysis Care, Inc., Shaker Heights, Ohio. Revisions to this study were made by Jan Lanier, JD, RN, and recently, Kathleen Morris, RN, Ohio Nurses Association. The authors and members of the planning committee have declared no conflict of interest.

Disclaimer: Information in this study is intended for educational purposes only. It is not intended to provide legal and/or medical advice or to be a comprehensive compendium of evidence-based practice. For specific implementation information, please contact an appropriate professional, organization, legal source, or facility policy.

STUDY

The Role of the Ohio Board of Nursing

The purpose of the Ohio Board of Nursing (OBN) is to protect the public.  Nursing is regulated because it is one of the professions, if done by unqualified persons, that could pose a risk of harm to the public. The regulation of nurses, like that of physicians, pharmacists, and other health care professionals, is within the purview of the state government by virtue of the 10th amendment to the United States Constitution. Thus, the OBN is a structure of state government.

The OBN is financially supported by the individual licensure fees which are paid by those who are regulated by the OBN. The payment of those fees is mandatory for those who wish to practice in Ohio. Because the OBN is a public body, its meetings are open to the public. The OBN’s authority and decision making are defined by the law. The main purpose of the law is to protect the public from the unsafe practice of nursing and dialysis care.

“The nurse practice act in any state defines nursing practice and establishes standards for nurses in each state.  It is the most definitive legal statute or legislative act regulating nursing practice” (1).  The “nurse practice act” in Ohio can be found in Title 47 of the Ohio Revised Code (ORC), specifically at Chapter 4723. ORC.

The Nurse Practice Act is applicable to the practice of all licensed nurses, that is, registered nurses (RN), licensed practical nurses (LPN), certified nurse practitioners (CNP), certified nurse-midwives (CNM), certified registered nurse anesthetists (CRNA), and clinical nurse specialists (CNS). A change in the nurse practice act in 2000 led to the inclusion of dialysis technicians and in 2003, community health workers were added to the OBN’s jurisdiction. In 2005, certified medication aides (MA-Cs) were recognized in Ohio law and became subject to Board of Nursing authority. The Nurse Practice Act grants the authority for enforcement of the law to the OBN. The law also gives the OBN the authority to adopt rules. The rules clarify or explain the law but cannot conflict with or expand the law. The rules can be found in the Ohio Administrative Code (OAC) and have the same force and effect as law. The OBN must enforce the law and rules regulating the practice of nursing as they are written even though individual nurses may not agree with the law.

The OBN enforces the law and rules by taking disciplinary action against individuals who have been granted a license or certificate to practice from the OBN. The OBN has no authority over health care facilities or employers of nurses. It has no authority over individuals who are not licensed or certified by the OBN.

The Role of Professional Nursing Organizations

“Professional nursing organizations are voluntary, private entities and the purposes, goals, and missions of the organization are determined by those who choose to be members of the organization.  In general, purposes of professional nursing organizations include advocating for the advancement of the profession of nursing and protecting the public. These organizations bring the practitioners together and develop professional standards of practice, codes of ethics, and engage in peer review in a voluntary process. Professional nursing organizations provide services to members. In general, meetings in which decisions are made are open to only those who are members of the organization” (2).

There are a number of professional nursing organizations in Ohio. Additionally, dialysis technicians may belong to a voluntary organization comprised of dialysis technicians. The Ohio Board of Nursing works collaboratively with nursing organizations as well as other health care and consumer organizations. However, organizations do not dictate the actions of the OBN. In some instances, the OBN may make decisions that are not supported by an individual organization.

One of the functions of some professional organizations is influencing the making of law through lobbying the state legislature. Indeed, one of the reasons for the establishment of the Ohio Nurses Association (ONA) in the early 20th century was to lobby the state legislature (Ohio General Assembly) to pass a Nurse Practice Act in Ohio.  ONA is one of three state nursing organizations which employ lobbyists. The other two are the Ohio Association of Advanced Practice Nurses (OAAPN) and the Ohio State Association of Nurse Anesthetists (OSANA).

