LPN 8 Hour Didactic IV Education

Transcription

1 LPN 8 Hour Didactic IV Education Nurse Practice Act and Regulations By Pamela Truscott, MSN, Nurse Educator, RN Provision of Nursing Care 172 NAC B - LPNs contribute to assessment of health status of patients Collect basic objective and subjective data from: Observations, examinations, interviews, and written records Record and report data collected Assist with validating, refining, and modifying data through utilization of available resources

2 Provision of Nursing Care Cont B Contributes to establishing nursing diagnoses Identify signs and symptoms of deviation from normal health status Identify learning needs Provision of Nursing Care Cont B Participate in development of the plan of care Recognition of cultural, ethnic and spiritual needs, as well as beliefs and rights to choice Provide data Contribute to identifying priorities and setting goals/outcomes and community resources Assist in identification of measures to maintain comfort, support functions, and maintain environment conducive to well being and learning needs

3 Provision of Nursing Care Cont B Participates in the assisting and giving of care by: Providing care when patients are stabilized and/or predictable Under direct supervision of RN, assisting with care for patient who is not stable/predictable Implementing nursing care according to priority needs and plan of care Implementing diagnostic or therapeutic regimens of licensed practitioners Directing/assigning nursing interventions Providing environment conducive to safety and health Documenting nursing interventions and client/patient responses to care Communicating interventions/responses to care to the health care team Provision of Nursing Care Cont B Contributes to evaluation of responses to nursing interventions Evaluation data must be documented and communicated to health care team Contribute to modification of plan of care based upon the evaluation

4 Standards for Direction RNs and licensed practitioners provide direction to LPNs Method and degree of direction vary based upon patient Condition Interventions Qualifications Competency Standards For LPNs to Receive Direction Direction must sufficiently instruct/guide LPNS to meet patient needs Direction may include identification of specific assessment data to be collected Direction may include identification of specific interventions Direction must include provision of supervision to LPNs

5 Standards For LPNs to Receive Direction Cont. LPNS must: Practice nursing only under circumstances in which direction is provided Exercise competence in provide interventions Initiate consultation according to observe s/s of deviations from normal Provide interventions according to direction Methods and Circumstances by which LPNs Receive Direction Indirect supervision provided through protocols Indirect supervision provided through periodic inspection and evaluation in combination with plans of care Direct supervision in combination with plans of care

6 Standards For Assignment Assignments of nursing interventions are made by licensed nurses to others who are authorized to provide nursing care Standards for LPNs Accepting Assignments Must accept only assignments authorized by level of nursing license Must accept only assignments that meet knowledge, skill and ability level Must acknowledge limitations in knowledge and skill and communicate need for specialized instruction Must give sufficient notice of intent to refuse assignment

7 Practice of LPNs: 172 NAC 102 Scope - regulations govern the participation of LPNs in the administration of intravenous therapy Administration of IV therapy is responsibility of RN as prescribed by licensed practitioner LPN may perform limited IV therapy interventions under direction of RN or licensed practitioner LPNs may not be used as a substitute for RN or licensed practitioner but may be used to complement them LPN may only provide IV interventions when there is a licensed practitioner or RN assessing patient at least once every 24 hours or more frequently Authority provided by Nebraska statute Acceptable Activities in IV Therapy LPN may perform all activities described in 172 NAC May perform certain activities while under direct supervision and/or direction of RN or licensed practitioner for adult patients May perform limited activities when under direction of RN or licensed practitioner for pediatric patient May administer approved medications

8 LPN Under Direct Supervision for Adult Patient Infuse IV fluids and administer meds to continuous flow central line Intermittent central line infusion or administration is not permitted Perform initial venipuncture in hand, forearm, antecubital fossa, and/or upper arm Device must be 3 inches in length or less Administer initial dose of approved medication Must be by approved method Add dextrose 10% as meal replacement LPN Under Direction for Adult Patient Perform venipuncture in hand, forearm, antecubital fossa, and/or upper arm Device must be 3 inches in length or less Calculate and adjust rate of flow Administer approved medications (see 172 NAC ) Administration of pain meds through patient-controlled administration pump, cassette/syringe must be commercially prepared or prepared by pharmacist, physician or RN Reinsert, convert, flush peripheral intermittent infusion devices

9 LPN Under Direction for Pediatric Patient Administer pain meds through patient-controlled administration pump Medication must be commercially-prepared or prepared by pharmacist, physician or RN Flush peripheral intermittent infusion device Consideration for Approved Medications: NAC A Adverse consequences How adverse consequences are manifested How adverse consequences are measured What intervention is required How intervention is applied

10 Not Approved Medications Blood and blood products Antineoplastic agents Oxytocics Anti-arrhythmics Hyperalimentation Reference Nebraska Health and Human Services Regulation and Licensure Professional and Occupational Licensure. Title 172. Provision of Nursing Care. Chapter 99. Nebraska Health and Human Services Regulation and Licensure Professional and Occupational Licensure. Title 172. Practice of Licensed Practical Nurses Certified. Chapter 102.

11 Contact Information Nebraska Health Care Association Licensed Practical Nurse Association of Nebraska 1200 Libra Drive, Suite 100 Lincoln, NE