What are Standing Orders and Are They Legal?

By Martha L. Teter MS, CRNP

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 Many states in the United States have laws and rules regarding the use of “standing orders” or protocols for non-prescribers to administer medications. Do you know what the laws in your state are? Heartbeat International strongly recommends that you research your state laws in this area and be sure you are in compliance with them if you are operating in any area according to standing orders for the administration of treatment or medication, such as in the area of STD/STI treatment.

As an example, in the State of Ohio, no medication may be given to any patient without prior assessment of the patient’s condition by a legal prescriber and documentation of the legal prescriber's order on the patient's record.

Legal prescribers in the State of Ohio, include Physicians, and the following Advanced Practice Nurses who also hold Certificates to Prescribe: Certified Nurse Practitioners, Certified Nurse Midwives and Certified Clinical Nurse Specialists. Many Certified Physician Assistants also have Certificates to Prescribe and are legal prescribers.

A standing order or protocol is a definitive set of treatment guidelines that include definitive orders for drugs and their specified doses. These “Standing Orders” have been authorized by a prescriber to be administered by a certified or licensed health care professional, to a patient for a specific condition. This type of “Standing Order” or Protocol may only be utilized by licensed health care professionals in Ohio in the following situations.

  1. Emergencies
  2. Administration of biologicals for the purpose of disease prevention, and
  3. Administration of vaccines for the purpose of preventing disease

The administration of drugs for any reason other than the above exceptions and that are not patient specific or authorized by the prescriber prior to implementation would be the unauthorized practice of medicine, which is a felony in the state of Ohio. The details of how and when the above exceptions may be applied are detailed in Ohio law.

If you would like to learn more about Ohio Law regarding standing orders, click here.

Many other states also have laws regulating standing orders. To learn more about the laws in your state, log onto the professional websites of The State Board of Nursing, The State Board of Medicine or the State Board of Pharmacy. Should you find that your current practices are not in compliance with your state law, Heartbeat International recommends that you place a hold on further treatment until such time as you can assure you are in compliance with your state law.

If you have any further questions please feel free to contact Heartbeat International.