PA scope of practice for LPN. IV pushes?

Nurses LPN/LVN

Updated:   Published

Specializes in LTC, peds, rehab, psych.

I had a question about LPNs doing IV pushes in Pennsylvania. As far as my understanding goes, and from what I've read under the PAcode for LPNs, that we are not allowed to do IV pushes.

My sister is in an ADN program right now, and has told me that one of the facilities that she does clinicals at does allow their LPNs to do IV pushes, and it was explained to her that the reason that they are allowed is due to special training. I've never heard of this before. When she told me that, I wondered if a law had changed, as they often do. I remember when I first became an LPN that we weren't allowed to take verbal orders from a doctor over the phone. That changed, and I thought maybe this had to, but I can't find any information on it.

Is there special training that legally allows an LPN to do IV pushes in PA?

I did IV pushes as an LPN student during clinicals. I live in Georgia, our rules may be different.

Specializes in LTC,Hospice/palliative care,acute care.

" The LPN is not authorized to administer the following intravenous fluids:

(A) Antineoplastic agents.

(B) Blood and blood products.

© Total parenteral nutrition. (D) Titrated medications and intravenous push medications other than heparin flush. "

That is directly from the Pa BON website-check it out and read about verbal orders. 049 Pa. Code 21.145. Functions of the LPN. Your sister may have misunderstood-the staff at her clinical site might be hanging anitbiotics and flushing the lines per their protocol. But I have seen plenty of facilities put their own spin on the regs-anything to hire less RN's and save more money.

LPNs do IV therapy including IV pushes in Tennessee as long as they are certified(some won't take the optional class i don't know why). If you are certified you start doing them in clinicals. Every facility has there own rules as to if there are certain drugs LPNs can't push, usually diltiazem. Yes we start IVs and maintain them here in TN. In fact, most of the IVs in the last hospital I worked at were started by the LPNs it was part of their job. Not to say the RNs wouldn't start them it was just left to the LPNs while the RN was doing assesments etc.

" The LPN is not authorized to administer the following intravenous fluids:

(A) Antineoplastic agents.

(B) Blood and blood products.

© Total parenteral nutrition. (D) Titrated medications and intravenous push medications other than heparin flush. "

That is directly from the Pa BON website-check it out and read about verbal orders. 049 Pa. Code *21.145.*Functions of the LPN. Your sister may have misunderstood-the staff at her clinical site might be hanging anitbiotics and flushing the lines per their protocol. But I have seen plenty of facilities put their own spin on the regs-anything to hire less RN's and save more money.

ktw's answer is the only one that matters, what LPNs in other states say they can do is irrelevant.

Specializes in LTC & Private Duty Pediatrics.

All:

Apparently Pennsylvania changed their scope of practice for LPNs, who are now

allowed to administer, initiate, and stop parenteral nutrition (TPN).

I am not sure when the law changed in Pennsylvania, but here is a link to the BON

website.

Please scroll down to Item 12 on the bottom of the page.

Again, this discussion pertains to PENNSYLVANIA LPN's only.

049 Pa. Code § 21.145. Functions of the LPN.

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(g) An LPN who has met the education and training requirements of § 21.145b (relating to IV therapy curriculum requirements) may perform the following IV therapy functions, except as limited under § 21.145a and only under supervision as required under subsection (f):

(1) Adjustment of the flow rate on IV infusions.

(2) Observation and reporting of subjective and objective signs of adverse reactions to any IV administration and initiation of appropriate interventions.

(3) Administration of IV fluids and medications.

(4) Observation of the IV insertion site and performance of insertion site care.

(5) Performance of maintenance. Maintenance includes dressing changes, IV tubing changes, and saline or heparin flushes.

(6) Discontinuance of a medication or fluid infusion, including infusion devices.

(7) Conversion of a continuous infusion to an intermittent infusion.

(8) Insertion or removal of a peripheral short catheter.

(9) Maintenance, monitoring and discontinuance of blood, blood components and plasma volume expanders.

(10) Administration of solutions to maintain patency of an IV access device via direct push or bolus route.

(11) Maintenance and discontinuance of IV medications and fluids given via a patient-controlled administration system.

(12) Administration, maintenance and discontinuance of parenteral nutrition and fat emulsion solutions.

(13) Collection of blood specimens from an IV access device.

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