|
|
To amend sections 3333.28, 4723.01, 4723.06, 4723.48, | 1 |
4723.482, and 4723.50; to amend, for the purpose | 2 |
of adopting new section numbers as indicated in | 3 |
parentheses, sections 4723.484 (4723.485) and | 4 |
4723.485 (4723.486); and to enact new section | 5 |
4723.484 and section 3333.29 of the Revised Code | 6 |
regarding prescriptive authority of out-of-state | 7 |
advanced practice nurses, cooperation among | 8 |
hospitals and state institutions of higher | 9 |
education with nursing education programs, and | 10 |
allocations from the Nurse Education Assistance | 11 |
Fund. | 12 |
Section 1. That sections 3333.28, 4723.01, 4723.06, 4723.48, | 13 |
4723.482, and 4723.50 be amended; sections 4723.484 (4723.485), | 14 |
and 4723.485 (4723.486) be amended for the purpose of adopting new | 15 |
section numbers as indicated in parentheses; and new section | 16 |
4723.484 and section 3333.29 of the Revised Code be enacted to | 17 |
read as follows: | 18 |
Sec. 3333.28. (A) The chancellor of the Ohio board of | 19 |
regents shall establish the nurse education assistance program, | 20 |
the purpose of which shall be to make loans to students enrolled | 21 |
in prelicensure nurse education programs at institutions approved | 22 |
by the board of nursing under section 4723.06 of the Revised Code | 23 |
and postlicensure nurse education programs approved by the | 24 |
chancellor under section 3333.04 of the Revised Code or offered by | 25 |
an institution holding a certificate of authorization issued under | 26 |
Chapter 1713. of the Revised Code. The board of nursing shall | 27 |
assist the chancellor in administering the program. | 28 |
(B) There is hereby created in the state treasury the nurse | 29 |
education assistance fund, which shall consist of all money | 30 |
transferred to it pursuant to section 4743.05 of the Revised Code. | 31 |
The fund shall be used by the chancellor for loans made under | 32 |
division (A) of this section and for expenses of administering the | 33 |
loan program. | 34 |
(C) | 35 |
chancellor shall distribute money in the nurse education | 36 |
assistance fund in the following manner: | 37 |
(1)(a) Fifty per cent of available funds shall be awarded as | 38 |
loans to registered nurses enrolled in postlicensure nurse | 39 |
education programs described in division (A) of this section. To | 40 |
be eligible for a loan, the applicant shall provide the chancellor | 41 |
with a letter of intent to practice as a faculty member at a | 42 |
prelicensure or postlicensure program for nursing in this state | 43 |
upon completion of the applicant's academic program. | 44 |
(b) If the borrower of a loan under division (C)(1)(a) of | 45 |
this section secures employment as a faculty member of an approved | 46 |
nursing education program in this state within six months | 47 |
following graduation from an approved nurse education program, the | 48 |
chancellor may forgive the principal and interest of the student's | 49 |
loans received under division (C)(1)(a) of this section at a rate | 50 |
of twenty-five per cent per year, for a maximum of four years, for | 51 |
each year in which the borrower is so employed. A deferment of the | 52 |
service obligation, and other conditions regarding the forgiveness | 53 |
of loans may be granted as provided by the rules adopted under | 54 |
division (D)(7) of this section. | 55 |
(c) Loans awarded under division (C)(1)(a) of this section | 56 |
shall be awarded on the basis of the student's expected family | 57 |
contribution, with preference given to those applicants with the | 58 |
lowest expected family contribution. However, the chancellor may | 59 |
consider other factors the chancellor determines relevant in | 60 |
ranking the applications. | 61 |
(d) Each loan awarded to a student under division (C)(1)(a) | 62 |
of this section shall be not less than five thousand dollars per | 63 |
year. | 64 |
(2) Twenty-five per cent of available funds shall be awarded | 65 |
to students enrolled in prelicensure nurse education programs for | 66 |
registered nurses, as defined in section 4723.01 of the Revised | 67 |
Code. | 68 |
(3) Twenty-five per cent of available funds shall be awarded | 69 |
to students enrolled in prelicensure professional nurse education | 70 |
programs for licensed practical nurses | 71 |
4723.01 of the Revised Code, or as determined by the chancellor | 72 |
with preference given to nurse education programs aimed at | 73 |
increasing enrollment in an area of need. | 74 |
After January 1, 2012, the chancellor shall determine the | 75 |
manner in which to distribute loans under this section. | 76 |
(D) Subject to the requirements specified in division (C) of | 77 |
this section, the chancellor shall adopt rules in accordance with | 78 |
Chapter 119. of the Revised Code establishing: | 79 |
(1) Eligibility criteria for receipt of a loan; | 80 |
(2) Loan application procedures; | 81 |
(3) The amounts in which loans may be made and the total | 82 |
amount that may be loaned to an individual; | 83 |
(4) The total amount of loans that can be made each year; | 84 |
(5) The percentage of the money in the fund that must remain | 85 |
in the fund at all times as a fund balance; | 86 |
(6) Interest and principal repayment schedules; | 87 |
(7) Conditions under which a portion of principal and | 88 |
