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(1) Prior to performing IV therapy, the practical nurse must have successfully completed a course of study that includes a process for evaluation, demonstration, and documentation of the knowledge, skills, and abilities required for safe administration of IV therapy procedures. Education and competency may be obtained through a board-approved, prelicensure nursing education program or a course of study utilizing appropriate education methods and qualified faculty.

(2) The practical nurse who has met the education and competency requirements of this rule may perform the following functions with venous access devices (central, midline, and peripheral) under the appropriate level of supervision:

(a) calculate and adjust IV infusion flow rate, including monitoring and discontinuing infusions;

(b) observe and report subjective and objective signs of adverse reactions to any IV administration and initiate appropriate nursing interventions;

(c) draw blood;

(d) monitor access site and perform site care and maintenance;

(e) monitor infusion equipment;

(f) change administration set, including add-on device and tubing;

(g) perform intermittent flushes for line patency maintenance;

(h) convert a continuous infusion to an intermittent infusion;

(i) insert or remove a peripheral venous access device, except central or midline catheters;

(j) initiate and administer IV medications and fluids with the exception of the medications specifically prohibited in ARM 24.159.1011;

(k) administer the following classifications of medications for adult clients via push or bolus:

(i) analgesics (including opiates);

(ii) antiemetics;

(iii) analgesic antagonists;

(iv) diuretics;

(v) corticosteroids;

(vi) standard flush solutions (heparin or saline); or

(vii) glucose.

(l) administer, monitor, and discontinue parenteral nutrition, fat emulsion solutions;

(m) assume monitoring of the administration of blood, blood components, or plasma volume expanders after the registered nurse has initiated and monitored the client for fifteen minutes; and

(n) discontinue the infusion of blood, blood components, or plasma volume expanders.

(3) Under the direct supervision of a dialysis registered nurse, the following hemodialysis procedures may be performed by a competent practical nurse:

(a) insert an arterio-venous fistula/graft needle;

(b) administer prescribed local anesthesia as needed prior to dialysis needle insertion;

(c) access, draw blood, flush with a normal saline solution or a specific heparin flush solution, and change dressings of hemodialysis central venous catheters; and

(d) administer prescribed doses of routine dialysis heparin.

History: 37-1-131, 37-8-202, MCA; IMP, 37-1-131, 37-8-202, MCA; NEW, 1997 MAR p. 1176, Eff. 4/8/97; AMD, 1998 MAR p. 2473, Eff. 9/11/98; AMD, 2000 MAR p. 954, Eff. 4/14/00; AMD, 2002 MAR p. 3149, Eff. 11/15/02; TRANS, from Commerce, & AMD, 2006 MAR p. 2035, Eff. 8/25/06; AMD, 2008 MAR p. 2180, Eff. 8/15/08; AMD, 2015 MAR p. 1389, Eff. 9/11/15.

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