The Ohio Board of Nursing’s Practice Intervention and Improvement Program

The Ohio Board of Nursing is the state agency that regulates the practice of nursing in Ohio. The mission of the Nursing Board is to protect the public by ensuring that nurses have the skills to provide care to patients. In instances where a nurse has violated the Ohio Nurse Practice Act, the Nursing Board has the authority to take a disciplinary action, such as to suspend or revoke a nurse’s license to practice in Ohio. However, in instances where the Nursing Board has reason to believe that a nurse has a deficiency in their practice that may be corrected, the Board may require the nurse to seek additional education and/or training.

The Nursing Board’s Practice Intervention and Improvement Program (“PIIP”) permits the Nursing Board to offer a nurse an opportunity to seek remedial education and training in a specific area instead of taking disciplinary action against a nurse who has a practice deficiency. The PIIP program is considered non-disciplinary and does not constitute a restriction or limitation on a nurse’s license. Participation in PIIP is confidential.

The criteria the Nursing Board uses to identify an individual’s practice deficiency includes, but is not limited to:

(1) Whether the public will be adequately protected from unsafe practice if the individual enters PIIP;
(2) Whether the individual’s practice deficiency resulted in harm to the patient;
(3) The likelihood that the identified practice deficiency can be corrected through remediation;
(4) The frequency of the occurrence of the practice deficiency;
(5) Whether the individual is eligible for participation in PIIP under 4723-18-03 of the Administrative Code; and
(6) Whether the individual has a mental or physical impairment that contributed to the practice deficiency.

If the supervising member believes, after investigation and review, that the individual’s practice deficiency can be successfully corrected through participation in PIIP, the Nursing Board may choose to take no disciplinary action. This decision is generally reached, if the individual enters into a Participatory Agreement with PIIP, complies with the terms and conditions of PIIP, and successfully completes PIIP.

The PIIP Participatory Agreement includes, but is not limited to, provisions that:

(1) Identify the practice deficiencies and the specific remediation (including educational interventions) the participant must complete;
(2) Require the participant to pay all expenses for the required remediation;
(3) Require the participant to provide the Participatory Agreement to a manager of the participant’s employers;
(4) Require the participant to participate in workplace monitoring;
(5) Require the participant to cause all workplace monitors to provide remediation and to send written progress reports regarding the participant’s progress to PIIP at specified intervals;
(6) Require the participant to submit a written personal progress report containing the information required by PIIP to PIIP at specified intervals; and
(7) Specify the terms and conditions the participant must meet to successfully complete the remediation, including the time frames for successfully completing both the educational intervention and workplace monitoring components of the remediation.

Generally, to comply with PIIP, the nurse will identify a nurse educator who will prepare an individualized course of study for the nurse. The course may include a series of written materials to review or a list of on-line continuing education courses that must be completed. The course of study is almost always tailored to the individual need of the nurse and generally does not require the nurse to return to complete coursework in a nursing school setting or to repeat an entire nursing course. The educator will generally meet individually with the nurse to evaluate their skills to determine if the deficiency in their practice has been remediated. In most instances, the nurse can complete the remedial education in a matter of weeks.

A PIIP participant can be terminated from PIIP for reasons including, but not limited to, the failure to: 1) comply with the Participatory Agreement; 2) progress through or successfully complete the educational intervention in the manner and time frame required; or 3) incorporate learned knowledge and skills into practice.

In addition to avoiding public discipline, a participant who successfully completes PIIP will not be reported to the National Council of State Boards of Nursing disciplinary data bank or the National Practitioner Data Bank (NPDB) unless the Nursing Board imposes disciplinary action against the participant.

As always, if you have a question about this post or the Ohio Board of Nursing in general, please feel free to contact one of the attorneys at the Collis Law Group LLC at 614-486-3909 or email me at beth@collislaw.com.

 

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Ohio RNs – License Renewal Time!

