Ohio Nurse Practice Act: 1 Hour Category A

Are you a nurse? How do you know? Only when you pick up the Nurse Practice Act (NPA) written by the state legislature of the state where you are applying for licensure can you know if you meet the specific definition of who may go by the title of nurse.

Each state governing body has the duty and obligation to its citizens to:

• Define who may be called a nurse.
• Define the process for achieving and maintaining that title.
• Determine what a nurse may or may not do.
• Outline to whom they are responsible.
• Determine appropriate corrections for those who fail to comply with the state NPA and how they will be applied.
• Be aware that while all NPAs discuss similar topics and share comparable content, the NPAs of any two states will not be identical.

As a professional, you are legally responsible for complying with the laws and regulations that govern you. Each licensed medical professional works under laws, statutes, and standards derived from local, state, and federal governing bodies and professional practice guidelines.

Maybe it is time to dust off your copy of the NPA you have sworn to follow. An application for professional licensure with acceptance is a legally binding contract to uphold your practice to the level mandated by the authorizing body. The practice of nursing is a right granted by a state to protect those who need nursing care. Safe, competent nursing practice is grounded in the law as written in the state NPA and its rules. Nurses can only function properly if they know their state's current regulations and governing practices. To find the NPA, go to the State of Ohio Board of Nursing web page to access the most recent copy here.

The goal is safety. The NPA is Chapter 4723 of the Ohio Revised Code (ORC). The ORC are statutes that aim to protect the public from unsafe care by ensuring that a minimum set of requirements is met and maintained by those whose practice in the area the state defines as nursing. An adjunct document is the Ohio Administration Code (OAC) Chapters 4723-1 through 4723-27 and Chapter 4743 Standards for Telehealth Services. The OAC is a set of rules that assist in implementing and interpreting the ORC.

The Ohio Board of Nursing is the administrative agency that implements and interprets the state's NPA. This authority is granted to the board by the NPA itself. However, the board has no actual control over the formation of the Act. That is the duty of the state legislators, who listen to suggestions from the board, professional organizations, legal counsel, and the citizens of Ohio. In the end, however, the state legislature determines the content of the NPA. As the Board of Nursing is the implementation aspect of the NPA governing nurses and nursing, some knowledge of how it is composed and formed may help understand its rulings and how to appeal or question its decisions.

The Ohio Board of Nursing is composed of thirteen members, selected by the Governor of Ohio specifically for this duty (ORC 4723.02, 2017). Eight of the members are to be registered nurses (RNs). Of these, at least two of the RNs are in advanced practice. Four of the five remaining positions on the board are reserved for licensed practical nurses (LPNs), with the last remaining seat being occupied by what is referred to as a 'consumer interest' representative (ORC 4723.02, 2017).

Each LPN and RN member is required to meet specific minimum standards. Each must have graduated from an approved nursing education program and hold a current Ohio nursing license. One member should be a citizen consumer interest representative. They are not required to be a member of any healthcare profession, nor may they or anyone in their family be employed in healthcare. As a further requirement, there should be no financial interest in the delivery or financing of health care (ORC 4723.02, 2017).

This group, the Board of Nursing, is charged with administering and enforcing the NPA and is equipped with an array of clearly defined powers and duties. Their terms of office are four years, commencing on the first day of January and ending on the thirty-first day of December (ORC 4723.02, 2017).

No one can practice nursing in Ohio without a license from the Ohio Board of Nursing. This includes RN, LPN, certified registered nurse anesthetist (CRNA), clinical nurse specialist (CNS), certified nurse-midwife (CNM), certified nurse practitioner (CNP), and advanced practice registered nurse (APRN) (ORC 4723.03, 2017).

The NPA defines the conditions under which a person can be called by the professional title "nurse" (ORC 4723.01, 2026). To be known as a nurse in Ohio, an application must be submitted to the state Board of Nursing (ORC 4723.09, 2023). This application will serve as a request to take the licensing examination. For a fee determined by the board, the application for examination follows a process described in the NPA that will determine if the educational program you have attended meets the minimum level acceptable for your requested credential. A criminal record background check is also conducted, and a testing date and location are assigned. Once testing is complete, the board issues a discipline-specific license, along with instructions for maintaining current licensure through board-approved continuing education courses.

