Contents Post-Test

Ohio Nurse Practice Act

Definitions

Registered nurse or licensed practical nurse is an individual who holds a current, valid license issued by the Board of Nursing that authorizes the practice of nursing either as a registered nurse or as a licensed practical nurse.

Practice of nursing as a registered nurse means providing to individuals and groups nursing care requiring specialized knowledge, judgment, and skill derived from the principles of biological, physical, behavioral, social, and nursing sciences.

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.

Assessing health status means the collection of data through nursing assessment techniques, which may include interviews, observation, and physical evaluations for the purpose of providing nursing care.

Practice as an RN

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 health 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.

Practice as an LPN

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 professional practice, except that administration of intravenous therapy shall be performed only in accordance with board regulations. Medications may be administered by a licensed practical nurse upon proof of completion of a course in medication administration approved 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 by the board to perform intravenous therapy.
  5. Delegation of nursing tasks as directed by a registered nurse.
  6. Teaching nursing tasks to licensed practical nurses and individuals to whom the licensed practical nurse is authorized to delegate nursing tasks as directed by a registered nurse.

Prohibitions

(A) No person shall engage in the practice of nursing as a registered nurse, represent the person as being a registered nurse, or use the title "registered nurse," the initials "R.N.," or any other title implying that the person is a registered nurse, for a fee, salary, or other consideration, or as a volunteer, without holding a current, valid license as a registered nurse.

(B) No person shall engage in the practice of nursing as a licensed practical nurse, represent the person as being a licensed practical nurse, or use the title "licensed practical nurse," the initials "L.P.N.," or any other title implying that the person is a licensed practical nurse, for a fee, salary, or other consideration, or as a volunteer, without holding a current, valid license as a practical nurse.

(C) No person shall use the titles or initials "graduate nurse," "G.N.," "professional nurse," "P.N.," "graduate practical nurse," "G.P.N.," "practical nurse," "P.N.," "trained nurse," "T.N.," or any other statement, title, or initials that would imply or represent to the public that the person is authorized to practice nursing in this state.

(D) No person shall employ a person not licensed as a registered nurse under this chapter to engage in the practice of nursing as a registered nurse. No person shall employ a person not licensed as a practical nurse under this chapter to engage in the practice of nursing as a licensed practical nurse.

(E) No person shall sell or fraudulently obtain or furnish any nursing diploma, license, certificate, renewal, or record, or aid or abet such acts.

Prohibited Practice

Medical diagnosis, prescription of medical measures, and the practice of medicine or surgery or any of its branches by a nurse are prohibited.

IV Therapy by Licensed Practical Nurses

(A) The Board of Nursing may authorize a licensed practical nurse to administer to an adult 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, if all of the following are true of the licensed practical nurse:

  1. The nurse has a current, valid license that includes authorization to administer medications.
  2. The nurse has successfully completed a course in intravenous administration approved by the Board that includes both of the following:
  1. A minimum of forty hours of training that includes all of the following:
  1. The curriculum established by rules adopted by the Board and in effect on January 1, 1999;
  2. Training in the anatomy and physiology of the cardiovascular system, signs and symptoms of local and systemic complications in the administration of fluids and antibiotic additives, and guidelines for management of these complications;
  3. Any other training or instruction the Board considers appropriate;
  1. A testing component that includes the successful performance of three venipunctures supervised by a physician or registered nurse in a health-care setting.

(B) A licensed practical nurse authorized by the Board to perform intravenous therapy may perform an intravenous therapy procedure only at the direction of one of the following:

  1. A licensed physician, dentist, optometrist, or podiatrist who is present and readily available at the facility where the intravenous therapy procedure is performed;
  2. A registered nurse who shall be readily available at the site where the intravenous therapy is performed, and before the licensed practical nurse initiates the intravenous therapy, the registered nurse shall personally perform an on-site assessment of the individual who is to receive the intravenous therapy.