The Role of the Ohio General Assembly in the Making of Nursing Law

The Nurse Practice Act (NPA) is the law (also called statute) governing the practice of nursing in Ohio. Like any other state law, it comes into being through the legislative process. That means that a bill must be introduced, or another bill amended, in the Ohio General Assembly. The Ohio General Assembly is the legislative or law making body for the state of Ohio.

Similar to the United States Congress, the Ohio General Assembly is made up of two houses, the Ohio Senate and the Ohio House of Representatives. The House of Representatives is comprised of 99 members and the Senate is comprised of 33 members.

Any bill, which is being considered by the General Assembly, is public information and any citizen has an opportunity to provide input into the law making process. Thus, persons other than nurses make nursing law.  Some nurses express disdain and frustration with the legislative process and vow never to be involved in “politics.” The reality is that the legislative process cannot be separated from “politics” in decisions about law.

Changes in the nursing law can occur through one of two ways. A bill specific to the issue is introduced or another bill, which has been already introduced, is amended. After bills traverse the process of committee hearings and votes by both chambers, the legislation is sent to the governor for action. Legislation becomes effective, that is becomes law, normally 90 days after signature by the governor.

The Role of Ohio Board of Nursing in Making Rules

As previously stated, the Ohio Board of Nursing has been given statutory authority by the General Assembly to administer and enforce the Nurse Practice Act (Section 4723.06(A), ORC). The OBN is authorized by law to issue all rules necessary to carry out the provisions of the law. As one example, the law states that continuing education is required in order to renew a nursing license or certificate (Section 4723.24 (C)(1), ORC). The specifics of meeting the CE requirement are spelled out in the rules (Chapter 4723-14, OAC). All rules of the OBN are found in Chapters 4723-1 through 4723-27 of the Ohio Administrative Code (OAC). It is not enough to practice in accordance with the law; nurses must also practice in accordance with the rules.

The rule making process for the OBN is set forth in another section of the Revised Code and is the same process for all state agencies which issue rules (Chapter 119, ORC). That process requires that the OBN review every one of its rules at least once every 5 years and determine whether the rule should be maintained as it is, revised or rescinded. In addition to the mandated five year review, the OBN may consider whether any other existent rule needs to be changed or if additional rules need to be proposed based upon new laws passed by the General Assembly.

The OBN seeks public input into the rule making process in a variety of ways. A public hearing provides an opportunity for Board members to hear from those affected by the rule. The law requires the Board (like all other state agencies) to file its proposed rules with the Joint Committee on Agency Rule Review (JCARR), and other state entities. Ultimately, JCARR, which is comprised of members of the General Assembly, decides if the rules will be effective.

Structure of the Ohio Board of Nursing

The law dictates the composition of the Ohio Board of Nursing (Section 4723.02, ORC). The OBN is made up of eight registered nurses (RN), four licensed practical nurses (LPN) and one consumer. Of the eight RNs, one must also be authorized to practice as an advanced practice nurse – either a CNM, CNP, CRNA, or CNS. All of the nurse members must: reside in Ohio; be a graduate of an approved nursing education program; hold a current, valid Ohio license; and have engaged in the practice of nursing for the five years immediately preceding appointment to the OBN.

The thirteenth member of the OBN represents the interests of consumers of nursing and dialysis care. The consumer member can have no association with or financial interest in the delivery or financing of health care.

The term of office is four years with terms expiring at the end of the calendar year. Board members may be appointed to one additional four-year term. The expiration of terms is staggered so that all board members’ terms do not expire at the same time.

The Governor appoints board members. Individuals who wish to be considered must contact the Governor’s office to begin the appointment process. Nursing organizations as well as other organizations put forth suggestions to the Governor for appointment. Individuals who are seeking appointment need to take the necessary steps to “lobby” if they hope to be successful.

The OBN as a whole meets every two months for two days to conduct the business of the OBN.  Board members serve on Board Advisory Groups and Task Forces, which require additional meetings. Members are paid for a portion of their time spent in doing the work of the OBN.

The OBN annually elects a President and Vice-President from its 12 nurse members. The law also requires that a registered nurse member be elected to serve as supervising member for disciplinary matters.

