(1) Intravenous
(IV) Push Medications - The administration of intravenous push medications
refers to medications administered from a syringe directly into an ongoing
intravenous infusion or into a saline or heparin lock. Intravenous push does
not include saline or heparin flushes.
(a)
Licensed Practical Nurses may deliver selected intravenous push medications
when prescribed by a licensed health care professional who has legal authority
to prescribe such medications, and when under the supervision of a licensed
physician, dentist or registered nurse pursuant to T.C.A. §
63-7-108, provided:
1. the Licensed Practical Nurse has a minimum
of six (6) months experience as a licensed nurse; and
2. the Licensed Practical Nurse has
successfully completed a course of study developed from the Infusion Nurse
Society Standards; or
3. has
successfully completed a formal (institutional/agency-based) intravenous
therapy training and competency program prior to January 1, 2007; and
4. the Licensed Practical Nurse practices
under the supervision (defined as "overseeing with authority") of a licensed
physician, dentist, or registered nurse pursuant to T.C.A.§
63-7-108. The supervisor shall
maintain accountability for the delegation while the Licensed Practical Nurse
is accountable for his/her acts; and
5. the Licensed Practical Nurse administers
IV push medications in peripheral lines only; and
6. Competency is demonstrated to the chief
nursing officer or the chief nursing officer's representative when the Licensed
Practical Nurse is employed by a facility required to be licensed pursuant to
T.C.A. §
68-11-204, or competency is
demonstrated to the supervising physician or dentist when the Licensed
Practical Nurse is not employed by a facility required to be licensed pursuant
to T.C.A. §
68-11-204; and
7. Documentation of competence is maintained
in the Licensed Practical Nurse's personnel file, signed and attested to by the
facility's chief nursing officer; and
8. the Licensed Practical Nurse administers
IV push medications only to adults weighing over eighty (80) pounds.
(b) Licensed Practical Nurses
shall not administer IV push medications to pediatric or prenatal and ante
partum obstetrical patients.
(c)
Licensed Practical Nurses shall not administer the following
fluids/medication/agents or drug classifications in the context of intravenous
therapy:
1. Chemotherapy; and
2. Serums; and
3. Oxytocics; and
4. Tocolytics; and
5. Thrombolytics; and
6. Blood or blood products; and
7. Titrated medications and dosages
calculated and adjusted by the nurse based on patient assessment and/or
interpretation of lab values and requiring the nurse's professional judgment;
and
8. Moderate sedation;
and
9. Anesthetics; and
10. Paralytics; and
11. Investigative or experimental
drugs.
