Ask Nurse Jesse: Retired Nurses and Vaccine Admin

website maker Anonymous Nurse:
I retired from nursing 10 years ago, and have an inactive license. However, with the COVID vaccine coming out soon, I would like to help administer the vaccine. Do I need to get my license renewed? Or are there some updates I need to do?

Nurse Jesse:

Under current law, if you are an Ohio retired nurse with an inactive license and you choose not to reactivate/reinstate the license, it is possible you could, with training updates and competency determinations (see 4723.489, ORC, pasted below), administer immunizations via applicable Delegation Rules if an APRN or physician is on site.

Unlicensed individuals have no authorized scope of practice and may only engage in nursing activities that are delegated to them. Nursing delegation is defined in Rule 4723-13-01(B), OAC, as the transfer of responsibility for the performance of a selected nursing task from a licensed nurse authorized to perform the task to an individual who does not otherwise have the authority to perform the task. The application of Chapter 4723-13, OAC, is always dependent on the individual patient and clinical circumstances as well as the knowledge and ability of the unlicensed individual to whom the task is delegated, all of which must be considered by the nurse prior to delegating. While law and rule governing nursing practice do not provide a list of delegable tasks, they do set some limits. Rule 4723-13-05(D) OAC, states that a RN, or a LPN at the direction of an RN, may delegate to an unlicensed person the administration of only the following medications: over the counter topical medications to be applied to intact skin for the purpose of improving a skin condition or providing a barrier and over the counter eye drops, ear drops, or suppository medications, foot soak treatments, and enemas. This would not include administration of vaccines.

By contrast, APRNs are not limited to the list of medications provided in Rule 4723-13-05(D) when delegating medication administration to unlicensed persons. APRNs must however comply with all requirements of Section 4723.48, ORC, and Section 4723.489, ORC, including specific requirements as to the unlicensed person’s documented education and demonstrated knowledge, skills, and ability to administer the drug safely, and, the requirement that the APRN is on site during the delegated medication administration. Sections 4723.48 and 4723.489, ORC, are pasted below for reference.

ORC Section 4723.48, Delegation of authority to administer certain drugs.
(A) A clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner who holds a license to practice nursing issued under section 4723.42 of the Revised Code may delegate to a person not otherwise authorized to administer drugs the authority to administer to a specified patient a drug, unless the drug is a controlled substance or is listed in the formulary established in rules adopted under section 4723.50 of the Revised Code. The delegation shall be in accordance with division (B) of this section and standards and procedures established in rules adopted under division (O) of section 4723.07 of the Revised Code.
(B) Prior to delegating the authority, the nurse shall do both of the following:
(1) Assess the patient and determine that the drug is appropriate for the patient;
(2) Determine that the person to whom the authority will be delegated has met the conditions specified in division (D) of section 4723.489 of the Revised Code.
Amended by 131st General Assembly File No. TBD, HB 216, §1, eff. 4/6/2017.

ORC Section 4723.489, Delegated authority to administer drugs.
A person not otherwise authorized to administer drugs may administer a drug to a specified patient if all of the following conditions are met:
(A) The authority to administer the drug is delegated to the person by an advanced practice registered nurse who is a clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner and holds a license issued under section 4723.42 of the Revised Code.
(B) The drug is not listed in the formulary established in rules adopted under section 4723.50 of the Revised Code , is not a controlled substance, and is not to be administered intravenously.
(C) The drug is to be administered at a location other than a hospital inpatient care unit, as defined in section 3727.50 of the Revised Code; a hospital emergency department or a freestanding emergency department; or an ambulatory surgical facility, as defined in section 3702.30 of the Revised Code.
(D) The person has successfully completed education based on a recognized body of knowledge concerning drug administration and demonstrates to the person’s employer the knowledge, skills, and ability to administer the drug safely.
(E) The person’s employer has given the advanced practice registered nurse access to documentation, in written or electronic form, showing that the person has met the conditions specified in division (D) of this section.
(F) The advanced practice registered nurse is physically present at the location where the drug is administered.
Amended by 131st General Assembly File No. TBD, HB 216, §1, eff. 4/6/2017.

 

This response is for informational purposes only and does not constitute legal advice.