Can LPN's in PA do PCA pumps?

  1. We got an admission today of a patient getting continuous dilaudid via a pca pump. There was alot of confusion about whether this was in our lpn's scope of practice. I looked up the regs (pa code interpretations section regarding medications)and I did find a section where it stated that it was in the RN's scope to monitor and administer pain meds via epidural catheter or other pain medication devices to be used as analgesia for pain control. Does anyone know if this is what they mean?
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  2. 7 Comments

  3. by   NRSKarenRN
    no, not included in practice act.

    interpretations regarding venipuncture, intravenous fluids, resuscitation and respiration—statement of policy.



    interpretations regarding the administration of drugs—statement of policy.
    (a) the following nursing practices fall within the scope of registered nursing practice under 21.11, 21.12 and 21.14 (relating to general functions; venipuncture; intravenous fluids; and administration of drugs):
    (b) the following nursing practices fall within the scope of registered nursing practice under 21.11 and 21.14:
    (5) monitoring and administering medications by epidural catheter or other pain relief devices to be used as analgesia for pain control. administration of medications as used in this paragraph does not include initiation of the medication.

    lpn's:
    3) the lpn complies with written policies and procedures which are established by a committee of nurses, physicians, pharmacists and the administration of the agency or institution employing or having jurisdiction over the lpn and which set forth standards, requirements and guidelines for the performance of venipuncture by the lpn and for the administration and withdrawal of intravenous fluids by the lpn. a current copy of the policies and procedures shall be provided to the lpn at least once every 12 months. the policies and procedures shall include standards, requirements and guidelines which:

    (i) list, identify and describe the intravenous fluids which may be administered by the lpn. the lpn is not authorized to administer the following intravenous fluids:
    (a) antineoplastic agents.
    (b) blood and blood products.
    (c) total parenteral nutrition.
    (d) titrated medications and intravenous push medications other than heparin flush.
    http://www.pacode.com/secure/data/04...bchapbtoc.html

    your interpretation is correct---only rn may perform in pa.
    Last edit by NRSKarenRN on Apr 21, '07
  4. by   withasmilelpn
    Thought so! Thankyou!
  5. by   pawashrn
    I maybe wrong but a PCA is delivered by the patient. An epidural is a continuous infusion and normally is a dilaudid based medication. So, to answer your question. If we are talking about an epidural, I would have to assume no. A LPN is not allowed to handle an IV/Narcotic medication.
  6. by   katie123
    No way!!!!
  7. by   CarVsTree
    Quote from pawashrn
    I maybe wrong but a PCA is delivered by the patient. An epidural is a continuous infusion and normally is a dilaudid based medication. So, to answer your question. If we are talking about an epidural, I would have to assume no. A LPN is not allowed to handle an IV/Narcotic medication.
    It is requested (i.e. button push) by the pt. but monitored and administered by the nurse who is accountable for control of that IV narcotic. Therefore no, LPN must be covered by RN for this pt. and RN must maintain the PCA.
    Last edit by CarVsTree on May 10, '07 : Reason: Edited to resemble english.
  8. by   shazibabe
    hiya just wondering what a lpn actually is as im from asutralia and dont understand.i know rn is registered nurse but we have pca personal care worker and en enrolled nurse as titles for nursing the pca was the old nurse assistant classification here in aust.
  9. by   CarVsTree
    Hi Shazi,

    PCA in this instance stands for patient controlled analgesia. The pt. pushes a button and the PCA pump administers the dose, if it is allowable per the RX. For example 1mg Morphine every 6 minutes for a lockout of 10mg (or 10 doses).

    We also have PCA's that are patient care assistants. CNA's, certified nursing assistants, etc.

    LPN stands for Licensed Practical Nurse. Equivalant title found in certain states within the US is Licensed Vocational Nurse. Generally, it is a program spanning a bit more than a year, but (supposedly) not as in depth (never went to LPN school so have no idea how in depth or not in depth the programs are). Also, the pre or co-requisites required are different. For instance I believe an LPN student is not required to have Anatomy & Physiology (correct me if I'm wrong LPN's).

    Anyway it is a lower level in nursing and so their scope of practice is more limited. It is this very thing that causes confusion in our system. In addition to LPN's/LVN's we have Diploma prepared RN's (hospital Program); Associate's Degree Prepared RN's ("2 year" program); and Bachelor's Prepared RN's (4 year program). And of course the graduate level Nurses which is a whole other can of worms.

    Hope this helps. If it's clear as mud than you understand it perfectly.

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