On July 1, 2017, the renewal window opened for registered nurses in Ohio.  The sooner you renew, the better.

 Cost and Timing:

Prior to September 15, 2017, the fee to renew your RN license is $65.00.  An RN Renewal Application filed after September 15, 2017 will also include a $50.00 late fee.  The RN license renewal window closes October 31, 2017.  After October 31, 2017, your RN license is considered by the Ohio Board of Nursing (“Nursing Board”) to have lapsed and you are unauthorized to practice nursing in Ohio until reinstated. 

For instructions on renewing your RN license and to review the questions in the RN Renewal Application go to: http://www.nursing.ohio.gov/PDFS/Forms/Samples/SAMPLE-RN_Renewal_App-2017.pdf

 When you are ready to renew your RN license, go to: http://www.nursing.ohio.gov/forms.htm#RenewalForms

Questions on the RN Renewal Application:

The RN Renewal Application includes, but is not limited to, questions concerning your employment, residency status, Social Security number, criminal matters, medical or mental health matters, and substance abuse matters.  You are required to answer all questions on the RN Renewal Application truthfully and accurately.  Additionally, there are certain instances where you are required to upload with your RN Renewal Application specific documents and a written statement explaining your response to a particular question(s) in the RN Renewal Application.

 Based on the response(s) in your RN Renewal Application, the Nursing Board may open an investigation.  If an investigation is opened, you may be contacted by a Nursing Board investigator by phone or email requesting additional information or documentation concerning your response(s). 

If you do not understand a particular question(s) in the RN Renewal Application, or do not know what additional information to submit to the Nursing Board in support of your RN Renewal Application, it is recommended to obtain experienced legal counsel to assist you with preparation of your response or before speaking with a Nursing Board investigator. 

As always, if you have any questions about this post or the Ohio Board of Nursing, contact one of the attorneys at the Collis Law Group LLC at 614-486-3909 or go to our website at http://www.collislaw.com for more information.

Ohio Nurses: Failure to Document May Result in Disciplinary Action Against Your Nursing License

The importance of documentation in the nursing field cannot be underestimated.

The Ohio Board of Nursing is authorized to discipline a licensee for (among other things) failure to practice in accordance with acceptable and prevailing standards of safe nursing care.  Failure to document the administration or otherwise account for the disposition of controlled substances that the Nurse removed from the Pyxis, or other place where controlled substances are stored, may also be the basis for the Nursing Board to discipline a nurse.

In certain cases, the Nursing Board will offer the Nurse a Consent Agreement as an alternative to an Administrative Hearing.  A Consent Agreement allows the Nurse to avoid the time, worry, and expense of an Administrative Hearing.  Nurses do not need to sign a Consent Agreement. It is always a good practice to read a proposed Consent Agreement very carefully.  We have seen Consent Agreements that are based on allegations of failure to document the administration or otherwise account for the disposition of controlled substances. In many cases, the Consent Agreement requires  (in some cases, lasting years)  random drug screening, narcotic restrictions, and practice restrictions, even when there was no history of drug use or abuse by the Nurse.

If the nurse does not sign a proposed Consent Agreement, he or she always has the right to go to an Administrative Hearing.  The nurse can present evidence that there is no history of drug use or abuse and that the nurse has an otherwise excellent history of employment.  The Board’s attorney is going to present its evidence that the nurse failed to document the administration or otherwise account for the disposition of controlled substances that were removed.

It is imperative to completely, accurately, and timely document the administration or disposition (waste) of controlled substances or other drugs! The Nursing Board may place a nurse on probation and subject them to multiple probationary terms, even if there is no evidence that they suffer from chemical dependency and even if there is no evidence of diversion.

As always, if you have any questions about this post or the Ohio Board of Nursing, contact one of the attorneys at the Collis Law Group LLC at 614-486-3909 or go to our website at http://www.collislaw.com for more information.

