IV Therapy for Medical Professionals

ADMINISTRATION OF INTRAVENOUS THERAPY BY LICENSED PRACTICAL NURSES

4B9-12.001  Assertion of Intent and Function64B9-12.002  Definitions

64B9-12.003 Points of Intravenous Remedy Exterior the Scope of Apply of the LPN 64B9-12.004 Authority for the LPN to Administer Restricted Types of Intravenous Remedy 64B9-12.005 Competency and Data Necessities Essential to Qualify the LPN to

Administer IV Remedy 64B9-12.006 Efficient Date of this Chapter64B9-12.001 Assertion of Intent and Function.

• The “follow of sensible nursing” tes,as defin contains the “administration of therapies and licensed sensible nurse “accountable and account particular person’s instructional preparation As medical science and advances experien and the calls for for well being care in Florida develop, the scope of nursing follow, typically, and of the follow of sensible nursing, specifically, is increasing. It has change into obligatory that the licensed sensible nurse, when certified by coaching and schooling and when accredited by the establishment at which the licensed sensible nurse is employed, have interaction within the restricted administration of intravenous remedy each to serve the general public and to permit the skilled nurse to raised carry out these acts requiring skilled nursing specialised data, judgment and ability.

• The aim of this rule is to guard the general public by making certain the provision of intravenoustherapy and its competent administration within the care of the in poor health, injured or the infirm. In step with the aim, this rule authorizes the certified licensed sensible nurse to manage these features of intravenous remedy inside the scope of follow of the licensed sensible nurse, enumerates these features of intravenous remedy outdoors the scope of follow of the licensed sensible nurse, and units out the tutorial and/or competency verification essential to administer, underneath course, restricted types of intravenous remedy.

Particular Authority 464.006 FS. Legislation Applied 464.003(three)(b) FS. Historical past–New 1-16-91, Previously 21O-21.001, 61F7-12.001, 59S-12.001.

• “Administration of Intravenous Remedy” is substances via the venous peripheral system, consisting of exercise which incorporates:

observing, initiating, monitoring, discontinuing, sustaining, regulating, adjusting, documenting, planning, intervening and evaluating.“Beneath the course of a registered profe skilled nurse has delegated intravenous remedy features to a professional licensed sensible nurse. The registered skilled nurse doesn’t in all cases need to be on the premises to ensure that the licensed sensible nurse to carry out the delegated features.

• “Direct supervision”   means   on   the  premises  aParticular Authority 464.006 FS. Legislation Applied 464.003(three)(b) FS. Historical past–New 1-16-91, Previously 21O-21.002, 61F7-12.002, 59S-12.002.

64B9-12.003 Points of Intravenous Remedy Exterior the Scope of Apply of the LPN.

• Points of intravenous remedy that are outdoors the scope of follow of the licensed sensible nurse until underneath the direct supervision of the registered skilled nurse or doctor and which shall not be carried out or initiated by licensed sensible nurses with out direct supervision embrace the next:

(a) Initiation of blood and blood merchandise;

(b) Initiation or administration of most cancers chemotherapy;

(c) Initiation of plasma expanders;

(d) Initiation or administration of investigational medication;

(e) Mixing IV answer;(f) IV pushes, besides heparin flushes and saline flushes.

• Though this rule limits the scope of licensed sensible nurse follow, it’s acceptable for licensed sensible nurses to take care of sufferers receiving such remedy.

Particular Authority 456.013(2), 490.004(Four) FS. Legislation Applied 456.013(2) FS. Historical past–New 1-16-91, Previously 21O-21.003, 61F7-12.003, 59S-12.003, Amended Four-9-98.

64B9-12.004 Authority for the LPN to Administer Restricted Types of Intravenous Remedy.

• Except for these features of intravenous remedy deemed outdoors the scope of follow of the licensed sensible nurse by Rule 64B9-12.003, F.A.C., above, and topic to the approval of the establishment at which the licensed sensible nurse is employed, any licensed sensible nurse who meets the competency data necessities of Rule 64B9-12.005, F.A.C., beneath, is permitted to manage intravenous remedy underneath the course of a registered skilled nurse.

• People who’ve accomplished a Board accredited prelicensure sensible nursing schooling program, skilled nursing college students who qualify as graduate sensible nurses, or licensed sensible nurses who haven’t accomplished the desired course underneath Rule 64B9-12.005, F.A.C., could have interaction in a restricted scope of intravenous remedy underneath the course of a registered nurse, doctor or dentist. This scope contains:

(a) Carry out calculation and alter stream fee;

• Observe and report subjective and goal indicators of adversarial reactions to IV administration;

• Examine insertion web site, change dressing, and take away intravenous needle or catheter from peripheral veins.

• Hanging luggage or bottles of hydrating fluid.

Particular Authority 464.006 FS. Legislation Applied 464.003(three)(b) FS. Historical past–New 1-16-91, Previously 21O-21.004, 61F7-12.004, 59S-12.004.

64B9-12.005 Competency and Data Necessities Essential to Qualify the LPN to Administer IV Remedy.