Nurses who possess active licenses outside of Ohio and request an Ohio nursing license, known as licensure by endorsement, may apply to the board to grant them Ohio licensure. Ohio's Board of Nursing is willing to grant endorsement, provided (ORC 4723.09, 2023):

• A clean criminal and disciplinary action background check comes back.
• The applicant provides evidence to the board that they have met the educational requirements.
• This will also include documentation of completion of at least two contact hours of continuing education directly related to the laws and rules that govern the practice of nursing in Ohio.

Foreign-born applicants seeking a nursing license in Ohio who possess licensure outside the country must provide proof that they have passed an English proficiency exam (ORC 4723.11, 2023).

Do not despair. A 180-day temporary permit to practice nursing is available to those who are having trouble getting their documentation together, as long as they have a current license from a recognized state or national nursing board (ORC 4723.09, 2023).

APRN licensure includes prescriptive authority for all CNPs, CNSs, and CNMs who meet the requirements (ORC 4723.481, 2024).

The Legislature in each state may establish rules and standards separate from any professional organization. For health professionals, the acts they may or may not do (as well as a minimum standard for measuring professional competency) are defined by the state in which they choose to practice or be employed.

The NPA's intent is to protect the public from unsafe practices and to provide competent, quality nursing care by qualified practitioners. The NPA also protects you, the nurse, by defining what is and is not a responsibility or duty required of you.

There are special requirements for LPNs to perform IV therapy procedures (ORC 4723.18, 2023). When an LPN is directed to do an IV therapy procedure, an RN or physician, a physician assistant, a dentist, an optometrist, or a podiatrist who is authorized to practice in Ohio shall be readily available at the site where the IV therapy is performed. Before the LPN initiates IV therapy, the RN shall personally perform an on-site assessment of the adult patient who will receive IV therapy. An LPN shall not initiate or maintain any of the following (ORC 4723.18, 2023):

• Blood or blood components.
• Solutions for total parenteral nutrition.
• Any cancer therapeutic medication, including but not limited to cancer chemotherapy or an antineoplastic agent.
• Solutions administered through any central venous line or arterial line, or any other line that does not terminate in a peripheral vein, except that an LPN authorized by the board to perform IV therapy may maintain the solutions specified that are being administered through a central venous line or peripherally inserted central catheter.
• Any investigational or experimental medication.

An LPN shall not initiate IV therapy in any vein, except that an LPN may initiate IV therapy in a vein of the hand, forearm, or antecubital fossa.

An LPN cannot perform any of the following procedures (ORC 4723.18, 2023):

1. Discontinuing a central venous, arterial, or any other line that does not terminate in a peripheral vein.
2. Initiating or discontinuing a peripherally inserted central catheter.
3. Mixing, preparing, or reconstituting any medication for IV, except that an LPN may prepare or reconstitute an antibiotic additive.
4. Administering medication via the IV route, including all the following activities:
   1. Adding medication to an IV solution or an existing infusion, except that an LPN may initiate an IV infusion containing one or more of the following elements: Dextrose 5%, normal saline, lactated ringers, sodium chloride 45%, sodium chloride 0.2%, and sterile water.
   2. Hang subsequent containers of the IV solutions that contain vitamins or electrolytes if an RN initiated the infusion of that same IV solution.
   3. Initiate or maintain an IV piggyback infusion containing an antibiotic additive.
   4. Inject medication via a direct IV route, except that an LPN can administer heparin or normal saline to flush an intermittent infusion device or heparin lock.
   5. Change tubing on any line, including, but not limited to, an arterial line or a central venous line, except that an LPN may change tubing on an IV line that terminates in a peripheral vein.
   6. Program or set any function of a patient-controlled infusion pump.

Any LPN may perform on any person some IV therapy procedures without receiving authorization to perform IV therapy from the board of nursing if both of the following apply (ORC 4723.181, 2023):

1. The LPN acts at the direction of an RN or a licensed physician, physician assistant, dentist, optometrist, or podiatrist. The RN or a licensed physician, dentist, optometrist, or podiatrist is on the premises where the procedure will be performed or accessible by some form of telecommunication.
2. The LPN demonstrates the knowledge, skills, and abilities to perform the procedure safely.