 

 

 

ADVANCED PRACTICE REGISTERED NURSES: New Legislation to take Effect on April 4, 2017

On January 4, 2017, Governor Kasich signed Ohio Substitute House Bill 216 into law.

Effective April 4, 2017, there will be new licensing criteria for advanced practice registered nurses (APRNs).  A new APRN license will replace the current “Certificate  of  Authority” and “Certificate  to Prescribe”.

The APRN license will also authorize a Certified Nurse-Midwife (CNM), a Certified Nurse Practitioner (CNP), and a Certified Nurse Specialist (CNS) to prescribe.  In order to obtain the new APRN license, CNPs, CNSs, and CNMs must have either a current Certificate to Prescribe or Certificate to Prescribe Externship, or have completed a 45-hour course in advanced pharmacology within five years of the application date.

Additional information is available from the Ohio Association of Advanced Practice Nurses here: http://c.ymcdn.com/sites/www.oaapn.org/resource/resmgr/hb_216/HB_216_Signed_Revised_-_Effe.pdf

A FAQ from the Ohio Association of Advanced Practice Nurses is here: https://oaapn.site-ym.com/page/HBFAQ

As always, if you have any questions about this post or the Ohio Board of Nursing, contact one of the attorneys at the Collis Law Group LLC at 614-486-3909 or go to our website at http://www.collislaw.com for more information.

Ohio Nurses and Social Media

Social media is a prevalent and common form of communication in society today.  Although social media offers benefits of faster and broader delivery of information, Ohio nurses should be aware of legal requirements and best practices in connection with the use of social media.

Ohio Administrative Code 4723-4-03(H) and 4723-4-04(H) prohibit all nurses from accessing patient information or disseminating patient information for purposes other than patient care, or for otherwise fulfilling the nurse’s assigned job responsibilities through social media, texting, emailing or any other form of communication.  Ohio Administrative Code 4723-4-06(Q) specifically prohibits nurses from using social media, texting, emailing, or other forms of communication with, or about a patient, for non-health care purposes or for purposes other than fulfilling the nurse’s assigned job responsibilities.

Violation of these rules may result in disciplinary action by the Ohio Board of Nursing.

The Ohio Board of Nursing website (http://nursing.ohio.gov/Practice.htm) has the following from the National Council of State Boards of Nursing:

NCSBN Offers Helpful Resources on Using Social Media

Nurses need to be aware of the potential ramifications of disclosing patient-related information. You are invited to use and share these resources:

-Take A Quiz – https://www.qzzr.com/c/quiz/157691/nursing-and-social-media-quiz-copy

-Watch A Video – https://www.ncsbn.org/347.htm

-Order Free Printed NCSBN Resources – A Nurse’s Guide to the Use of Social Media at https://www.ncsbn.org/3739.htm; Poster: Social Media in Nursing: Understand the Benefits and the Risks at https://www.ncsbn.org/6842.htm; Poster: Common Myths and Misunderstandings of Social Media at https://www.ncsbn.org/6843.htm

Do not indiscriminately use social media, texts, emails, or any other form of communication.  Be mindful of your legal obligations and follow best practices.  Take the quiz, watch the video, and review the guide!  These resources are informative and helpful.

As always, if you have any questions about this post or the Ohio Board of Nursing, contact one of the attorneys at the Collis Law Group LLC at 614-486-3909 or go to our website at http://www.collislaw.com for more information.

Ohio LPNs experience difficulties renewing licenses with new online system

LPNs who are renewing their nursing licenses in Ohio this year are required by the Ohio Board of Nursing to renew online. The Ohio Board of Nursing will no longer accept paper renewal or initial licensure applications. All applications must be submitted online.