When a licensed practical nurse authorized by the Board to perform intravenous therapy performs an intravenous therapy procedure in a home at the direction of a registered nurse or licensed physician, dentist, optometrist, or podiatrist, a registered nurse shall be on the premises of the home or facility or accessible by some form of telecommunication.

Intravenous Therapy Procedures

(A) No licensed practical nurse shall perform any of the following intravenous therapy procedures:

  1. Initiating or maintaining any of the following:
  1. Blood or blood components;
  2. Solutions for total parenteral nutrition;
  3. Cancer therapeutic medications including, but not limited to, cancer chemotherapy or an anti-neoplastic agents;
  4. Investigational or experimental medications;
  5. Solutions administered through any central venous line or arterial line or any other line that does not terminate in a peripheral vein;
  6. An intravenous piggyback infusion.
  1. Discontinue a central venous, arterial, or any other line that does not terminate in a peripheral vein;
  2. Initiate or discontinue a peripherally inserted central catheter;
  3. Aspirate any intravenous therapy line to maintain patency;
  4. Program or set any function of a patient controlled analgesic;
  5. Mix, prepare or reconstitute any medication for intravenous therapy;
  6. Administer medications by an intravenous route;
  7. Inject medications by a direct intravenous route;
  8. Change tubing on an arterial line, a central venous line, or on any line that does not terminate in a peripheral vein.

(B) A licensed practical nurse authorized by the board to perform intravenous therapy procedures, may perform the following procedures only for individuals aged eighteen or older and only when directed to do so by a licensed physician, dentist, optometrist, podiatrist, or registered nurse:

  1. Administer through a central venous line or a peripherally inserted central catheter the following solutions only:
  1. An infusion containing one or more of the following elements:
  1. Dextrose 5%;
  2. Normal saline;
  3. Lactated ringers;
  4. Sodium chloride 0.45%;
  5. Sodium chloride 0.2%; or
  6. Sterile water;
  1. Subsequent containers of the intravenous therapy solutions that contain vitamins or electrolytes, provided a registered nurse initiated the infusion of that same intravenous solution.
  1. Initiate or maintain a peripheral intravenous piggyback infusion containing an antibiotic;
  2. Prepare or reconstitute only an antibiotic additive to be administered through a peripheral infusion;
  3. Inject heparin or normal saline to flush an intermittent infusion device or heparin lock, including, but not limited to, bolus or push;
  4. Change tubing on an intravenous line only if the line terminates in a peripheral vein;
  5. Initiate intravenous therapy only in the hand, forearm or antecubital space for the administration of solutions containing one or more of the following:
  1. An infusion containing one or more of the following elements:
  1. Dextrose 5%;
  2. Normal saline;
  3. Lactated ringers;
  4. Sodium chloride 0.45%;
  5. Sodium chloride 0.2; or
  6. Sterile water
  1. Subsequent containers of the intravenous therapy solutions that contain vitamins or electrolytes, provided a registered nurse initiated the infusion of that same intravenous solution.

(C) A licensed practical nurse authorized by the board to perform intravenous therapy procedures may perform the procedures only if one of the following requirements are satisfied:

  1. The licensed practical nurse is directed to perform intravenous therapy by a licensed physician, dentist, optometrist, or podiatrist who is present and readily available at the facility where the intravenous therapy procedure is performed;
  2. The licensed practical nurse is directed to perform intravenous therapy by a registered nurse who has personally performed an on-site assessment of the individual to receive intravenous therapy, and that registered nurse or another registered nurse is readily available at the site where the intravenous therapy procedure is performed;
  3. When the intravenous therapy procedures are performed in a long-term care facility, or in an intermediate care facility for the mentally retarded, a registered nurse who directs the authorized licensed practical nurse to perform intravenoustherapy is either:
  1. On the premises of the facility; or
  2. Accessible by some form of telecommunication;

(D) Any licensed practical nurse may perform any of the intravenous therapy procedures on any person without receiving authorization to perform intravenous therapy from the board of nursing, if both of the following apply:

