Bill Text: OH HB301 | 2013-2014 | 130th General Assembly | Comm Sub

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Bill Title: To authorize a person not otherwise authorized to do so to administer certain drugs pursuant to delegation by an advanced practice registered nurse who holds a certificate to prescribe.

Spectrum: Bipartisan Bill

Status: (Introduced - Dead) 2014-05-22 - Committee Report - A [HB301 Detail]

Download: Ohio-2013-HB301-Comm_Sub.html

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As Reported by the House Health and Aging Committee

130th General Assembly Regular Session 2013-2014

Am. H. B. No. 301

Representatives Pelanda, Bishoff 

Cosponsors: Representatives Hood, Blessing, Brenner, Antonio, Reece, Fedor, Schuring 

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A BILL

To amend sections 4723.07 and 4723.48 and to enact

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section 4723.488 of the Revised Code to authorize

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a person not otherwise authorized to do so to

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administer certain drugs pursuant to delegation by

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an advanced practice registered nurse who holds a

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certificate to prescribe.

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BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

Section 1. That sections 4723.07 and 4723.48 be amended and	7
section 4723.488 of the Revised Code be enacted to read as	8
follows:	9

Sec. 4723.07.  In accordance with Chapter 119. of the Revised	10
Code, the board of nursing shall adopt and may amend and rescind	11
rules that establish all of the following:	12

(A) Provisions for the board's government and control of its	13
actions and business affairs;	14

(B) Minimum standards for nursing education programs that	15
prepare graduates to be licensed under this chapter and procedures	16
for granting, renewing, and withdrawing approval of those	17
programs;	18

(C) Criteria that applicants for licensure must meet to be	19
eligible to take examinations for licensure;	20

(D) Standards and procedures for renewal of the licenses and	21
certificates issued by the board;	22

(E) Standards for approval of continuing nursing education	23
programs and courses for registered nurses, licensed practical	24
nurses, certified registered nurse anesthetists, clinical nurse	25
specialists, certified nurse-midwives, and certified nurse	26
practitioners. The standards may provide for approval of	27
continuing nursing education programs and courses that have been	28
approved by other state boards of nursing or by national	29
accreditation systems for nursing, including, but not limited to,	30
the American nurses' credentialing center and the national	31
association for practical nurse education and service.	32

(F) Standards that persons must meet to be authorized by the	33
board to approve continuing education programs and courses and a	34
schedule by which that authorization expires and may be renewed;	35

(G) Requirements, including continuing education	36
requirements, for reactivating inactive licenses or certificates,	37
and for reinstating licenses or certificates that have lapsed;	38

(H) Conditions that may be imposed for reinstatement of a	39
license or certificate following action taken under section	40
3123.47, 4723.28, 4723.281, 4723.652, or 4723.86 of the Revised	41
Code resulting in a license or certificate suspension;	42

(I) Requirements for board approval of courses in medication	43
administration by licensed practical nurses;	44

(J) Criteria for evaluating the qualifications of an	45
applicant for a license to practice nursing as a registered nurse,	46
a license to practice nursing as a licensed practical nurse, or a	47
certificate of authority issued under division (B) of section	48
4723.41 of the Revised Code for the purpose of issuing the license	49
or certificate by the board's endorsement of the applicant's	50
authority to practice issued by the licensing agency of another	51
state;	52

(K) Universal and standard precautions that shall be used by	53
each licensee or certificate holder. The rules shall define and	54
establish requirements for universal and standard precautions that	55
include the following:	56

(1) Appropriate use of hand washing;

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(2) Disinfection and sterilization of equipment;

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(3) Handling and disposal of needles and other sharp	59
instruments;	60

(4) Wearing and disposal of gloves and other protective	61
garments and devices.	62

(L) Standards and procedures for approving certificates of	63
authority to practice nursing as a certified registered nurse	64
anesthetist, clinical nurse specialist, certified nurse-midwife,	65
or certified nurse practitioner, and for renewal of those	66
certificates;	67

(M) Quality assurance standards for certified registered	68
nurse anesthetists, clinical nurse specialists, certified	69
nurse-midwives, or certified nurse practitioners;	70

(N) Additional criteria for the standard care arrangement	71
required by section 4723.431 of the Revised Code entered into by a	72
clinical nurse specialist, certified nurse-midwife, or certified	73
nurse practitioner and the nurse's collaborating physician or	74
podiatrist;	75