interest obligations incurred by an individual under the program | 89 |
will be forgiven; | 90 |
(8) Ways that the program may be used to encourage | 91 |
individuals who are members of minority groups to enter the | 92 |
nursing profession; | 93 |
(9) Any other matters incidental to the operation of the | 94 |
program. | 95 |
(E) The obligation to repay a portion of the principal and | 96 |
interest on a loan made under this section shall be forgiven if | 97 |
the recipient of the loan meets the criteria for forgiveness | 98 |
established by division (C)(1)(b) of this section, in the case of | 99 |
loans awarded under division (C)(1)(a) of this section, or by the | 100 |
chancellor under the rule adopted under division (D)(7) of this | 101 |
section, in the case of other loans awarded under this section. | 102 |
(F) The receipt of a loan under this section shall not affect | 103 |
a student's eligibility for assistance, or the amount of that | 104 |
assistance, granted under section 3333.12, 3333.122, 3333.22, | 105 |
3333.26, 3333.27, 5910.03, 5910.032, or 5919.34 of the Revised | 106 |
Code, but the rules of the chancellor may provide for taking | 107 |
assistance received under those sections into consideration when | 108 |
determining a student's eligibility for a loan under this section. | 109 |
Sec. 3333.29. (A) As used in this section, "state institution | 110 |
of higher education" has the same meaning as in section 3345.011 | 111 |
of the Revised Code. | 112 |
(B) The chancellor of the Ohio board of regents shall | 113 |
establish, within the Ohio skills bank, a mechanism to facilitate | 114 |
communication, cooperation, and partnerships among state | 115 |
institutions of higher education with nursing education programs | 116 |
and between state institutions of higher education and hospitals | 117 |
in this state to meet regional and statewide nursing education | 118 |
needs. | 119 |
Sec. 4723.01. As used in this chapter: | 120 |
(A) "Registered nurse" means an individual who holds a | 121 |
current, valid license issued under this chapter that authorizes | 122 |
the practice of nursing as a registered nurse. | 123 |
(B) "Practice of nursing as a registered nurse" means | 124 |
providing to individuals and groups nursing care requiring | 125 |
specialized knowledge, judgment, and skill derived from the | 126 |
principles of biological, physical, behavioral, social, and | 127 |
nursing sciences. Such nursing care includes: | 128 |
(1) Identifying patterns of human responses to actual or | 129 |
potential health problems amenable to a nursing regimen; | 130 |
(2) Executing a nursing regimen through the selection, | 131 |
performance, management, and evaluation of nursing actions; | 132 |
(3) Assessing health status for the purpose of providing | 133 |
nursing care; | 134 |
(4) Providing health counseling and health teaching; | 135 |
(5) Administering medications, treatments, and executing | 136 |
regimens authorized by an individual who is authorized to practice | 137 |
in this state and is acting within the course of the individual's | 138 |
professional practice; | 139 |
(6) Teaching, administering, supervising, delegating, and | 140 |
evaluating nursing practice. | 141 |
(C) "Nursing regimen" may include preventative, restorative, | 142 |
and health-promotion activities. | 143 |
(D) "Assessing health status" means the collection of data | 144 |
through nursing assessment techniques, which may include | 145 |
interviews, observation, and physical evaluations for the purpose | 146 |
of providing nursing care. | 147 |
(E) "Licensed practical nurse" means an individual who holds | 148 |
a current, valid license issued under this chapter that authorizes | 149 |
the practice of nursing as a licensed practical nurse. | 150 |
(F) "The practice of nursing as a licensed practical nurse" | 151 |
means providing to individuals and groups nursing care requiring | 152 |
the application of basic knowledge of the biological, physical, | 153 |
behavioral, social, and nursing sciences at the direction of a | 154 |
licensed physician, dentist, podiatrist, optometrist, | 155 |
chiropractor, or registered nurse. Such nursing care includes: | 156 |
(1) Observation, patient teaching, and care in a diversity of | 157 |
health care settings; | 158 |
(2) Contributions to the planning, implementation, and | 159 |
evaluation of nursing; | 160 |
(3) Administration of medications and treatments authorized | 161 |
by an individual who is authorized to practice in this state and | 162 |
is acting within the course of the individual's professional | 163 |
practice, except that administration of intravenous therapy shall | 164 |
be performed only in accordance with section 4723.17 or 4723.171 | 165 |
of the Revised Code. Medications may be administered by a licensed | 166 |
practical nurse upon proof of completion of a course in medication | 167 |
administration approved by the board of nursing. | 168 |
(4) Administration to an adult of intravenous therapy | 169 |
authorized by an individual who is authorized to practice in this | 170 |
state and is acting within the course of the individual's | 171 |
professional practice, on the condition that the licensed | 172 |
practical nurse is authorized under section 4723.17 or 4723.171 of | 173 |
the Revised Code to perform intravenous therapy and performs | 174 |
