Policy and Advocacy for Improving Population Health

Ohio Board of Nursing
 In Ohio, Advanced Practice Registered Nurses (APRNs) must practice under a Standard Care Arrangement with a physician. Advanced Practice Nurses in Ohio must practice under a physician or podiatrist when providing direct patient care in a healthcare organization. According to (Ohio Board of Nursing, 2021) an “Advanced Practice Registered Nurse may prescribe a Schedule II-V controlled substance under the direction of a physician or podiatrist.” In Ohio, the APRNs must prescribe according to the Standard Care Arrangement with the collaborating physician, consistent with the APRNs national certification and according to the state and federal law (Ohio Laws & Administrative Rules, 2018). An APRN who prescribes medications must complete an approved 45-hour course in advance pharmacology.
Delaware Board of Nursing
     According to (Delaware.gov, 2021) an Advanced Practice Registered Nurse who is approved for independent practice is “allowed to practice and prescribe outside the employment of an established healthcare organization, healthcare delivery system, physician, podiatrist, or practice group owned by a physician or podiatrist without a collaborative agreement.” An APRN in Delaware who has practiced for at least two years and has 4,000 hours in their current practice can also practice independently without a collaborating agreement. Delaware.gov (2021) grants APRNs prescriptive authority when granting an initial license by direct application or endorsement. An APRN may prescribe, administer, and dispense legend medications, including Schedule II-V controlled substances (Delaware.gov, 2021).
The Difference Between the Ohio Board of Nursing and The Delaware Board of Nursing  
     In Ohio, an APRN must work under a collaborating physician, and the physician does not have to be on-site with the APRN. The APRN can order labs, and radiology tests, prescribe medication, and perform a physical examination. In Delaware, the APRNs can prescribe medication and treat patients independently without a collaborating agreement if they have practiced in their population focus for two years and have completed 4,000 full-time hours. 
APRNs Legal Authority to Practice within the Full Scope of Education and Experience
     An APRN must apply for a full practice authority to practice independently without a collaboration agreement with a podiatrist or physician. The APRN has the authority to prescribe without having a collaborating team on site. To adhere to the regulations, the APRN must complete the required continuing education and training hours in the area of their certification in addition to required clinical experience hours. APRNs must complete 80 hours of continuing education and medical education for their licensure renewal every two years. The APRNs must obtain a DEA number and complete an approved continuing education prescribing course.
Delaware.gov (2021). Division of Professional Regulation 1900 Boards of Nursing. https://regulations.delaware.gov/AdminCode/title24/1900.shtml 
Ohio Board of Nursing (2021). APRN Licensure and Practice in Ohio. https://nursing.ohio.gov/wp-content/uploads/2021/02/APRN-Licensure-and-Practice.pdf#:~:text=APRN%20Education%20Programs%
Ohio Laws & Administrative Rules (2018). Continuing education requirements. https://codes.ohio.gov/ohio-administrative-cod/rule-4723-8-10

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