The ODA and the OSMA requested additional information from the Ohio Board of Nursing regarding nurses microneedling, cool sculpting and performing other cosmetic procedures AKA Medi-Spa. Please see below as well as the attached links. If you have additional questions, please contact ODA Executive Director, Jill Hostetler, odaexec@ohderm.org.
RN/LPN. The Nurse Practice Act and related rules do not prohibit an LPN or RN, when engaging in the practice of nursing, from performing microneedling or coolscupting if they do so pursuant to a specific current order from an authorized provider. See Section 4723.01(B)(5), ORC, (for RNs) and Section 4723.01(F)(3), ORC, (for LPNs), and 4723.151(A), ORC. As always, they would be required to meet the standards of care in Chapter 4723-4. For example, Rules 4723-4-03(D) (RN) and 47234-04(D) (LPN), OAC, say that an RN or an LPN may provide care which is beyond basic preparation for RN or LPN practice provided the nurse obtains education that emanates from a recognized body of knowledge, the nurse demonstrates knowledge, skills, and abilities to perform the nursing care, and the nurse maintains documentation satisfactory to the board of these educational and competency requirements. The nurse must have an specific current order from an individual who is authorized to practice in Ohio who is acting within the course of the individual’s professional practice, and the nursing care to be provided as ordered does not involve a function or procedure that is prohibited by any other law or rule.
LPN’s dependent scope of practice. Note that the LPN scope of practice is dependent upon direction from an authorized provider or an RN (in addition to the required order discussed above). Standards of practice in Chapter 4723-4, OAC, require that when a RN provides direction to the LPN, the RN must first assess the condition of the client who needs nursing care, including, but not limited to, the stability of the client, the type of nursing care the client requires, the complexity and frequency of the nursing care needed, the training, skill, and ability of the licensed practical nurse who will be performing the specific function or procedure, to perform the specific function or procedure, and the availability and accessibility of resources necessary to safely perform the specific function or procedure. The RN directing the LPN must determine the appropriateness of directing the LPN to provide the care based upon those factors. The LPN’s dependent scope of practice, and the requirement for “direction” is discussed in detail on pp 3-5 (including FAQ on p. 5) of the attached RN LPN Scope document.
APRN. APRN-CNP, -CNS and -CNMs do not require ‘supervision’ to engage in practice but are required to have entered into a standard care arrangement (SCA) with at least one collaborating physician prior to engaging in practice as an APRN. Section 4723.431(A), ORC. An APRN may engage in practice that is consistent with their scope (meaning it is consistent with their national certification as an APRN, see Section 4723.43, ORC); is included in the statement of services in the SCA they entered into with their collaborating physician; and can be performed consistent with standards of safe patient care. This last requirement would go to the knowledge, skills, and abilities of the APRN, the environment in which the APRN is practicing, etc.
The Nurse Practice Act and related administrative rules are available at www.nursing.ohio.gov. Attached for general reference are a few of the practice resources available on the Board website, including decision making models to assist nurses in determining whether a specific procedure, task or activity is within their scope of practice and, if so, whether the specific procedure, task or activity is consistent with standards of practice, appropriate to perform based on the individual nurse’s knowledge and skills, and is appropriate based on the clinical setting. You may subscribe to eNews at www.nursing.ohio.gov to receive timely announcements from the Board.