As a registered nurse in Ohio, it has become routine to timely submit a complete RN renewal application at the same time every two years. However, a CTP-E is issued for one year and expires one year from the date of issuance, NOT one year after you start working as a nurse. In addition, once a CTP is issued, the renewal date may be different from the date the nurse renews their license. It is imperative that you know when you need to renew your license, CTP-E and CTP.  You will not receive a letter or notification from the Nursing Board to remind you to renew your certificate to prescribe.  It is illegal to continue to prescribe on a lapsed CTP-E or CTP!

The Ohio Board of Nursing requires advanced practice nurses who have had no prior experience prescribing medications or therapeutic devices to obtain a Certificate to Prescribe-Externship (“CTP-E”).  The purpose of the externship is to create a period during which the nurse’s prescribing activities are reviewed and evaluated by a supervising professional for the purpose of ongoing improvement of the nurse’s competence, knowledge, and skill in pharmacokinetic principles and the application of these principles to the nurse’s area of practice.

In order to apply for a CTP-E, the applicant must hold a valid Ohio R.N. license as well as a current Certificate of Authority to practice as a certified nurse midwife, nurse practitioner or nurse specialist.  In addition, the applicant must have completed required coursework on advanced pharmacology.  Once all materials have been submitted and reviewed by the Board of Nursing, the CTP-E will be issued for one year.  The year begins on the date the CTP-E is issued by the Board.  It is critical to remember this date.

During this year, the advanced practice nurse is required to complete 1,500 hours of supervised prescribing (500 hours under the direct supervision of a supervising professional).  Direct supervision means that the supervising professional is on-site when the nurse is prescribing.  300 of the 500 direct supervision hours must be supervised by a physician; the remaining 200 hours may, with the collaborating physician’s permission, be supervised by an advanced practice nurse with prescriptive authority, not a CTP-E.  The remaining 1,000 hours may be indirectly supervised.  This means that a physician, in accordance with a schedule documented in the standard care arrangement, regularly and timely reviews the nurse’s prescriptions and prescribing practices.

Once the advanced practice nurse has completed the required supervision hours through the CTP-E, the supervision must be documented by the collaborating physician and submitted directly to the Board of Nursing on Form B.  PLEASE NOTE that Form B must be submitted well prior to the end of the expiration date on the CTP-E to allow the Board time to review it and issue the advanced practice nurse applicant a Certificate to Prescribe.  Even if Form B is submitted timely, it is illegal to continue to prescribe after the year for the CTP-E has expired unless the nurse has received the Certificate to Prescribe.  Advanced practice nurses may face discipline if they continue to prescribe once the CTP-E has expired if they have not been issued a Certificate to Prescribe.

A CTP-E cannot be renewed.  It can be extended for a one-time period of 2 years, if a request to extend is timely received by the Board before the CTP-E expires.

As always, if you have any questions about his post or about the Ohio Board of Nursing in general, please contact one of the attorneys at the Collis Law Group LLC at 614-486-3909 or email beth@collislaw.com.