Scope of Practice for Starting IV's

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    I am wondering exactly who can start an IV line. I know an RN and MD can. Specifically, can a phlebotomist, nursing assistant, LPN, or lab tech? Also, in an ambulatory surgery center setting, can anyone other than an RN do patient assessment or teaching? Thanks!!
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  4. 0
    i have never been able to find info like that. ive seen medical assistants giving TB tests before and it really made me wonder
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    I'm assuming you're strictly talking about starting the line and not asking about specific IV meds/fluids/blood products/etc.

    LPN can start a line, but is technically supposed to be certified by their facility or via a state-sponsored IV therapy program (some Tennessee Technology Centers host these).

    In some cases, an ED tech/ER tech can start a line (depends on facility policy), but I believe they have to be an EMT-IV and not a CNA/MA/etc to do this.

    Phlebotomist/MLT/CNA/MA can not legally start an IV, despite the phleb's/MLT's comprehensive training in vampirism.

    In order to start an IV line, you should be within your scope of practice to administer IV medication (even if it's just normal saline). Phleb/MLT/CNA/MA are not licensed/certified to administer IV medication.
    tsalagicara likes this.
  6. 1
    Quote from DonaldJ
    In order to start an IV line, you should be within your scope of practice to administer IV medication (even if it's just normal saline). Phleb/MLT/CNA/MA are not licensed/certified to administer IV medication.

    Medical assistants can and do start lines in TN based on the practice setting.
    sethmctenn likes this.
  7. 1
    Quote from meandragonbrett
    Medical assistants can and do start lines in TN based on the practice setting.
    I would be interested in reading the Tennessee Code that allows this. According to the AAMA, CMA's do not prepare or administer IV medication.
    tsalagicara likes this.
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    We have been taught that only RN's can do any kind of assesment and/or teaching!
    bbarnhill likes this.
  9. 1
    Quote from ~FutureNurse~
    We have been taught that only RN's can do any kind of assesment and/or teaching!
    LPNs CAN and do assess in the state of TN. RNs must complete the initial health assessment on admission but LPNs are able to collect and document data.
    tsalagicara likes this.
  10. 0
    Quote from meandragonbrett
    LPNs CAN and do assess in the state of TN. RNs must complete the initial health assessment on admission but LPNs are able to collect and document data.
    There is a huge difference in collecting data and assessment. CNAs can collect data (temp, BP ... on non-complex patients in TN) but they are NOT allowed to assess because that is part of the nursing process. (Assessment, Diagnose, Plan, Intervene, Evaluate). You may not delegate any part of the nursing process either.
  11. 0
    It seems like you have knowledge of this stuff. I have witnessed first hand an MA in the state of TN administering IV meds for conscious sedation. As well as starting an IV and she is not certified to do so. So my question is how do I report it or who rather do I report it to? I have called the board of nursing and they humm hawed around and sent me a form that is patient specific and I would rather keep the patient out of this but I feel it needs addressed.
    Not sure how to handle it.
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    You can report it to your nurse manager and if nothing gets done and it continues report it up your chain of command till someone takes action. Document your contacts with the other people though so you don't get in trouble for circumventing the chain of command. When they find out their middle management didn't take charge and step up in these unsafe practice situations, they will and SHOULD be reprimanded. I'm a little harsh but Id fire anyone that didn't take action. That is pt safety at stake and I will not trust anyone that compromises (knowingly) pt safety. If I couldn't trust them with my pts then they need to leave the facility.

    This is probably why I would never make a good CNO as I would not have a three strike rule. Depending on the knowledge of the actions happening I would have a 1 strike and you are out policy. NEVER compromise when it comes to your pts. They are more important than anything else. Its your job as an RN to fight and stand up for them. They are too sick to do so.


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