The OBN appoints an Executive Director (ED) annually, who, according to law, must be a registered nurse (Section 4723.05, ORC). The ED in turn hires staff to carry out the functions and directives of the board. The ED and various staff members may be present at board meetings and may be asked to speak to certain issues, but may not vote.

The OBN, by law, may appoint Advisory Groups, which make recommendations to the OBN (Section 4723.02, ORC). Currently, the Advisory Groups are:

–  Advisory Group on Continuing Education

–  Advisory Group on Dialysis

–  Advisory Group on Education

Qualifications for appointment to the Advisory Groups vary dependent upon the group. The requirements for the composition of the Dialysis Advisory Group as well as its functions are set forth in the law (Section 4723.71, ORC) whereas the other Advisory Groups are created by the OBN.

The law also mandates one other interdisciplinary committee, the Committee on Prescriptive Governance (CPG), (Section 4723.491, ORC). This committee is comprised of a CNM, a CNP, a CNS, a registered nurse member of the OBN, four physicians, and two pharmacists. The CPG develops recommendations regarding the authority of all CNMs, CNPs, and CNSs to prescribe drugs.

Recently, the Board began issuing so-called Interpretive Guidelines in response to questions raised regarding practice issues. Rather than maintaining an advisory group on practice and education, as had been the approach, the Board now convenes a Board Committee made up solely of Board members that then meets during the regular Board meetings. The committee obtains public input on the issue under discussion and gets feedback as to how proposed guideline language might affect practice.

Scopes of Practice and Orders

Registered nurse and licensed practical nurse

Scopes of practice for those regulated by the OBN are found in varying places in the law. The scope of practice for the RN can be found in Section 4723.01(B), ORC, which states:

“Practice of nursing as a registered nurse” means providing to individuals and groups nursing care derived from the principles of biological, physical, behavioral, social, and nursing sciences. Such nursing care includes:

(1)     Identifying patterns of human responses to actual or potential health problems amenable to a nursing regimen;

(2)     Executing a nursing regimen through the selection, performance, management and evaluation of nursing actions;

(3)     Assessing health status for the purpose of providing nursing care;

(4)     Providing health counseling and teaching;

(5)     Administering medications, treatments, and executing regimens authorized by an individual who is authorized to practice in this state and is acting within the course of the individual’s professional practice;

(6)     Teaching, administering, supervising, delegating, and evaluating nursing practice.”

In that same definition section of the law, Section 4723.01(F), ORC, states:

“The practice of nursing as a licensed practical nurse” means providing to individuals and groups nursing care requiring the application of basic knowledge of the biological, physical, behavioral, social and nursing sciences at the direction of a licensed physician, dentist, podiatrist, optometrist, chiropractor, or registered nurse.  Such nursing care includes:

  1. Observation, patient teaching, and care in a diversity of health care settings;
  2. Contributions to the planning, implementation, and evaluation of nursing;
  3. Administration of medications and treatments authorized by an individual who is authorized to practice in this state and is acting within the course of the individual’s practice, on the condition that the licensed practical nurse is authorized by the Board of Nursing.
  4. 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 4723.17 or 4723.171 of the Revised Code to perform intravenous therapy and performs intravenous therapy only in accordance with those sections.
  5. Delegation of nursing tasks as directed by a registered nurse.
  6. Teaching nursing tasks to licensed practical nurses, individuals to whom the licensed practical nurse is authorized to delegate nursing tasks as directed by a registered nurse.

A frequently asked question relates directly to the legal differences in the scope of practice of the RN and LPN. As can be seen by words of the law, the most fundamental difference defined is that of independent versus dependent functioning. The definition of the practice of nursing by the RN outlines six broad functions, five of which are independent functions meaning they can be initiated solely at the discretion of the RN after assessment of the situation and needs of the client.

Conversely, all the functions set forth in the law for the LPN are defined as dependent functions, performed at the direction of the registered nurse, physician, dentist, optometrist, chiropractor, or podiatrist. This does not mean that the LPN can only practice in the presence of one of those individuals, but it does mean that the LPN cannot practice nursing independently. The entire scope of practice defined for the LPN must be done at the direction of one of the individuals listed in the law. Both the LPN and the healthcare professional directing the care must be aware of this fact.

