Practice Page Shortcuts: General Information / Interpretive Guidelines / Advanced Practice Nursing / Prescriptive Authority Resources / Committee on Prescriptive Governance (CPG) Upcoming CPG Meeting Material / Mandatory Reporting

General Information

   Adobe Acrobat FileRN and LPN Decision Making Model
   Adobe Acrobat FileSchool Nurse Decision Making Model
   Adobe Acrobat FilePICC Tip Verification by RN via X-Ray Prohibited
   Adobe Acrobat FileRN and LPN Scopes of Practice

   Adobe Acrobat FileRN and LPN Practice FAQs
   Adobe Acrobat FileTransition to Practice - NCSBN Press Release
   Adobe Acrobat FileTransition to Practice White Paper by the Legislative
              and Practice Committee of the Ohio Organization of Nurse Executives


New Ohio Law: Determination and Pronouncement of Death

An amendment to the Ohio Nurse Practice Act (Chapter 4723, Ohio Revised Code (ORC)) authorizes certified nurse practitioners, clinical nurse specialists, and registered nurses, under specific circumstances, to determine and pronounce death. The new law is effective March 22, 2013 by the enactment of Am Sub HB 284 during the 129th General Assembly.

Adobe Acrobat FileClick Here for the Complete Announcement


Adobe Acrobat FileClick Here to Download Am Sub HB 284

Adobe Acrobat FileClick Here to Download the Legislative Services Commission Final Analysis


Patient Safety Initiative - Creating a Culture of Safety and Accountability

By implementing a more comprehensive approach to practice complaints, the Board is more directly addressing and impacting patient safety. The goal is to increase patient safety through effective reporting, remediation, modification of systems, and accountability. The objectives are to:

Adobe Acrobat File Click Here for the Complete Summary

Adobe Acrobat FileClick Here for the Patient Safety Initiative Booklet


Patient Centered Medical Home (PCMH) Education Pilot Project

In June 2010, Ohio House Bill 198 established the Patient Centered Medical Home (PCMH) Education Pilot Project enabling 44 primary care practices (40 physician-led and 4 APRN-led) educationally affiliated with select medical or nursing schools in Ohio to implement the PCMH model of care in their practices. TransforMED, a nationally known company with a successful history of assisting primary care practices towards transformation to the PCMH model, has been contracted to facilitate several components of the Pilot Project.

Additional information regarding the PCMH Education Pilot Project can be found online at:
http://www.odh.ohio.gov/landing/medicalhomes/Education%20Pilot%20Project.aspx


Interpretive Guidelines

   Adobe Acrobat FileIntroduction: Utilizing Interpretive Guidelines
   Adobe Acrobat File
Guidelines for Registered Nurse Filling and Unfilling a Client’s Gastric Band
  
Adobe Acrobat FileGuidelines for Conservative Sharp Wound Debridement
   Adobe Acrobat FileGuidelines for Intrapartum Monitoring of Obstetrical Patients Receiving Epidural Infusions
   Adobe Acrobat FileGuidelines for Monitoring and Management of Epidural Infusions
   Adobe Acrobat FileGuidelines for Administration of Medications, and Monitoring
              of Patients Receiving Intravenous Moderate Sedation for Medical/Surgical Procedures

   Adobe Acrobat FileGuidelines for the Care of Patients Receiving Intramuscular, Subdermal,
              or Subcutaneously Injected Medications for Cosmetic/Aesthetic Treatment

   Adobe Acrobat FileGuidelines for a Registered Nurse’s Role in Emergent Intubation Performed by an Authorized Provider
   Adobe Acrobat FileGuidelines for Registered Nurse Performance of a History and Physical Examination
              for Purposes of Providing Nursing Care

   Adobe Acrobat FileGuidelines for Registered Nurse Use of Devices for PICC Tip Placement Confirmation in Adults

Certificate of Authority (COA) Information

   Adobe Acrobat FileApproved National Certifying Organizations
   Adobe Acrobat FileDecision Making Guide for Determining APRN Scope of Practice
   Adobe Acrobat FileInstructions for Updating Collaborating Physician Information


   Internal Page LinkClick Here for Certificate of Authority Verification
   Internal Page LinkClick Here for Advanced Practice Forms 



Advanced Practice Registered Nurses

   Internal Page LinkClick Here for Advanced Practice Forms 


APRN Consensus Model

The APRN Consensus Model is the result of the collaborative work of the APRN Consensus Work Group and the National Council of State Boards of Nursing (NCSBN) APRN Advisory Committee with extensive review and comments from the larger APRN stakeholder community. The Consensus Model was developed to promote uniformity in requirements for advanced practice nursing.

