Ohio Board of Nursing CE Requirement: Ohio Law and Rules Category A 2-hour course. Fulfills the requirement for 2 contact hours of Category A CE for nurses (RN/LPN) applying for licensure by endorsement (from another state). Ohio Nurse Practice Act covers standards for competent nursing practice of Ohio nurses.
3.8 / 1019 ratings
"Very thorough yet easy to digest and understand!" - Karen, RN in Ohio
"The content was very well-organized and concise, making a technical topic easier to understand. Thanks!" - Mary, RN in Ohio
"Great course. I appreciate the opportunity to print the course content to read through and comprehend the information." - Nancy, RN in Ohio
"The course was very educational in preparing me for my Ohio license." - Patrice, RN
This course fulfills the Category A requirement for 2 contact hours of CE on the Ohio Nurse Practice Act and the rules of the Ohio Board of Nursing.
Nursing
Course Price: $20.00
Contact Hours: 2
This CE Activity, OLN-I-3144-2023 offered by Wild Iris Medical Education Inc has been approved for 2.0 Category A contact hours by the Ohio Board of Nursing through the approver unit at the Ohio League for Nursing (OBN-006-92) and the program is approved to be offered through August 24, 2025
Wild Iris Medical Education, Inc., is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.
Nurse planners, content experts, faculty, and others in control of content (either individually or as a group) have no relevant financial relationships with ineligible companies.
This course was not Joint Provided. No outside commercial support was received for the creation of this course material.
Course Availability: Expires August 24, 2025. You must score 80% or better on the test and complete the course evaluation to earn a certificate of completion for this CE activity. Wild Iris Medical Education, Inc., provides educational activities that are free from bias. The information provided in this course is to be used for educational purposes only. It is not intended as a substitute for professional healthcare. Medical Disclaimer Legal Disclaimer Disclosures Special Needs
This course fulfills the Category A requirement for 2 contact hours of CE on the Ohio Nurse Practice Act and the rules of the Ohio Board of Nursing.
State-Mandated
Course Price: $20.00
Contact Hours: 2
This CE Activity, OLN-I-3144-2023 offered by Wild Iris Medical Education Inc has been approved for 2.0 Category A contact hours by the Ohio Board of Nursing through the approver unit at the Ohio League for Nursing (OBN-006-92) and the program is approved to be offered through August 24, 2025
Wild Iris Medical Education, Inc., is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.
Course Availability: Expires August 24, 2025. You must score 80% or better on the test and complete the course evaluation to earn a certificate of completion for this CE activity. Wild Iris Medical Education, Inc., provides educational activities that are free from bias. The information provided in this course is to be used for educational purposes only. It is not intended as a substitute for professional healthcare. Medical Disclaimer Legal Disclaimer Disclosures Special Needs
This course fulfills the Category A requirement for 2 contact hours of CE on the Ohio Nurse Practice Act and the rules of the Ohio Board of Nursing.
Ohio Nurse Practice Act (2 Hours)
Law and Rules – Category A
Copyright © 2023 Wild Iris Medical Education, Inc. All Rights Reserved.
LEARNING OUTCOME AND OBJECTIVES: Upon completion of this continuing education course, you will have increased your knowledge of the standards of safe nursing practice in accordance with the Ohio Nurse Practice Act and the state’s laws and rules. Specific learning objectives to address potential knowledge gaps include:
Each state and territory in the United States has a Nurse Practice Act and a board of nursing with the authority to define and regulate the practice of nursing. The board also has the authority to discipline nurses who break nursing laws and regulations (Boehning, 2022) . This course presents the standards of safe nursing practice as outlined in the Ohio Nurse Practice Act and the rules of Section 4723 of the Ohio Administrative Code as written by the Ohio Board of Nursing in accordance with Section 4723 of the Ohio Revised Code.
All licensed medical professionals, including licensed nurses, work under accepted standards derived from local, state, and federal laws as well as professional guidelines. The Ohio Board of Nursing (OBN) is an agency of government that was created by Ohio law. The OBN regulates the practice of nursing in Ohio by implementing rules for nursing education and practice based on the Nurse Practice Act (NPA) . The rules are outlined in Ohio Administrative Code (OAC) Section 4723. Chapters 1 through 27 of Section 4723 of the OAC establish regulations for licensure, standards of practice, discipline, and nursing education (OBN, n.d.-a) .