The IV therapy procedures that any LPN may perform are limited to the following (ORC 4723.181, 2023):

• Verification of the type of peripheral IV solution being administered.
• Examination of a peripheral infusion site and the extremity for possible infiltration.
• Regulation of a peripheral IV infusion according to the prescribed flow rate.
• Discontinuation of a peripheral IV device at the appropriate time.
• Performance of routine dressing changes at the insertion site of a peripheral venous or arterial infusion, peripherally inserted central catheter infusion, or central venous pressure subclavian infusion.

At the direction of a physician or an RN, an LPN may perform the following activities to perform dialysis (ORC 4723.18, 2023):

• The routine administration and regulation of saline solution to maintain an established fluid plan.
• The administration of a heparin dose IV.
• The administration of a heparin dose peripherally via a fistula needle.
• The loading and activation of a constant infusion pump or the intermittent injection of a dose of medication that is administered via the hemodialysis blood circuit and through the patient's venous access point.

Ohio joined the Nurse Licensure Compact (NLC) on January 1, 2023, allowing nurses (RNs and LPNs only) who hold a valid, unrestricted license in Ohio to practice virtually or over state lines in many other compact states across the country without obtaining additional licenses. The multi-state license is like having a driver's license in that it is recognized across state lines (NLC, n.d.).

In Ohio, the NPA recognizes that nurses can be found everywhere, doing many different tasks at all levels of care. Therefore, it has specifically addressed the standards expected from advanced practice registered nurses. These standards apply to the following titles:

• Certified nurse midwife
• Certified nurse practitioner
• Certified registered nurse anesthetist
• Clinical nurse specialist

Ohio is a reduced-practice state for nurse practitioners, meaning that before beginning practice, a standard care arrangement shall be entered into with each physician or podiatrist with whom the certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist collaborates. The standard care arrangement can be revised to add or delete a physician or podiatrist within that employment setting, rather than creating a new arrangement. A new standard care arrangement is needed when the nurse is employed in a different setting and practices with different collaborators. The collaborating physician's or podiatrist's practice must be the same or similar to the nurse's practice and must be authorized to practice in Ohio. The Ohio Board of Nursing does not need to approve the agreement, but may review it for compliance (ORC 4723.431, 2025).

A standard care arrangement includes at least (ORC 4723.431, 2025):

• Criteria for referral of a patient by the clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner to a collaborating physician, podiatrist, or another physician or podiatrist.
• A process for the clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner to obtain a consultation with the collaborator.
• A plan for coverage in instances of emergency or planned absences.
• A process for resolution of disagreements regarding matters of patient management between the clinical nurse specialist, certified nurse-midwife, certified nurse practitioner, a collaborating physician or podiatrist, or another physician or podiatrist.
• An agreement that the collaborating physician completes and signs the death certificate.

Components of the standard care arrangement include the following (ORC 4723.50, 2023):

• When the APRN is prescribing medications, the collaborative physician or podiatrist must be within an acceptable travel time between their location and the APRN's location.
• Other criteria recommended by the committee on prescriptive governance.

The most current copy of the standard care arrangement and any legal authorization signed by a physician must be available from the employer. Upon the board's request, the certified nurse practitioner, certified nurse-midwife, or clinical nurse specialist must provide a copy of the standard care arrangement to the board (OAC 4723-8-04, 2026).

When a hospital negotiates a standard care arrangement, the review and approval of the arrangement must follow the hospital governing body's policies and procedures and the hospital medical staff's bylaws, policies, and procedures. The nurse must notify the board within 30 days of the identity of a collaborating physician or podiatrist, and of any change in the name or business address of a collaborating physician or podiatrist (OAC 4723-8-04, 2026).

A clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner may prescribe any drug or therapeutic device in any form or route of administration if (ORC 4723-9-10, 2025):

1. The ability to prescribe the drug or therapeutic device is within the scope of the practice.
2. The prescription is consistent with the terms of a standard care arrangement.
3. The prescription would not exceed the prescriptive authority of the collaborating physician.
4. The individual drug, subtype, or therapeutic device is not excluded by the formulary.
5. The prescription meets the requirements of state and federal law.
6. A valid prescriber-patient relationship exists. This relationship may include, but is not limited to:
   1. Obtaining a thorough, relevant history of the patient.
   2. Conducting a physical or mental examination of the patient.
   3. Rendering a diagnosis.
   4. Prescribing medication.
   5. Consulting with the collaborating physician when necessary.
   6. Documenting these steps in the patient's medical records.