LACE (Licensure, Accreditation, Certification, and Education), a communication network that includes licensure, accreditation, certification, and educational organizations that represent the components of APRN regulation, is facilitating the implementation of the APRN Consensus Model with stakeholders interested in advancing uniformity in APRN regulation and requirements.

NCSBN is taking a major role in promoting and assisting state boards of nursing in the adoption of the regulatory components of the APRN Consensus Model. Beginning in 2008 and subsequently, the Ohio Board of Nursing reviewed the APRN Consensus Model and the related NCSBN Model Law and Rules. Below are two grids that provide comparison information about the APRN Consensus Model requirements and the Ohio Nurse Practice Act and administrative rules. For questions regarding the requirements of the APRN Consensus Model compared to the Ohio Nurse Practice Act and administrative rules, please email practice@nursing.ohio.gov.

The APRN Consensus Model, as well as numerous related documents are available at www.ncsbn.org.

Adobe Acrobat File2012 APRN Consensus Model by State

Adobe Acrobat FileComparison of the Consensus Model for Ohio


Emergency Facility Opioid and Other Controlled Substances Prescribing Guidelines

The Ohio Emergency and Acute Care Facility Opioid and Other Controlled Substances Prescribing Guidelines (OOCS Guidelines) were issued in May of 2012. The OOCS Guidelines were developed through a collaborative effort of health care/medical professional associations, individual medical professionals and state agencies that were brought together under the Professional Education Work Group of the Governor’s Cabinet Opiate Action Team (GCOAT). These guidelines along with the accompanying patient handout and pocket card guide were distributed to all hospitals and emergency physicians in Ohio in August 2012. The OOCS Guidelines, patient handout, pocket cards and background information can be accessed at this link: http://www.healthyohioprogram.org/ed/guidelines.

Please share this information with emergency medical professionals and emergency and acute care facilities in your area and encourage them to implement these guidelines. A limited quantity of the pocket cards is still available. To request pocket cards please send an email to: BHPRR@odh.ohio.gov


Sub. SB 83 (SB 83) Expanded Authority to Prescribe Schedule II Controlled Substances

SB 83, introduced by Senator Scott Oelslager on February 16, 2011, expanded the authority of advanced practice registered nurses (APRNs) who hold a Certificate to Prescribe (CTP) to prescribe schedule II controlled substances. The bill was signed by Governor Kasich on March 9, 2012 and became effective on June 8, 2012.

As directed by SB 83, the Board adopted rules pertaining to schedule II controlled substances, including prescribing and CE requirements for CTP holders. New Rule 4723-9-13, OAC, addresses the CE requirements and when you renew your CTP, you will be required to verify completion of the continuing education course.

The amended rules in Chapters 4723-8 and 4723-9 became effective on November 5, 2012 to provide ample time for CTP holders to complete the required six hours of continuing education before the renewal cycle ends on August 31, 2013. To review the rules, go to the front page of the web site and click on “Law and Rules”.

FAQs answering questions about the new prescribing law and CE requirements are located at the link below. If you have additional questions, please contact the Board at practice@nursing.ohio.gov.


Am. Sub. HB 93 Pain Management Clinics; OARRS

In May 2011, Governor Kasich signed into law Amended Substitute House Bill 93, sponsored by Representatives David E. Burke, R.Ph., and Dr. Terry Johnson, D.O. Amended Substitute House Bill 93 aggressively focuses on further regulating facilities and prescribers operating as pain management clinics by requiring that the Board of Pharmacy license those clinics. Additionally, the Medical Board must adopt rules establishing standards for physician operation of pain management clinics and standards to be followed by physicians who provide care at pain management clinics. The bill also modifies the operation of OARRS (Ohio Automated Rx Review System), a drug database administered by the Pharmacy Board that is used to monitor the misuse and diversion of controlled substances and other dangerous drugs.Click Here to View the Complete Summary


Rule on Advanced Practice Registered Nurses Primary Source Recertification Documentation

If you are an advanced practice registered nurse, your certificate of authority (COA) is current and valid only if you meet all requirements of the Board including maintaining certification or recertification by the applicable national certifying organization. Please refer to the 'Nursing Practice' page of the Board’s website for a list of Board approved national organizations.

