Missouri Code of State Regulations
Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE
Division 2200 - State Board of Nursing
Chapter 6 - Intravenous Infusion Treatment Administration
Section 20 CSR 2200-6.030 - Intravenous Infusion Treatment Administration by Qualified Practical Nurses; Supervision by a Registered Professional Nurse

Universal Citation: 20 MO Code of State Regs 2200-6.030

Current through Register Vol. 49, No. 6, March 15, 2024

PURPOSE: This amendment clarifies the duties of licensed practical nurses related to intravenous (IV) therapy.

(1) Qualified practical nurses shall only perform venous access and intravenous (IV) infusion treatment modalities according to the specific provisions of section 335.016, RSMo, 20 CSR 2200-5.010, and this chapter. A qualified practical nurse shall only perform such activities under the direction and supervision of a registered professional nurse or a person licensed by a state regulatory board to prescribe medications and intravenous infusion treatments (hereinafter the "licensed prescriber").

(2) Qualified practical nurses who perform venous access and intravenous infusion treatment modalities shall:

(A) Maintain accountability to the registered professional nurse or licensed prescriber who is directing and supervising the individual's practical nursing care acts involving venous access and intravenous infusion treatment modalities;

(B) Maintain ongoing, documented, specialized knowledge, education, skills, training, judgment, and experience related to practical nursing care acts involving venous access and intravenous infusion treatment modalities;

(C) Ensure that appropriate, authorized prescriber orders for patient care involving venous access and intravenous infusion treatment modalities are in place before patient care is begun;

(D) Only engage in practical nursing care acts involving venous access and intravenous infusion treatment modalities that are within the individual's authorized scope of practice as specified in section 335.016, RSMo, 20 CSR 2200-5.010, and this chapter; and

(E) Only engage in practice consistent with lawful written policies and procedures of the individual's employer as well as any state or federal laws applicable to the individual's employer.

(3) Registered professional nurses who direct and supervise qualified practical nurses in the performance of acts involving venous access and intravenous infusion treatment modalities shall:

(A) Provide appropriate direction and supervision for practical nursing care acts involving venous access and intravenous infusion treatment modalities that are within the qualified practical nurse's authorized scope of practice as specified in section 335.016, RSMo, 20 CSR 2200-5.010, and this chapter;

(B) Provide appropriate direction and supervision based on reasonable and prudent assessments, judgments, and decisions concerning the specialized knowledge, education, skills, training, judgment, and experience of the qualified practical nurse designated to perform specific acts involving venous access and intravenous infusion treatment modalities; and

(C) Only engage in direction, supervision and practice consistent with lawful, written policies and procedures of the individual's employer and any state or federal laws applicable to the individual's employer.

(4) Qualified practical nurses who have documented competency verification by the individual's employer, but who are not IV-Certified according to these rules, may:

(A) Observe, monitor, and maintain pre-calculated intravenous parenteral fluid infusion flow rate including total parenteral nutrition, peripheral parenteral nutrition, blood, and blood products;

(B) Observe and monitor peripheral venous access sites for evidence of developing complications;

(C) Observe and monitor patient for evidence of adverse response to prescribed venous access and intravenous infusion treatment modalities;

(D) Remove indwelling peripheral venous access devices that do not exceed three inches (3") in length, excluding mid-line catheters;

(E) Obtain blood and blood products from the blood bank in accordance with established blood bank protocol;

(F) Perform pre-transfusion blood and blood product cross-checking procedures at patient bedside with a registered professional nurse;

(G) Perform phlebotomy for the purpose of obtaining blood specimens for laboratory testing and/or donor collection; and

(H) Report and document actions taken and observations made.

(5) In addition to the functions and duties set forth in section (4), graduate practical nurses, IV-Certified licensed practical nurses, and licensed practical nurses who hold an active multistate license to practice under the nurse licensure compact who have documented competency verification by the individual's employer may -

(6) In addition to the functions and duties set forth in sections (4) and (5), and with additional individualized education and experience that includes documented competency verification by the individual's employer, graduate practical nurses, IV-Certified licensed practical nurses, and licensed practical nurses who hold an active multistate license to practice under the nurse licensure compact may -

(7) Graduate practical nurses, IV-Certified licensed practical nurses, and licensed practical nurses who hold an active multistate license to practice under the nurse licensure compact shall NOT, under any condition, perform the following functions or duties:

*Original authority: 335.017, RSMo 1983 and 335.036, RSMo 1975, amended 1981, 1985, 1993, 1995, 1999, 2007, 2008, 2011 .

Disclaimer: These regulations may not be the most recent version. Missouri 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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