  1. The licensed practical nurse acts at the direction of a registered nurse or a licensed physician, dentist, optometrist, or podiatrist and the registered nurse, physician, dentist, optometrist, or podiatrist is on the premises where the procedure is to be performed or accessible by some form of telecommunication; and
  2. The licensed practical nurse can demonstrate the knowledge, skills, andability necessary to perform the procedure safely

(E) The intravenous therapy procedures that a licensed practical nurse may perform are limited to the following:

  1. Verification of the type of peripheral intravenous solution being administered;
  2. Examination of a peripheral infusion site and the extremity for possible infiltration;
  3. Regulation of a peripheral intravenous infusion according to the prescribed flow rate;
  4. Discontinuation of a peripheral intravenous device at the appropriate time; and
  5. Performance of routine dressing changes at the insertion site of a peripheral venous or arterial infusion, peripherally inserted central catheter infusion, or central venous pressure subclavian infusion.

Intravenous Procedures That May be Performed by an LPN Who Is Not Authorized by the Board to Perform Intravenous Therapy

(A) A licensed practical nurse may perform on any person any of the intravenous therapy procedures without receiving authorization to perform intravenous therapy from the Board of Nursing if both of the following apply:

  1. The licensed practical nurse acts at the direction of a registered nurse or a licensed physician, dentist, optometrist, or podiatrist and the registered nurse, physician, dentist, optometrist, or podiatrist is on the premises where the procedure is to be performed or accessible by some form of telecommunication.
  2. The licensed practical nurse can demonstrate the knowledge, skills, and ability to perform the procedure safely.

(B) The intravenous therapy procedures that a licensed practical nurse may perform pursuant to division (A) of this section are limited to the following:

  1. Verification of the type of peripheral intravenous solution being administered;
  2. Examination of a peripheral infusion site and the extremity for possible infiltration;
  3. Regulation of a peripheral intravenous infusion according to the prescribed flow rate;
  4. Discontinuation of a peripheral intravenous device at the appropriate time;
  5. Performance of routine dressing changes at the insertion site of a peripheral venous or arterial infusion, peripherally inserted central catheter infusion, or central venous pressure subclavian infusion.

Renewal of License

(A) All active licenses shall be renewed biennially according to a schedule established by the Board of Nursing. The Board shall provide an application for renewal to every holder of an active license, except when the Board is aware that an individual is ineligible for license renewal for any reason, including pending criminal charges in this state or jurisdiction, failure to comply with a disciplinary order from the Board or terms of a consent agreement entered into with the Board, failure to pay fines or fees owed to the Board, or failure to provide on the Board's request documentation of having completed the continuing nursing education requirements.

If the Board provides a renewal application by mail, the application shall be addressed to the last known post-office address of the holder and mailed before the date specified in the Board's schedule. Failure of the holder to receive an application for renewal from the Board shall not excuse the holder from the requirements contained in this section.

The license holder shall complete the renewal form and return it to the treasurer of state with the renewal fee on or before the date specified by the Board. The license holder shall report any conviction, plea, or judicial finding regarding a criminal offense that constitutes grounds for the Board to impose sanctions since the holder last submitted an application to the Board.

The treasurer shall immediately forward the renewal application to the Board. On receipt of the renewal application, the Board shall verify that the applicant meets the renewal requirements and shall renew the license for the following two-year period.

If a renewal application that meets the renewal requirements is submitted after the date specified in the Board's schedule, but before expiration of the license, the Board shall grant a renewal upon payment of the late renewal fee.

Continuing Education

(A) A nurse who seeks to renew an active license to practice nursing in Ohio must obtain twenty-four contact hours of continuing education during the renewal period.

  1. For the period immediately following licensure by examination, a nurse who holds an active license to practice nursing in Ohio is not required to complete any contact hours of continuing education for the first license renewal;
  2. A nurse who has been licensed by endorsement in Ohio for a period of time that is less than or equal to one year shall complete twelve contact hours of continuing education that meet the requirements of this chapter;
  3. A nurse who has been licensed by endorsement in Ohio for more than one year shall complete twenty-four contact hours of continuing education that meet the requirements of this chapter.