However, as WSYX Channel 6 Investigative Reporter Brooks Jarosz discovered, the new online application process has not been without problems. See Jarosz’s report: http://abc6onyourside.com/investigators/technical-problems-persist-for-nurses-license-renewal

In order to start the renewal process, each nurse should have received a letter from the Nursing Board with their Log In ID. If a nurse moved since their last renewal and has not updated their address with the Nursing Board, the nurse may not have received their Log In ID. In Ohio, nurses are required to maintain a current address with the Nursing Board. Nurses can update their address at the Nursing Board’s website. The Nursing Board will not accept emails or a letter advising of a new address.

There are 58,000 licensed LPNs in Ohio. Ohio LPN licenses which have not been renewed timely lapse on November 1, 2016. If you have not timely renewed your Ohio LPN license, you MAY NOT WORK ON AN EXPIRED OR LAPSED LICENSE.

Do not wait until the last minute to attempt to renew your license. After September 15, you will be charged a late fee in connection with your renewal application.

To check on the status of your license, visit the Nursing Board’s online license verification page at: https://elicense.ohio.gov/oh_verifylicense

As always, if you have any questions about this post or the Ohio Board of Nursing, contact one of the attorneys at the Collis Law Group LLC at 614-486-3909 or email me at beth@collislaw.com.

Ohio Nurses: Things To Consider If You Receive a Notice of Opportunity for Hearing from the Ohio Board of Nursing

Last week, I attended the Ohio Board of Nursing’s bi-monthly meeting where the members of the Board issued final sanctions against dozens of Ohio nurses.  At that meeting, the members of the Board also authorized the issuance of over sixty Notices of Opportunity for Hearing to Ohio licensed nurses.  The Notice of Opportunity for Hearing (or Notice of Automatic Suspension or Notice of Immediate Suspension) outlines specific charges against the nurse, which, if proven, can form the basis for the nurse to have their license revoked, suspended, placed on probation or reprimanded.

There are legal timelines that must be followed for a nurse to request a Hearing in order to defend their professional license.  Failure to timely request a Hearing can bar the nurse from presenting ANY defense to the Board.

There is no routine disciplinary matter when it comes to a nurse’s professional license.  Disciplinary sanctions imposed by the Board may affect a nurse’s ability to practice nursing in the short-term and can also impose permanent practice and/or narcotic restrictions.

If you receive a Notice of Opportunity for Hearing (or Notice of Automatic Suspension or Notice of Immediate Suspension), it is highly recommended to obtain experienced legal counsel to assist you before the Board.  When hiring legal counsel, here are a few things to consider:

EXPERIENCE:

  • Does the attorney have experience with the type of matter for which you need representation?
  • Is this type of matter a usual part of the attorney’s practice?
  • Has the attorney handled any cases similar to your particular matter?
  • If it is a matter where a settlement or hearing may be involved, how many of those matters has the attorney handled?
  • In general for this type of matter, what does the attorney consider to be a good result?
  • Can the attorney explain the process to you?

ACCESS:

  • What is the best way to communicate with the lawyer and how will he or she communicate with you?
  • When can you expect to hear from the attorney?
  • Are there other people in the attorney’s office who can assist you should an emergency arise while your attorney is unavailable?
  • How will you know what work the attorney has done or will be doing on your matter?

COMPATIBILITY:

  • Will you be comfortable sharing your information with the attorney?
  • Do you understand the information the attorney is telling you?
  • Are there different approaches to your situation, and if so, how will the attorney decide which to take or recommend to you?

FEES:

  • How does the attorney charge you?  Based on hours worked?  Fixed fee?  Or some other method?
  • Is payment required up front?  If so, how and when is that money applied to your account?
  • Will you receive statements for the work performed?
  • Will you be charged for expenses (ex:  travel, hotel, postage, copy charges)?
  • Does the attorney accept credit card payments?

This is a general guide and is not legal advice.  Of course, there may be other questions or concerns you may want to discuss with a potential attorney based on your individual circumstances or issues.

As always, if you have any questions about this post or about the Ohio Board of Nursing in general, please feel free to contact one of the attorneys at the Collis Law Group LLC at 614-486-3909 or email me at beth@collislaw.com.