The Nurse Practice Act 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, community health workers, and medication aides. The OBN regulates over 300,000 licenses and certificates. According to the OBN website, their top priorities are:
Board members are public officials, and OBN meetings are open to the public. The board is made up of thirteen members appointed by the governor. The members include:
The board has the legal authority to administer and enforce all provisions of the Nurse Practice Act. It must review each rule within the Ohio Administrative Code 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).
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.
The Scope of Practice Decision-Making Model includes the following steps:
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) .
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.
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.
| Chapter 4723-1 | Board Organization and Records |
| Chapter 4723-2 | Licensing for Active Duty Military and Veterans |
| Chapter 4723-3 | Definitions |
| Chapter 4723-4 | Standards of Practice Relative to Registered Nurses or Licensed Practical Nurses |
| Chapter 4723-5 | Nursing Education Program |
| Chapter 4723-6 | Alternative Program for Chemical Dependency/Substance Use Disorder Monitoring |
| Chapter 4723-7 | Examination and Licensure |
| Chapter 4723-8 | Advanced Practice Registered Nurse Certification and Practice |
| Chapter 4723-9 | Prescriptive Authority |
| Chapter 4723-13 | Delegation of Nursing Tasks |
| Chapter 4723-14 | Continuing Education |
| Chapter 4723-16 | Hearings |
| Chapter 4723-17 | Intravenous Therapy Courses for Licensed Practical Nurses |
| Chapter 4723-18 | Practice Intervention and Improvement Program (PIIP) |
| Chapter 4723-20 | Prevention of Disease Transmission |
| Chapter 4723-23 | Dialysis Technicians |
| Chapter 4723-25 | Nurse Education Grant Program |
| Chapter 4723-26 | Community Health Workers |
| Chapter 4723-27 | Medication Administration by Certified Medication Aide |
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 endorsement 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, 2023) .
One of the hallmarks of a profession is that its members band together in shared association to provide a variety of services for its members. These services include such things as continuing education, collective bargaining, legislative advocacy, and information about the profession. These organizations are not set up by state laws or through the government.
The American Nurses Association is the nationwide professional organization representing the interests of nurses. In Ohio, professional associations include:
Typically, associations are run by boards of trustees elected by members who pay voluntary membership dues.
The Ohio Nurses Association was founded in 1904 and serves as a leader and advocate for the 180,000 professional nurses practicing in the state of Ohio. The following mission statement and core values are listed on their website:
Mission: To advance professional nursing in Ohio. This will be accomplished through:
Core Values:
The primary difference between the Ohio Board of Nursing and professional organizations is that professional organizations have no legal authority, whereas the Ohio Board of Nursing has authority because it was established by the Nurse Practice Act with the unambiguous function of promoting and protecting the health of citizens through safe nursing practice.
In addition to abiding by the laws established in the Nurse Practice Act, every member of a profession is expected to read, understand, and abide by the ethical standards of its occupation. In the case of nursing, the American Nurses Association (ANA) publishes the Code of Ethics for Nurses with Interpretive Statements to guide nurses’ professional practice.
The following provisions of the code that broadly describe the ethical obligations of nurses:
Provision 1. The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every individual.
Provision 2. The nurse’s primary commitment is to the patient, whether an individual, family, group, community, or population.
Provision 3. The nurse promotes, advocates for, and protects the rights, health, and safety of the patient.
Provision 4. The nurse has authority, accountability, and responsibility for nursing practice; makes decisions; and takes action consistent with the obligation to provide optimal care.
Provision 5. The nurse owes the same duties to self as to others, including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competence, and continue personal and professional growth.
Provision 6. The nurse, through individual and collective effort, establishes, maintains, and improves the ethical environment of the work setting and conditions of employment that are conducive to safe, quality health care.
Provision 7. The nurse, in all roles and settings, advances the profession through research and scholarly inquiry, professional standards development, and the generation of both nursing and health policy.
Provision 8. The nurse collaborates with other health professionals and the public to protect human rights, promote health diplomacy, and reduce health disparities.
Provision 9. The profession of nursing, collectively through its professional organizations, must articulate nursing values, maintain the integrity of the profession, and integrate principles of social justice into nursing and health policy.
[This section covers subsections (A) through (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 Administrative 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:
RNs must (E) implement any order for a patient in a timely manner unless they believe or have reason to believe the order is:
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:
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:
The tasks assigned to LPNs must also be within the licensed practical nurse’s legal scope of practice.