Additional legal differences between RNs and LPNs can be found in rules. The rules in Chapter 4723-5,OAC, which relate to pre-licensure nursing education programs, detail the differences in the curriculums of the RN and LPN programs as well as faculty preparation. Additionally, rules entitled, “Standards of Safe Nursing Practice for Registered Nurses and Licensed Practical Nurses” are found in Chapter 4723-4, OAC. These rules outline the differences in the implementation of the nursing process by RNs and LPNs.

Another frequently asked question relates to the issue of “from whom can the RN or LPN take orders?” The answer can be found in reviewing Section 4723.01(B) (5) and (F)(3), ORC. Both the RN and LPN can administer medications and treatments which have been authorized by individuals licensed to practice in Ohio who are acting within their scope of practice. Thus, orders can be taken from a CNM, CNP, CRNA or CNS for ordering of diagnostic tests since that is within their scope of practice. Authority to prescribe medications may be granted by the OBN to qualified CNMs, CNP, and CNSs. RNs and LPNs working with those practitioners need to ascertain whether or not they have certificates to prescribe before they implement medication orders. Similarly, physician assistants may also prescribe medication under Ohio law and nurses may implement those orders in accordance with standards of safe practice set out in Chapter 4723-4 OAC.

Advanced Practice Nurses

Certified nurse-midwives (CNM); certified nurse practitioners (CNP); certified registered nurse anesthetists (CRNA) and clinical nurse specialists (CNS)

The scopes of practice for these individuals can be found in Section 4723.43, ORC, which states in part:

“A certified registered nurse anesthetist, clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner may provide to individuals and groups nursing care that requires knowledge and skill obtained from advanced formal education and clinical experience.” Inherent in each of the four advanced scopes of practice is the concept that one cannot use any of the four titles without a certificate of authority (COA) from the OBN. This is known as “Title Protection” and applies also to the titles of registered nurse and licensed practical nurse.

A commonality in the scopes of practice for the CNM, CNP, and CNS, is the requirement of a collaborative practice with a physician (or podiatrist) (Section 4723.43 (A), (C), and (D), ORC); the requirement of a standard care arrangement (Section 4723.431, ORC); and the authority to prescribe medications under Section 4723. 48, ORC. This is in contrast to the CRNA scope that mandates supervision by a physician, podiatrist, or dentist (Section 4723.43 (B), ORC) and does not require a standard care arrangement. A CRNA is not required to obtain a certificate to prescribe in order to provide anesthesia care.

The educational preparation and requirements of national certification for CNPs, CNMs, CRNAs and CNSs are set forth in Section 4723.41, ORC. This is an important provision for registered nurses who may aspire to one of these four roles to keep in mind. In order to obtain a COA to practice as either a CNP, CNM, CRNA or CNS, an individual must have both graduate preparation with a major in a nursing specialty and certification from a national certifying organization which meets the criteria found in Section 4723.46, ORC.

Dialysis Technicians

Dialysis technicians may do the following according to Section 4723.72, ORC:

  • Perform and monitor dialysis procedures, including initiating, monitoring, and discontinuing dialysis;
  • Draw blood;
  • Administer medications, which are limited to:
  •  – Intradermal lidocaine or therapeutically equivalent local anesthetic;
  •  – Intravenous heparin;
  •  – Intravenous normal saline;
  •  – Patient specific dialysate.
  •  – Oxygen, when it has been delegated by an RN.

According to this same section of the law, dialysis technicians provide dialysis care only if the care has been delegated by a physician or registered nurse and the technician is under the supervision of the physician or registered nurse. Supervision is defined as in the immediate presence of that individual.

Community Health Workers

Section 4723-81 ORC

Community health workers (CHW) are recognized by the OBN as community representatives who advocate for individuals and groups in the community by assisting them in accessing community health and supportive resources through the provision of such services as education, role modeling, outreach, home visits and referrals. The certification program under the auspices of the OBN recognizes these workers as members of the community in which they provide services with a unique perspective of community needs that enable them to develop culturally appropriate solutions to problems and translate the solutions into practice.

When the services performed by CHWs involve nursing tasks, the tasks must be delegated and supervised by a registered nurse.