(B) On or after September 1, 2001 for registered nurses, and on or after September 1, 2002 for licensed practical nurses, and for every renewal period thereafter, at least one of the required hours of continuing education shall be category A continuing education.

(C) A licensed practical nurse who maintains an active license as a registered nurse in Ohio shall not be required to meet the continuing education requirement for renewal of the license to practice as a practical nurse.

(D) A nurse from another jurisdiction who applies for licensure by endorsement in Ohio shall not be required to meet the continuing education requirement to obtain licensure.

(E) A nurse shall attest to completion of the continuing education required by this rule on the application for renewal. The board may, at its discretion, require the applicant for renewal to show proof of completion of continuing education. If, prior to the expiration of the renewal period a nurse fails to provide proof of completion of continuing education upon the request of the board, the license shall lapse.

(F) To reactivate an inactive license or to reinstate a lapsed license to practice nursing in Ohio, the applicant shall complete twenty-four contact hours of continuing education during the twenty-four months immediately preceding the application.

  1. If the license of a registered nurse or licensed practical nurse has been inactive or lapsed for less than five years, the continuing education shall be twenty-four contact hours of continuing education that includes one hour of category A.
  2. If the license of a registered nurse or licensed practical nurse has been inactive or lapsed for five years or more, the continuing education shall consist of twenty-four contact hours. The twenty-four contact hours shall be documented in a manner that allows for the identification of learning objectives that satisfy the following:
  1. Two contact hours of category A with learning objectives that address scopes of practice for registered and licensed practical nurses, standards of safe practice, and nursing delegation;
  2. Six contact hours with learning objectives that address application of the nursing process and critical thinking, clinical reasoning, or nursing judgment related to patient care;
  3. Six contact hours pertaining to pharmacology with learning objectives that include, but are not limited to, drug classifications, medication errors, and patient safety;
  4. Two contact hours that include learning objectives related to clinical or organizational ethical principles in health care; and
  5. Eight contact hours that include learning objectives related to an area relevant to the nurse’s practice.
     
  1. The continuing education required by this paragraph shall be used only for the purpose of reactivating an inactive license, or reinstating a lapsed license, and shall not be applied toward the continuing education required for renewal of a license.

(G) A nurse who requests that a license to practice in Ohio be placed on inactive status shall not be required to meet the continuing education requirement for the period during which the license is on inactive status. To return to active status, the nurse shall comply with paragraph (E) of this rule.

(H) A nurse seeking to reactivate or reinstate a license shall provide to the board proof of completion of continuing education consistent with the requirement of paragraph

(F) of this rule. If a nurse fails to provide proof of completion of continuing education, the license shall not be reactivated or reinstated.

(I) A nurse may use a waiver to satisfy the continuing education requirement for one renewal period only, and the nurse shall notify the board in writing requesting the waiver. Once a nurse notifies the board of the intent to use the waiver, the waiver shall not be rescinded and use of the waiver shall be documented by the board on the nurse’s license to practice nursing.

(J) A nurse shall not use the waiver to satisfy the requirements of rule 4723-8-10 of the Administrative Code, or to fulfill the requirements for reactivating or reinstating a license as set forth in paragraph (E) of this rule.

(K) A nurse who earns in excess of the number of hours required by this chapter during a single renewal period shall not apply the excess hours to satisfy future continuing education requirements.

Inactive License

A license holder who does not intend to practice in Ohio may send to the Board written notice to that effect on or before the renewal date, and the Board shall classify the license as inactive. During the period that the license is classified as inactive, the holder may not engage in the practice of nursing in Ohio and is not required to pay the renewal fee.

The holder of an inactive license or an individual who has failed to renew the individual's license may have the license restored or renewed upon meeting the requirements for restoring and renewing licenses.

