Tenn. Comp. R. & Regs. 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 completed a 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 nurse pursuant 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.

(c) 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 on patient assessment and/or interpretation of 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.

(2) Universal Precautions for the Prevention of HIV Transmission - The Board adopts, as if fully set out herein, rules 1200-14-03-.01 through 1200-14-03-.03 inclusive, of the Department of Health and as they may from time to time be amended, as its rule governing the process for implementing universal precautions for the prevention of HIV transmission for health care workers under its jurisdiction.

Notes

Tenn. Comp. R. & Regs. 1000-02-.15

Original rule filed September 21, 1994; effective December 5, 1994. Amendment filed November 22, 2000; effective February 6, 2001. Amendment filed January 18, 2006; effective April 3, 2006.

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-7-108, 63-7-109, and 63-7-207.