intravenous therapy only in accordance with those sections; | 175 |
(5) Delegation of nursing tasks as directed by a registered | 176 |
nurse; | 177 |
(6) Teaching nursing tasks to licensed practical nurses and | 178 |
individuals to whom the licensed practical nurse is authorized to | 179 |
delegate nursing tasks as directed by a registered nurse. | 180 |
(G) "Certified registered nurse anesthetist" means a | 181 |
registered nurse who holds a valid certificate of authority issued | 182 |
under this chapter that authorizes the practice of nursing as a | 183 |
certified registered nurse anesthetist in accordance with section | 184 |
4723.43 of the Revised Code and rules adopted by the board of | 185 |
nursing. | 186 |
(H) "Clinical nurse specialist" means a registered nurse who | 187 |
holds a valid certificate of authority issued under this chapter | 188 |
that authorizes the practice of nursing as a clinical nurse | 189 |
specialist in accordance with section 4723.43 of the Revised Code | 190 |
and rules adopted by the board of nursing. | 191 |
(I) "Certified nurse-midwife" means a registered nurse who | 192 |
holds a valid certificate of authority issued under this chapter | 193 |
that authorizes the practice of nursing as a certified | 194 |
nurse-midwife in accordance with section 4723.43 of the Revised | 195 |
Code and rules adopted by the board of nursing. | 196 |
(J) "Certified nurse practitioner" means a registered nurse | 197 |
who holds a valid certificate of authority issued under this | 198 |
chapter that authorizes the practice of nursing as a certified | 199 |
nurse practitioner in accordance with section 4723.43 of the | 200 |
Revised Code and rules adopted by the board of nursing. | 201 |
(K) "Physician" means an individual authorized under Chapter | 202 |
4731. of the Revised Code to practice medicine and surgery or | 203 |
osteopathic medicine and surgery, except as used in divisions (C) | 204 |
and (D) of section 4723.482 of the Revised Code. | 205 |
(L) "Collaboration" or "collaborating" means the following: | 206 |
(1) In the case of a clinical nurse specialist, except as | 207 |
provided in division (L)(3) of this section, or a certified nurse | 208 |
practitioner, that one or more podiatrists acting within the scope | 209 |
of practice of podiatry in accordance with section 4731.51 of the | 210 |
Revised Code and with whom the nurse has entered into a standard | 211 |
care arrangement or one or more physicians with whom the nurse has | 212 |
entered into a standard care arrangement are continuously | 213 |
available to communicate with the clinical nurse specialist or | 214 |
certified nurse practitioner either in person or by radio, | 215 |
telephone, or other form of telecommunication; | 216 |
(2) In the case of a certified nurse-midwife, that one or | 217 |
more physicians with whom the certified nurse-midwife has entered | 218 |
into a standard care arrangement are continuously available to | 219 |
communicate with the certified nurse-midwife either in person or | 220 |
by radio, telephone, or other form of telecommunication; | 221 |
(3) In the case of a clinical nurse specialist who practices | 222 |
the nursing specialty of mental health or psychiatric mental | 223 |
health without being authorized to prescribe drugs and therapeutic | 224 |
devices, that one or more physicians are continuously available to | 225 |
communicate with the nurse either in person or by radio, | 226 |
telephone, or other form of telecommunication. | 227 |
(M) "Supervision," as it pertains to a certified registered | 228 |
nurse anesthetist, means that the certified registered nurse | 229 |
anesthetist is under the direction of a podiatrist acting within | 230 |
the podiatrist's scope of practice in accordance with section | 231 |
4731.51 of the Revised Code, a dentist acting within the dentist's | 232 |
scope of practice in accordance with Chapter 4715. of the Revised | 233 |
Code, or a physician, and, when administering anesthesia, the | 234 |
certified registered nurse anesthetist is in the immediate | 235 |
presence of the podiatrist, dentist, or physician. | 236 |
(N) "Standard care arrangement" means a written, formal guide | 237 |
for planning and evaluating a patient's health care that is | 238 |
developed by one or more collaborating physicians or podiatrists | 239 |
and a clinical nurse specialist, certified nurse-midwife, or | 240 |
certified nurse practitioner and meets the requirements of section | 241 |
4723.431 of the Revised Code. | 242 |
(O) "Advanced practice nurse" means a certified registered | 243 |
nurse anesthetist, clinical nurse specialist, certified | 244 |
nurse-midwife, or certified nurse practitioner. | 245 |
(P) "Dialysis care" means the care and procedures that a | 246 |
dialysis technician is authorized to provide and perform, as | 247 |
specified in section 4723.72 of the Revised Code. | 248 |
(Q) "Dialysis technician" means an individual who holds a | 249 |
current, valid certificate or temporary certificate issued under | 250 |
this chapter that authorizes the individual to practice as a | 251 |
dialysis technician in accordance with section 4723.72 of the | 252 |
Revised Code. | 253 |
(R) "Certified community health worker" means an individual | 254 |
who holds a current, valid certificate as a community health | 255 |
