Nursing

Practice Alerts & Guidelines

The Practice of IV Therapy by Licensed Practical Nurses
Essential Course Content

1. LEGAL ASPECTS AND PRACTICE OF IV THERAPY
   1. New York Nursing Practice Act
   2. New York State Regulations - 10 NYCRR 400.25; The role of the licensed practical nurse in intravenous therapy procedures
   3. New York State Regulation - 10 NYCRR 700.4, The role of the licensed practical nurse in intravenous therapy procedures
   4. New York State Education Guidelines for The Practice of IV Therapy by LPNs in Long Term Care and/or Acute Care
   5. National Patient Safety Goals from JCAHO (see: www.JCAHO.org and click onto Patient Safety Goals and then onto type of facility)
   6. Standards of Practice re: Prescribing Practitioners' IV Orders
      1. Solution (additives, when applicable)
      2. Medication
      3. Dosage
      4. Volume (total amount to be administered)
      5. Rate of flow
      6. Frequency
      7. Route
      8. Any special precautions if applicable
   7. Appropriate Agency Policies & Procedures for IV Therapy (for example: verbal orders, transcription of orders, LPNs & blood administration, LPNs & IV push, etc.)
2. REVIEW OF ANATOMY AND PHYSIOLOGY
   1. Vascular System
   2. Integumentary
3. FLUID AND ELECTROLYTE BALANCE
   1. Body's reaction to dehydration and over hydration
   2. Types of IV fluids
4. EQUIPMENT AND NURSING CARE IN IV THERAPY
   1. Review facilities' policy and procedure
   2. Terminology - Scope of Infusion Therapy
   3. Infection Control (Asepsis)
   4. Equipment and supplies
      1. Pumps
      2. Delivery Systems
      3. Insulin Devices
   5. Drip Rate Calculation
   6. Sites
   7. Techniques
      1. Peripheral venous lines
         1. Preparing and labeling IV
         2. Initiating IV
         3. Monitoring and discontinuing
         4. Recording and reporting
      2. Central venous lines
         1. Preparing IV and labeling IV
         2. Initiating IV
         3. Monitoring and discontinuing
         4. Recording and reporting
      3. Modes of Administration
         1. Continuous
            1. Medicated
            2. Unmedicated
         2. Intermittent
            1. IV push
            2. Medicated secondary IV
            3. Blood Components
5. COMPLICATIONS
   1. Signs and symptoms of complications, side effects or untoward reactions.
      1. Peripheral venous lines
      2. Central venous lines
   2. Factors related to complications
   3. Nursing Intervention
   4. Reporting to the RN Supervisor
6. MEDICATIONS
   1. Terms and abbreviations associated with IV medication
   2. Sound-alike-look-alike-drugs (SALAD)
   3. Drug Incompatibility
7. DOCUMENTATION
   • Facility specific documentation required for IV Therapy
8. DEMONSTRATION OF COMPETANCY IN IV THERAPY
   1. Initial
   2. Annual review