Disciplinary Action

(A) The Board of Nursing may revoke or may refuse to grant a nursing license, certificate of authority, or dialysis technician certificate to a person found by the Board to have committed fraud in applying for or securing any nursing license, certificate of authority, or dialysis technician certificate issued by the Board.

(B) The Board of Nursing may impose one or more of the following sanctions: deny, revoke, suspend, or place restrictions on any nursing license, certificate of authority, or dialysis technician certificate issued by the Board; reprimand or otherwise discipline a holder of a nursing license, certificate of authority, or dialysis technician certificate; or impose a fine of not more than five hundred dollars per violation. The sanctions may be imposed for any of the following:

  1. Denial, revocation, suspension, or restriction of authority to practice a health-care occupation, including nursing or practice as a dialysis technician, for any reason other than a failure to renew, in Ohio or another state or jurisdiction;
  2. Engaging in the practice of nursing, or engaging in practice as a dialysis technician, having failed to renew a nursing license or dialysis technician certificate, or while a nursing license or dialysis technician certificate is under suspension;
  3. Conviction of, a plea of guilty to, a judicial finding of guilt of a misdemeanor committed in the course of practice;
  4. Conviction of, a plea of guilty to, a judicial finding of guilt of any felony or of any crime involving gross immorality or moral turpitude;
  5. Selling, giving away, or administering drugs or therapeutic devices for other than legal and legitimate therapeutic purposes; or conviction of, a plea of guilty to, a judicial finding of guilt of violating any municipal, state, county, or federal drug law;
  6. Conviction of, a plea of guilty to, a judicial finding of guilt of an act in another jurisdiction that would constitute a felony or a crime of moral turpitude in Ohio;
  7. Conviction of, a plea of guilty to, a judicial finding of guilt of an act in the course of practice in another jurisdiction that would constitute a misdemeanor in Ohio;
  8. Self-administering or otherwise taking into the body any dangerous drug, in any way not in accordance with a legal, valid prescription issued for that individual;
  9. Habitual indulgence in the use of controlled substances, other habit-forming drugs, or alcohol or other chemical substances to an extent that impairs ability to practice;
  10. Impairment of the ability to practice according to acceptable and prevailing standards of safe nursing care because of habitual or excessive use of drugs, alcohol, or other chemical substances that impair the ability to practice;
  11. Impairment of the ability to practice according to acceptable and prevailing standards of safe nursing care because of a physical or mental disability;
  12. Assaulting or causing harm to a patient or depriving a patient of the means to summon assistance;
  13. Obtaining or attempting to obtain money or anything of value by intentional misrepresentation or material deception in the course of practice;
  14. Adjudication by a probate court of being mentally ill or mentally incompetent;
  15. The suspension or termination of employment by the Department of Defense or the Veterans Administration of the United States for any act that violates or would violate this chapter;
  16. Violation of this chapter or any rules adopted under it;
  17. Violation of any restrictions placed on a nursing license or dialysis technician certificate by the Board;
  18. Failure to use universal blood and body fluid precautions;
  19. Failure to practice in accordance with acceptable and prevailing standards of safe nursing care or safe dialysis care;
  20. In the case of a registered nurse, engaging in activities that exceed the practice of nursing as a registered nurse;
  21. In the case of a licensed practical nurse, engaging in activities that exceed the practice of nursing as a licensed practical nurse;
  22. In the case of a dialysis technician, engaging in activities that exceed those permitted;
  23. Aiding and abetting a person in that person's practice of nursing without a license or practice as a dialysis technician without a certificate issued under this chapter;
  24. In the case of a certified registered nurse anesthetist, clinical nurse specialist, certified nurse-midwife, certified nurse practitioner, or advanced practice nurse:
  1. Waiving the payment of all or any part of a deductible or copayment that a patient, pursuant to a health insurance or health-care policy, contract, or plan that covers such nursing services, would otherwise be required to pay if the waiver is used as an enticement to a patient or group of patients to receive health-care services from that provider;
  2. Advertising that the nurse will waive the payment of all or any part of a deductible or copayment that a patient, pursuant to a health insurance or health-care policy, contract, or plan that covers such nursing services, would otherwise be required to pay;
  3. Sanctions shall not be imposed under division (B)(24) of this section against any licensee who waives deductibles and copayments as follows:
  1. In compliance with the health benefit plan that expressly allows such a practice. Waiver of the deductibles or copayments shall be made only with the full knowledge and consent of the plan purchaser, payer, and third-party administrator. Documentation of the consent shall be made available to the Board upon request.
  1. Failure to comply with the terms and conditions of participation in the chemical dependency monitoring program;
  2. Failure to comply with the terms and conditions required under the practice intervention and improvement program;
  3. Prescribing any drug or device to perform or induce an abortion, or otherwise performing or inducing an abortion;
  4. Failure to establish and maintain professional boundaries with a patient;
  5. Regardless of whether the contact or verbal behavior is consensual, engaging with a patient other than the spouse of the registered nurse, licensed practical nurse, or dialysis technician in any of the following:
  1. Sexual contact;
  2. Verbal behavior that is sexually demeaning to the patient or may be reasonably interpreted by the patient as sexually demeaning.

