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Prepared by: Jim McGovern, Esq. & Brennan Santa, Law Clerk

All Registered Nurses (RNs) in Ohio must be aware of their scope of practice and stay within the established boundaries. For example, RNs can oversee LPNs in their administration of intravenous (IV) therapy in certain situations. Understanding IV therapy and other areas can impact whether an Ohio RN exceeds their scope of practice and violates the Nurse Practice Act.

The scope of practice for an RN is found in the Ohio Revised Code section 4723.01. This article does not contain all of the information necessary for an RN to avoid violating the Nurse Practice Act, but should instead be treated as a general guideline and reminder.

In general, when an RN is directing an LPN in patient care, the RN must first perform assessments on the patient. The RN must assess the condition of the patient, the type of nursing care the patient requires, the complexity and frequency of the care needed, the skill of the LPN, and the availability and accessibility of resources necessary to safely perform the specific function or procedure.¹ The RN must perform these assessments before the LPN begins to assist with the patient.

An LPN can perform certain types of IV therapy at the direction of an RN, so long as the RN is authorized by the state, and the RN is on the premises where the procedure is to be performed, or accessible by telecommunication.² The LPN must demonstrate the knowledge, skills, and ability to perform the procedure safely.³ The LPN is limited to certain kinds of IV procedures; for a list, see the Ohio Revised Code.⁴ RNs should not allow LPNs within their supervision to go beyond their scope of practice.

For IV therapy of adult patients, an LPN may perform IV therapy at the direction of an RN.⁵ However, an RN (it’s whether the one directly supervising the LPN, or another RN) must be readily available at the site.⁶ Further, the RN must perform an on-site assessment of the adult patient before the LPN initiates the IV therapy.⁷

The Ohio Board of Nursing has created a flowchart to assist RNs and LPNs to determine whether an activity is within their scope of practice and in adherence to the Nurse Practice Act. RNs (and LPNs) can view this flowchart online and consult it.⁸ RN scope of practice is also explained online by the Ohio Board of Nursing.⁹

Ohio RNs who go beyond their scope of practice, or who allow LPNs under their supervision to exceed their scope of practice, may place patients at risk. Further, they risk having their license sanctioned by the Ohio Board of Nursing. If you need guidance regarding RN supervision of LPNs, other scope of practice issues, as well as any licensure concerns, contact Graff and McGovern.

1. Rule 4723-4-03 – Ohio Administrative Code | Ohio Laws ↩︎
2. Section 4723.181 – Ohio Revised Code | Ohio Laws ↩︎
3. Id. ↩︎
4. Id. ↩︎
5. Section 4723.18 – Ohio Revised Code | Ohio Laws ↩︎
6. Id. ↩︎
7. Id. ↩︎
8. RN & LPN Decision Making Model | Ohio Board of Nursing ↩︎
9. Nursing Practice and Scopes of Practice | Ohio Board of Nursing ↩︎