Ohio Administrative Code Title 4723 - Ohio Board of Nursing
Ohio Administrative Code Title 4723 — Ohio Board of Nursing
Overview
OAC Title 4723 contains the rules promulgated by the Ohio Board of Nursing (OBN). These rules regulate the education, licensure, scope of practice, and professional conduct of nurses and other healthcare providers under the Board’s authority in Ohio. This includes:
Registered Nurses (RNs)
Licensed Practical Nurses (LPNs)
Advanced Practice Registered Nurses (APRNs: CNP, CNS, CNM, CRNA)
Dialysis technicians
Community health workers
Medication aides
The overarching purpose of these rules is to protect the health and safety of the public by ensuring high standards of nursing practice and professional accountability.
Scope of Title 4723
Title 4723 includes rules covering:
Licensure and Certification
Nursing Practice Standards
Education Programs and Approval
Disciplinary Actions
Delegation and Supervision
Continuing Education
APRNs and Prescriptive Authority
Scope and Limitations for Non-nurse Health Workers (e.g., medication aides)
Key Chapters and Provisions
1. Licensure and Certification (OAC 4723-7)
RNs and LPNs must pass the NCLEX exam.
Licenses must be renewed every two years.
APRNs require an RN license plus additional certification in their specialty.
Criminal background checks and proof of education are mandatory.
2. Standards of Nursing Practice (OAC 4723-4)
Defines the minimum acceptable standards for safe and effective care.
Nurses must:
Accurately document care.
Respect patient confidentiality.
Communicate effectively with patients and colleagues.
Practice within their legal scope of practice.
Failure to meet these standards may result in disciplinary action.
3. Continuing Education (OAC 4723-14)
RNs and LPNs must complete 24 contact hours of CE per renewal cycle, including:
One hour on law and rules of nursing practice in Ohio.
APRNs may have additional CE requirements depending on their area of practice.
4. Delegation and Supervision (OAC 4723-13)
RNs and LPNs may delegate tasks to unlicensed personnel (e.g., nursing assistants) under strict guidelines.
Nurses must ensure:
The task is appropriate for delegation.
The delegatee is competent.
Proper supervision is in place.
5. Disciplinary Process (OAC 4723-16)
Grounds for discipline include:
Substance abuse.
Fraud or misrepresentation.
Gross negligence or incompetence.
Criminal convictions related to practice.
The Board may impose:
Suspension, revocation, or limitation of license.
Fines.
Mandated treatment or education programs.
The disciplinary process includes notice, hearing, and appeal rights.
6. Advanced Practice Nurses and Prescribing (OAC 4723-8)
APRNs (e.g., Nurse Practitioners, Clinical Nurse Specialists) must:
Hold national certification.
Have a Standard Care Arrangement (SCA) with a collaborating physician (unless independent authority is granted under law).
Apply for Certificate to Prescribe (CTP) and complete pharmacology coursework.
7. Education Program Approval (OAC 4723-5)
Nursing schools in Ohio must be approved by the Board.
The Board reviews curriculum, faculty qualifications, and program outcomes (e.g., NCLEX pass rates).
Programs can be placed on provisional status or approval withdrawn for non-compliance.
Relevant Case Law Interpreting Title 4723
While specific rules may not always be directly cited in court decisions, several important Ohio cases illustrate how courts handle disciplinary and regulatory matters under Title 4723:
1. In re Application of Jane Doe, 2009 Ohio App. LEXIS 3767
Issue: Applicant was denied licensure due to a past felony conviction.
Holding: The court upheld the Board’s decision, ruling that it had discretion to deny licensure if the applicant's background posed a risk to public safety.
Significance: Reinforces the Board’s power under OAC 4723-7 and 4723-16 to deny licensure based on criminal history.
2. State ex rel. Collins v. Ohio Board of Nursing, 2014 Ohio App. LEXIS 4512
Issue: Nurse challenged suspension for narcotic diversion and documentation falsification.
Holding: The court affirmed the Board’s findings, stating the nurse violated standards of practice under OAC 4723-4.
Significance: Affirms that misconduct related to patient safety and ethics justifies severe discipline.
3. Ohio Board of Nursing v. Smith, 2011 Ohio Misc. LEXIS 998
Issue: Nurse failed to complete required continuing education.
Holding: Court found the Board acted properly in suspending the license.
Significance: Supports strict enforcement of OAC 4723-14 CE requirements.
4. In re Discipline of RN License of Johnson, 2017 Ohio App. LEXIS 987
Issue: Nurse violated the conditions of a consent agreement for substance use monitoring.
Holding: Court upheld revocation of license for noncompliance with OAC 4723-16 disciplinary rules.
Significance: Shows the Board’s authority to impose and enforce monitoring agreements.
Legal Principles Underlying OAC Title 4723
Public Protection: The primary duty of the Board is to safeguard patients.
Professional Accountability: Nurses must uphold ethical and professional standards.
Regulatory Authority: The Board has wide discretion in setting and enforcing rules under the authority granted by the Ohio Revised Code Chapter 4723.
Due Process: Nurses are entitled to notice, hearing, and appeal when facing discipline.
Ongoing Competence: Continuing education and supervision requirements ensure ongoing competence and safety in practice.
Summary
OAC Title 4723 provides the regulatory foundation for the practice of nursing and related professions in Ohio. It defines the expectations, limitations, and responsibilities of those licensed by the Ohio Board of Nursing. These rules protect the public by:
Ensuring that nurses are properly trained, licensed, and educated.
Defining clear standards of care and professional behavior.
Creating pathways for discipline when standards are violated.
Supporting accountability through transparent procedures.
Ohio courts routinely uphold the Board’s disciplinary decisions when due process is followed and evidence supports the findings.
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