Code of Colorado Regulations
700 - Department of Regulatory Agencies
716 - Division of Professions and Occupations - State Board of Nursing
3 CCR 716-1 - NURSING RULES AND REGULATIONS
Section 3 CCR 716-1.9 - RULES AND REGULATIONS FOR THE LICENSED PRACTICAL NURSE IN RELATION TO IV AUTHORITY
Universal Citation: 3 CO Code Regs 716-1 ยง 9
Current through Register Vol. 47, No. 17, September 10, 2024
A. BASIS: The Rules contained in this Rule 1.9 are adopted pursuant to authority granted the Board by sections 12-255-101 to 134, C.R.S., as amended, and specifically pursuant to authority granted in section 12-255-107(1)(e), C.R.S., as amended.
B. PURPOSE: These Rules are adopted to set forth the guidelines for the Licensed Practical Nurse (LPN) related to his/her role in intravenous therapy and venous blood sampling. The patient care responsibilities of LPNs should be within the parameters of their educational preparation and their demonstrated abilities. Therefore, LPNs and their supervisors have a joint responsibility to assure that LPNs practice within the scope of their educational basis and demonstrated abilities.
C. DEFINITIONS:
For the purposes of Rule 1.9 , the following terms have the indicated meaning:
1. "Adult Client"
is an individual whose chronological age is thirteen years or older.
2. "Approved IV Therapy Course/Program" is an
IV Therapy Course/Program, as defined in paragraph (7), and accepted by the
Board, that includes theory/lab and clinical practice related to the knowledge,
skills and ability to perform IV therapy and venous blood sampling, and also
meets the standards set in Section (G) of Rule 1.9.
3. "Board" is the State Board of
Nursing.
4. "Direct Injection" is
the administration of a drug directly into the Venous Access Device or through
the proximal port on a continuous infusion set.
5. "Intravenous Fluids" means fluids
containing one or more of the following elements: dextrose 5%; normal saline;
lactated ringers; sodium chloride 0.45%; or sodium chloride 0.2%.
6. "IV Authority" refers to Board granted
permission to practice IV therapy and venous blood sampling.
7. "IV Therapy Course/Program" prepares the
LPN to perform IV therapy and venous blood sampling, utilizing Venous Access
Devices, as defined in paragraph (12), on the Adult Client within the scope of
practice, as defined in Section (D).
8. "Peripheral Veins" are the veins not in
the chest, neck or abdomen.
9.
"Preceptor" is a licensed professional or a licensed practical nurse with IV
Authority, employed by a healthcare agency, who assumes joint teaching
responsibility with the clinical instructor, when the instructor is not present
in the setting.
10. "Pre-mixed"
means IV solution prepared and labeled by an authorized licensed professional
or manufacturer. Manufacturer prepared solutions include those closed systems
requiring activation to administer.
11. "Supervision" means a professional nurse,
physician, dentist, or podiatrist is physically present or accessible by some
form of telecommunication.
12.
Types of "Venous Access Devices":
a.
Peripheral catheters
(1) "Peripheral short
catheter" is a Venous Access Device less than 3 inches (7.5 cm) in
length.
(2) "Peripheral midline
catheter" means a peripherally inserted catheter whose tip terminates no
further than the axilla and is between 3 inches and 8 inches (7.5 cm and 20 cm)
in length.
b. Central
catheters
(1) "PICC (peripherally inserted
central catheter)" means an IV catheter whose tip terminates in the superior
vena cava and is confirmed by chest x-ray.
(2) "Central catheter" means an IV catheter
whose tip terminates in the superior vena cava and may be either tunneled,
implanted, or percutaneously inserted, and is confirmed by chest
x-ray.
D. SCOPE OF PRACTICE OF THE LICENSED PRACTICAL NURSE WITH IV AUTHORITY
1.
The patient care responsibilities of the LPN should be within the parameters of
their educational preparation and their demonstrated abilities.
2. A LPN with IV Authority may perform the
following procedures under the Supervision of a professional nurse, physician,
dentist, or podiatrist:
a. Calculate and
observe flow rate of intravenous infusions;
b. Stop the flow of Intravenous Fluids, as
defined in Sections (C)(5) and (C)(10) of Rule 1.9 ;
c. Remove peripheral short catheter for Adult
Clients;
d. Report and document
observations and procedures relating to intravenous infusion and insertion
sites;
e. Utilize Peripheral Veins
for intravenous access with a peripheral short catheter;
f. Perform blood sampling from a peripheral
vein or through a central Venous Access Device using a syringe or vacutainer
device.
g. Administer the
following:
(1) Intravenous Fluids through
Venous Access Devices;
(2)
Pre-mixed Intravenous Fluids containing electrolytes and vitamins;
(3) Pre-mixed antibiotic solutions via Venous
Access Devices delivered per labeled instructions by gravity flow, pump or
Direct Injection for a period of time consisting of greater than five minutes
in duration; and/or
(4) The first
dose of IV antibiotic therapy under the observation of a professional nurse,
physician, podiatrist, or dentist who is present in the same patient care
area.
h. Regulate the
prescribed flow rate of the Intravenous Fluids;
i. Monitor the systemic effects of
intravenous therapy;
j. Flush
Venous Access Devices designed to maintain venous patency with normal saline or
a sub-therapeutic dosage of heparin;
k. Change dressings and/or caps to Venous
Access Devices; and/or
l. Switch
from continuous infusion of Intravenous Fluid to heparin/saline lock.