[This section covers subsections (A) through (J) of the OAC 4723-4-04, Standards relating to competent practice as a licensed practical nurse.]
A licensed practical nurse (LPN) must function (A) within the scope of practice of an LPN as set forth in division (F) of Section 4723.01 of the Ohio Revised Code and the rules of the Ohio Board of Nursing.
An LPN must (B) maintain current knowledge of the duties, responsibilities, and accountabilities for safe nursing practice.
An LPN must (C) demonstrate competency and accountability 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.
An LPN may (D) provide nursing care beyond basic preparation for an LPN provided the LPN obtains appropriate education; demonstrates knowledge, skills, and abilities; and maintains satisfactory records of meeting these requirements. The LPN must have a valid order or direction from an authorized individual acting within their professional practice, and the nursing care cannot involve a function or procedure prohibited by any law or rule.
LPNs must (E) implement or clarify an order in a timely manner unless they believe or have reason to believe the order is:
When (F) clarifying an order or direction, the LPN must consult with an authorized practitioner or directing RN. If the LPN decides not to follow the direction, the LPN, in a timely manner, must:
An LPN must (G) report to and consult with other nurses or other members of the healthcare team and make referrals as necessary.
An LPN 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 assigned job responsibilities. This includes not disseminating patient information through social media, texting, emailing, or any other form of communication for purposes other than patient care.
An LPN (I) must not disclose identifiable patient healthcare information unless the patient gives written consent by a properly executed release of information. Only in limited circumstances in accord with authorized legal authority should an LPN release individually identifiable patient healthcare information without written consent of the patient.
When directed to observe, advise, instruct, or evaluate the performance of a nursing task, the LPN must (J) use acceptable standards of safe nursing care as a basis for that observation, advice, instruction, teaching, or evaluation and should communicate information consistent with acceptable standards of safe nursing care with respect to the nursing task.
[This section covers subsections (A) through (D) of the OAC 4723-4-05, Standards relating to competent practice as a certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, or clinical nurse specialist.]
A certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, and clinical nurse specialist must (A):
When the practice of a certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist is evaluated, the (B) evaluation must be done by a collaborating licensed physician or podiatrist, or an advanced practice registered nurse holding a current, valid license with the same designation as the individual being evaluated.
When the practice of a certified registered nurse anesthetist is evaluated, the (C) evaluation must be done by a supervising licensed physician, podiatrist, dentist, or certified registered anesthetist whose license is current and valid.
A certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, or clinical nurse specialist may provide care within their specialty, provided the nurse (D):
[This section covers subsections (A) through (Q) of the OAC 4723-4-06, Standards of nursing practice promoting patient safety.]
(A–C) When providing direct nursing care to patients or engaging in nursing practice in person or by telecommunication, licensed nurses, certified nurse-midwives, certified nurse practitioners, certified registered nurse anesthetists, or clinical nurse specialists must display and identify their applicable title or initials (degree) or identify to each patient or healthcare provider the nurse’s title or initials (degree) as a registered nurse or licensed practical nurse.
Licensed nurses must (D) delegate nursing tasks, including medication administration, only in accordance with chapters 4723-13, 4723-23, 4723-26, or 4723-27 of the OAC. (See also “Delegation Guidelines” below.)
Licensed nurses must (E) report and document their nursing assessments and observations, care provided, and the patient’s response to that care in a complete, timely, and accurate manner. Licensed nurses must report any (F) errors in or deviations from a current valid order to the appropriate practitioner in a timely and accurate manner.
Licensed nurses must (G) not falsify, or conceal by any method, patient records or any other document prepared or used in the course of nursing practice. This includes case management documents or reports, time records, reports, and other documents related to billing for nursing services.
Licensed nurses must (H) implement measures to promote a safe environment for patients and (I) delineate, establish, and maintain a professional boundary between themselves and patients. They must (J) provide privacy during examination and care and treat each patient with courtesy, respect, and full recognition of dignity and individuality.
Licensed nurses must (K) not engage in behavior that causes or may cause physical, verbal, mental, or emotional abuse to a patient or engage in behavior that a reasonable person would interpret as physical, verbal, mental, or emotional abuse.
A licensed nurse must not (L) misappropriate the property of patients or:
A licensed nurse must not (M):
The patient is always presumed incapable of giving free, full, or informed consent to the behaviors by the nurse set forth in (L) and (M) above.