Exemptions from Licensure Requirement

The law does not prohibit any of the following:

(A) The practice of nursing by a student currently enrolled in and actively pursuing completion of a prelicensure nursing education program approved by the Board of Nursing, if the student's practice is under the auspices of the program and the student acts under the supervision of a registered nurse serving for the program as a faculty member, teaching assistant, or preceptor;

(B) The rendering of medical assistance to a licensed physician, licensed dentist, or licensed podiatrist by a person under the direction, supervision, and control of such licensed physician, dentist, or podiatrist;

(C) The activities of persons employed as nursing aides, attendants, orderlies, or other auxiliary workers in patient homes, nurseries, nursing homes, hospitals, home health agencies, or other similar institutions;

(D) The provision of nursing services to family members or in emergency situations;

(E) The care of the sick when done in connection with the practice of religious tenets of any church and by or for its members;

(F) The activities of an individual who currently holds a license to practice nursing in another jurisdiction, if the individual's license has not been revoked, the individual is not currently under suspension or on probation, the individual does not represent the individual as being licensed under this chapter, and one of the following is the case:

  1. The individual is engaging in the practice of nursing by discharging official duties while employed by or under contract with the United States government or any agency thereof;
  2. The individual is engaging in the practice of nursing as an employee of an individual, agency, or corporation located in the other jurisdiction in a position with employment responsibilities that include transporting patients into, out of, or through this state, as long as each trip in this state does not exceed seventy-two hours;
  3. The individual is consulting with an individual licensed in this state to practice any health-related profession;
  4. The individual is engaging in activities associated with teaching in this state as a guest lecturer at or for a nursing education program, continuing nursing education program, or in-service presentation;
  5. The individual is conducting evaluations of nursing care that are undertaken on behalf of an accrediting organization, including the national league for nursing accrediting committee, the joint commission on accreditation of healthcare organizations, or any other nationally recognized accrediting organization;
  6. The individual is providing nursing care to an individual who is in this state on a temporary basis, not to exceed six months in any one calendar year, if the nurse is directly employed by or under contract with the individual or a guardian or other person acting on the individual's behalf;
  7. The individual is providing nursing care during any disaster, natural or otherwise, that has been officially declared to be a disaster by a public announcement issued by an appropriate federal, state, county, or municipal official.

Immunity

The Board shall investigate evidence that appears to show that any person has violated any rule of the Board. Any person may report to the Board any information the person may have that appears to show a violation of any rule of the Board. In the absence of bad faith, any person who reports such information or who testifies before the Board in any adjudication shall not be liable for civil damages as a result of the report or testimony.