worker issued by the board of nursing under section 4723.85 of the | 256 |
Revised Code. | 257 |
Sec. 4723.06. (A) The board of nursing shall: | 258 |
(1) Administer and enforce the provisions of this chapter, | 259 |
including the taking of disciplinary action for violations of | 260 |
section 4723.28 of the Revised Code, any other provisions of this | 261 |
chapter, or rules adopted under this chapter; | 262 |
(2) Develop criteria that an applicant must meet to be | 263 |
eligible to sit for the examination for licensure to practice as a | 264 |
registered nurse or as a licensed practical nurse; | 265 |
(3) Issue and renew nursing licenses, dialysis technician | 266 |
certificates, and community health worker certificates, as | 267 |
provided in this chapter; | 268 |
(4) Define the minimum curricula and standards for | 269 |
educational programs of the schools of professional nursing and | 270 |
schools of practical nursing in this state; | 271 |
(5) Survey, inspect, and grant full approval to prelicensure | 272 |
nursing education programs that meet the standards established by | 273 |
rules adopted under section 4723.07 of the Revised Code. | 274 |
Prelicensure nursing education programs include, but are not | 275 |
limited to, associate degree, baccalaureate degree, diploma, and | 276 |
doctor of nursing programs leading to initial licensure to | 277 |
practice nursing as a registered nurse and practical nurse | 278 |
programs leading to initial licensure to practice nursing as a | 279 |
licensed practical nurse. | 280 |
(6) Grant conditional approval, by a vote of a quorum of the | 281 |
board, to a new prelicensure nursing education program or a | 282 |
program that is being reestablished after having ceased to | 283 |
operate, if the program meets and maintains the minimum standards | 284 |
of the board established by rules adopted under section 4723.07 of | 285 |
the Revised Code. If the board does not grant conditional | 286 |
approval, it shall hold an adjudication under Chapter 119. of the | 287 |
Revised Code to consider conditional approval of the program. If | 288 |
the board grants conditional approval, at its first meeting after | 289 |
the first class has completed the program, the board shall | 290 |
determine whether to grant full approval to the program. If the | 291 |
board does not grant full approval or if it appears that the | 292 |
program has failed to meet and maintain standards established by | 293 |
rules adopted under section 4723.07 of the Revised Code, the board | 294 |
shall hold an adjudication under Chapter 119. of the Revised Code | 295 |
to consider the program. Based on results of the adjudication, the | 296 |
board may continue or withdraw conditional approval, or grant full | 297 |
approval. | 298 |
(7) Place on provisional approval, for a period of time | 299 |
specified by the board, a program that has ceased to meet and | 300 |
maintain the minimum standards of the board established by rules | 301 |
adopted under section 4723.07 of the Revised Code. At the end of | 302 |
the period, the board shall reconsider whether the program meets | 303 |
the standards and shall grant full approval if it does. If it does | 304 |
not, the board may withdraw approval, pursuant to an adjudication | 305 |
under Chapter 119. of the Revised Code. | 306 |
(8) Approve continuing nursing education programs and courses | 307 |
under standards established in rules adopted under section 4723.07 | 308 |
of the Revised Code; | 309 |
(9) Approve peer support programs, under rules adopted under | 310 |
section 4723.07 of the Revised Code, for nurses, for dialysis | 311 |
technicians, and for certified community health workers; | 312 |
(10) Establish a program for monitoring chemical dependency | 313 |
in accordance with section 4723.35 of the Revised Code; | 314 |
(11) Establish the practice intervention and improvement | 315 |
program in accordance with section 4723.282 of the Revised Code; | 316 |
(12) Issue and renew certificates of authority to practice | 317 |
nursing as a certified registered nurse anesthetist, clinical | 318 |
nurse specialist, certified nurse-midwife, or certified nurse | 319 |
practitioner; | 320 |
(13) Approve under section 4723.46 of the Revised Code | 321 |
national certifying organizations for examination and | 322 |
certification of certified registered nurse anesthetists, clinical | 323 |
nurse specialists, certified nurse-midwives, or certified nurse | 324 |
practitioners; | 325 |
(14) Issue and renew certificates to prescribe in accordance | 326 |
with
sections 4723.48 and | 327 |
(15) Grant approval to the planned classroom and clinical | 328 |
study required by section | 329 |
be eligible for a certificate to prescribe; | 330 |
(16) Make an annual edition of the formulary established in | 331 |
rules adopted under section 4723.50 of the Revised Code available | 332 |
to the public either in printed form or by electronic means and, | 333 |
as soon as possible after any revision of the formulary becomes | 334 |
effective, make the revision available to the public in printed | 335 |
form or by electronic means; | 336 |
(17) Provide guidance and make recommendations to the general | 337 |
assembly, the governor, state agencies, and the federal government | 338 |
with respect to the regulation of the practice of nursing and the | 339 |
enforcement of this chapter; | 340 |