Effective February 1, 2011, the Board requires primary source verification for advanced practice registered nurse national recertification. For this to occur, you must request that your national certifying organization notify the Board directly of national recertification within thirty days of your recertification. The Board no longer accepts documentation of recertification from a COA holder.

If you have any questions, please contact the Advanced Practice Unit at aprn@nursing.ohio.gov or (614) 466-6180.


Prescriptive Authority / Certificate to Prescribe (CTP)

New Active Cumulative Morphine Equivalent (ACME) Graph

There is a new feature, the active cumulative morphine equivalent graph, in the Ohio Automated Rx Reporting system (OARRS). This graph allows prescribers to view a patient’s ACME score for a period of time up to 24 months. To learn more about this new feature, including a sample of the new graph as part of a patient’s history report, see http://pharmacy.ohio.gov/MEDGraph.


Ohio House Bill 314: Prescribing Opioids to Minors
Effective September 17, 2014

Effective September 17, 2014, HB 314 requires all authorized prescribers to obtain and document informed consent when prescribing a controlled substance containing opioids to a minor, unless the prescribing is done in response to a medical emergency or meets other specific circumstances set forth in statute. Thank you to the Ohio Board of Pharmacy for providing and allowing the Nursing Board to use their document as a basis for this advisory. Click here to download the advisory.


APRN Prescriber Alert: Prepare for Change

Hydrocodone Combination Products (HCPs) Classified as Schedule II Controlled Substances
Effective October 6, 2014

Effective October 6, 2014, all hydrocodone combination products (HCPs) will be classified as schedule II controlled substances pursuant to a rule adopted by the United States Drug Enforcement Agency (DEA). For specific guidance in prescribing and complying with this new regulation, click on the link to review the Ohio State Board of Pharmacy’s guidance document, http://www.pharmacy.ohio.gov/hydrocodone.


Tramadol and Products Containing Tramadol Classified as Schedule IV Controlled Substance
Effective August 18, 2014

Effective August 18, 2014, tramadol and products containing tramadol will be classified as Schedule IV controlled substances in the state of Ohio pursuant to a rule adopted by the United States Drug Enforcement Agency (DEA).

APRNs with prescriptive authority (CTP holders) will continue to be able to prescribe tramadol and products containing tramadol, in accordance with the Formulary. However, APRNs with prescriptive authority need to be aware of the requirements specified in the Ohio State Board of Pharmacy’s guidance document in preparation for the change in the drug classification. For example, because tramadol and products containing tramadol will be classified as controlled substances, APRNs prescribing these products will need to obtain a DEA number, if they do not have one already.

For specific guidance in prescribing and complying with this new regulation, click on the link below to review the Ohio State Board of Pharmacy’s guidance document. Please note the necessary steps to take prior to August 18, 2014 to prepare for the change.

If you have any questions about the guidance document, please contact the Ohio State Board of Pharmacy at 614-466-4143 or email by visiting http://www.pharmacy.ohio.gov/Contact.aspx.

If you have questions about the Formulary or prescribing as an APRN, contact aprn@nursing.ohio.gov.


Important Changes to CTP Formulary

All CTP holders are required to amend their written standard care arrangements to comply with recent changes made to the Formulary by the Board of Nursing (Board)’s Committee on Prescriptive Governance (CPG). All drugs and drug categories that are listed in the Formulary under the new prescribing designation column, “In Accordance with the Standard Care Arrangement,” must be reviewed with the Collaborating Physician, and based on that review, given one of the following designations that is required to be documented in the written Standard Care Arrangement: may not prescribe; may prescribe; physician initiation; or physician consult. The amendments must be made no later than April 1 2014. Click here for the complete announcement.


Accessing the Practice Insight Report

The Practice Insight Report will provide prescribers with information about their patients. Accessing a Practice Insight Report is a simple process.

Step 1: After logging into OARRS, press the Submit link in the Requests Menu. This is the same link you press to request a Patient Rx History Report.

Step 2: In the upper left-hand corner of the request screen, above where you would enter your patient’s last name, there is a drop-down box that currently says “Patient”. Change this to Practitioner. After the screen changes, press the “Submit” button. There is no need to enter any additional information; the form is pre-populated.

Step 3: After your request has been submitted, click “View” from the requests menu. You will now see your “Practitioner” request listed among your normal “Patient” requests. Within a minute or two, your report will be ready for you to review.

