Nurse Practitioner Scope of Practice: Ohio

Ohio has a history of being progressive.  In 1852, for example, Ohio was the first state to enact laws protecting working women.  In 1865, Ohio was the first state to establish an ambulance service.  But, does this progressive and innovative spirit apply when it comes to scope of practice laws in the Buckeye Sate?  Sort of.

Ohio falls somewhere in the middle of the spectrum regarding state laws affecting nurse practitioners.  While nurse practitioners are not allowed to practice free of physician oversight in Ohio, NP-MD collaboration laws aren't as strict as some in other states.  Let's take a look at the specifics of the nurse practitioner scope of practice in Ohio.

Ohio's Nurse Practitioner Supervision Laws

Nurse practitioners in Ohio must practice under a Standard Care Arrangement with a physician.  This agreement is a written contract between a nurse practitioner and collaborating physician.   The Standard Care Arrangement outlines which services the NP offers as well as how often the nurse practitioner's performance will be reviewed including chart review.  The agreement must also include prescribing parameters and a statement regarding health care of infants up to one year of age and recommendations for provider visits through three years of age.  The Standard Care Arrangement is to be signed by both the NP and MD and kept at all practice locations.  The agreement must be reviewed and signed each year. 

While Ohio does require that nurse practitioners work under a collaborating physician, the regulations are lenient compared to many other states.  A physician does not need to practice on site with the nurse practitioner.  The nurse practitioner's performance must only be reviewed on an annual basis.  A semi-annual review of the nurse practitioner's prescribing practices is required.  Ohio State Law does not outline a specific percentage of NP charts that must be reviewed.  

Ohio's Nurse Practitioner Prescribing Laws

Nurse practitioners in Ohio have enjoyed recent advancements regarding their ability to prescribe.  In 2012, NPs practicing in Ohio were awarded the freedom to prescribe schedule II drugs.  Prior to 2012, nurse practitioners in Ohio were only allowed to prescribe a 24-hour supply of these medications.  Nurse practitioners in Ohio are not allowed to prescribe any drugs or devices to perform or induce abortion. 

Nurse practitioners may only write prescriptions as part of a formal prescriber-patient relationship.  This means that the NP has obtained a patient history, performed a physical exam and diagnosed the patient's medical condition.  This process must be outlined in a medical record.  Except in an emergency situation, nurse practitioners in Ohio are not allowed to prescribe medication for family members or other "individuals for whom the nurse's personal or emotional involvement may render the nurse unable to exercise detached professional judgement in making diagnostic or therapeutic decisions".  In other words, NPs are prohibited from writing prescriptions for their friends too.

Other Scope of Practice Laws

Nurse practitioners in Ohio may sign handicap parking permits and worker's comp claims.  They may not sign death certificates. 

Do you practice in Ohio?  How do state laws affect your practice?

 

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Comments

In Ohio can I see a Nurse Practitioner as my primary care instead of a Doctor?

Marlene

It is important to note that while Ohio is progressive in these areas, Doctorally prepared APN providers may not be addressed as "Doctor" in the clinical setting. The Ohio Medical Association was behind this mandate. The Fl Medical Association (FMA) is currently using controlled-substance prescriptive privileges as leverage toward this end.

Casarnp@aol.com