Iowa Admin. Code r. 655-6.5 - Additional acts which may be performed by licensed practical nurses
(1) A licensed
practical nurse shall be permitted to supervise unlicensed assistive personnel
under the provisions of Iowa Code section
152.1(5)
"b."
a. Supervision , among
other things, includes any or all of the following:
(1) Direct observation of a function or
activity.
(2) Delegation of nursing
tasks while retaining accountability.
(3) Determination that nursing care being
provided is adequate and delivered appropriately.
b. Supervision shall be in accordance with
the following:
(1) A licensed practical nurse
working under the supervision of a registered nurse shall be permitted to
supervise in an intermediate care facility for persons with an intellectual
disability or in a residential health care setting.
(2) A licensed practical nurse working under
the supervision of a registered nurse may direct the activities of other
licensed practical nurses and unlicensed assistive personnel in an acute care
setting in giving care to individuals assigned to the licensed practical nurse.
The registered nurse must be in the proximate area .
(3) A licensed practical nurse working under
the supervision of a registered nurse may supervise in a nursing facility if
the licensed practical nurse completes the National Healthcare Institute's
Supervisory Course for Iowa's Licensed Practical Nurses within 90 days of
employment in a supervisory role. Documentation of the completion of the course
shall be maintained by the licensed practical nurse. A licensed practical nurse
shall be entitled to supervise without completing the course if the licensed
practical nurse was performing in a supervisory role on or before October 6,
1982. A licensed practical nurse who is currently enrolled as a full-time
student in a registered nurse program and is scheduled to graduate within one
year is not required to complete the course. If the licensed practical nurse
does not obtain a registered nurse license within one year, the licensed
practical nurse must take the course to continue supervisory duties.
(2) A licensed
practical nurse shall be permitted to practice as a diagnostic radiographer
while under the supervision of a licensed practitioner provided that
appropriate training standards for use of radiation-emitting equipment are met
as outlined in
641-42.1 (136C).
(3) A licensed practical
nurse shall be permitted to perform, in addition to the functions set forth in
subrule 6.3(4), procedures related to the expanded scope of practice of
intravenous therapy upon completion of the board -approved expanded intravenous
therapy certification course .
(4)
To be eligible to enroll in the course, the licensed practical nurse shall:
a. Hold a current unrestricted Iowa license
or an unrestricted license in another state recognized for licensure in this
state pursuant to the nurse licensure compact contained in Iowa Code chapter
152E.
b. Have documentation of 1040
hours of practice as a licensed practical nurse.
c. Be practicing in a licensed hospital, a
nursing facility or a certified end-stage renal dialysis unit whose policies
allow the licensed practical nurse to perform procedures related to the
expanded scope of practice of intravenous therapy.
(5) The course must be offered by an approved
Iowa board of nursing provider of nursing continuing education. Documentation
of course completion shall be maintained by the licensed practical nurse and
employer.
(6) The board -approved
course shall incorporate the responsibilities of the licensed practical nurse
when providing intravenous therapy via a peripheral intravenous catheter , a
midline catheter and a peripherally inserted central catheter (PICC) to
children, adults and elderly adults. When providing intravenous therapy, the
LPN shall be under the supervision of a registered nurse. Procedures which may
be performed if delegated by the registered nurse are as follows:
a. Initiation of a peripheral intravenous
catheter for continuous or intermittent therapy using a catheter not to exceed
three inches in length.
b.
Administration, via a peripheral intravenous catheter , midline catheter , and a
PICC line, of premixed electrolyte solutions or premixed vitamin solutions. The
first dose shall be administered by the registered nurse. The solutions must be
prepackaged by the manufacturer or premixed and labeled by a registered
pharmacist or registered nurse.
c.
Administration, via a peripheral intravenous catheter , midline catheter , and a
PICC line, of solutions containing potassium chloride that do not exceed 40 meq
per liter and that do not exceed a dose of 10 meq per hour. The first dose
shall be administered by the registered nurse. The solutions must be
prepackaged by the manufacturer or premixed and labeled by a registered
pharmacist or registered nurse.
d.
Administration, via a peripheral intravenous catheter , midline catheter , and a
PICC line, of intravenous antibiotic solutions prepackaged by the manufacturer
or premixed and labeled by a registered pharmacist or registered nurse. The
first dose shall be administered by the registered nurse.
e. Maintenance of the patency of a peripheral
intravenous catheter , midline catheter , and a PICC line with a prefilled
heparin or saline syringe flush, prepackaged by the manufacturer or premixed by
a registered pharmacist or registered nurse.
f. Changing the dressing of a midline
catheter and a PICC line per sterile technique.
(7) Procedures which shall not be delegated
by the registered nurse to the licensed practical nurse are as follows:
a. Initiation and discontinuation of a
midline catheter or a peripherally inserted central catheter (PICC).
b. Administration of medication by bolus or
IV push except maintenance doses of analgesics via a patient-controlled
analgesia pump set at a lock-out interval.
c. Administration of blood and blood
products, vasodilators, vasopressors, oxytoxics, chemotherapy, colloid therapy,
total parenteral nutrition, anticoagulants, antiarrhythmics, thrombolytics, and
solutions with a total osmolality of 600 or greater.
d. Provision of intravenous therapy to a
client under the age of 12 or any client weighing less than 80 pounds, with the
exception of those activities authorized in the limited scope of practice found
in subrule 6.3(4).
e. Provision of
intravenous therapy in any other setting except a licensed hospital, a nursing
facility and a certified end-stage renal dialysis unit, with the exception of
those activities authorized in the limited scope of practice found in subrule
6.3(4).
This rule is intended to implement Iowa Code chapters 136C and 152.
Notes
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