Current through Register Vol. 50, No. 9, March 1, 2024
NECESSITY, FUNCTION, AND CONFORMITY:
KRS
314.131(1) authorizes the
Board of Nursing to promulgate administrative regulations as may be necessary
to enable it to carry into effect the provisions of KRS Chapter 314.
KRS
314.404(7) requires the
board to promulgate an administrative regulation to establish a list of medical
tests that a licensed certified professional midwife may order when providing
certified professional midwifery services that is limited to only those tests
that are indicated and approved for the safe conduct of pregnancy, labor or
birth, and care of a client and not intended for the diagnosis or management of
any acute condition unrelated to pregnancy. This administrative regulation
establishes the medical tests and formulary for licensed certified professional
midwives.
Section 1. An LCPM may
independently order the following medical tests:
(1) Complete blood count (CBC);
(2) Blood type, Rh, and antibody
screen;
(3) Screening for
gestational diabetes;
(4) Hepatitis
B and C panels for immunity or infection;
(5) HIV test;
(6) HPV test;
(7) Pap smear;
(8) Screen tests for syphilis, chlamydia,
gonorrhea, and herpes;
(9) Rubella
titers;
(10) Urine or serum
HCG;
(11) Urinalysis;
(12) Urine culture including Group B
strep;
(13) Vaginal culture for
Group B strep;
(14) Varicella
titers;
(15) Ultrasound for fetal
viability, confirmation of singleton intrauterine pregnancy, gestational age,
fetal position, placental localization, anatomy scan, amniotic fluid index, or
nuchal translucency;
(16) Standard
state newborn screening for metabolic disorders;
(17) Newborn hearing screening;
(18) Critical congenital heart disease
screening (pulse oximetry);
(19)
Maternal prenatal genetic screening for errors of metabolism;
(20) Hemoglobin A1C;
(21) Standard screening tests for fetal
genetic abnormalities including Quad Screen and cell-free DNA
testing;
(22) TSH
screening;
(23) Non-stress
tests;
(24) Neo-Bilirubin or
Total-Bilirubin;
(25) Coombs and
blood type test of the newborn; and
(26) The fetal screen and Rhogam tests of the
client.
Section 2. An
LCPM may order any other test which is determined as necessary after
consultation with a physician or other appropriate licensed healthcare
provider.
Section 3.
(1) An LCPM may obtain, transport, and
administer the following legend medications:
(a) Vitamin K;
(b) Rho D immune globulin;
(c) Erythromycin ophthalmic ointment USP,
five-tenths (0.5) percent;
(d)
Oxygen;
(e) Hepatitis B
vaccine;
(f) Antibiotics which
shall be administered pursuant to United States Centers for Disease Control
(CDC) Guidelines for Prophylaxis:
1.
Penicillin;
2.
Ampicillin;
3. Cefazolin;
4. Clindamycin; and
5. Vancomycin;
(g) Topical anesthetics:
1. Procaine HCl;
2. Novacaine;
3. Benzocaine;
4. Cetacaine; and
5. Generic equivalents;
(h) Lidocaine, one (1) percent up to twenty
(20) milliliters per patient;
(i)
Epinephrine;
(j) Glucose gel to be
administered orally for neonatal hypoglycemia;
(k) Tranexamic acid;
(l) Oxytocin;
(m) Lactated ringer's;
(n) Normal saline; and
(o) Medical supplies needed to administer the
medications listed in this administrative regulation.
(2)
(a) An
LCPM shall obtain and transport for emergencies Oxytocin for prevention of
postpartum hemorrhage and Lactated Ringer's or Normal Saline for intravenous
infusion.
(b) The LCPM shall obtain
and transport at least one (1) of the following to be used in the event of
postpartum hemorrhage and if Oxytocin is not successful:
1. Methylergonovine (Methergine);
2. Hemabate; or
3. Misoprostal (Cytotec).