When licensed nurses (N) function in administrative roles, they must make sure that there are procedures in place and implemented to verify that every nurse, dialysis technician, or medication aide working under their administration has a current valid license in Ohio or valid certificate in Ohio to practice in the role to which they are assigned.
Only RNs may (O) supervise or evaluate the nursing practice of RNs and LPNs; however, non-nursing supervisors may evaluate nurse employees in matters other than the practice of nursing. RNs who supervise other nurses are not required to be regularly on-site but must be continuously available via telecommunication with the nurse being supervised and be able to take any action necessary, including visits on-site, to make sure that the nurse being supervised is practicing according to standards of safe nursing care outlined in Chapter 4723 of the Ohio Revised Code and the rules of the Ohio Board of Nursing. RNs who evaluate other nurses must conduct on-site visits.
A licensed nurse must not (P) make, submit, or cause to be submitted any false, misleading, or deceptive statements to the Ohio Board of Nursing, current or prospective employers, facilities or organizations for whom the nurse is working in a temporary assignment, members of the healthcare team, or law enforcement personnel.
A nurse must not (Q) use social media, texting, emailing, or other forms of communication with or about a patient for non-healthcare purposes or for purposes other than fulfilling the nurse’s assigned job responsibilities.
[This section covers subsections (A) through (H) of the OAC 4723-13-05, Criteria and standards for a licensed nurse delegating to an unlicensed person.]
When all conditions for delegation set forth in Chapter 4723-13-05 of the OAC are met, a registered nurse may delegate a nursing task to an unlicensed person (A) and a licensed practical nurse may delegate a nursing task to an unlicensed person at the direction of the registered nurse (B). These conditions are summarized below.
Except as otherwise authorized by law or this chapter, a licensed nurse may delegate to an unlicensed person the administration of only the following medications (D):
Prior to delegating a nursing task to an unlicensed person, the delegating nurse must make certain determinations regarding the nature of the task and the qualifications of the unlicensed person who will carry it out (E):
Prior to delegating a nursing task, the delegating nurse must also make certain determinations regarding the patient and the conditions (F):
The delegating nurse must be accountable for the decision to delegate nursing tasks to an unlicensed person (G).
If a licensed nurse determines that an unlicensed person is not correctly performing a delegated nursing task, the licensed nurse must immediately intervene (H).
[This section covers subsection (C) of the OAC 4723-13-05, Criteria and standards for a licensed nurse delegating to an unlicensed person; subsections (A) through (B) of the ORC 4723.48, Delegation of authority to administer certain drugs; and subsections (A) through (F) of the ORC 4723.489, Delegated authority to administer drugs.]
An advanced practice registered nurse (APRN) such as a clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner may delegate medication administration to unlicensed personnel when both of the following requirements have been met:
Delegating Tasks
Sabrina is an RN in a busy medical-surgical department at a hospital in Columbus. She is in the middle of passing morning medications when her new post-op patient, Mr. Winters, rings in complaining of severe pain. When she arrives to Mr. Winters’ room, Sabrina performs a focused assessment of his surgical dressing and finds everything within normal limits. Sabrina consults the electronic medication administration record (eMAR) and sees that Mr. Winters has IV morphine ordered for severe pain. She also recalls the report from the PACU nurse stating that Mr. Winters’ blood pressure was running low.
In reviewing the tasks at hand, Sabrina knows she needs to continue with medications for her other patients, to get a new set of vitals on Mr. Winters to be sure his blood pressure won’t bottom out with a new dose of IV morphine, and then to administer the pain medication to Mr. Winters. In order to accomplish her tasks in a timely manner, Sabrina determines that it is necessary to delegate something to the appropriate assistive personnel. She remembers that Martha, a certified nursing assistant, has also been assigned to her patients.
Sabrina contacts Martha to see if she is available to take Mr. Winters’ blood pressure, knowing that taking patients’ vitals is within Martha’s education and training and is part of her normal assignment as a certified nursing assistant. Sabrina indicates to Martha that she will continue passing medications while Martha gets the patient’s vitals, which she should carry out right away. Sabrina informs Martha that she will be with the patient in the next room by the time Martha has the vital signs. Martha agrees and begins to take Mr. Winters’ blood pressure.