(18) Make an annual report to the governor, which shall be | 341 |
open for public inspection; | 342 |
(19) Maintain and have open for public inspection the | 343 |
following records: | 344 |
(a) A record of all its meetings and proceedings; | 345 |
(b) A file of holders of nursing licenses, registrations, and | 346 |
certificates granted under this chapter; dialysis technician | 347 |
certificates granted under this chapter; and community health | 348 |
worker certificates granted under this chapter. The file shall be | 349 |
maintained in the form prescribed by rule of the board. | 350 |
(c) A list of prelicensure nursing education programs | 351 |
approved by the board; | 352 |
(d) A list of approved peer support programs for nurses, | 353 |
dialysis technicians, and certified community health workers. | 354 |
(B) The board may fulfill the requirement of division (A)(8) | 355 |
of this section by authorizing persons who meet the standards | 356 |
established in rules adopted under section 4723.07 of the Revised | 357 |
Code to approve continuing nursing education programs and courses. | 358 |
Persons so authorized shall approve continuing nursing education | 359 |
programs and courses in accordance with standards established in | 360 |
rules adopted under section 4723.07 of the Revised Code. | 361 |
Persons seeking authorization to approve continuing nursing | 362 |
education programs and courses shall apply to the board and pay | 363 |
the appropriate fee established under section 4723.08 of the | 364 |
Revised Code. Authorizations to approve continuing nursing | 365 |
education programs and courses shall expire, and may be renewed | 366 |
according to the schedule established in rules adopted under | 367 |
section 4723.07 of the Revised Code. | 368 |
In addition to approving continuing nursing education | 369 |
programs under division (A)(8) of this section, the board may | 370 |
sponsor continuing education activities that are directly related | 371 |
to the statutes and rules pertaining to the practice of nursing in | 372 |
this state. | 373 |
Sec. 4723.48. (A) A clinical nurse specialist, certified | 374 |
nurse-midwife, or certified nurse practitioner seeking authority | 375 |
to prescribe drugs and therapeutic devices shall file with the | 376 |
board of nursing a written application for a certificate to | 377 |
prescribe. The board of nursing shall issue a certificate to | 378 |
prescribe to each applicant who meets the requirements specified | 379 |
in section 4723.482 or | 380 |
Except as provided in division (B) of this section, the | 381 |
initial certificate to prescribe that the board issues to an | 382 |
applicant shall be issued as an externship certificate. Under an | 383 |
externship certificate, the nurse may obtain experience in | 384 |
prescribing drugs and therapeutic devices by participating in an | 385 |
externship that evaluates the nurse's competence, knowledge, and | 386 |
skill in pharmacokinetic principles and their clinical application | 387 |
to the specialty being practiced. During the externship, the | 388 |
nurse may prescribe drugs and therapeutic devices only when one or | 389 |
more physicians are providing supervision in accordance with | 390 |
rules adopted under section 4723.50 of the Revised Code. | 391 |
After completing the externship, the holder of an externship | 392 |
certificate may apply for a new certificate to prescribe. On | 393 |
receipt of the new certificate, the nurse may prescribe drugs and | 394 |
therapeutic devices in collaboration with one or more physicians | 395 |
or podiatrists. | 396 |
(B) In the case of an applicant who on May 17, 2000, was | 397 |
approved to prescribe drugs and therapeutic devices under section | 398 |
4723.56 of the Revised Code, as that section existed on that date, | 399 |
the initial certificate to prescribe that the board issues to the | 400 |
applicant under this section shall not be an externship | 401 |
certificate. The applicant shall be issued a certificate to | 402 |
prescribe that permits the recipient to prescribe drugs and | 403 |
therapeutic devices in collaboration with one or more physicians | 404 |
or podiatrists. | 405 |
In the case of an applicant who meets the requirements of | 406 |
division (C) of section 4723.482 of the Revised Code, the initial | 407 |
certificate to prescribe that the board issues to the applicant | 408 |
under this section shall not be an externship certificate. The | 409 |
applicant shall be issued a certificate to prescribe that permits | 410 |
the recipient to prescribe drugs and therapeutic devices in | 411 |
collaboration with one or more physicians or podiatrists. | 412 |
Sec. 4723.482. (A) | 413 |
and (D) of this section, an applicant shall include with the | 414 |
application submitted under section 4723.48 of the Revised Code | 415 |
all of the following: | 416 |
(1) Subject to section 4723.483 of the Revised Code, evidence | 417 |
of holding a current, valid certificate of authority issued under | 418 |
this chapter to practice as a clinical nurse specialist, certified | 419 |
nurse-midwife, or certified nurse practitioner; | 420 |
(2) Except for a person who on May 17, 2000, was approved to | 421 |
prescribe drugs and therapeutic devices under section 4723.56 of | 422 |
the Revised Code, as that section existed on that date, evidence | 423 |