E. OUTSIDE THE SCOPE OF IV AUTHORITY
1. A licensed
practical nurse with IV Authority may not perform any of the following
procedures as they are outside the LPN's scope of practice:
a. Administration of IV medications, except
as allowed in Section (D)(2)(g) of Rule 1.9 ;
b. Access or de-access implanted central
venous access ports;
c. Insertion
of a PICC line or a peripheral midline catheter;
d. Repair of Venous Access Devices;
e. Remove a central venous access
catheter;
f. Administration of
parenteral nutrition solutions;
g.
Administration of blood and blood products;
h. Administration of chemotherapy intravenous
medications/solutions;
i.
Administration of thrombolytic agent to declot a catheter; and/or
j. Direct Injection of any IV medication for
a period of time consisting of five minutes or less in duration.
F. REQUIREMENTS FOR OBTAINING IV AUTHORITY
1.
Successful completion of an Approved IV Therapy Course/Program is required if:
a. The LPN's IV Authority was removed on
January 1, 2006, or;
b. The LPN had
not received IV Authority prior to January 1, 2006, or;
c. The LPN's basic practical nursing program
did not include an Approved IV Therapy Course/Program.
2. Upon the successful completion of an
Approved IV Therapy Course/Program, the applicant must:
a. Possess an active, unencumbered Colorado
or multi-state practical nurse license.
b. Submit an IV Authority application on a
current Board approved form, and pay the applicable fee.
c. Verify completion of an Approved IV
Therapy Course/Program through a Board approved competency checklist.
3. An applicant by Endorsement of
IV Authority from another state or territory of the United States must:
a. Possess an active, unencumbered Colorado
or multi-state practical nurse license.
b. Upon endorsement for licensure, submit an
IV Authority application on a current Board approved form, and pay the
applicable fee.
c. Submit proof of
successful completion of an Approved IV Therapy Course/Program.
4. United States military
personnel who have education and training documented on an official transcript
and determined to be substantially equivalent, as determined by the Board, to
the Approved IV Therapy Course/Program curriculum requirements in Rule 1.9
Rules and Regulations for the Licensed Practical Nurse in Relation to IV
Authority will be eligible to IV Authority as provided for in section
12-20-202(4),C.R.S.,
and are subject to requirements of section (F)(2) of this Rule 1.9.
G. STANDARDS FOR IV THERAPY/VENOUS BLOOD SAMPLING COURSES
1. Curriculum for IV Therapy Course/Program
shall:
a. Provide adequate theory and
supervised clinical practice in IV therapy related to the Adult Client
necessary for the performance of nursing functions, as outlined in Section (D)
of Rule 1.9.
b. Provide the
following content:
(1) Legal implications and
scope of practice.
(2) Role of the
licensed practical nurse in intravenous therapy.
(3) Related anatomy and physiology, including
the physiology of aging and site selection.
(4) Fluids and electrolytes.
(5) Commonly used Intravenous
Fluids.
(6) Hazards and
complications of IV therapy, local and systemic.
(7) Psychological aspects of
venipuncture.
(8) Infection control
measures.
(9) Identifying types of
Venous Access Devices.
(10)
Monitoring Venous Access Devices.
(11) Dressing and cap changes.
(12) Initiating, monitoring, regulating,
replacing, and discontinuing Intravenous Fluids.
(13) Use of appropriate equipment, including
IV pumps.
(14) Drug
incompatibilities.
(15)
Administration of Pre-mixed vitamins and electrolytes.
(16) Pharmacology of heparin and
antibiotics.
(17) Administration of
Pre-mixed IV antibiotics.
(18)
Flushing of Venous Access Devices designed to maintain venous
patency.
(19) Collection of venous
blood specimens from Peripheral Veins and central Venous Access Devices for
tests and use of appropriate equipment for same.
(20) Nursing care, intervention, reporting
and documentation related to intravenous therapy/venous blood
sampling.
c. Each
student shall complete clinical practice or simulated clinical practice related
to:
(1) Peripheral short catheter insertion on
Adult Clients.
(2) Initiation and
monitoring of Intravenous Fluid administration on Adult Clients through Venous
Access Devices.
(3) Flushes into
Venous Access Devices designed to maintain venous patency for Adult
Clients.
(4) Administration of
Pre-mixed antibiotics via Venous Access Device to Adult Clients.
(5) Utilization of IV pumps.
(6) Peripheral venous blood sampling on Adult
Clients.
(7) Discontinuation of
peripheral short devices.
(8)
Documentation of nursing actions and observations.
(9) Sterile dressing change on central Venous
Access Devices.
(10) Blood
collection from a central Venous Access Device.
d. At the discretion of the instructor,
students may demonstrate knowledge and competency in skills with validation of
previous IV therapy education.
e.
The Board may review new IV Therapy Course/Program applications and approve IV
Therapy Course/Programs that meet the standards set forth in Section
(G)(1)(a-c) of Rule 1.9.
f. All
Approved IV Therapy Courses/Programs shall submit an annual report on a Board
approved form to demonstrate compliance with Rule 1.9. Failure to submit an
annual report may result in withdrawal of Board approval.
H. WITHDRAWAL OF IV AUTHORITY
1. The Board may withdraw IV
Authority if the Board has reasonable cause to believe that the nurse no longer
meets the requirements for IV Authority as set forth in section (F) of this
Rule 1.9, or the Board has reasonable cause to believe that the nurse is unable
to practice IV Authority with reasonable skill and safety.
Adopted April 22, 2009
Revised April 26, 2012
Effective July 1, 2012
Disclaimer: These regulations may not be the most recent version. Colorado may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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