• The board endorses the Intravenous Remedy Course Tips issued by the Training Division of the Nationwide Federation of Licensed Sensible Nurses, November, 1983. The intravenous remedy schooling should include the next elements:

(a) Insurance policies and procedures of each the Nurse Apply Act and the using company in regard to intravenous remedy. This contains legalities of each the Licensed Sensible Nurse function and the administration of protected care. Ideas of charting are additionally included.

(b) Psychological preparation and assist for the affected person receiving IV remedy in addition to the suitable members of the family/ important others.

(c) Web site and performance of the peripheral veins used for veinpuncture.

(d) Process for veinpuncture, together with bodily and psychological preparation, web site choice, pores and skin preparation, palpation of veins, and assortment of kit.

(e) Relationship between intravenoushomeostaticand regulatorytherapy an features, with consideration to the scientific manifestations of fluid and electrolyte imbalance.

(f) Indicators and signs of native and systemic problems within the supply of fluids and drugs and the preventive and therapy measures for these problems.

(g) Identification of assorted kinds of gear utilized in administering intravenous remedy with content material associated to standards to be used of every and technique of troubleshooting for malfunction.

(h) Formulation used to calculate fluid and drug administration fee.

(i) Strategies of administering medication intravenously and benefits and drawbacks of every.

(j) Ideas of compatibility and incompatibility of medicine and options.

(ok) Nursing administration of the affected person receiving drug remedy, together with ideas of chemotherapy, protocols, actions, and unintended effects.

(l) Nursing administration of the affected person receiving blood and blood elements, following institutional protocol. Embrace indications and contraindications to be used; identification of adversarial reactions.

(m) Nursing administration of the affected person receiving parenteral vitamin, together with ideas of metabolism, potential problems, and bodily and psychological measures to make sure the specified therapeutic impact.

(n) Ideas of an infection management in IV remedy, together with aseptic method and prevention and therapy of iatrogenic an infection.

(o) Nursing administration of particular IV remedy procedures which might be generally used within the scientific setting, reminiscent of heparin lock, central traces, and arterial traces.

(p) Glossary of widespread terminology pertinent to IV fluid remedy.

(q) Efficiency verify record by which to judge scientific utility of information and abilities.

• Central Strains. The Board acknowledges that via acceptable schooling and coaching, a

Licensed Sensible Nurse is able to performing intravenous remedy through central traces underneath the course of a registered skilled nurse as outlined in subsection 64B9-12.002(2), F.A.C. Acceptable schooling and coaching requires a minimal of 4 (Four) hours of instruction. The requisite 4 (Four) hours of instruction could also be included as a part of the thirty (30) hours required for intravenous remedy schooling laid out in subsection (Four) of this rule. The schooling and coaching required on this subsection shall embrace, at a minimal, didactic and scientific practicum instruction within the following areas:

• Central venous anatomy and physiology;CVL web site evaluation;

• CVL dressing and cap modifications;

• CVL flushing;

• VL medicine and fluid administration;

• CVL blood drawing; and

• CVL problems and remedial measures.

Upon completion of the intravenous remedy coaching through central traces, the Licensed Sensible Nurse shall be assessed on each theoretical data and follow, in addition to scientific follow and competence. The scientific follow evaluation have to be witnesses by a Registered Nurse

who shall file a proficiency assertion relating to intravenous remedy through central traces. The proficiency assertion shall be saved within the Licensed

Sensible                      Nurse’s   personnel  file.

• Suppliers: The LPN/IV schooling have to be sponsored by a supplier of constant schooling programs accredited by the Board pursuant to Rule 64B9-5.005, F.A.C. To be certified to show any such course, the trainer have to be a at the moment licensed registered nurse in good standing on this state, have instructing expertise, and have skilled nursing expertise, together with IV remedy. The supplier will probably be liable for issuing a certificates verifying completion of the requisite variety of hours and course content material.

• Instructional Alternate options. The cognitive coaching shall embrace a number of of the next:

(a) Submit-graduate Degree Course. In recognition that the curriculum necessities mandated by subsection 64B9-2.006(three), F.A.C., for sensible nursing packages are in depth and that each licensed sensible nurse won’t administer IV Remedy, the course essential to qualify a licensed sensible nurse to manage IV remedy shall be not lower than a thirty (30) hour post-graduate degree course instructing features of IV remedy containing the elements enumerated in subsection 64B9-12.005(1), F.A.C.

(b) Credit score for Earlier Training. The persevering with schooling supplier could credit score the licensed sensible nurse for earlier IV remedy schooling on a post-graduate degree, offering every part of the course content material of subsection 64B9-12.005(1), F.A.C., is examined by and competency demonstrated to the supplier.

(c) Nontraditional Training. Persevering with schooling suppliers could choose nontraditional schooling alternate options for acquisition of cognitive content material outlined in Rule 64B9-12.005, F.A.C. Such alternate options embrace:

1. Interactive movies;

2. Self research;

3. Different nontraditional schooling that could be submitted to the Board for consideration and attainable approval. Any persevering with schooling suppliers utilizing nontraditional schooling should make provisions for demonstration of and verification of information.

• Medical Competence. The course have to be adopted by supervised scientific follow in intravenous remedy as wanted to reveal scientific competence. Verification of scientific competence shall be the duty of every establishment using a licensed sensible nurse based mostly on institutional protocol. Such verification shall be given via a signed assertion of a Florida licensed registered nurse.