An APRN with prescriptive authority may delegate medication administration to an unlicensed person (ORC 4723.489, 2017). However, there are requirements about the setting, APRN supervision/presence, and education of that person.

An APRN with prescriptive authority has many requirements and limitations. These include (ORC 4723.481, 2024):

• Limitation on prescribing Schedule II controlled substances.
• Limitation on prescribing controlled substances.
• An exclusionary formulary species.
• Authority may not exceed the prescriptive authority of the collaborating physician or podiatrist.

The exclusionary formulary is on the Board of Nursing website(Ohio Board of Nursing, n.d.).

The Ohio Automated RX Reporting System is a resource available to APRNs by the State of Ohio Board of Pharmacy. The morphine equivalent daily dose (MED) helps to calculate a client's opioid intake. The MED is used to convert various opioid analgesics to a morphine equivalent dose using accepted conversion tables provided by the state board of pharmacy. The calculator can be found here(Ohio Board of Pharmacy, n.d.).

Ohio Administrative Code, Rule 4723-7-08 (2024), went into effect February 1, 2024, requiring all individuals who hold a certificate or license issued by the Ohio Board of Nursing to report a misdemeanor with a direct and substantial relationship to practice under Chapter 4723 of the ORC, felony conviction, violating of any municipal, state, county, or federal drug law, or Driving Under the Influence (DUI)/Operating a Vehicle Impaired (OVI) or physical control while under the influence within 30 days to the Ohio Board of Nursing.

Many states require proof of ongoing professional learning as a condition for gaining and renewing a license to practice nursing in their jurisdiction. We will examine the continuing professional education expectations outlined in the Ohio NPA.

License renewal for nurses in Ohio is on a two-year cycle. Every two years, nurses must complete and possess documentation that they have completed 24 contact hours of continuing education, one hour of which must be directly related to the statutes and rules pertaining to the practice of nursing in the state of Ohio. For APRNs, at least 12 of the 24 contact hours must include continuing education in advanced pharmacology (ORC 4723.24, 2017).

For those who come to a renewal date after holding an Ohio licensure for one year or less, there is a lessened expectation of 12 contact hours of continuing education. If an individual has held an Ohio license for more than one year, they are held to the higher renewal standard of 24 contact hours (OAC 4723-14-03, 2026).

Each applicant for renewal must attest that they have completed the required number and levels of continuing education within the two-year time window. Documented evidence of completion must be available on request by the board (ORC 4723.24, 2017).

To reactivate or reinstate a lapsed license, the nurse applicant must complete 24 contact hours of continuing education and possess documentation that completion occurred during the 24 months immediately before their reapplication date (OAC 4723-14-03, 2026).

The applicant must apply to the Ohio State Board of Nursing for license reactivation or reinstatement. The applicant must report any conviction, pleas, or judicial finding regarding a criminal offense that constitutes grounds for the board to impose sanctions under section 4723.28 of the Revised Code (2025). Twenty-four hours of continuing education must have been completed within the last two years of license reactivation. If the license lapsed less than two years prior, or the applicant holds a current, valid license in another jurisdiction, one hour of the 24 hours of continuing nursing education must be directly related to the statutes and rules of nursing practice within Ohio. If the license has lapsed for more than two years, and the applicant does not hold a current, valid license in another jurisdiction, two hours of the 24 hours of continuing nursing education must include two contact hours of category A with learning outcomes that address scopes of practice for registered and licensed practical nurses, standards of safe practice, and nursing delegation (OAC 4723-14-03, 2026).

If more than five years have passed since the nursing license was active, the applicant must submit a request to the Bureau of Criminal Identification and Investigation for a criminal records check and a check of Federal Bureau of Investigation records (ORC 4723.091, 2025).

It is an assigned duty for the board to investigate evidence that appears to show a violation has occurred (ORC 4723.28, 2025). The NPA spells out the process by which the board investigates evidence having the appearance that a license or certificate holder has committed fraud, misrepresentation, or deception in applying for or securing a license or failed to practice following acceptable standards of safe practice (ORC 4723.28, 2025).

Powers held by the board include the ability to (ORC 4723.28, 2025):

• Deny, revoke, suspend, or place restrictions on any nursing license.
• Reprimand or otherwise discipline a holder of a nursing license.
• Impose a fine of not more than five hundred dollars per violation.

