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wildirismedicaleducation.comOH NPA Laws and Rules - Category A 1.0 HourAn 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 LPNobtains appropriate education; demonstrates knowledge, skills, and abilities; and maintainssatisfactory records of meeting these requirements. The LPN must have a valid order or directionfrom an authorized individual acting within their professional practice, and the nursing carecannot involve a function or procedure prohibited by any law or rule.LPNs must (E) implement or clarify an order in a timely manner unless or whenever theybelieve or have reason to believe the order is: Inaccurate Not properly authorized Not current or valid Harmful or potentially harmful to a patient Contraindicated by other documented informationWhen (F) clarifying an order or direction, the LPN must consult with an authorized practitioneror directing RN. If the LPN decides not to follow the direction, the LPN, in a timely manner,must: Notify the ordering practitioner or directing RN of the decision not to follow the order Document that the ordering practitioner or directing RN was notified and state the reasonfor not following the direction Take any other action to ensure the safety of the patientAn LPN must (G) report to and consult with other nurses or other members of the healthcareteam and make referrals as necessary.An LPN must (H) maintain the confidentiality of patient information, communicating patientinformation with other members of the healthcare team for healthcare purposes only andaccessing patient information only for patient care purposes or for fulfilling assigned jobresponsibilities. 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) does not disclose identifiable patient healthcare information unless the patient giveswritten consent by a properly executed release of information. Only in limited circumstances inaccord with authorized legal authority does an LPN release individually identifiable patienthealthcare information without a written consent of the patient. 2021 WILD IRIS MEDICAL EDUCATION, INC.6

wildirismedicaleducation.comOH NPA Laws and Rules - Category A 1.0 HourWhen directed to observe, advise, instruct, or evaluate the performance of a nursing task, theLPN (J) uses acceptable standards of safe nursing care as a basis for that observation, advice,instruction, teaching, or evaluation and communicates information consistent with acceptablestandards of safe nursing care with respect to the nursing task.STANDARDS OF COMPETENCY FOR ADVANCED PRACTICENURSES[This section covers subsections (A) thru (D) of the OAC 4723-4-05, Standards relating to competent practiceas a certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, or clinical nursespecialist.]A certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, andclinical nurse specialist must (A): Function within the scope of practice of nursing for a registered nurse as set forth indivision (B) of Section 4723.01 of the Ohio Revised Code and the rules of the OhioBoard of Nursing. Function within the nurse’s applicable scope of practice as set forth in section 4723.43of the Ohio Revised Code and the rules of the Ohio Board of Nursing. If authorized by Ohio law to prescribe, practice according to Section 4723.481 of theOhio Revised Code and Section 4723-9 of the Ohio Administrative Code.When the practice of a certified nurse-midwife, certified nurse practitioner, or clinical nursespecialist is evaluated, the (B) evaluation must be done by a collaborating licensed physician orpodiatrist, or an advanced practice registered nurse holding a current, valid license with the samedesignation as the individual being evaluated.When the practice of a certified registered nurse anesthetist is evaluated, the (C) evaluation mustbe done by a supervising licensed physician, podiatrist, dentist, or certified registered anesthetistwhose license is current and valid.A certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, orclinical nurse specialist may provide care within their specialty, provided the nurse (D): Obtains appropriate education from a recognized body of knowledge Demonstrates knowledge, skills, and abilities Maintains documented evidence of these skills and abilities 2021 WILD IRIS MEDICAL EDUCATION, INC.7

wildirismedicaleducation.comOH NPA Laws and Rules - Category A 1.0 HourSTANDARDS THAT PROMOTE PATIENT SAFETY[This section covers subsections (A) thru (Q) of the OAC 4723-4-06, Standards of nursing practice promotingpatient safety.](A–C) When providing direct nursing care to patients or engaging in nursing practice in personor by telecommunication, licensed nurses, certified nurse-midwives, certified nurse practitioners,certified registered nurse anesthetists, or clinical nurse specialists must display and identifytheir applicable title or initials (degree) or identify to each patient or healthcare provider thenurse’s title or initials (degree) as a registered nurse or licensed practical nurse.Licensed nurses must (D) delegate nursing tasks, including medication administration, onlyin 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 document any (F) errors in or deviations from a prescribed regimen tothe appropriate practitioner in a timely and accurate manner.Licensed nurses must (G) not falsify, or conceal by any method, patient records or any otherdocument prepared or used in the course of nursing practice. This includes case managementdocuments or reports, time records, reports, and other documents related to billing for nursingservices.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 wouldinterpret as physical, verbal, mental, or emotional abuse.A licensed nurse must not (L) misappropriate the property of patients or: Engage in behavior to seek or obtain personal gain at the patient’s expense, or that mayreasonably be interpreted as such Engage in behavior that constitutes inappropriate involvement in the patient’s personalrelationships or financial matters, or that may reasonably be interpreted as suchA licensed nurse must not (M): Engage in sexual conduct with a patient, or conduct that may be interpreted as sexual 2021 WILD IRIS MEDICAL EDUCATION, INC.8

