Monitor and adjust flow rates of any venous access device/line. Start a venous line using a midline catheter. Start any central venous line including PICC lines. Identify and set up equipment and solutions for infusion through any venous access device (peripheral or central line). LPNs may not independently provide IV therapy in Home Care settings.(Long term care facilities must follow acute care RN supervision guidelines on sub-acute units.) The provision of IV therapy by an LPN must be under the on-site supervision of an RN at all times that the LPN is providing IV therapy.The Practice of IV Therapy by Licensed Practical Nurses in Long Term Care Settings SAS: Saline administration, saline, flush procedure. SASH: Saline administration, saline, heparin flush procedure. These devices are used to infuse only isotonic drugs or fluid. Such devices do not have their distal end in the central venous system. Midline Catheters: Long-line peripherally inserted venous access devices. Central Venous Arm Port: Peripherally implanted central venous line devices for long term IV therapy. and its related company, BCR, Inc.) Central Venous Chest Port: Implanted central venous line devices for long term IV therapy. ( "HICKMAN" and "BROVIAC" are registered trademarks of C. Examples include various ports, triple lumen, "BROVIAC"®, and "HICKMAN"® catheters, etc. Insertion sites may be peripheral, for example, peripherally inserted central catheter (PICC) lines or central. These devices may be tunneled, non-tunneled, or implanted. Central Venous Device/Line: Any infusion device whose distal end is placed in the central venous system. A glossary is also provided defining terms used in the chart.įor additional information, including a document on the practice of IV therapy by LPNs in Acute Care Settings, please contact the State Board for Nursing by mail: New York State Education Building - Office of the Professions, 89 Washington Ave., Board for Nursing Office, Second Floor, West Wing, Albany, NY 12234, phone: 51, extension 120, or e-mail: of Terms Venous Access Device/Line: Any centrally or peripherally inserted venous infusion device/line. The chart also includes advanced technical procedures that require assessment and critical analysis skills that are beyond the scope of practice of LPNs and that cannot be performed by an LPN regardless of the degree of education, experience or supervision. The accompanying chart displays select tasks that can be performed by an LPN practicing in long term care settings, under appropriate supervision, who has demonstrated competency in intravenous therapy administration. It is appropriate for IV competency evaluation to be included in the annual performance review of each licensee. The RN must document, at least every shift, assessment of the patient's condition relative to the intravenous therapy.įacilities must ensure that LPNs permitted to perform intravenous therapy procedures have satisfactorily completed an initial training program, received supervised clinical experiences, demonstrated competence in the performance of intravenous therapy, are appropriately supervised by RNs and complete an annual IV therapy update. In the opinion of the State Board for Nursing, the practice of intravenous therapy by LPNs in long term care settings requires RN supervision, which must be on-site at all times that IV therapy is being provided by the LPN (long term care facilities must follow acute care guidelines on sub-acute units). Education Law does not permit LPNs to make any patient assessments (interpret or evaluate clinical data). Regardless of the degree of delegation, however, the RN retains the ultimate responsibility for the administration and clinical management of intravenous therapy, including assessment of the patient for symptoms and reactions. The delegation of these activities is based on the RN's professional judgement, the competence of the LPN, policy and procedures of the institution and standards of nursing practice. A Registered Professional Nurse (RN) may delegate select activities associated with the administration of intravenous therapy to an appropriately competent LPN. The role of the LPN in providing intravenous therapy is determined by a number of factors including the complexity of the procedure, the degree of direction, the setting, as well as the skill and competence of the licensee. In response to numerous inquiries concerning the role of the licensed practical nurse (LPN) in the administration of intravenous therapy in long term care settings, the New York State Board for Nursing provides the following clarifying document.
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