(O) Continuing education standards for clinical nurse	76
specialists who were issued a certificate of authority to practice	77
as a clinical nurse specialist under division (C) of section	78
4723.41 of the Revised Code as that division existed at any time	79
before the effective date of this amendmentMarch 20, 2013;	80

(P) For purposes of division (B)(31) of section 4723.28 of	81
the Revised Code, the actions, omissions, or other circumstances	82
that constitute failure to establish and maintain professional	83
boundaries with a patient;	84

(Q) Standards and procedures for delegation under division	85
(C) of section 4723.48 of the Revised Code of the authority to	86
administer drugs.	87

The board may adopt other rules necessary to carry out the	88
provisions of this chapter. The rules shall be adopted in	89
accordance with Chapter 119. of the Revised Code.	90

Sec. 4723.48.  (A) A clinical nurse specialist, certified	91
nurse-midwife, or certified nurse practitioner seeking authority	92
to prescribe drugs and therapeutic devices shall file with the	93
board of nursing a written application for a certificate to	94
prescribe. The board of nursing shall issue a certificate to	95
prescribe to each applicant who meets the requirements specified	96
in section 4723.482 or 4723.485 of the Revised Code.	97

Except as provided in division (B) of this section, the	98
initial certificate to prescribe that the board issues to an	99
applicant shall be issued as an externship certificate. Under an	100
externship certificate, the nurse may obtain experience in	101
prescribing drugs and therapeutic devices by participating in an	102
externship that evaluates the nurse's competence, knowledge, and	103
skill in pharmacokinetic principles and their clinical application	104
to the specialty being practiced. During the externship, the nurse	105
may prescribe drugs and therapeutic devices only when one or more	106
physicians are providing supervision in accordance with rules	107
adopted under section 4723.50 of the Revised Code.	108

After completing the externship, the holder of an externship	109
certificate may apply for a new certificate to prescribe. On	110
receipt of the new certificate, the nurse may prescribe drugs and	111
therapeutic devices in collaboration with one or more physicians	112
or podiatrists.	113

(B) In the case of an applicant who meets the requirements of	114
division (C) of section 4723.482 of the Revised Code, the initial	115
certificate to prescribe that the board issues to the applicant	116
under this section shall not be an externship certificate. The	117
applicant shall be issued a certificate to prescribe that permits	118
the recipient to prescribe drugs and therapeutic devices in	119
collaboration with one or more physicians or podiatrists.	120

(C)(1) The holder of a certificate issued under this section	121
may delegate to a person not otherwise authorized to administer	122
drugs the authority to administer a drug, other than a controlled	123
substance, listed in the formulary established under division	124
(B)(1) of section 4723.50 of the Revised Code to a specified	125
patient. The delegation shall be in accordance with division	126
(C)(2) of this section and standards and procedures established in	127
rules adopted under division (O) of section 4723.07 of the Revised	128
Code.	129

(2) Prior to delegating authority, the certificate holder	130
shall do both of the following:	131

(a) Assess the patient and determine that the drug is	132
appropriate for the patient;	133

(b) Determine that the person to whom the authority will be	134
delegated has met the conditions specified in division (D) of	135
section 4723.488 of the Revised Code.	136

Sec. 4723.488. A person not otherwise authorized to	137
administer drugs may administer a drug to a specified patient if	138
all of the following conditions are met:	139

(A) The authority to administer the drug is delegated to the	140
person by an advanced practice registered nurse who is a clinical	141
nurse specialist, certified nurse-midwife, or certified nurse	142
practitioner and holds a certificate to prescribe issued under	143
section 4723.48 of the Revised Code.	144

(B) The drug is listed in the formulary established under	145
division (B) of section 4723.50 of the Revised Code but is not a	146
controlled substance and is not to be administered intravenously.	147

(C) The drug is to be administered at a location other than a	148
hospital inpatient care unit, as defined in section 3727.50 of the	149
Revised Code; a hospital emergency department or a freestanding	150
emergency department; or an ambulatory surgical facility, as	151
defined in section 3702.30 of the Revised Code.	152

(D) The person has successfully completed education based on	153
a recognized body of knowledge concerning drug administration and	154
demonstrates to the person's employer the knowledge, skills, and	155
ability to administer the drug safely.	156

(E) The person's employer has given the advanced practice	157
registered nurse access to documentation, in written or electronic	158
form, showing that the person has met the conditions specified in	159
division (D) of this section.	160

(F) The advanced practice registered nurse is physically	161
present at the location where the drug is administered.	162

Section 2. That existing sections 4723.07 and 4723.48 of the	163
Revised Code are hereby repealed.	164