Wisconsin LPN Scope of Practice

[WI_home_RN]

living in wisconsin, I work private duty without an agency. I work with a handful of rns and one lpn. our patient recently underwent surgical insertion of a port-a-cath for extended IV antibiotics. can our staff lpn adminster these IV abx or is just an RN thing? I called the state and no one has gotten back to me and I'm not finding any info on my searches. can anyone help, give advice, or point me in the right directly? thanks much!!

[mallarddudes]

living in wisconsin, i work private duty without an agency. i work with a handful of rns and one lpn. our patient recently underwent surgical insertion of a port-a-cath for extended iv antibiotics. can our staff lpn adminster these iv abx or is just an rn thing? i called the state and no one has gotten back to me and i'm not finding any info on my searches. can anyone help, give advice, or point me in the right directly? thanks much!!

position of the board of nursing on performance of iv therapy by licensed practical nurses

the board of nursing has responded to numerous inquiries regarding the role of the lpn related to iv therapy. the following information should be of assistance in determining the extent of involvement by lpns in initiating, maintaining, monitoring and discontinuing iv's in specific practice settings.

it is not within the scope of practice of the lpn in wisconsin to independently perform iv therapy. however, acts involving iv therapy may be delegated by the rn to the lpn and to other nursing assistive personnel under section n6.03(3), wis. adm. code. these acts include starting peripheral iv lines, adding medication to the intravenous fluids, monitoring of intravenous fluids which carry medication, and monitoring intravenous fluids for hydration purposes. since these acts are all within the scope of practice of the professional nurse, they may be delegated by the rn to the lpn. there must be willingness on the part of the rn to delegate and on the lpn to accept such delegated acts.

it is the opinion of the practice committee of the board of nursing that such delegated nursing acts beyond basic nursing care require direct supervision. the board of nursing has interpreted direct supervision, defined in section n6.02(6), wis. adm. code, as necessitating on-site supervision. therefore, the rn supervising the lpn in the performance of iv therapy must be physically present in the facility and immediately available.

while the board of nursing position statement on the performance of iv therapy by lpns includes monitoring of iv fluids as an act requiring direct supervision, it is not the board's intent that observation of iv infusions on controlled infusion pumps by the lpn requires direct supervision. if the rn pre-programs the iv infusion on a controlled pump and performs the client assessment, then the lpn may monitor the infusion under general supervision of the rn and report any concerns or problems with the infusion to the rn. if there is a need for a medication change, for additional medication, or for correction of a problem with the infusion, then the lpn performing these procedures must do so under direct supervision. monitoring by lpn's of iv infusions that are not pump-controlled does require direct supervision.

furthermore, the lpn must be competent to perform the delegated acts associated with iv therapy. competence is based upon appropriate education, training or experience. it is essential that there be documentation of the education, training, or experience attesting to the competence of the lpn to perform the delegated acts. in section n7.03(1)(g) wis. adm. code, the board of nursing cites as negligence, "offering or performing services as a licensed practical nurse or registered nurse for which the licensee or registrant is not qualified by education, training or experience."