Mandatory Reporting

(A) Reports to the Board of Nursing shall be made as follows:

  1. Every employer of registered nurses, licensed practical nurses, or dialysis technicians shall report to the Board of Nursing the name of any current or former employee who holds a nursing license or dialysis technician certificate issued under this chapter who has engaged in conduct that would be grounds for disciplinary action by the Board.
  2. Nursing associations shall report to the Board the name of any registered nurse or licensed practical nurse and dialysis technician associations shall report to the Board the name of any dialysis technician who has been investigated and found to constitute a danger to the public health, safety, and welfare because of conduct that would be grounds for disciplinary action by the Board except that an association is not required to report the individual's name if the individual is maintaining satisfactory participation in a peer support program approved by the Board.
  3. If the prosecutor in a case where the trial court issued an order of dismissal upon technical or procedural grounds of a charge of a misdemeanor committed in the course of practice, a felony charge, or a charge of gross immorality or moral turpitude, knows or has reason to believe that the person charged is licensed under this chapter to practice nursing as a registered nurse or as a licensed practical nurse or holds a certificate issued under this chapter to practice as a dialysis technician, the prosecutor shall notify the Board of Nursing on forms prescribed and provided by the Board. The report shall include the name and address of the license or certificate holder, the charge, and the certified court documents recording the action.

(B) If any person fails to provide a report required by this section, the Board may seek an order from a court of competent jurisdiction compelling submission of the report.

Standards of Safe Nursing Practice as a Registered Nurse

(A) A registered nurse shall provide nursing care within the scope of practice of nursing for a registered nurse.

(B) A registered nurse shall maintain current knowledge of the duties, responsibilities, and accountabilities for safe nursing practice.

(C) A registered nurse shall demonstrate competence and accountability in all areas of practice in which the nurse is engaged which includes, but is not limited to, the following:

  1. Consistent performance of all aspects of nursing care; and
  2. Recognition, referral or consultation, and intervention, when a complication arises.

(D) A registered nurse may provide nursing care which is beyond basic nursing preparation for a registered nurse, provided:

  1. The nurse obtains education which emanates from a recognized body of knowledge relative to the nursing care to be provided;
  2. The nurse demonstrates knowledge, skills, and abilities necessary to provide the nursing care;
  3. The nurse maintains documentation satisfactory to the board;
  4. The nurse has a specific current order from an individual who is authorized to practice in this state and is acting within the course of the individual’s professional practice; and
  5. The nursing care does not involve a function or procedure which is prohibited by any other law or rule.

(E) A registered nurse shall, in a timely manner:

  1. Implement any order for a client unless the registered nurse believes or should have reason to believe the order is:
  1. Inaccurate;
  2. Not properly authorized;
  3. Not current or valid;
  4. Harmful, or potentially harmful to a client; or
  5. Contraindicated by other documented information; and
  1. Clarify any order for a client when the registered nurse believes or should have reason to believe the order is:
  1. Inaccurate;
  2. Not properly authorized;
  3. Not current or valid;
  4. Harmful, or potentially harmful to a client; or
  5. Contraindicated by other documented information.

(F) When clarifying an order, the registered nurse shall, in a timely manner:

  1. Consult with an appropriate licensed practitioner;
  2. Notify the prescribing practitioner when the licensed nurse makes the decision not to follow the direction or administer the medication or treatment as prescribed;
  3. Document that the practitioner was notified of the decision not to follow the direction or administer the medication or treatment, including the reason for not doing so; and
  4. Take any other action needed to assure the safety of the client.

(G) A registered nurse shall timely report to and consult as necessary with other nurses or other members of the health-care team and make referrals as appropriate.

(H) A registered nurse shall maintain the confidentiality of client information obtained in the course of nursing practice. The registered nurse is not precluded from communicating appropriate client information with other members of the health-care team for health-care purposes only.

(I) To the maximum extent feasible, identifiable client health-care information shall not be disclosed by a registered nurse unless the client has consented through a properly executed release to the disclosure of identifiable client health-care information. A registered nurse shall report individually identifiable client information without written consent in limited circumstances only and in accordance with an authorized law, rule, or other recognized legal authority.