Martha finds Sabrina as she is coming out of the room next door and reports that Mr. Winters’ blood pressure is 118/58, which presents no contraindication to administering the IV morphine. Sabrina goes to the department’s med room to obtain the pain medication and administers the morphine, relieving Mr. Winters’ pain. She thanks Martha for her help and then returns to her other patients.
Applying the Model Yourself
Take a moment to think of a situation in your own practice when you may need to delegate a task to assistive personnel. Then review each of the delegation guidelines in the box above and ask yourself whether you may delegate the task or not according to Ohio’s nursing rules.
[This section covers subsections (A) and (B) of the OAC 4723-4-07, Standards for applying the nursing process as a registered nurse.]
A registered nurse (A) must apply the nursing process in the practice of nursing as set forth in division (B) of section 4723.01 of the Ohio Revised Code and in the rules of the OBN. Nurses provide care to patients using a cyclic series of steps called the nursing process. With clinical judgment, RNs assess, analyze/report, plan, implement, and evaluate the changing status of patients. RNs apply the nursing process in various practice settings and collaborate with patients, family, significant others, and members of the healthcare team according to the following standards.
The standards for implementing the nursing process (B) also apply to a certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, or clinical nurse specialist.
Assessment involves the accurate and timely collection of both subjective and objective data about a patient’s condition from the patient, family members, significant others, and members of the healthcare team. The RN may direct or delegate the gathering of data but must document and report it, as appropriate, to other members of the healthcare team.
In an accurate and timely manner, RNs identify, organize, assimilate, and interpret relevant data. RNs establish, accept, or modify a nursing diagnosis, which will be carried out through nursing interventions, and report the patient’s health status and nursing diagnosis as needed to other members of the healthcare team.
In an accurate and timely way, RNs develop, establish, maintain, or modify the nursing care plan with current nursing science, including the nursing diagnosis, desired patient outcomes or goals, and nursing interventions. RNs communicate the plan of care and all care plan modifications to members of the healthcare team.
In an accurate and timely way, RNs implement the nursing care plan. RNs execute the nursing regimen; implement current valid orders or directions from authorized practitioners; and provide nursing care commensurate with their education, knowledge, skills, and abilities. RNs assist and collaborate with other healthcare providers in the care of the patient and delegate nursing tasks, including medication administration, only in accordance with applicable rules and laws (see also “Delegation Guidelines” earlier in this course).
In an accurate and timely way, RNs evaluate, document, and report patient responses to nursing interventions and progress toward expected outcomes to appropriate members of the healthcare team. RNs then reassess the patient’s health status, establishing or modifying any aspect of the nursing plan.
[This section covers the OAC 4723-4-08, Standards for applying the nursing process as a licensed practical nurse.]
Licensed practical nurses must contribute to the nursing process as set forth in division (F) of section 4723.01 of the Ohio Revised Code and rules of the OBN. The steps of the nursing process are cyclical in nature, so that the patient’s changing status affects the action of LPNs as they assess, plan, implement, and evaluate the patient’s status. The LPN collaborates, as appropriate, with the patient, family, significant others, and members of the healthcare team. The LPN must use the following standards for applying the nursing process.
The LPN contributes to the nursing assessment of a patient. In an accurate and timely manner, LPNs collect and document objective and subjective data related to the patient’s health status and report the data to the directing registered nurse or healthcare provider and other members of the healthcare team. The subsequent analysis of this data, however, is not part of the LPN’s role.
In an accurate and timely manner, LPNs contribute to the development, maintenance, or modification of the nursing component of the care plan and communicate the nursing care plan and all modifications of the plan to appropriate members of the healthcare team.
Licensed practical nurses implement the nursing care plan in an accurate and timely manner as follows:
In an accurate and timely manner, LPNs contribute to the evaluation of patient responses to nursing interventions, document and communicate patient responses to nursing interventions to appropriate members of the healthcare team, and contribute to the reassessment of the patient’s health status and to modifications of any aspect of the nursing plan of care.
Nursing Process
Jeffrey is a registered nurse supervising the care for Henry, who is one day post-op for a total hip replacement. This afternoon Judy, the LPN providing direct nursing care for Henry, reports to Jeffrey that Henry has developed chest discomfort and shortness of breath. Jeffrey gathers data that includes Henry’s appearance, vital signs, oxygen saturation, heart sounds, and breath sounds (assessment).
Jeffrey then analyzes the collected data, determines that Henry has impaired gas exchange (nursing diagnosis), and contacts the physician to report the findings and receive direction (analysis/reporting).