Unlike the law applicable to nurse and dialysis technicians, certification by OBN is not mandatory for individuals acting in a community health worker capacity. That is, individuals who engage in the activities defined as the scope of practice for CHWs are not required to obtain certification from OBN. Doing so is voluntary. The law expressly prohibits CHWs from administering or performing any other activity that requires judgment based on nursing knowledge or expertise.

Standards of Safe Nursing Practice

The OBN has established minimal acceptable standards of safe and effective nursing practice for nurses (which includes advanced practice nurses) in any setting. Those standards can be found in Chapter 4723-4, OAC. Among provisions in the chapter are:

  • The duty to clarify orders (from any individual), about which the nurse may have concerns (Rules 4723-4-03 (E) and (F) and 4723-4-04(E) and (F), OAC);
  • The duty to maintain confidentiality (Rule 4723-4-03 (H), OAC and Rule 4723-4-04(H), OAC);
  • The duty to display the applicable title or initials when providing direct care to patients (Rule 4723-4-06(A), OAC);
  • The duty to promote a safe environment for each client (Rule 4723-4-06(H), OAC);
  • The duty to delineate, establish, and maintain professional boundaries with each client (Rule 4723-4-06 (I), OAC). Delegation rules can be found in Chapter 4723-13, OAC.

Similar standards, which apply to dialysis technicians can be found in Rule 4723-23-14, OAC. OBN rules also will set forth standards for community health workers in Rule 4723-26-10 OAC.

Delegation

Delegation rules can be found in Chapter 4723-13, OAC. Delegation is the transfer of the responsibility for the performance of a selected nursing task from a licensed nurse authorized to perform the task to an individual who does not have the authority to perform the task. Nurses who delegate according to the rules minimize their risk of exposure to liability.

Licensed nurses may not delegate medication administration to unlicensed individuals unless a specific law allows it. Examples of settings where a law allows delegation of the administration of some medications are: group homes under the auspices of the Ohio Department of Developmental Disability (OD/DD), county boards of intermediate care facilities for DD (Rule 4723-13-02, OAC). Unlicensed individuals may assist patients with self-medication in any setting where self-administration is allowed.

Basically, the delegation rules require a licensed nurse to assess the client, teach the task to an unlicensed assistive personnel (UAP), and supervise the performance of the task. The crucial factor in delegation is the exercise of nursing judgment by the nurse. Delegation is client or patient specific.  It may be appropriate for a UAP to be taught a variety of nursing tasks. That does not mean the UAP should perform every task they are competent to perform on every patient. Tasks may be delegated to a UAP which:

– Require no judgment based upon nursing knowledge or expertise;
– Have reasonably predictable results;
– Can be performed safely according to exact, unchanging directions;
– The performance does not require complex observations or critical decisions;
– No repeated nursing assessments are required;
– There are no life threatening consequences. [See Rule 4723-13-05 (C)(3) OAC]

Direct, on-site supervision is required for delegation if the substantial purpose of the setting is the provision of health care. The nurse is accountable for assessing the situation and is responsible for the decision to delegate. The nurses are accountable for the task which is delegated and UAPs are accountable for their own actions.

Disciplinary Provisions 

One of the most misunderstood powers of the OBN is its role in disciplinary action. The grounds for disciplinary action and the process for that to occur are found in Section 4723.28, ORC. These provisions apply to all nurses and dialysis technicians. Rules of the OBN establish standards-and procedures for imposing sanctions on community health workers [See Section 4723.88 (F) ORC] and medication aides [Rule 4723-27-09 OAC] and Rule 4723-26-11 OAC.

The OBN does not take any disciplinary action without due process of law. In other words, there are no “nursing board police” who will “take away” your license immediately upon some error occurring. No action is taken by the OBN without an investigation of all the facts pertinent to the situation and an opportunity for the licensed nurse or dialysis technician, CHW or MA-C to explain. Any kind of action taken by the OBN, just like other regulating boards such as the medical and pharmacy boards, must be in accordance with Chapter 119 ORC, which sets forth strict rules for due process.

