The delegating nurse shall: 3. Health Services Partners Air Quality Allergies Asthma Independently insert or remove a CVAD, arterial catheter, or intraspinal catheter; Insert a peripherally inserted midline catheter. An individual with a nursing license (licensed practical nurse or registered nurse) meets the qualifications to perform the pre-admission/resident assessment. TheInstitute for Safe Medication Practices (ISMP)is a good resource for determining whether a medication is safe to crush. The nursing laws and rules allow a competent and appropriately trained licensed practical nurse from performing laser therapy for cosmetic purposes under the direction of an authorized health care practitioner or under the direction and supervision of a registered nurse. The Nursing Care Quality Assurance Commission (NCQAC) recommends telemedicine training be completed as soon as possible as a demonstration of competency. The licensed practical nurse may administer naloxone or other opioid antagonist to anyone at risk for having or witnessing an opioid overdose. It is beyond the scope of a licensed practical nurse to independently perform training, performance appraisals, or competency validation related to nursing practice of the registered nurse or advanced registered nurse practitioner. This may include self-administering epinephrine using an EAI or a prefilled medication device if authorized in the prescription. The nursing laws and rules allow a licensed practical nurse to provide care in an ICU, PCU, or recovery room. (6) The nurse shall only practice nursing in the state of Washington with a current Washington license; (7) The licensed nurse shall not permit their license to be used by another person; (8) The nurse shall have knowledge of the statutes and rules governing nursing practice and shall function within the legal scope of nursing practice; (9) The nurse shall not aid, abet or assist any other person in violating or circumventing the laws or rules pertaining to the conduct and practice of professional registered nursing and licensed practical nursing; or. The licensed practical nurse may collect the data and then have the registered nurse review the data and complete the assessment to determine the patient' needs and developing the nursing care plan. Philosophy governing approval of nursing education programs. The licensed practical nurse should use theScope of Practice Decision Treeto determine if any activities are within the nurse's legal and individual scope of practice. A prescription or order from an authorized provider is required. Telemedicine as defined inRCW 70.41.020(13)means, the delivery of health care services through the use of interactive audio and video technology, permitting real-time communication between the patient at the originating site and the provider, for the purpose of diagnosis, consultation, or treatment [but] does not include the use of audio-only telephone, facsimile, or email.. It is not within the scope of practice for a licensed practical nurse to start an intravenous line without an order from an authorized health care practitioner. The licensed practical nurse should use theScope of Practice Decision Treeto determine if these activities are within the nurse's legal and individual scope of practice. It is within the scope of practice of an appropriately trained and competent licensed practical nurse to perform a routine and non-complex cardiac stress test under the direction of an authorized health care practitioner, or under the direction and supervision of a registered nurse, following clinical practice standards. The licensed practical nurse practices in an interdependent role when carrying out nursing care and a dependent role when carrying out medical regimens. The licensed practical nurse should use theScope of Practice Decision Treeto determine if these activities are within the nurse's legal and individual scope of practice. See theNCQAC Standing and Verbal Orders Advisory Opinionfor guidelines and recommendations. This rule defines a consistent standard of nursing care with the delegation of nursing tasks to nursing assistants or home care aides. The licensed practical nurse works under the direction of an authorized health care practitioner within the practitioner's. TheDrug Enforcement Administration (DEA)does state that, an individual (secretary or nurse) may be designated by the practitioner to prepare prescription for the practitioner's signature.. It would be prudent to identify steps in the standing order as to what level a triage call becomes complex requiring the licensed practical nurse to refer to or consult with the registered nurse or other authorized health care practitioner. Bedside caregivers and supervisors should be familiar with this detail in the patient care plan and POLST. The licensed practical nurse may assist an authorized health care practitioner or the registered nurse in performing a lumbar puncture, following clinical practice standards. Criteria for approval of LPN and RN refresher course program located in Washington state. The broadly written laws and rules allow nurses to practice to their full scope of practice in any setting. A prescription or order from an authorized provider may be necessary if complications occur or if medical treatment is required. Is the nursing assistant or home care aide, registered or certified and properly trained in the nurse delegation for nursing assistants or home care aides? There must be an order from an authorized provider. An order is required from an authorized health care practitioner for laboratory tests involving puncturing of the skin. The licensed practical nurse should use theScope of Practice Decision Treeto determine if specific activities are within the licensed practical nurse's legal and individual scope of practice. The nursing laws and rules allow a competent and appropriately trained licensed practical nurse to apply medications, such as Latisse, used for eyelash growth under the direction of an authorized health care practitioner or under the direction and supervision of a registered nurse. The licensed practical nurse should use theScope of Practice Decision Treeto determine if these activities are within the nurse's legal and individual scope of practice. The licensed practical nurse should use theScope of Practice Decision Treeto determine if these activities are within the nurse's legal and individual scope of practice. The licensed practical nurse should use theScope of Practice Decision Treeto determine if performing compounding medications is within the licensed practical nurse's regulatory and individual scope of practice. Only the registered nurse may delegate to assistive personnel to perform diabetes management tasks in this setting. See theWashington State Department of Health Patient Rights Guidelinesfor more information. The licensed practical nurse should use theScope of Practice Decision Treeto determine if these activities are within the nurse's legal and individual scope of practice. (10) The nurse shall not disclose the contents of any licensing examination or solicit, accept or compile information regarding the contents of any examination before, during or after its administration. The NCQAC suggests the following: It may be within the scope of practice of the competent and appropriately trained licensed practical nurse to administer and read the TB skin test under the direction of an authorized health care practitioner or under the direction and supervision of the registered nurse. The licensed practical nurse may document symptoms or other findings and may