Disciplinary proceedings that take place after an investigation may appear before a hearing examiner or be resolved by a consent agreement. When findings indicate that an individual's practice is substandard yet not posing a serious risk, the board can recommend participation in the state-guided practice intervention and improvement program (PIIP) rather than formal disciplinary action.

During the investigation, the board can compel the subject to submit to a mental or physical examination (ORC 4723.28, 2025). Failure to submit to a mental or physical examination when directed constitutes an admission of allegations. If the board finds that an individual is impaired, the individual may have to submit to care, counseling, or treatment as a condition for initial, continued, reinstated, or renewed authority to practice.

The individual shall be allowed to demonstrate to the board that the individual can begin or resume the individual's occupation in compliance with acceptable and prevailing standards of care under the provisions of the individual's authority to practice (ORC 4723.28, 2025).

Not all reasons for discipline are major violations. The board oversees all aspects of nursing practice within the area of its jurisdiction and may choose to investigate and discipline such things as reports of:

• A nurse license holder not using universal and standard infection control precautions.
• Offering to 'waive' client fees/co-payments (ORC 4723.28, 2025).
• Reports of a nurse supplying more than a 72-hour quantity of sample medications or therapeutic devices (ORC 4723.481, 2024).

Activities that may result in disciplinary action include (ORC 4723.28, 2025):

1. Denial, revocation, suspension, or the restriction of authority to practice for any reason other than failure to renew a license. 
2. The practice of nursing or a dialysis technician, having failed to renew a nursing license.
3. Conviction of:
   • A plea of guilty to a judicial finding of guilt.
   • A judicial finding of guilt resulting from a plea of no contest.
   • A judicial finding of eligibility for a pretrial diversion or similar program of intervention instead of a conviction for a misdemeanor committed during practice.
   • A felony.
   • A crime of immorality or moral turpitude.
4. Selling, giving away, or administering drugs or therapeutic devices for other than legal and legitimate therapeutic purposes.
5. Violating any municipal, state, county, or federal drug law.
6. An act in another jurisdiction that would constitute a felony or a crime of moral turpitude in Ohio.
7. An act during practice in another jurisdiction that would constitute a misdemeanor in Ohio.
8. Illegal drug use.
9. Impairment of the ability to practice according to acceptable and prevailing standards of care due to:
   • Use of drugs, alcohol, or other chemical substances.
   • A physical or mental disability.
10. Assaulting or causing harm to a patient or depriving a patient of the means to summon assistance.
11. Stealing anything of value.
12. Adjudication by a probate court of being mentally ill or mentally incompetent.
13. Violation of any restrictions placed by the board on a nursing license or dialysis technician certificate.
14. Failure to use universal and standard precautions.
15. Failure to practice following acceptable and prevailing standards of safe care.
16. Exceeding practice standards.
17. Aiding and abetting a person in that person's practice without a license or certificate.
18. A nurse waiving the payment of all or any part of the bill to entice patients.
19. Failure to comply with:
    • Substance use disorder monitoring program.
    • Practice intervention and improvement program.
20. APRN failure to:
    • Meet the quality assurance standards.
    • Maintain a standard care arrangement.
    • Practice following the standard care arrangement.
    • Prescribing drugs and therapeutic devices correctly.
21. Prescribing any drug or device to perform or induce an abortion.
22. Failure to establish and maintain professional boundaries with a patient.
23. Regardless of whether the contact or verbal behavior is consensual, engaging with a patient other than your partner in any of the following:
    • Sexual contact.
    • Verbal behavior that is sexually demeaning to the patient.
24. Assisting suicide.
25. Failure to comply with the requirements before issuing a minor a prescription for an opioid analgesic.
26. Revocation, suspension, restriction, reduction, or termination of clinical privileges.
27. Termination or suspension of a certificate of registration to prescribe drugs.
28. Failure to comply with the state Board of Pharmacy database unless the state Board of Pharmacy no longer maintains a drug database (ORC 4729.75, 2019).

In response to the COVID-19 pandemic, the Ohio Revised Code was updated to allow synchronous or asynchronous technology to provide services within the professional's scope of practice (ORC 4743.09, 2025). Telehealth services are the use of technology by a healthcare professional to provide services to a patient at a site other than the provider's location. The standard of care for such services must be equal to the standard of care for in-person services (Ezeamii et al., 2024).