of successfully completing the instruction in advanced | 424 |
pharmacology and related topics specified in division (B) of this | 425 |
section; | 426 |
(3) The fee required by section 4723.08 of the Revised Code | 427 |
for a certificate to prescribe; | 428 |
(4) Any additional information the board of nursing requires | 429 |
pursuant to rules adopted under section 4723.50 of the Revised | 430 |
Code. | 431 |
(B) All of the following apply to the instruction required | 432 |
under division (A)(2) of this section: | 433 |
(1) The instruction must be obtained not longer than three | 434 |
years before the application for the certificate to prescribe is | 435 |
filed. | 436 |
(2) The instruction must be obtained through a course of | 437 |
study consisting of planned classroom and clinical study that is | 438 |
approved by the board of nursing in accordance with standards | 439 |
established in rules adopted under section 4723.50 of the Revised | 440 |
Code. | 441 |
(3) The content of the instruction must be specific to the | 442 |
applicant's nursing specialty and include all of the following: | 443 |
(a) A minimum of thirty contact hours of training in advanced | 444 |
pharmacology that includes pharmacokinetic principles and clinical | 445 |
application and the use of drugs and therapeutic devices in the | 446 |
prevention of illness and maintenance of health; | 447 |
(b) Training in the fiscal and ethical implications of | 448 |
prescribing drugs and therapeutic devices; | 449 |
(c) Training in the state and federal laws that apply to the | 450 |
authority to prescribe; | 451 |
(d) Any additional training required pursuant to rules | 452 |
adopted under section 4723.50 of the Revised Code. | 453 |
(C) An applicant who practiced or is practicing as a clinical | 454 |
nurse specialist, certified nurse-midwife, or certified nurse | 455 |
practitioner in another jurisdiction or as an employee of the | 456 |
United States government, and is not seeking authority to | 457 |
prescribe drugs and therapeutic devices by meeting the | 458 |
requirements of division (A) or (D) of this section, shall include | 459 |
with the application submitted under section 4723.48 of the | 460 |
Revised Code all of the following: | 461 |
(1) Subject to section 4723.483 of the Revised Code, evidence | 462 |
of holding a current, valid certificate of authority issued under | 463 |
this chapter to practice as a clinical nurse specialist, certified | 464 |
nurse-midwife, or certified nurse practitioner; | 465 |
(2) The fee required by section 4723.08 of the Revised Code | 466 |
for a certificate to prescribe; | 467 |
(3) Either of the following: | 468 |
(a) Evidence of having held, for a continuous period of at | 469 |
least one year during the three years immediately preceding the | 470 |
date of application, valid authority issued by another | 471 |
jurisdiction to prescribe therapeutic devices and drugs, | 472 |
including at least some controlled substances; | 473 |
(b) Evidence of having been employed by the United States | 474 |
government and authorized, for a continuous period of at least one | 475 |
year during the three years immediately preceding the date of | 476 |
application, to prescribe therapeutic devices and drugs, including | 477 |
at least some controlled substances, in conjunction with that | 478 |
employment. | 479 |
(4) If the applicant includes the evidence described in | 480 |
division (C)(3)(a) of this section, documentation from a licensed | 481 |
physician in a form acceptable to the board that the prescribing | 482 |
component of the nurse's practice was overseen or supervised by | 483 |
a licensed physician in the other jurisdiction; | 484 |
(5) If the applicant includes the evidence described in | 485 |
division (C)(3)(b) of this section, documentation from a licensed | 486 |
physician employed by the United States government in a form | 487 |
acceptable to the board that the prescribing component of the | 488 |
nurse's practice was overseen or supervised by a licensed | 489 |
physician employed by the United States government; | 490 |
(6) Evidence of having completed a two-hour course of | 491 |
instruction approved by the board in the laws of this state that | 492 |
govern drugs and prescriptive authority; | 493 |
(7) Any additional information the board requires pursuant to | 494 |
rules adopted under section 4723.50 of the Revised Code. | 495 |
(D) An applicant who practiced or is practicing as a clinical | 496 |
nurse specialist, certified nurse-midwife, or certified nurse | 497 |
practitioner in another jurisdiction or as an employee of the | 498 |
United States government, and is not seeking authority to | 499 |
prescribe drugs and therapeutic devices by meeting the | 500 |
requirements of division (A) or (C) of this section, shall include | 501 |
with the application submitted under section 4723.48 of the | 502 |
Revised Code all of the following: | 503 |
(1) Subject to section 4723.483 of the Revised Code, evidence | 504 |
of holding a current, valid certificate of authority issued under | 505 |
this chapter to practice as a clinical nurse specialist, certified | 506 |
nurse-midwife, or certified nurse practitioner; | 507 |
(2) The fee required by section 4723.08 of the Revised Code | 508 |
for a certificate to prescribe; | 509 |
(3) Either of the following: | 510 |
