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New Ohio Law allows NPS and PAS to delegate injections to medical assistants.

For many years Ohio physicians have had authority under state law to delegate clinical tasks, including drug administration, to unlicensed staff such as medical assistants. Thanks to a new law signed in July by Governor John Kasich, advanced practice registered nurses (APRNs) and physician assistants (PAs) now may also delegate medication administration to unlicensed assistants.

Senate Bill 110, which becomes effective October 15, 2015, is a comprehensive update of Ohio's laws governing the licensure and practice scopes of APRNs and PAs. Of special interest to AMT members, the new law specifies conditions under which a PA or an APRN with prescribing authority--which include clinical nurse specialists, certified nurse-midwifes, and certified nurse practitioners (NPs)--may delegate drug administration.

Delegation by APRNs

In order to lawfully delegate medication administration, the APRN must first apply for and obtain from the state nursing board a certificate of authority to prescribe drugs. Once the APRN has authority to prescribe, he or she may delegate administration of drugs to an unlicensed assistant under the following conditions:

* The APRN may only delegate administration of drugs, other than controlled substances, that are listed on a formulary maintained by the Board of Nursing.

* Prior to delegating the authority, the APRN must:

(a) assess the patient and determine that the drug is appropriate for the patient; and

(b) determine, based on documentation made available by the person's employer, that the unlicensed person to whom the authority will be delegated has successfully completed a recognized education program concerning drug administration and has demonstrated to the person's employer the knowledge, skills, and ability to administer the drug safely.

* The drug is to be administered at a location other than a hospital inpatient care unit; a hospital emergency department or a freestanding emergency department; or an ambulatory surgical facility, as defined in the State Code.

* The APRN must be physically present at the location where the drug is administered.

Delegation by PAs

If acting pursuant to a supervision agreement with a supervising physician, a PA may delegate performance of a task to implement a patient's plan of care or, if the conditions listed below are met, the PA may delegate administration of a drug. The PA must be physically present at the location where the task is performed or the drug administered. Prior to delegating a task or administration of a drug, a PA must determine that the task or drug is appropriate for the patient and that the person to whom the delegation is to be made can safely perform the task or administer the drug.

The PA may delegate medication administration only if each of the following conditions is satisfied:

(1) The PA has been granted physician-delegated prescriptive authority.

(2) The drug is included in the formulary established by the State Medical Board under the new law.

(3) The drug is not a controlled substance.

(4) The drug will not be administered intravenously.

(5) The drug will not be administered in a hospital inpatient care unit; a hospital emergency department; a freestanding emergency department; or an ambulatory surgical facility as defined and licensed under the State Code.

Although medical assistants traditionally have been viewed as functioning under the direct supervision of a physician, an increasing number of states have moved to allow NPs and other APRNs, as well as PAs, to delegate drug administration and other clinical tasks to unlicensed personnel. AMT supports this expansion of delegation authority, so long as appropriate chains of command are established and the delegating licensed practitioner retains medical and legal responsibility for the assistant's actions.

The text of SB 110 can be found at the following link to the Legislature's website: https://www.legislature.ohio. gov/legislation/legislation-summary?id=GA131-SB-110

The new law does not affect the preexisting authority of physicians to delegate medical tasks to unlicensed personnel. The State Medical Board's rules concerning delegation by physicians can be accessed at: http://codes.

by AMT Legal Counsel

Michael N. McCarty

Holland & Knight LLP, Washington, DC
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Title Annotation:government news
Author:McCarty, Michael N.
Publication:AMT Events
Date:Sep 1, 2015
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