Current through Register Vol. 43, No. 02, November 27, 2024
(1) The registered nurse or licensed
practical nurse shall have applied knowledge of medication administration and
safety, including but not limited to:
(c) Expected
therapeutic benefit of medication.
(e) Indications based on existing patient
illness or injury processes.
(f)
Contraindications based on presence of additional known patient illnesses,
disease processes, or pre-existing conditions.
(g) Possible side effects and interventions
for same.
(h) Adverse reactions and
interventions for same.
(i)
Emergency interventions for anaphylactic reactions.
(j) Safety precautions, including but not
limited to:
(k) Interactions with other drugs, foods, or
complementary therapies.
(l)
Calculation of drug dosages.
(m)
Federal and state legal requirements related to storage of controlled
substances.
(n) Healthcare facility
policy and procedure on secure storage of all medications.
(o) Patient education specific to
medication.
(2) The
licensed nurse shall exercise decision-making skills when administering
medications, to include but not limited to:
(a) Whether medications should be
administered.
(b) Assessment of
patient's health status and complaint prior to and after administering
medications, including as needed (PRN) medications.
(c) When to contact the prescriber.
(d) Education of patient, family, and
caregiver regarding prescribed medication.
(3) The licensed nurse shall exhibit skills
when administering medications, including but not limited to:
(a) Physical ability to open medication
packaging and access delivery systems.
(b) Read, write, and comprehend
English.
(c) Read, write, and
comprehend scientific phrases relevant to administration of
medication.
(d) Measuring
medication dosages.
(f) Routes of
administration.
(g) Proper usage of
technical equipment for medication administration.
(4) Documentation of medication
administration shall comply with the principles of documentation and include
safety precautions of medication administration, controlled drug records per
federal and state law, and facility policy.
(5) Administration of medications by routes
beyond basic educational preparation, including but not limited to intrathecal,
intracavitary, and intraosseous, require a standardized procedure.
(6) The topical, intradermal, subcutaneous,
or intramuscular administration of a local anesthetic agent in a specified
amount designated by order of a licensed physician or dentist and in compliance
with the Food and Drug Administration regulations may be performed by a
licensed nurse when they meet the requirements of Rule
610-X-6-.04 or
610-X-6-.05 respectively.
(7) The monitoring
and adjustment of local anesthetic agent(s) and analgesic agent(s) infusing via
an epidural, brachial plexus, intrathecal or femoral catheter placed by a
qualified certified registered nurse anesthetist or qualified licensed
physician may be performed by a registered nurse, with the use of an electronic
pump or infusion reservoir, as ordered by a legally authorized prescriber.
(a) The registered nurse is authorized to
replace and refill reservoirs with a solution prepared by a licensed registered
pharmacist. The registered nurse is authorized to adjust infusion rates at the
direction of a physician licensed to practice medicine or a certified
registered nurse anesthetist.
(b) A
standardized procedure is required for monitoring and adjustment of epidural,
intrathecal, brachial plexus, and femoral catheter infusions of local
anesthetics and analgesics.
(c) The
organized program of study shall include:
1.
Advanced cardiac life support or other comparable certification.
2. Review of pertinent anatomy, physiology,
and pathophysiology.
3. Electronic
pump/reservoir management.
4.
Theory of epidural analgesia.
5.
Neurological assessment.
6.
Recognition and management of complications.
7. Pharmacokinetics and
pharmacodynamics
8. Annual review
and competency evaluation.
(d) The registered nurse is not authorized to
administer bolus dosages via an epidural, intrathecal, or brachial plexus
catheter.
(8) Intravenous
chemotherapeutic agents may be administered by a registered nurse, following
participation in:
(a) An organized program of
study.
(b) Supervised clinical
practice.
(c) Demonstrated clinical
competence.
(d) Annual evaluation
of competence.
Author: Alabama Board of Nursing
Statutory Authority:
Code of Ala.
1975, §§
34-21-2(c)(21).