(a) Evidence of having held, for a continuous period of at | 511 |
least one year during the three years immediately preceding the | 512 |
date of application, valid authority issued by another | 513 |
jurisdiction to prescribe therapeutic devices and drugs, | 514 |
excluding controlled substances; | 515 |
(b) Evidence of having been employed by the United States | 516 |
government and authorized, for a continuous period of at least one | 517 |
year during the three years immediately preceding the date of | 518 |
application, to prescribe therapeutic devices and drugs, excluding | 519 |
controlled substances, in conjunction with that employment. | 520 |
(4) If the applicant includes the evidence described in | 521 |
division (D)(3)(a) of this section, documentation from a licensed | 522 |
physician in a form acceptable to the board that the prescribing | 523 |
component of the nurse's practice was overseen or supervised by | 524 |
a licensed physician in the other jurisdiction; | 525 |
(5) If the applicant includes the evidence described in | 526 |
division (D)(3)(b) of this section, documentation from a licensed | 527 |
physician employed by the United States government in a form | 528 |
acceptable to the board that the prescribing component of the | 529 |
nurse's practice was overseen or supervised by a licensed | 530 |
physician employed by the United States government; | 531 |
(6) Any additional information the board requires pursuant to | 532 |
rules adopted under section 4723.50 of the Revised Code. | 533 |
Sec. 4723.484. (A) Except as provided in division (B) of this | 534 |
section, to successfully complete an externship as required under | 535 |
section 4723.485 of the Revised Code, the holder of an externship | 536 |
certificate must complete at least one thousand five hundred hours | 537 |
during which the certificate holder's prescribing practices are | 538 |
supervised in accordance with division (A) of section 4723.48 of | 539 |
the Revised Code. | 540 |
(B) A holder of an externship certificate who obtained the | 541 |
certificate by meeting the requirements of division (D) of section | 542 |
4723.482 of the Revised Code, to successfully complete an | 543 |
externship as required under section 4723.485 of the Revised Code, | 544 |
must do both of the following: | 545 |
(1) Complete at least five hundred hours during which the | 546 |
certificate holder's prescribing practices are supervised in | 547 |
accordance with division (A) of section 4723.48 of the Revised | 548 |
Code; | 549 |
(2) Complete a two-hour course of instruction approved by the | 550 |
board of nursing in the laws of this state that govern drugs and | 551 |
prescriptive authority. | 552 |
| 553 |
issued under section 4723.48 of the Revised Code as an externship | 554 |
certificate is valid for not more than one year, unless earlier | 555 |
suspended or revoked by the board of nursing. The certificate may | 556 |
be extended for an additional year if the holder submits to the | 557 |
board evidence of continued participation in an externship. If an | 558 |
externship is terminated for any reason, the nurse shall notify | 559 |
the board. | 560 |
(B) To be eligible for a certificate to prescribe after | 561 |
receiving an externship certificate, an applicant shall include | 562 |
with the application submitted under section 4723.48 of the | 563 |
Revised Code all of the following: | 564 |
(1) A statement from a supervising physician attesting to the | 565 |
applicant's successful completion of the externship; | 566 |
(2) The fee required by section 4723.08 of the Revised Code | 567 |
for a certificate to prescribe; | 568 |
(3) Any additional information the board requires pursuant to | 569 |
rules adopted under section 4723.50 of the Revised Code. | 570 |
| 571 |
issued under section 4723.48 of the Revised Code that is not | 572 |
issued as an externship certificate is valid for two years, unless | 573 |
otherwise provided in rules adopted under section 4723.50 of the | 574 |
Revised Code or earlier suspended or revoked by the board. The | 575 |
board of nursing shall renew certificates to prescribe according | 576 |
to procedures and a renewal schedule established in rules adopted | 577 |
under section 4723.50 of the Revised Code. | 578 |
(B) The board may renew a certificate to prescribe if the | 579 |
holder submits to the board all of the following: | 580 |
(1) Evidence of having completed during the previous two | 581 |
years at least twelve hours of continuing education in advanced | 582 |
pharmacology, or, if the certificate has been held for less than a | 583 |
full renewal period, the number of hours required by the board in | 584 |
rules adopted under section 4723.50 of the Revised Code; | 585 |
(2) The fee required under section 4723.08 of the Revised | 586 |
Code for renewal of a certificate to prescribe; | 587 |
(3) Any additional information the board requires pursuant to | 588 |
rules adopted under section 4723.50 of the Revised Code. | 589 |
(C) The continuing education in pharmacology required under | 590 |
division (B)(1) of this section must be received from an | 591 |
accredited institution recognized by the board. The hours of | 592 |
continuing education required are in addition to any other | 593 |
continuing education requirement that must be completed pursuant | 594 |
