Lpn- central/picc lines - page 3
OK... I knew this would happen and i need advice.. So i just started my new position and I'm in the orientation phase, which is involving IV therapy training. I'm a LPN new grad and was in class... Read More
Nov 21, '11 by Rico84Just wanted to give an update regarding LPNS using central/picc lines. I emailed the board of nursing in ohio and got a reply. "Thecommuter" venous access means peripheral or CENTRAL access, it doesn't mean through a vein only. It is not "way" out of scope of practice for a LPN in this state. This is the response.
The regulations pertaining to LPN IV therapy are located in Section 4723.17, ORC, and Chapter 4723-17, OAC. A LPN who is IV therapy certified, acting under the direction of a RN or physician, may administer any of the approved solutions listed in Section 4723.17(D)(6)(a), ORC, and Rule 4723-17-03(B)(1), OAC, through a central venous line or PICC line. A LPN may inject heparin or normal saline to flush an intermittent infusion device or heparin lock. A LPN is not prohibited from flushing a PICC line that is being used intermittently with heparin or normal saline.
a) 5% dextrose and water; (b) 5 % dextrose and lactated ringers;
(c) 5% dextrose and normal saline;
(d) Normal saline;
(e) Lactated ringers;
(f) 0.45 % sodium chloride and water; or
(g) 0.2 % sodium chloride and water; or
(2) Administer any of the solutions set forth in paragraph (B)(1) of this rule that contain vitamins or electrolytes after a registered nurse initiates the first infusion of the solution containing vitamins or electrolytes.
Nov 22, '11 by HazelLPNQuote from thecommuteractually, drawing labs off a lines and uacs was in my scope of practice as an lpn. there are a few states that allow lpns to do whatever they have been trained to do and they have few restrictions with the state bon, although the facility can restrict the practice. as far as starting an a line or drawing an abg without a line, the docs always did the former and respiratory did the latter....never an rn except for an advanced practice nurse.(nnps in the nicu were the ones you wanted to put the uac in your kid....vs the resident who might be out of practice).it means access through a vein. plain and simple.
some rns are specially trained to access arteries (radial artery, brachial artery, femoral artery, ulnar artery, etc.) for arterial blood gas draws, catheterizations, and so forth. this is arterial access, not venous access.
arterial access is way out of the lpn's scope of practice. venous access is within the lpn's scope of practice in most states.
best to you,
Nov 23, '11 by TheCommuter, BSN, RN Senior ModeratorQuote from rico84i was an lvn/lpn for four years (2006 to 2010) and accessed many piccs and central lines. these lines are located in veins, so they fall under the realm of venous access. picc lines and central lines are forms of venous access, not arterial access.just wanted to give an update regarding lpns using central/picc lines. i emailed the board of nursing in ohio and got a reply. "thecommuter" venous access means peripheral or central access, it doesn't mean through a vein only. it is not "way" out of scope of practice for a lpn in this state.
central line: a catheter (tube) that is passed through a vein to end up in the thoracic (chest) portion of the vena cavaa picc is inserted in a peripheral vein, such as the cephalic vein, basilic vein, or brachial vein and then advanced through increasingly larger veins, toward the heart until the tip rests in the distal superior vena cava or cavoatrial junction.
Nov 23, '11 by Rico84LOL.. good for you... But noone mentioned 'ARTERIAL ACCESS". So your original comment wasn't needed. I was looking for current LPNS to answer my questions.
Nov 24, '11 by TheCommuter, BSN, RN Senior ModeratorQuote from Rico84Please keep in mind that if you post something on a very public forum, you really do not have any control over picking and choosing the respondents (or the responses) to the discussions that you start. It would have also helped immensely if you had started this thread in the correct forum if you had only wanted input from current LPNs. You originally started this thread in the General Nursing forum. Therefore, half of the people who responded are RNs. The thread had to later be moved to the LPN Corner.LOL.. good for you... But noone mentioned 'ARTERIAL ACCESS". So your original comment wasn't needed. I was looking for current LPNS to answer my questions.
Not every single member is going to post replies that go exactly along with what you wish to hear. Not every single member is going to post a response that you believe is contributory or 'needed.' Thus, you always have the option of completely skipping the supposedly 'unneeded' posts or clicking on the ignore function. I wish you much success and professional development in your new job. In addition, I hope that you're successful with your second attempt at the RN program.Last edit by TheCommuter on Nov 24, '11 : Reason: added something
Nov 26, '11 by jimthorpQuote from mama_dNot all BON's are created eual. I asked the PA BON a specfic question several years ago and they refused to provide an answer.It's been my experience that generally speaking, the facility's scope of what you can do will be more limited than what the state says. However, to be sure, call or email your BON. If the Practice Act wording is vague and questionable (which does happen), email yourself a note about who you talked to, when, and the question you asked and what the answer is, just in case.
Nov 26, '11 by Rico84really!! that would be weird, to ask the BON and they refuse on you. I recently asked if LPNS could take critical labs over the phone from lab, bc for some odd reason they don't let us at this hospital. They replied so quickly and said YES..its within our scope to accept a critical and notify the physician. Some of the rules are just odd.
Nov 26, '11 by jimthorpQuote from Rico84I thought it was weird too. I even asked my state assemblyman for help. Still no answer from the PA BON.really!! that would be weird, to ask the BON and they refuse on you.
Interesting though, they have pending legislation clariying the very issue I raised but it has sat idle or two years.
Nov 27, '11 by jimthorpQuote from Rico84what kind of question do you have?
I wanted to know if LPN's could access and maintain PICC lines. I had already read the NPA and nowhere was ANY VAD mentioned but the question was brought by up by many coworkers so I decided to go to the top for an answer and was turned away citing some legal drivel why they could not advise me even though the NPA says they can.
Nov 16, '12 by StinkMomBombQuote from TheCommuterUm, you are amazing!!This is helpful to everyone. So, I'm a new grad LPN from MI and NAPNES certified, this means I can do an IV push?...don't want to get terminology wrongi hope that this helps.