LPN starting IVs?

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Specializes in Critical Care.

Hey everyone, I heard that LPNs can't begin/push/finish IV treatments. I tried to look up info for the state of TN and it didn't help with my question.

So if they can't do IVs... would they be able to if they had an IV certification? I heard you get paid a bit more if you are certified.

Thanks ?

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Hey everyone, I heard that LPNs can't begin/push/finish IV treatments. I tried to look up info for the state of TN and it didn't help with my question.

So if they can't do IVs... would they be able to if they had an IV certification? I heard you get paid a bit more if you are certified.

Thanks :)

My best friend is a LPN in TN i'll ask her and be back

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Specializes in Critical Care.

Thanks :)

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Specializes in Complex pedi to LTC/SA & now a manager.

Depends on the state. Some states IV certified LPNs can start IVs and run fluids and piggy back medications, but not push any meds other than a heparin or saline flush. In some states, an LPN may not be able to initiate a blood transfusion without direct supervision of an RN. This is defined by individual state BoN and nurse practice act.

In the next state, the scope of practice may be wider and an LPN with IV certification can push certain IV drugs and initiate blood transfusions as per facility policy.

Best bet is to contact the state board of nursing for information.

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Contact the Board of Nursing Directly. Here in Iowa our BON has the Scope of Practice posted and it is out of the scope of practice for an LPN to Start an IV, Administer Medications via IV. We are able to change the dressings, clear fluid bags, and d/c iv's. There is an advanced scope certification course for LPNs to be able to do IV Therapy. So contact the BON and see what you can and can not do so you don't hear it from them later when they threaten your licence.

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Specializes in Critical Care.

@Arronlpn Thank you! :D

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Direct text message from her:

'In TN They can start IVs as long as the main med is a vitamin, mineral, nutrient, or piggy back meds so long as the 45% or less is not a narcotic. Like an antibiotic with potassium or something. My wording could be a lot better'

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

The LVN scope of practice in Texas is wide open and basically allows LVNs to perform whatever skills the facility permits them to do.

I was flushing and maintaining peripheral IV lines, PICCs, and other types of central lines during my four years as an LVN in Texas (2006 to 2010). The LVNs at my current place of employment start IVs, maintain them, flush them, perform PICC and central line dressing changes, and give meds through them. Contrary to popular beliefs, LVNs at my workplace give meds via IV push and IV piggyback, and they also monitor blood transfusions.

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Specializes in Complex pedi to LTC/SA & now a manager.

Since the OP apparently is a nurse in TN, from the TN BoN: http://www.state.tn.us/sos/rules/1000/1000-02.20111103.pdf

1000-02-.15 SCOPE OF PRACTICE.

(1) Intravenous (IV) Push Medications - The administration of intravenous push medications refers to medications administered from a syringe directly into an ongoing intravenous infusion or into a saline or heparin lock. Intravenous push does not include saline or heparin flushes.

(a) Licensed Practical Nurses may deliver selected intravenous push medications when prescribed by a licensed health care professional who has legal authority to prescribe such medications, and when under the supervision of a licensed physician, dentist or registered nurse pursuant to T.C.A. 63-7-108, provided:

1. the Licensed Practical Nurse has a minimum of six (6) months experience as a licensed nurse; and

2.. the Licensed Practical Nurse has successfully completeda course of study

developed from the Infusion Nurse Society Standards; or

3. has successfully completed a formal (institutional/agency-based) intravenous therapy training and competency program prior to January 1, 2007; and

4. the Licensed Practical Nurse practices under the supervision (defined as“overseeing with authority”) of a licensed physician, dentist, or registered nursepursuant to T.C.A. 63-7-108. The supervisor shall maintain accountability for the delegation while the Licensed Practical Nurse is accountable for his/her acts; and

5. the Licensed Practical Nurse administers IV push medications in peripheral lines

only; and

6. Competency is demonstrated to the chief nursing officer or the chief nursing officer’s representative when the Licensed Practical Nurse is employed by a facility required to be licensed pursuant to T.C.A. 68-11-204, or competency is demonstrated to the supervising physician or dentist when the Licensed Practical Nurse is not employed by a facility required to be licensed pursuant to T.C.A. 68-11-204; and

7. Documentation of competence is maintained in the Licensed Practical Nurse’s personnel file, signed and attested to by the facility’s chief nursing officer; and

8. the Licensed Practical Nurse administers IV push medications only to adults weighing over eighty (80) pounds.

(b) Licensed Practical Nurses shall not administer IV push medications to pediatric or prenatal and ante partum obstetrical patients.

© Licensed Practical Nurses shall not administer the following fluids/medication/agents or drug classifications in the context of intravenous therapy:

1. Chemotherapy; and

2. Serums; and

3. Oxytocics;
and

4. Tocolytics; and

5. Thrombolytics; and

6. Blood or blood products; and

7. Titrated medications and dosages calculated and adjusted by the nurse based onpatient assessment and/or interpretationof lab values and requiring the nurse’s professional judgment; and

8. Moderate sedation; and

9. Anesthetics; and

10. Paralytics; and

11. Investigative or experimental drugs

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Be sure that you also check with your facility policy on LPN's scope in the facility. Your TN scope is clear, however, the facility may not be willing to allow you to work to that scope. Just be sure that you know what your scope is per facility.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

This document may help as well......http://www.centerfornursing.org/research/assessment_lpn_intravenous_practice_tn.pdf

Google is your friend

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Be sure that you also check with your facility policy on LPN's scope in the facility. Your TN scope is clear, however, the facility may not be willing to allow you to work to that scope. Just be sure that you know what your scope is per facility.

Good point. It's been my experience that facilities tend to restrict LPN practice even more than the state scope of practice.

For example, my state is fairly open re: IV's. The BON says I can maintain an IV, give meds by piggyback and give some meds by IV push. But my facility chooses to just restrict us from IV's altogether. Not only can't I give meds via IV, we're not allowed to even flush a peripheral IV. I'm supposed to get a RN for anything concerning IV therapy.

I think the "LPNs can do this, but not this" nature of our scope of practice accounts for this. It's hard for management to keep track an enforce exactly what we can and can't do. So its easier and safer in their eyes to simply make it a "RN only" function.

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