to this chapter. | 595 |
Sec. 4723.50. (A) In accordance with Chapter 119. of the | 596 |
Revised Code, the board of nursing shall adopt rules as necessary | 597 |
to implement the provisions of this chapter pertaining to the | 598 |
authority of clinical nurse specialists, certified nurse-midwives, | 599 |
and certified nurse practitioners to prescribe drugs and | 600 |
therapeutic devices and the issuance and renewal of certificates | 601 |
to prescribe. Initial rules shall be adopted not later than twenty | 602 |
months after | 603 |
The board shall adopt rules that are consistent with the | 604 |
recommendations the board receives from the committee on | 605 |
prescriptive governance pursuant to section 4723.492 of the | 606 |
Revised Code. After reviewing a recommendation submitted by the | 607 |
committee, the board may either adopt the recommendation as a rule | 608 |
or ask the committee to reconsider and resubmit the | 609 |
recommendation. The board shall not adopt any rule that does not | 610 |
conform to a recommendation made by the committee. | 611 |
(B) The board shall adopt rules under this section that do | 612 |
all of the following: | 613 |
(1) Establish a formulary listing the types of drugs and | 614 |
therapeutic devices that may be prescribed by a clinical nurse | 615 |
specialist, certified nurse-midwife, or certified nurse | 616 |
practitioner. The formulary may include controlled substances, as | 617 |
defined in section 3719.01 of the Revised Code. The formulary | 618 |
shall not permit the prescribing of any drug or device to perform | 619 |
or induce an abortion. | 620 |
(2) Establish safety standards to be followed by a nurse when | 621 |
personally furnishing to patients complete or partial supplies of | 622 |
antibiotics, antifungals, scabicides, contraceptives, prenatal | 623 |
vitamins, antihypertensives, drugs and devices used in the | 624 |
treatment of diabetes, drugs and devices used in the treatment of | 625 |
asthma, and drugs used in the treatment of dyslipidemia. | 626 |
(3) Establish criteria for the components of the standard | 627 |
care arrangements described in section 4723.431 of the Revised | 628 |
Code that apply to a nurse's authority to prescribe. The rules | 629 |
shall be consistent with that section and include all of the | 630 |
following: | 631 |
(a) Quality assurance standards; | 632 |
(b) Standards for periodic review by a collaborating | 633 |
physician or podiatrist of the records of patients treated by the | 634 |
nurse; | 635 |
(c) Acceptable travel time between the location at which the | 636 |
nurse is engaging in the prescribing components of the nurse's | 637 |
practice and the location of the nurse's collaborating physician | 638 |
or podiatrist; | 639 |
(d) Any other criteria recommended by the committee on | 640 |
prescriptive governance. | 641 |
(4) Establish standards and procedures for issuance and | 642 |
renewal of a certificate to prescribe, including specification of | 643 |
any additional information the board may require under division | 644 |
(A)(4), (C)(7), or (D)(6) of section 4723.482 or division (B)(3) | 645 |
of section
| 646 |
(5) Establish requirements for board approval of the | 647 |
instruction in advanced pharmacology and related topics required | 648 |
by section 4723.482 of the Revised Code; | 649 |
(6) Establish requirements for board approval of the two-hour | 650 |
course of instruction in the laws of this state as required under | 651 |
division (C)(6) of section 4723.482 of the Revised Code and | 652 |
division (B)(2) of section 4723.484 of the Revised Code; | 653 |
(7) Establish standards and procedures for the appropriate | 654 |
conduct of an externship | 655 |
described in section 4723.484 of the Revised Code, including the | 656 |
following: | 657 |
(a) Standards and procedures to be used in evaluating a | 658 |
nurse's
participation
in an externship | 659 |
660 | |
661 |
(b) Standards and procedures for the supervision that a | 662 |
physician must provide during an externship, including supervision | 663 |
provided by working with the nurse and supervision provided by | 664 |
making timely reviews of the records of patients treated by the | 665 |
nurse. The manner in which supervision must be provided may vary | 666 |
according to the location where the nurse is practicing and with | 667 |
the nurse's level of experience. | 668 |
Section 2. That existing sections 3333.28, 4723.01, 4723.06, | 669 |
4723.48, 4723.482, 4723.484, 4723.485, and 4723.50 of the Revised | 670 |
Code are hereby repealed. | 671 |
Section 3. Notwithstanding the requirement of division (A) of | 672 |
section 4723.50 of the Revised Code that the Board of Nursing | 673 |
adopt rules consistent with the recommendations the Board receives | 674 |
from the Committee on Prescriptive Governance, the Board shall | 675 |
amend the rules that were adopted under section 4723.50 of the | 676 |
Revised Code to reflect the amendment by this act of sections | 677 |
4723.48 and 4723.482 and the enactment by this act of new section | 678 |
4723.484 of the Revised Code. Until the rules have been amended | 679 |
accordingly, the Board shall not enforce any rule that is | 680 |
inconsistent with sections 4723.48 and 4723.482 of the Revised | 681 |
Code as amended by this act and new section 4723.484 as enacted by | 682 |
this act. | 683 |