The investigatory process by the OBN is initiated by the filing of a complaint. A complaint is evidence that demonstrates that a person has violated a provision (or provisions) of the law or the rules of the OBN. All complaints are evaluated to determine if the OBN has the authority to investigate. Complaints may be referred to another agency for investigation such as the Department of Health if the complaint falls within the authority of that agency.

If the evidence gathered during the investigation warrants further action, formal charges will be made and the nurse or certificate holder will be sent a “Notice of Opportunity for Hearing.” The hearing is a formal process and both the OBN and the licensee or certificate holder presents his/her case before a hearing officer. Nurses or dialysis technicians, CHWs  and MA-Cs who find themselves at this stage of disciplinary action should seek the advice of an attorney if they have not already done so.

The hearing officer listens to both sides of the case, that is, the OBN’s case setting forth the evidence of a violation and the licensee or certificate holder’s explanation and/or denial of wrongdoing. Both sides may present witnesses who may either have direct knowledge of the case or may be experts in the area in question.

The hearing officer makes a determination based upon the evidence. If it is determined a violation or violations have occurred, the hearing officer recommends the level of disciplinary action. A range of options is available in terms of disciplinary action. The range includes:

–  Permanent revocation – prohibited from ever practicing nursing or dialysis care or as a CHW or MA-C.
–  Indefinitely/automatically/immediately suspended- prohibited from practicing for specified time period after which the nurse, technician, CHW , or MA-C may request reinstatement.
–  Indefinite suspension with stay – on “probation.”  May work as nurse or dialysis technician or CHW or MA-C but must be monitored and submit progress reports; may also have restrictions on practice.
–  Restrictions – have limits on such things as medication administration, shift work, or type of setting worked  placed on their practice.
–  Reprimand – acknowledgement that something done was wrong. Does not prohibit practice, may include restrictions.
–  Fines – a fine of up to $500.00 for each violation.
–  Otherwise discipline – examples include additional CE, take/retake certain education courses, write papers, public presentations, repeat nursing education dialysis technician, CHW or MA-C training program.

The transcript of the hearing and the hearing officer’s recommendations are reviewed by the members of the OBN with the exception of the supervising member who has been involved in the preparation of the case. The OBN members, having reviewed the materials prior to attending the board meeting, review the cases and hearing officer’s recommendations at a regular board meeting. They may accept or modify the recommendations of the hearing officer. The results of the OBN’s deliberations are reported in “open session.”

The OBN also has two programs which provide alternatives to disciplinary action: the Alternative Program and the Practice Intervention and Improvement Program. The goal of these non-disciplinary programs is to encourage early intervention and treatment or remediation to prevent harm to patients.

The Alternative Program for Chemical Dependency (Section 4723.35, ORC) is available to nurses, dialysis technicians and CHWs who have substance abuse problems. Individuals who enter this program must submit to the terms of the program, which include temporary voluntary surrender of the license or certificate issued by OBN and ongoing monitoring, for the duration of participation in the program. Non-compliance with the terms and conditions will result in referral for disciplinary action by the OBN.

The other alternative to discipline is the Practice Intervention and Improvement Program (PIIP) (Section 4723.282, ORC). The OBN may refer individuals who have an identified practice deficiency that can be corrected through remediation to this program. Individuals who enter this program must complete the terms of remediation or be referred for disciplinary action.

Please note, under current law, MA-Cs are not eligible to participate in either of the alternative programs.

The OBN can only take disciplinary action in relationship to licensed nurses, dialysis technicians, and CHWs and MA-Cs. The OBN cannot discipline employers of nurses who may be coercing nurses to inappropriately delegate, nor can the OBN mandate staffing ratios. The OBN can, however, investigate complaints and, in some instances, the process of investigation provides an opportunity for education about nursing law.

REFERENCES

Catalano, J. T.  Contemporary professional nursing, Philadelphia: F. A. Davis, (1996); p. 306.

Roe, C.  The regulation of nursing practice today.  Home Care Provider, (2000); 5(1):30.

OAC and ORC 4723, 2015.

To read or get a copy of the Nurse Practice Act (law) and/or rules, go to the board’s web site at www.nursing.ohio.gov or call the Ohio Board of Nursing at: 614-466-3947.

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