Ohio Law and Rules for Nurses. Presented by Lisa Klenke, MBA, RN, NEA-BC October 24, 2013

Transcription

1 Ohio Law and Rules for Nurses Presented by Lisa Klenke, MBA, RN, NEA-BC October 24, 2013

2 Board of Nursing Strategic Initiatives Law related to Disciplinary Action of Licensees and Certificate Holders Scope of Practice and Interpretive Guidelines Board Initiatives, Legislation and Communication Objectives

3 Assure licensees and certificate holders meet statutory and regulatory requirements for licensure or certification Handle complaints, investigations and adjudications to safeguard the health of the public and provide alternatives to discipline when appropriate Approve pre-licensure education programs Maintain competency based on CE Standards Address pertinent regulatory issues Implement technological systems to increase organizational efficiency and use of resources Strategic Initiatives

4 Compliance, Discipline, and Monitoring During fiscal year 2012, the Board received 7,298 complaints.

5 Common Grounds for Discipline Drug Related Offenses Self Administration of Unauthorized Drugs/Habitual Indulgence/Impairment to Practice Impairment due to Mental or Physical Disability Assaulting a Patient Material deception in the Course of Practice Failure to Use Universal Precautions Failure to Practice in Accordance with Acceptable and Prevailing Standards of Safe Nursing Practice (Discuss Administrative Rules)

6 Statutory Requirements The mission of the Ohio Board of Nursing is to actively safeguard the health of the public through the effective regulation of nursing care. The Nurse Practice Act (Chapter 4723) of the Ohio Revised Code and Chapters through of the Ohio Administrative Code create the framework that allows the Board to carry out its mission. A major function of the Board is to investigate complaints and adjudicate violations.

7 Summary of Complaints Type of Complaint Number Action Taken in Another State/Jurisdiction 642 (184) APN Practice Issue 70 (15) Boundaries 39 (4) Criminal 262 (201) Default/Child Support 5 (7) Dialysis Applicant 55 (34) Drugs/Alcohol 641 (722) Endorsement Applicant 306 (231) Fraud (Medicare/Medicaid) 13 (12)

8 Summary of Complaints (con t) Type of Complaint Number Imposter/Never Licensed 26 (13) Invalid License(Lapsed/Inactive) 30 (222) Miscellaneous 1634 (341) NCLEX Test Applicant 1583 (915) Non-Compliance 211 (95) Patient Abuse 69 (64) Practice 866 (761) Medication Aide Applicant 5 (5) Renewal Applicant 515 (192)

9 Board Actions Type of Action Number Board Order 205 Permanent Surrender 44 Default Order 44 Consent Agreement 568 Notice of Opportunity 204 Immediate Suspension 85 Automatic Suspension 81 Suspension Without Stay 262 Suspend with Stay (Probation) 300 Revocation/Permanent Revocation 122 Reprimand 133

10 Just Culture Background Medical errors and patient safety are a national concern and must be a top priority A punitive culture does not take into account systems issues and a blame-free culture does not hold individuals appropriately accountable Healthcare professionals are human and humans make mistakes We are legally and ethically obligated to hold individuals accountable for their competency and behaviors that impact patient care Ohio Board of Nursing s Patient Safety Initiative

11 How Does Just Culture Impact Nurses Practicing in Ohio? The Ohio Board of Nursing has begun a Patient Safety Initiative and uses the Just Culture Model as the basis for Board imposed discipline for practice errors.

12 OBN s Collaborative Initiative Objectives Increase Employer Reporting of Information Related to Practice Breakdown Increase Employer-Sponsored Practice Remediation Create a state and national database using TERCAP data Handle Cases incorporating the principles of Just Culture

13 Criminalization of Medical Errors Colorado Nurses Ohio Pharmacist Wisconsin Nurse Hurricane Katrina

14 Is It Within My Nursing Scope of My Practice To It is impossible to develop an all-inclusive list of activities that a nurse may perform. A nurse must possess the appropriate knowledge, skills, and abilities in the areas of practice in which they are engaged.

15 Decision Making Guide for Scope of Practice Step 1: Define the Activity or Task Step 2: Legality Step 3: Competency Step 4: Safety Step 5: Accountability Additional Considerations LPNs Advanced Practiced Nurses

16 Interpretive Guidelines Moderate Sedation Emergent Intubation Gastric Band Filling Conservative Sharp Wound Debridement OB Patient Epidural Infusions Non- OB Patient Epidural Infusions IM/SD or SQ Injections for Cosmetic/Aesthetic Treatment H and Ps by Nurses PICC Line Placement Verification

17 Board of Nursing Initiatives Ohio Action Coalition Alternative Program Changes Prescription Drug Initiatives Senate Bill 83-Schedule II Prescription HB 303-Nurse Practice Act Revisions Communications

18 Ohio Action Coalition The Board is discussing the various views regarding legislatively mandating baccalaureate nursing education within ten years of initial licensure. The Board supports IOM recommendation 4 80% BSN by 2020.

19 Senate Bill 83-Schedule II Prescriptions Administrative Rules adopted CTP applicants require 48 Hours of instruction in advanced pharmacology with 6 hours specific to Schedule II controlled substances Standard Care Agreement Changes Required CE for existing CTP holders Limitations of Schedule II prescriptions to settings of care OARRS Education

20 Sub. H.B 303 Substantive Changes to the Nurse Practice Act APN designation changed to APRN. Provides title recognition to Advanced Practice Registered Nurses (APRN), the nationally accepted term now used to refer to registered nurses who have attained this advanced degree of licensing and certification APN collaborating physician notification to the Board Clarifies the language for certain grounds for discipline Education Program Adjudication Background Checks for Lapsed or Inactive Licenses required Mandatory Reporting to the Board by a designated individual licensed by the Board

21 HB 303 (Continued) Streamlines certain Board practices and data collection requirements Extends the Nurse Education Grant Program for an additional ten years Modifies certain provisions of the Licensed Practical Nurse scope of practice Requires out-of-state applicants to complete a two hour course on Ohio laws and rules Exempts those who did not renew a license because of military service from paying the $100 reinstatement fee Increases the length of the extension period that the Board may grant to an APRN who is continuing to participate in an externship program Conforms laws governing dialysis technicians and interns to federal requirements

22 Communications Momentum (Quarterly) Board Website Electronic Mailing Service (E-News) Twitter Liaison Relationships Practice Committee Format Open Forum

23 CONTACT YOUR BOARD Ohio Board of Nursing 17 South High Street Columbus, Ohio

24 QUESTIONS? Questions?