The Practice Insight Report is run based on the DEA number that you provided on your OARRS registration. If you did not provide this number, or if it is out of date, please contact us at info@ohiopmp.gov to update your information.

The Board of Pharmacy believes that this new report will provide prescribers with a wealth of new information but also recognizes that many providers would like to see additional information. Health care professionals registered with OARRS can expect additional information added to the Practice Insight Report over the coming months and years as new sources of data become available.

The Board encourages OARRS users to provide feedback and suggestions regarding this report or other system improvements by emailing info@ohiopmp.gov. The Board encourages all prescribers to register with OARRS. For more information on registration, please visit: www.ohiopmp.gov.


Opiate Prescribing Resource Website

The appropriate treatment of pain is a priority in Ohio.  The Governor’s Cabinet Opiate Action Team (GCOAT), the Nursing Board, and a group of professional health care provider regulatory boards, associations, individual providers and other key stakeholders have focused their efforts on educating health care professionals and patients.  The goal of this educational effort is to help reduce and eliminate the misuse and abuse of opioid drugs.

The website www.opioidprescribing.ohio.gov features the “Guidelines for Prescribing Opioids for the Treatment of Chronic, Non-Terminal Pain”, a one-hour continuing education video and information and links to an improved OARRS reporting system keyed to this initiative. 

Using the recently adopted guidelines in coordination with OARRS reports is a best practice that offers insight into a patient’s use of opioids and other controlled substances while also alerting prescribers to possibilities of medication conflicts and signs of abuse, addiction or diversion.  OARRS reports have recently been enhanced to include a dosage calculator to assist prescribers in determining whether patients are at, near or over the daily 80 MED highlighted in the guidelines.


General Information

   Adobe Acrobat FileSelected Laws and Rules Related to Prescribing by CTP Holders

   Internal Page LinkClick Here for Prescriptive Authority Verification
   Internal Page LinkClick Here for Prescriptive Authority Application Forms

Resources

Internal Page Link Ohio Automated Rx Reporting System

Internal Page LinkOhio Opioid Prescribing Guidelines

Internal Page Link
Center for Safe Prescribing

Internal Page Link
Drug Enforcement Administration (DEA) Registration & Validation
(Includes link to Practitioner’s Manual.)

Internal Page Link
Facts and Comparisons - Online
(Facts and Comparisons subscription required.)

Formulary for CTP Holders

 The formulary contains bookmark links in the index to more easily access each drug category.

   Adobe Acrobat FileFormulary with Index for CTP Holders (May 19, 2014)
   Adobe Acrobat FileSpecial Formulary Update (Effective March 20, 2014)
   Adobe Acrobat FileFormulary Review and Revision Request Form  -   Adobe Acrobat FileMS-Word Template



Committee on Prescriptive Governance (CPG)

About the CPG

   Adobe Acrobat FileGeneral Information About CPG Appointments
   Adobe Acrobat FileCPG Public Roster for 2014


Updates from the CPG

January 2014
Adobe Acrobat FilePDF [582 K]
May 2014
Adobe Acrobat FilePDF [340 K]
January 2013
Adobe Acrobat FilePDF [428 K]
May 2013
Adobe Acrobat FilePDF [451 K]

October 2013
Adobe Acrobat File  PDF [397 K]

January 2012
Adobe Acrobat FilePDF [428 K]
May 2012
Adobe Acrobat FilePDF [348 K]
October 2012
 Adobe Acrobat File  PDF [319 K]
January 2011
Adobe Acrobat FilePDF [284 K]
May 2011
 Adobe Acrobat FilePDF [488 K]
September 2011
Adobe Acrobat FilePDF [444 K]
January 2010
Adobe Acrobat FilePDF [448 K]

October 2010
 Adobe Acrobat FilePDF [300 K]
January 2009
Adobe Acrobat FilePDF [280 K]
 
May 2009
Adobe Acrobat FilePDF [488 K]
September 2009
Adobe Acrobat FilePDF [444 K]
October 2008
Adobe Acrobat FilePDF [519 K]

CPG Meeting Materials

Meeting Date: September 22, 2014

  Adobe Acrobat File September 2014 CPG Meeting Agenda
  Adobe Acrobat File May 2014 Draft CPG Meeting Minutes
  Adobe Acrobat File September 2014 CPG Meeting Materials
     

Mandatory Reporting and Practice

   Adobe Acrobat FileMandatory Reporting and Practice


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