LPN's and Broviac/PICC lines

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    I'm an RN at a long term skilled pediatric facility. We get a good deal of patients with broviac lines. Some of the LPN's who are IV certified feel they are able to care for the broviac line. While I don't doubt their skill or knowledge I wonder if it is within the scope of practice for an LPN to put anything through a broviac, or even to change a broviac dressing. Any one have any feelings or information regarding this issue? Is it totally up to policy and procedure of the facility?

    I see it as LPNs cannot do IV pushes (generally, correct?) for peripheral lines how in the world can they licensed to push on broviac lines?

    I am not intending to insult the role of LPNs, I'm curious as to the the stance within their license.

    Thank you to anyone who has information.
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  4. 8 Comments so far...

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    I wish I had an exact answer but I think it depends on your state practice act, I think there should be something that outlines exactly what an IV certified LPN can and cannot do with IV lines.
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    Totally depends on the state. In my state LPNs can do anything with an IV.
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    Quote from racing-mom4
    Totally depends on the state. In my state LPNs can do anything with an IV.
    You did not mention which state that you are from, but there are meds that are restricted in each and every state as far as adminstration by an LPN/LVN. Scope of practice does not cover all.

    And a broviac or PICC line are also not considered peripheral IVs so addtional statutes are in place with those as well.
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    As mentioned, it depends on your State. I am an LPN and I am allowed by my State and facility to flush central lines, change central line dressings, and hang IVFs and premixed solutions such as antibiotics. I may not administer IV push medications via central line.
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    I am having the same issue w/ a group who does infusions. The LPN's are great. I freely admit they know a great deal more about some subjects than I do. The problem, however, is that they are adjusting rates of meds through central lines and blood products. It doesn't matter what the state says about this, the facility's policy says it should not be going on. I don't want people who are trying to help when it is busy being nailed when a patient has a complication. I am not saying the complications would occur because of them. I am worried they be in the wrong place at the wrong time and then get into trouble because they are working outside of the policy.
    lindarn likes this.
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    The poster above brought up a very good point here, and one that often gets mislooked or over-looked. The state has one set of what a nurse can do, and that is whether an RN or an LPN in their policies and procesures as to what can be done.

    A facility can further restrict what they permit in their facility to be done by an RN or an LPN, and it also depends on the type of unit that you are working on. There are medications that can only be given in the ICU, and are not permitted to be given on a med-surg floor by an RN.

    You are covered for insurance by the facility that you are working at, and need to be covered by their rules. As long as they do not give you more things than the state says that you can do, they are just fine and what you need to abide by.

    What you have done at one facility, does not mean that it is the case all over the place. You need to know specifics for where you are working, as well as what your state permits. And as we keep stating, each state has a separate BON and each can set up their own rules.
    Pediatric4077 likes this.
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    As an RN, you need to be aware of the scope of practice of LPNs and CNAs that you work with.
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    Quote from Pediatric4077
    I see it as LPNs cannot do IV pushes (generally, correct?) for peripheral lines how in the world can they licensed to push on broviac lines?
    To obtain a definitive answer to your query, please place a much-needed telephone call to your state's BON (board of nursing). Different states have widely varying scopes of practice for LPNs/LVNs.

    In my state of residence (Texas), LPNs/LVNs are allowed to do IV pushes for peripheral lines and PICCs. Some states disallow LPNs to do these things. None of the members know which state you live and practice in, since you have not provided us with that important information. Therefore, we are not in a position to accurately answer your question.
    Pediatric4077 likes this.


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