06/29/2016

You Asked....We Answered

The second and fourth weeks, LeadingAge Ohio staff share technical questions and advice that have been asked of them by members recently. If you have a question you would like to see featured in You Asked/We Answered, email Nisha Hammel, Director of Advocacy at nhammel@leadingageohio.org, or Anne Shelley, Director of Regulatory Relations, at ashelley@leadingageohio.org.

 

You Asked:

When a patient dies, we have LPN's that are on call, and who are sometimes on site to assess a patient’s death and call the physician to report absent vital signs.  Is this acceptable?  The law states RN but the physician is actually the one who pronounces, correct?

We Answered:

Yes, you can have an LPN take call and since death is the expected outcome,  the on-call LPN can go out to the death and call the physician reporting the absence of vital signs. In this case, the physician is the one that technically pronounces the patient dead via the phone.

The new law in Ohio (2013) allows the RN in hospice and palliative care (but not in other healthcare settings) to pronounce the patient dead. An RN who pronounces a patient dead is subsequently required to notify the physician within 24 hours about the patient’s pronouncement of death and time of death.  

However, the Ohio Board of Nursing has given their opinion that an LPN cannot call an Advanced Practice Nurse (APN) and report the absence of vital signs and have the APN pronounce the patient dead over the phone.  Only a physician can pronounce a patient dead from the assessment of a “competent observer”.  Please see the Codes referenced below.

Ohio Administrative Code: Chapter  4731- 14: Pronouncement of Death

Also, ORC 4723-36 is the Board of Nursing Rule which specifically outlines RN pronouncement of death.