When prescribing a schedule II-controlled substance, an initial in-person visit may be required; however, if the patient is receiving palliative or hospice care, this requirement is waived. The requirement is also waived for a patient who meets any of the following: medication-assisted treatment or any other medication for opioid-use disorder, who is a patient with a mental health condition, or who, as determined by the clinical judgment of a health care professional, is in an emergency (ORC 4743.09, 2025).

Telehealth services may be denied, and the healthcare professional may require the patient to attend in-person visits only. If the client is present in another state, Ohio allows the healthcare provider to complete the visit if it is permitted by the laws of the state in which the patient is located.

Sarah, an RN with five years of experience in a busy medical-surgical unit at a large urban hospital, is known for her excellent clinical skills and compassionate patient care. She recently encountered a situation that required careful consideration of direction practices, particularly involving peripheral IV therapy.

Scenario:

Sarah's unit was experiencing a particularly hectic shift. The patient census was high, and the complexity of patient needs required efficient task management. One of Sarah's patients, Mr. Johnson, was admitted with severe dehydration and required immediate IV fluid therapy. At the same time, several other patients needed urgent care.

After doing an initial assessment of Mr. Johnson, Sarah recognized the need to manage her time effectively and decided to direct the task of starting Mr. Johnson's peripheral IV to Lisa, an LPN on her team. Lisa has been an LPN for three years and is certified in IV therapy, a skill she frequently utilizes.

Considerations:

Sarah's decision to direct the IV therapy to Lisa involved several critical considerations:

Scope of Practice:

RN Scope: As an RN, Sarah is responsible for the overall assessment, planning, and evaluation of patient care. She can direct tasks but must ensure they are within the LPN's scope of practice.

LPN Scope: LPNs can perform peripheral IV therapy if they have received the necessary training. Lisa meets these criteria, enabling her to start and manage IVs under RN supervision.

Competence and Experience:

Through her certification and experience, Lisa has demonstrated competence in IV therapy. Sarah has observed Lisa's proficiency in this area, reinforcing her confidence in directing this task.

Patient Safety and Outcome:

Sarah ensured that directing the IV therapy would not compromise patient safety. She considered Mr. Johnson's condition and recognized that timely IV therapy was crucial. Given Lisa's skills, Sarah trusted that the task would be performed safely and effectively.

Supervision and Support:

Sarah provided clear instructions to Lisa, outlining the specifics of the IV therapy needed for Mr. Johnson. She remained available for consultation and supervision, ready to step in if complications arose.

Execution:

Lisa approached Mr. Johnson to explain the procedure and ensure his comfort. She skillfully inserted the IV catheter and initiated the fluid therapy per the doctor's orders and Sarah's instructions. Lisa monitored Mr. Johnson for any adverse reactions throughout the process, ensuring the IV therapy progressed smoothly.

Sarah checked in regularly to oversee the procedure, verifying that everything was proceeding according to plan. She praised Lisa for her competence and thanked her for her assistance, reinforcing a collaborative and supportive team environment.

Outcomes:

Lisa performing IV therapy resulted in several positive outcomes:

Timely Patient Care. Mr. Johnson received the necessary IV fluids promptly, which improved his condition and stabilized his vital signs.

Efficient Workload Management. By directing the task, Sarah managed her workload more effectively, allowing her to attend to other critical patient needs without delay.

Enhanced Team Collaboration. This reinforced trust and collaboration between Sarah and Lisa, promoting a positive working relationship and mutual respect.

Professional Development. Lisa gained further confidence in her IV therapy skills and appreciated Sarah's trust in her, which contributed to her professional growth.

Case Study Conclusion:

This case study highlights the importance of thoughtful delegation in nursing practice. By considering the scope of practice, competence, patient safety, and supervision needs, Sarah successfully directed IV therapy to Lisa, resulting in improved patient care and effective teamwork. This scenario underscores the critical role of directing tasks in optimizing nursing workflows and enhancing patient outcomes.

The NPA is the definition set by a state for what a nurse is and what requirements they must meet to practice within that state. The NPA is put in place to protect the public. When we seek initial licensure or renewal of a license from a state, we agree to practice our profession in a manner that meets or exceeds the level of care set by that state.

In Ohio, we have seen an example of a well-crafted NPA, an Act that recognizes the many functions and levels at which a professional nurse might practice. Recognition of professional nursing practice as a specific and specialized means of providing nursing care indicates an understanding of what nurses are and what they do.

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