Advance Practice Nurses: COA and CTP
Registered nurses who complete required education and meet certification requirements for specialty areas are considered advance practice nurses and receive a Certificate of Authority (COA) from the Board of Nursing. The COA allows them to practice within the scope of their specialty. Advance practice nurses include:
There are specific issues related to the relationship that advance practice nurses have with physicians or podiatrists:
Standard care arrangement: Written, formal guide for planning and evaluating a patient’s health care. It is developed by one or more collaborating physicians or podiatrists with a clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner.
Collaboration: One or more physicians or podiatrists with whom an advanced practice nurse has entered into a standard care arrangement are available to communicate with the nurse either in person, by radio, telephone, or other form of telecommunication.
Supervision: A physician, dentist, or podiatrist is in the immediate presence of a certified nurse anesthetist who is administering anesthesia. Ohio Board of Nursing approved list of national certifying organization/agencies:
Link to Ohio Revised Code:
Chapter 4723.41 Requirements for practicing nurse-midwifery or other specialty.
Some advance practice nurses can apply for a Certificate to Prescribe (CTP), which allows them to prescribe drugs and therapeutic devices. This is first issued as an externship (CTP-E) and requires supervision by one or more physicians for a year. The CTP/CTP-E allows a nurse to prescribe any drug/medication that is not excluded within the appropriate scope of practice. Oxygen and plasma expanders are considered medications and require the CTP/CTP-E to prescribe. There are a number of non-drug ordering situations that require a COA but do not require CTP/CTP-E, as long as the patient population is within the nurse’s scope of practice:
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