(J) The registered nurse shall use acceptable standards of safe nursing care as a basis for any observation, advice, instruction, teaching, or evaluation and shall communicate information which is consistent with acceptable standards of safe nursing care.

(K) When a registered nurse provides direction to a licensed practical nurse, the registered nurse shall first assess:

  1. The condition of the client who needs nursing care, including, but not limited to, the stability of the client;
  2. The type of nursing care the client requires;
  3. The complexity and frequency of the nursing care needed;
  4. The training, skill, and ability of the licensed practical nurse who will be performing the specific function or procedure, to perform the specific function or procedure; and
  5. The availability and accessibility of resources necessary to safely perform the specific function or procedure.

Standards of Competent Practice as a Licensed Practical Nurse

(A) A licensed practical nurse shall function within the scope of practice of nursing for a licensed practical nurse.

(B) A licensed practical nurse shall maintain current knowledge of the duties, responsibilities, and accountabilities for safe nursing practice.

(C) A licensed practical nurse shall demonstrate competence and accountability in all areas of practice in which the nurse is engaged which includes, but is not limited to, the following:

  1. Consistent performance of all aspects of nursing care; and
  2. Recognition, referral or consultation, and intervention, when a complication arises.

(D) A licensed practical nurse may provide nursing care which is beyond basic preparation for a licensed practical nurse provided:

  1. The nurse obtains education which emanates from a recognized body of knowledge relative to the nursing care to be provided;
  2. The nurse demonstrates knowledge, skills, and abilities necessary to perform the nursing care;
  3. The nurse maintains documentation satisfactory to the board;
  4. The nurse has a specific current valid order or direction from an individual who is authorized to practice in this state and is acting within the course of the individual’s professional practice; and
  5. The nursing care does not involve a function or procedure which is prohibited by any other law or rule.

(E) A licensed practical nurse shall, in a timely manner:

  1. Implement any order or direction for a client unless the licensed practical nurse believes or should have reason to believe the order or direction is:
  1. Inaccurate;
  2. Not properly authorized;
  3. Not current or valid;
  4. Harmful, or potentially harmful to a client; or
  5. Contraindicated by other documented information; and
  1. Clarify any order or direction for a client when the licensed practical nurse believes or should have reason to believe the order or direction is:
  1. Inaccurate;
  2. Not properly authorized;
  3. Not current or valid;
  4. Harmful, or potentially harmful to a client; or
  5. Contraindicated by other documented information.

(F) When clarifying an order or direction, the licensed practical nurse shall, in a timely manner:

  1. Consult with an appropriate licensed practitioner or directing registered nurse;
  2. Notify the ordering practitioner or directing registered nurse when the licensed practical nurse makes the decision not to follow the order or direction or administer the medication or treatment as prescribed;
  3. Document that the practitioner or directing registered nurse was notified of the decision not to follow the direction or order, or administer the medication or treatment, including the reason for not doing so; and
  4. Take any other action needed to assure the safety of the client.

(G) A licensed practical nurse shall, in a timely manner report to and consult as necessary with other nurses or other members of the health care team and make referrals as necessary.

(H) A licensed practical nurse shall maintain the confidentiality of client information obtained in the course of nursing practice. The licensed practical nurse shall communicate client information with other members of the health care team for health care purposes only.

(I) To the maximum extent feasible, identifiable client health care information shall not be disclosed by a licensed practical nurse unless the client has consented through a properly executed release to the disclosure of identifiable client health care information. A licensed practical nurse shall report individually identifiable client information without written consent in limited circumstances only, and in accordance with an authorized law, rule, or other recognized legal authority.

(J) When a licensed practical nurse is directed to observe, advise, instruct, or evaluate the performance of a nursing task, the licensed practical nurse shall use acceptable standards of safe nursing care as a basis for that observation, advice, instruction, teaching, or evaluation and shall communicate information which is consistent with acceptable standards of safe nursing care.