Re: Can LPN do PICC meds in Iowa
Iowa RN's and LPN s should be aware of practice acts
Chapter 6 NURSING PRACTICE FOR REGISTERED NURSES/LICENSED PRACTICAL NURSES
655.6.1 Definitions.
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655.6.2 Minimum standards of nursing practice for registered nurses.
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655.6.3 Minimum standards of practice for licensed practical nurses.
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655.6.4 Additional acts which may be performed by registered nurses.
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655.6.5 Additional acts which may be performed by licensed practical nurses.
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655.6.6 Specific nursing practice for licensed practical nurses.
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655.6.7 Specific nursing practice for registered nurses.
View http://www.legis.state.ia.us/aspx/AC...009&agency=655
IAC Ch 6, p.1
655—6.3(152) Minimum standards of practice for licensed practical nurses.
6.3(1)
The licensed practical nurse shall recognize and understand the legal implications within the scope of nursing practice. The licensed practical nurse shall perform services in the provision of supportive or restorative care under the supervision of a registered nurse or physician as defined in the Iowa Code.
6.3(2)
The licensed practical nurse shall participate in the nursing process, consistent with acceptedand prevailing practice, by assisting the registered nurse or physician. The licensed practical nurse may
assist the registered nurse in monitoring, observing and reporting reactions to therapy.
6.3(3)
The licensed practical nurse shall not perform any activity requiring the knowledge and skill
ascribed to the registered nurse, including:
a. The initiation of or assessment related to procedures/therapies requiring the knowledge or skill
level ascribed to the registered nurse.
b. The initiation of intravenous solutions, intravenous medications and blood components.
c. The administration of medicated intravenous solutions, intravenous medications and blood
components.
d. The initiation or administration of medications requiring the knowledge or skill level currently
ascribed to the registered nurse.
6.3(4)
A licensed practical nurse, under the supervision of a registered nurse, may engage in
the limited scope of practice of intravenous therapy. In providing the limited scope of therapy, the
licensed practical nurse may add intravenous solutions without medications to established peripheral
intravenous sites, regulate the rate of nonmedicated intravenous solutions, administer maintenance
doses of analgesics via the patient-controlled analgesic pump set at a lock-out interval, and discontinue
intravenous therapy. Nursing tasks which may be delegated in a certified end-stage renal dialysis unit
by the registered nurse to the licensed practical nurse with documented training include:
a.
Initiation and discontinuation of the hemodialysis treatment utilizing an established vascular
access.
b.
The administration of local anesthetic prior to cannulation of the vascular access site.
c.
Administration of prescribed dosages of heparin solution or saline solution utilized in the
initiation and discontinuation of hemodialysis.
d.
The administration via the extracorporeal circuit of the routine intravenous medications
erythropoietin, Vitamin D Analog and iron, excluding any iron preparation that requires a test dose in
a certified end-stage renal dialysis setting, after the registered nurse has administered the first dose.
When the registered nurse delegates the administration of the intravenous medications set out in this
paragraph, there must be a written facility policy that defines the practice and written verification of the
competency of the licensed practical nurse in accordance with the facility’s written policy.
6.3(5)
The licensed practical nurse may provide nursing care in an acute care setting. When the
nursing care provided by the licensed practical nurse in an acute care setting requires the knowledge and
skill level currently ascribed to the registered nurse, a registered nurse or physician must be present in
the proximate area. Acute care settings requiring the knowledge and skill ascribed to the registered nurse
include, but are not limited to:
a.
Units where care of the unstable, critically ill, or critically injured individual is provided.
b.
General medical-surgical units.
c.
Emergency departments.
d.
Operating rooms. (A licensed practical nurse may assist with circulating duties when supervised
by a registered nurse circulating in the same room.)
e.
Postanesthesia recovery units.
f.
Labor and delivery/birthing units.
h.
Mental health units.
6.3(6)
The licensed practical nurse may provide nursing care in a non-acute care setting. When the
nursing care provided by the licensed practical nurse in a non-acute care setting requires the knowledge
and skill level currently ascribed to the registered nurse, the registered nurse or physician must be present
Ch 6, p.2 IAC
in the proximate area. The non-acute care settings requiring the knowledge and skill level ascribed to
the registered nurse include, but are not limited to:
a.
Community health. (Subrules 6.6(1) and 6.6(4) are exceptions to the “proximate area”
requirement.)
b.
School nursing. (Subrules 6.6(2) and 6.6(3) are exceptions to the “proximate area”
requirement.)
c.
Correctional facilities.
e.
Community mental health nursing.
6.3(7)
The licensed practical nurse shall conduct nursing practice by respecting the rights of an
individual or group.
6.3(8)
The licensed practical nurse shall conduct nursing practice by respecting the confidentiality
of an individual or group, unless obligated to disclose under proper authorization or legal compulsion.
6.3(9)
The licensed practical nurse shall recognize and understand the legal implications of
accountability. Accountability includes but need not be limited to the following:
a.
Performing those activities and functions which require the knowledge and skill level currently
ascribed to the licensed practical nurse and seeking assistance when activities and functions are beyond
the licensee’s scope of preparation.
b.
Accepting responsibility for performing assigned and delegated functions and informing the
registered nurse when assigned and delegated functions are not executed.
c.
Executing the medical regimen prescribed by a physician. In executing the medical regimen as
prescribed by the physician, the licensed practical nurse shall exercise prudent judgment in accordance
with minimum standards of nursing practice as defined in these rules. If the medical regimen
prescribed by the physician is not carried out based on the licensed practical nurse’s prudent judgment,
accountability shall include but need not be limited to the following:
(1) Timely notification of the physician who prescribed the medical regimen that said order(s) was
not executed and reason(s) for same.
(2) Documentation on the medical record that the physician was notified and reason(s) for not
executing the order(s).
d.
Wearing identification which clearly identifies the nurse as a licensed practical nurse when
providing direct patient care unless wearing identification creates a safety or health risk for either the
nurse or the patient.
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