Haw. Code R. § 16-88-59 - Standards to administer parenteral therapy

(a) To protect the general public, every licensee authorized to administer parenteral therapy in the licensee's practice shall make a good faith effort to comply with the standards set forth in this section. These standards are designed to be a systematic process to improve professional performance, a measurable tool for implementation and disciplinary action, and a statement of level of practice for the best outcome in patient care. Standard of practice guidelines for parenteral therapy are not intended to replace professional clinical judgment in individual cases, but rather to establish patient care parameters for safe and effective patient care.

(b) Standards of care summary:

(1) General and intravenous specific history and physical examination;

(2) Appropriate laboratory evaluations;

(3) Referrals: assessment of referral from other provider and necessity for potential referral from your facility;

(4) Prevention and intervention: assessment of need for prevention of adverse events specific to the patient's history and condition and intervention in the plan to address these assessments;

(5) Follow up evaluation: evaluate the patient at the end of treatment and on discharge;

(6) Stated assessment on weekly, monthly, quarterly, or yearly basis: the original plan should have treatment goals and intervals for follow up assessment;

(7) Therapeutic options: address other options (additional to the original plan) as the need arises;

(8) Self management education: assure that patient follow-up instruction is given and patient care at home is addressed; and

(9) Note appropriate details of treatment in a patient's record.

(c) A written intravenous order shall include the following information:

(1) Patient: name and date;

(2) Type of carrier solution and amount;

(3) Type and amount of medication added to the carrier solution;

(4) Rate of infusion;

(5) Route solution is given (e.g., intravenous, intramuscular, etc.); and

(6) Type of access device used: catheter, butterfly, or central venous access device.

(d) The following procedure is required prior to providing initial or new intravenous therapy to patients:

(1) The written order for intravenous therapy shall be issued by a licensed naturopathic physician who is authorized to administer parenteral therapy;

(2) Each patient shall read and sign an informed consent form for intravenous therapy;

(3) For patients that have been referred to the clinic by another physician for intravenous therapy, ensure that the desired intravenous treatment is clearly described and that any questions or concerns are addressed with the referring physician prior to the patient visit;

(4) Review patient history;

(5) Perform the required physical examination and vital signs;

(6) Evaluate other considerations relative to intravenous therapy from the intake form;

(7) Perform appropriate laboratory tests;

(8) Compliance with the professional standards of the Centers for Disease Control and Prevention and Occupational Safety and Health Administration for the prevention of contamination and infection control;

(9) Utilize sterile and hygienic techniques at all times during the procedure, from preparation of the intravenous solution to cleansing the injection site and attention to maintaining the sterile field throughout the procedure; and

(10) Document a Procedure/Alternatives/Risks/Questions (PARQ) communication with the patient during the first consultation regarding intravenous therapy:

(A) Procedure: explain the procedure;

(B) Alternatives: inform the patient about alternatives to the procedure;

(C) Risks: assess and address the risks involved; and

(D) Questions: answer the patient's questions and concerns.

Notes

Haw. Code R. § 16-88-59

[Eff and comp 2/14/11; comp 4/13/12] (Auth: HRS § 455-6) (Imp: HRS §§ 455-6, 455-11)