wildirismedicaleducation.comOH NPA Laws and Rules - Category A 1.0 Hour Engage in verbal behavior that is seductive or sexually demeaning to a patient, or thatmay be interpreted as suchThe patient is always presumed incapable of giving free, full, or informed consent to thebehaviors by the nurse set forth in (L) and (M) above.When licensed nurses (N) function in administrative roles, they must make sure that there areprocedures in place and implemented to verify that every nurse, dialysis technician, ormedication aide working under their administration has a current valid license or valid certificatein 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, nonnursing supervisors may evaluate nurse employees in matters other than the practice of nursing.A licensed nurse must not (P) make, submit, or cause to be submitted any false, misleading, ordeceptive statements to the OBN, current or prospective employers, facilities or organizationsfor whom the nurse is working, members of the healthcare team, or law enforcement personnel.A nurse must (Q) not use social media, texting, emailing, or other forms of communication withor about a patient for nonhealthcare purposes or for purposes other than fulfilling the nurse’sassigned job responsibilities.DELEGATION GUIDELINESWhen all conditions for delegation set forth in Chapter 4723-13-05 of the OAC are met, aregistered nurse may delegate a nursing task to an unlicensed person and a licensed practicalnurse may delegate a nursing task to an unlicensed person at the direction of the registerednurse. These conditions are summarized below.Except as otherwise authorized by law or this chapter, a licensed nurse may delegate to anunlicensed person the administration of only the following medications: Over-the-counter topical medications to be applied to intact skin for the purpose ofimproving a skin condition or providing a barrier Over-the-counter eye drop, ear drop, and suppository medications, foot soaktreatments, and enemasPrior to delegating a nursing task to an unlicensed person, the delegating nurse must makecertain determinations regarding the nature of the task and the qualifications of theunlicensed person who will carry it out. The nursing task is within the scope of practice of the delegating nurse 2021 WILD IRIS MEDICAL EDUCATION, INC.9

wildirismedicaleducation.comOH NPA Laws and Rules - Category A 1.0 Hour The nursing task is within the knowledge, skill, and ability of the nurse delegatingthe nursing task The nursing task is within the training, ability, and skill of the unlicensed personwho will be performing the delegated nursing task Appropriate resources and support are available for the performance of the taskand management of the outcome Adequate and appropriate supervision by a licensed nurse of the performance ofthe nursing task is available That:o The nursing task requires no judgment based on nursing knowledge andexpertise on the part of the unlicensed person performing the tasko The results of the nursing task are reasonably predictableo The nursing task can be safely performed according to exact, unchangingdirections, with no need to alter the standard procedures for performing the tasko The performance of the nursing task does not require that complex observationsor critical decisions be made with respect to the nursing tasko The nursing task does not require repeated performance of nursing assessmentso The consequences of performing the nursing task improperly are minimal andnot life-threateningPrior to delegating a nursing task, the delegating nurse must also make certain determinationsregarding the patient and the conditions: Identify the individual on whom the nursing task may be performed and a specific timeframe during which it may be performed. Complete an evaluation of the conditions that relate to task to be performed, including:o An evaluation of the individual who needs nursing careo The types of nursing care the individual requireso The complexity and frequency of the nursing care neededo The stability of the individual who needs nursing careo A review of the evaluations performed by other licensedhealthcare professionalsThe delegating nurse shall be accountable for the decision to delegate nursing tasks to anunlicensed person. 2021 WILD IRIS MEDICAL EDUCATION, INC.10

wildirismedicaleducation.comOH NPA Laws and Rules - Category A 1.0 HourIf a licensed nurse determines that an unlicensed person is not correctly performing adelegated nursing task, the licensed nurse shall immediately intervene.STANDARDS FOR APPLYING THE NURSING PROCESS FOR RNs[This section covers subsections (A) and (B) of the OAC 4723-4-07, Standards for applying the nursing process as aregistered nurse.]A registered nurse must apply the nursing process in the practice of nursing as set forth indivision (B) of section 4723.01 of the ORC and in the rules of the board. Nurses give care topatients using a cyclic series of steps called the nursing process. With critical thinking andclinical judgment, RNs assess, analyze/report, plan, implement, and evaluate the changingstatus of patients. They apply the nursing process in various practice settings and collaboratewith patients, family, significant others, and members of the healthcare team according to thefollowing standards.The standards for implementing the nursing process also apply to a certified nurse-midwife,certified nurse practitioner, certified registered nurse anesthetist, or clinical nurse specialist.AssessmentAssessment involves the accurate and timely collection of both subjective and objective dataabout a patient’s condition from the patient, family members, significant others, and members ofthe healthcare team. The RN may direct or delegate the gathering of data but must document andreport it, as appropriate, to other members of the healthcare team.Analysis and ReportingIn an accurate and timely manner, RNs identify, organize, assimilate, and interpret relevant data.They establish, accept, or modify a nursing diagnosis, which is used as a basis for nursinginterventions, and report the patient’s health status and nursing diagnosis as needed to othermembers of the healthcare team.PlanningIn an accurate and timely way, RNs develop, establish, maintain, or modify the nursing care planwith current nursing science, including the nursing diagnosis, desired patient outcomes or goals,and nursing interventions. They communicate the plan of care and all modifications to membersof the healthcare team.ImplementationIn an accurate and timely way, RNs implement the nursing care plan. They execute the nursingregimen; implement current valid orders or directions by authorized practitioners; and provide 2021 WILD IRIS MEDICAL EDUCATION, INC.11

