278 along with standing orders, support nursing judgment in providing safe, quality care to workers. Guidelines are important for several reasons, including providing a standard approach for nursing practice, ensuring quality, maintaining accountability, enhancing communication, and promoting continuing education. OTCs should be used only within the context of nursing guidelines written in a consistent for- mat, dated, signed by the licensed health care provider and OHN, and reviewed and revised at least annually. The OHN can practice independently under the state nursing practice act. However, collabora- tive strategies with physicians for standing orders are necessary or when medications are pre- scribed and administered. Nursing Roles The OHN determines which OTCs are needed in the work setting and how they will be admin- istered in the health unit. Consistent with current state laws and administrative rules, written, signed, and periodically updated standing orders may be necessary to guide the administration of medications. The OHN must be knowledgeable about the mechanisms of action and the effects of any medication administered and must anticipate any unusual reactions and be able to respond appropriately. Interdisciplinary Interactions and Collaboration
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