Jeffrey and Judy together modify Henry’s nursing care plan to reflect the care required of a patient with either a suspected pulmonary or fat embolism. The plan includes interventions to address Henry’s chest discomfort and shortness of breath (planning). They communicate the plan of care to other members of the nursing team.
Judy carries out the modified nursing care plan, providing direct patient care and/or delegating nursing tasks to other members of the team as needed (implementation).
Throughout the day, Jeffrey and Judy evaluate Henry’s status frequently and find that Henry’s chest discomfort and dyspnea are improving (evaluation).
[This section covers subsections (A) through (D) of OAC 4723-4-09, Specialty certification. This section does not apply to advanced practice nurses licensed to practice pursuant to section 4723.41 of the ORC.]
An RN with a current, valid license to practice nursing in Ohio may use a title or initials denoting specialty certification in a particular area of specialty in nursing granted by a national certifying organization with established standards (B). The certifying organization must have established standards stating the requirements for specialty practice, including practice qualifications, formal education, continuing education, or demonstration of knowledge, and must include a psychometrically sound examination in the particular area of specialty nursing.
The title to be used by the RN who focuses in a particular specialty in nursing shall be the title granted by the national certifying organization (C). The registered nurse may use such title or initials following the title Registered Nurse or the initials RN.
No person may use any title or initials implying or representing specialty certification (D) unless that person has been granted a specialty certification title in nursing by a national certifying organization.
[This section covers ORC 4723.28, Disciplinary actions; OAC 4723-16, Hearings; and OAC 4723-18, Practice intervention and improvement program.]
The Ohio Board of Nursing protects the public’s health and welfare by overseeing and ensuring the safe practice of nursing. It regulates and oversees nursing practice by enforcing the nursing laws and rules of the state. Violations are serious and may result in discipline by the board.
Violations of nursing laws and rules can result in sanctions, including denial, revocation, suspension, or restriction of licenses; reprimand or discipline; and/or fines. Violations that may result in sanctions include, but are not limited to:
(For a complete list, see ORC 4723.28, Disciplinary actions.)
The Board of Nursing responds to possible violations of nursing laws and rules. This may include investigation of the complaint against a nurse, hearings, examination of evidence, and the calling of witnesses. The nurse may represent themself before the board or be represented by an attorney. Unless subpoenaed by the board, the nurse is not required to appear in person at any hearing.
When making a decision regarding disciplinary action, the board considers:
As a resolution to the possible violation, the board may close the case, issue a nondisciplinary advisory letter, refer the nurse to the Practice Intervention and Improvement Program (see below) with employer remediation, or impose disciplinary sanctions. A matter may also be resolved through a settlement agreement submitted to and ratified by the board.
The Practice Intervention and Improvement Program (PIIP) is a confidential alternative-to-discipline program for eligible licensees as authorized in section 4723.282 of the Ohio Revised Code. The program establishes a structured remedial education and monitoring program in cases where a nurse has failed to practice safe nursing but whose practice deficiency can be corrected through participation in the PIIP rather than through disciplinary action. The PIIP utilizes educational interventions such as continuing education activities, courses provided by a post-secondary educational institution, or activities provided by the nurse’s employer.
In order to determine a nurse’s eligibility for this program, the board applies these and other criteria:
Those eligible for the program must develop a participatory agreement that includes these and other elements, as detailed in the OAC:
If a PIIP participant fails to comply with or successfully fulfill the agreement, the board will proceed with disciplinary action.
The Ohio Nurse Practice Act defined the scope of practice for nurses in Chapter 4723 of the Ohio Revised Code and established the Ohio Board of Nursing. The Board of Nursing is responsible for the administration and enforcement of the Nurse Practice Act. This responsibility is accomplished through Section 4723 of the Ohio Administrative Code (OAC) . The OAC are the rules written by the Ohio Board of Nursing in accordance with the Ohio Nurse Practice Act.
Chapters 1 through 27 of the OAC contain the rules and regulations for all aspects of nursing practice in the state of Ohio. The OAC sets forth the standards of competent nursing practice and standards for promoting patient safety. By so doing, OAC 4723 fulfills the mission of the Board of Nursing to actively safeguard the health of the public through the effective regulation of nursing care. It is the responsibility of all nurses in the state of Ohio to be familiar with and to abide by these laws and rules.