wildirismedicaleducation.comOH NPA Laws and Rules - Category A 1.0 Hournursing care commensurate with their education, knowledge, skills, and abilities. They assist andcollaborate 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).EvaluationIn an accurate and timely way, RNs evaluate, document, and report patient responses to nursinginterventions and progress toward expected outcomes to appropriate members of the healthcareteam. They then reassess the patient’s health status, establishing or modifying any aspect of thenursing plan.STANDARDS FOR APPLYING THE NURSING PROCESS FORLPNs[This section covers the OAC 4723-4-08, Standards for applying the nursing process as a licensed practical nurse.]Licensed practical nurses contribute to the nursing process as set forth in division (F) of section4723.01 of the ORC and rules of the board. The steps of the nursing process are cyclic in nature,so that the patient’s changing status affects the action of nurses 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 licensed practical nurse shall use thefollowing standards for applying the nursing process.AssessmentThe 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 andreport the data to the directing registered nurse or healthcare provider and other members of thehealthcare team. The subsequent analysis and reporting of this data, however, is not part of theLPN’s role.PlanningIn an accurate and timely manner, LPNs contribute to the development, maintenance, ormodification of the nursing component of the care plan and communicate the nursing care planand all modifications of the plan to appropriate members of the healthcare team.ImplementationLicensed practical nurses implement the nursing care plan in an accurate and timely manneras follows: Provide nursing interventions 2021 WILD IRIS MEDICAL EDUCATION, INC.12

wildirismedicaleducation.comOH NPA Laws and Rules - Category A 1.0 Hour Collect and report patient data as directed Administer medications and treatments prescribed by an authorized individual Provide basic nursing care at the direction of an RN, advanced practice registered nurse,or licensed physician, dentist, optometrist, chiropractor, or podiatrist Collaborate with other nurses and members of the healthcare team Delegate tasks as directed, including medication administration, only in accordance withthe OAC (see also “Delegation Guidelines” earlier in this course)EvaluationIn an accurate and timely manner, LPNs contribute to the evaluation of patient responses tonursing interventions, document and communicate patient responses to nursing interventions toappropriate members of the healthcare team, and contribute to the reassessment of the patient’shealth status and to modifications of any aspect of the nursing plan of care.CONCLUSIONThe Ohio Nurse Practice Act defined the scope of practice for nurses in Chapter 4723 of theOhio Revised Code and established the Ohio Board of Nursing. The Board of Nursing isresponsible for the administration and enforcement of the Nurse Practice Act. This responsibilityis accomplished through Section 4723 of the Ohio Administrative Code (OAC). The OAC arethe 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 nursingpractice in the state of Ohio. It sets forth the standards of competent nursing practice andstandards for promoting patient safety. By so doing, OAC 4723 fulfills the mission of the Boardof Nursing to actively safeguard the health of the public through the effective regulation ofnursing care. It is the responsibility of all nurses in the state of Ohio to be familiar with and toabide by these laws and rules. RESOURCESOhio Administrative Code (OAC), Section 4723, Board of Nursinghttp://codes.ohio.gov/oac/4723Ohio Board of Nursinghttp://www.nursing.ohio.govOhio Revised Code (ORC), Chapter 4723, Nurseshttp://codes.ohio.gov/orc/4723 2021 WILD IRIS MEDICAL EDUCATION, INC.13

wildirismedicaleducation.comOH NPA Laws and Rules - Category A 1.0 HourREFERENCESNational Council of State Boards of Nursing (NCSBN). (2018). What every nurse needs to know about state andterritorial boards of nursing. Retrieved from https://www.ncsbn.org/What Every Nurse Needs to Know.pdfOhio Board of Nursing (OBN). (2021). What we do. Retrieved from https://nursing.ohio.gov/about-the-board/Ohio Board o

by the Ohio Board of Nursing in accordance with Section 4723 of the Ohio Revised Code. Specific learning objectives to address potential knowledge gaps include: Describe the Ohio Scope of Practice Decision-Making Model. Discuss the standards for competent nursing practice of RNs and LPNs in Ohio.