Current through Register Vol. 49, No. 18, September 16, 2024
PURPOSE: This amendment clarifies intravenous (IV)
treatment modalities course requirements.
(1) A venous access and intravenous (IV)
infusion treatment modalities course shall prepare the non IV-Certified
qualified practical nurse to safely perform the functions and procedures
inherent in selected intravenous infusion treatment modalities as set forth in
this rule.
(2) Course providers
shall only design and conduct a venous access and intravenous infusion
treatment modalities course as specified in this rule. The course shall provide
sufficient instruction for the following qualified practical nurse participants
to become IV-Certified in Missouri:
(A) A
practical nurse currently licensed to practice in Missouri;
(B) A practical nurse with a temporary permit
to practice in Missouri;
(C) A
graduate practical nurse of a non-Missouri practical nursing education program
seeking licensure in Missouri; or
(D) A federal employee who possesses a
current license as a practical nurse in another state who is enrolling in a
course provided by a federal facility located in Missouri.
(3) Course providers may offer the venous
access and intravenous (IV) infusion modalities course to licensed practical
nurses who hold an active multistate license to practice under the nurse
licensure compact as preparation for IV competency to be verified by the
employer.
(4) Curriculum.
(A) The curriculum of a venous access and
intravenous infusion treatment modalities course shall include the following
components:
1. Review of the Missouri Nursing
Practice Act including the current venous access and intravenous infusion
treatment modalities regulations;
2. Review of the policies and procedures of
the clinical agency where practical experience is received;
3. Structure of the circulatory system
including anatomical location and physiology of veins used for venous
access;
4. Relationship between
parenteral fluid treatment administration and the body's homeostatic and
regulatory function with attention to the clinical manifestation of fluid and
electrolyte imbalance and cellular physiology;
5. Principles of infection control in venous
access and parenteral fluid administration;
6. Identification of various types of
equipment used in venous access and parenteral fluid administration, with
content related to criteria for use of each, and means of troubleshooting for
malfunctions;
7. Principles and
practices related to intravenous drug and/or fluid administration across the
life span;
8. Nursing management of
venous access and parenteral fluid administration procedures that are commonly
used in patient care settings;
9.
Procedure for obtaining venous access including appropriate equipment
selection, psychological preparation of the patient, site selection, aseptic
skin preparation, insertion and stabilization of the venous access device,
application of dressing to insertion site, and documentation of
procedure;
10. Maintenance of
venous access site and parenteral fluid administration system components
according to established current practices;
11. Monitoring venous access site for
evidence of local complications, parenteral fluid infusion flow rate, and
response to treatment;
12.
Adjusting parenteral fluid flow rate in various clinical situations;
13. Procedure for removal of peripheral
venous access device upon completion of the prescribed treatment or if
suspected or confirmed complications arise;
14. Calculation of drug dosage and parenteral
fluid administration flow rates; and
15. Principles of phlebotomy.
(B) The curriculum to be offered
shall be approved by the board.
1. The course
provider shall develop the curriculum. The course provider may select an IV
Therapy text of choice. The text may be utilized as the curriculum stem.
Content specific to IV Therapy certification in Missouri shall be added. The
curriculum shall contain all of the components listed in paragraphs (4)(A)
1.-5. of this rule and be submitted to the board for approval.
(C) A course shall, at a minimum,
consist of -
1. Thirty (30) hours of classroom
and skills laboratory instruction or its equivalent, (e.g., faculty-student
interactive study); and
2. Eight
(8) hours of supervised clinical practice, which shall include at least one (1)
successful performance of peripheral venous access and the initiation of an
intravenous infusion treatment modality on an individual.
(D) There shall be written course outcomes
that identify the expected competencies of the participant upon completion of
the course.
(E) The course
participant shall complete a pretest(s) in pharmacology, anatomy and
physiology, and asepsis to determine the participant's level of knowledge at
the beginning of the course.
(F)
All classroom and clinical instruction and practice shall be supervised by a
registered professional nurse designated by the provider and who meets the
faculty qualifications as stated in section (5) of this rule.
(5) Faculty Qualifications and
Responsibilities.
(A) Nursing faculty shall
hold a current, undisciplined license or temporary permit to practice as a
registered professional nurse in Missouri; and the license to practice
professional nursing has never been disciplined in any jurisdiction. Nursing
faculty shall have a minimum of two (2) years of clinical experience within the
last five (5) years that included responsibility for performing venous access
and intravenous infusion treatment modalities.
(B) All non-nurse faculty shall possess the
professional preparation and qualifications to teach the specific content for
which they are responsible.
(C) For
the clinical component of the course, the maximum faculty to student ratio
shall be one to three (1:3) for observational experiences and the performance
of non-invasive procedures and functions. The faculty to student ratio shall be
one to one (1:1) during the performance of peripheral venous access and
initiation of an intravenous infusion treatment modality on an individual.
(D) The course provider shall
designate a registered professional nurse to be the course coordinator who
shall be responsible for all aspects of the course.
(6) Classroom and Clinical Facilities.
(A) Classrooms shall be of sufficient size
and contain the necessary equipment and teaching aids to implement the
course.
(B) The clinical facilities
utilized shall be sufficient to allow for appropriate implementation of the
course and may include, but are not limited to, acute care, long-term care,
ambulatory care, and community agencies that provide intravenous infusion
treatment modalities.
(C) Faculty
and course participants shall have access to the necessary intravenous
treatment equipment and patients/ clients receiving intravenous treatment
modalities, including pertinent medical records.
(D) There shall be a signed written agreement
between the course provider of the course and each cooperating clinical
facility that specifies the roles, responsibilities, and liabilities of each
party. This written agreement will not be required if the only clinical
facility to be used is also the provider of the course.
(7) To successfully complete a venous access
and intravenous infusion treatment modalities course for the purpose of
becoming IV-Certified, the qualified participant shall -
(A) Achieve a minimum grade of eighty percent
(80%) on a written final examination of no fewer than fifty (50) multiple
choice items;
(B) Demonstrate
clinical competency in the mastery of the course objectives; and
(C) Perform at least one (1) successful
peripheral venous access and initiate an intravenous infusion treatment
modality on an individual.
(8) Record Keeping.
(A) The provider of an approved course shall
maintain records documenting each participant's attendance, scores, and
competencies. These records shall be kept for a period of at least five (5)
years. A copy of this record shall be provided to the course
participant.
(B) The provider of an
approved course shall award a certificate, using a form provided by the board,
to each participant who successfully completes the course.
(C) Within thirty (30) days of a
participant's successful completion of an approved course, the designated
course coordinator shall submit the required participant information to the
board on a form provided by the board.
*Original authority: 335.017, RSMo 1983 and 335.036, RSMo
1975, amended 1981, 1985, 1993, 1995, 1999, 2007, 2008, 2011
.