document using a nursing diagnosis already made by the registered nurse. The licensed practical nurse must be competent to carry specific steps identified in the standing order or verbal order. A licensed practical nurse may administer medications and perform treatments or procedures without the registered nurse or other authorized health care practitioner on the premises. Competent practice may require the administration of first aid and/or CPR. See theCompounding Medications by Licensed Practical Nurses, Registered Nurses, and Advanced Registered Nurse Practitioners Advisory Opinionfor more information. The nurse must have a valid prescription, either in the nurse's name, in the name of an entity, in the name of a person or patient, or through a standing order. WebWashington state nursing care quality assurance commission community-based and in-home care setting delegation decision tree. The licensed practical nurse may assist an authorized health care practitioner or the registered nurse, in performing an amniotomy, following clinical practice standards. These procedures require a prescription from an authorized health care practitioner. A focused nursing assessment means recognizing patient characteristics that may affect the patient's health status, gathering and recording nursing assessment data and demonstrating attentiveness by observing, monitoring and reporting signs, symptoms, and changes in patient conditions in an ongoing manner to the registered nurse or other authorized medical provider. The nursing laws and rules requires general supervision of a licensed practical nurse. The licensed practical nurse should use theScope of Practice Decision Treeto determine if these activities are within the licensed practical nurse's legal and individual scope of practice. The Nursing Care Quality Assurance Commission supports the use of medication organizers following standards of practice for medication administration. Use and protection of professional titles. The law, RCW 43.70.495, requires the nurse to sign and retain an attestation of completion. WebThe nurse delegating the task supervises the performance of the unlicensed person. The nurse may want to consult with an authorized health care practitioner or a registered nurse in situations when the nurse is unsure if the patient still requires an intravenous line or if the patient's intravenous line is insufficient to support the therapy needed. Such person shall be a member of one of the classes of persons as directed in RCW. PO Box 47852 Olympia, Washington 98504-7852 . There may be other regulations, such as Centers for Medicare and Medicaid Services (CMS) who defines the requirements for supervision (general or direct), and other parameters for reimbursement of the procedure. A licensed practical nurse does not require additional licensure as an esthetician to perform laser therapy for cosmetic purposes. The Nursing Care Quality Assurance Commission'sStanding Orders and Verbal Orders Advisory Opinionprovides additional guidance and recommendations. Continuing education requirements for ARNP prescriptive authority. The LPN should begin CPR and continue until help arrives if a valid POLST indicating CPR/Attempt Resuscitation. Extended or satellite nursing campus of nursing education programs approved in Washington state. The nurse may also get a prescription in their own name from their health care practitioner. Determination and pronouncement of death by a licensed registered nurse. The licensed practical nurse should use theScope of Practice Decision Treeto determine if these activities are within the nurse's legal and individual scope of practice. The planning conference should include the patients or residents medical provider, the patient and/or surrogate decision-maker, and key family members. These procedures require a prescription from an authorized health care practitioner. Exceptions to nursing faculty degree requirements in prelicensure registered nurse nursing education programs. Naloxone(Narcan) is the current standard of treatment for opioid overdose. The licensed practical nurse should use theScope of Practice Decision Treeto determine if these activities are within the nurse's legal and individual scope of practice. Orders for OTC drugs or devices may be done using standing orders from an authorized health care practitioner or a registered nurse as identified in the nursing care plan. Initial licensure for registered nurses and practical nurses who graduate from an international school of nursing. Medical regimens require a prescription or order from an authorized health care practitioner. Washington state nursing care quality assurance commission community-based and in-home care setting delegation decision tree. The Nursing Care Quality Assurance Commission determines that it is not within the scope of the licensed practical nurse to administer stem cell transplants by intravitreal infusion, retrobulbar infusion, spinal infusion, or other complex administration techniques. The licensed practical nurse should use theScope of Practice Decision Treeto determine if handing out a pre-labeled, pre-packed sample is within the licensed practical nurse's regulatory and individual scope of practice. Ongoing evaluation and approval of nursing education programs located in Washington state. Mitomycin C), and Bacillus Calmette-Gurin (immunotherapy) drugs. Naloxone has not been shown to produce tolerance or cause physical or psychological pain. The licensed practical nurse implementing the order is required to see clarification of the order when the licensed practical nurse believes or has any reason to believe one of these contraindications exists, and to take any other action necessary to assure the safety of the patient. It is not within the scope of practice for the licensed practical nurse to delegate nursing tasks to non-credentialed assistive personnel in the public and private, kindergarten through twelve grade school setting (RCW 28A.210 Common School Provisions: Health-Screening and Requirements). CPR should be stopped in absence of a pulse if CPR is started for a patient with a POLST indicating DNAR. This page also includes links to laws and regulations on the Washington State Legislature website. (c) The registered nurse and licensed practical nurse act as client advocates in health maintenance and clinical care. Not all medications may be split. These procedures require a prescription from an authorized health care practitioner. Advanced care planning is thoughtful conversations between health care professionals, the patient and/or surrogate. Denial, statement of deficiencies, conditional approval or withdrawal of approval of nursing education programs located in Washington state. The licensed practical nurse must be competent to do these activities. The SNF may allow the licensed practical nurse to initiate the admission assessment within licensed practical nurse's scope of practice including collecting information and data without a registered nurse on the premises with the intent that the registered nurse will complete the comprehensive assessment and care planning. It is not within the scope of practice of the licensed practical nurse to perform an assessment by proxy. The Nursing Care Quality Assurance Commission'sStanding Orders and Verbal Orders Advisory Opinionprovides additional guidance and recommendations. Telehealth may not be appropriate in some circumstances. RCW 69.41.095allows the Licensed Practical Nurse to have a prescription for an opioid antagonist in the nurse's name to carry and administer in the non-work setting. A prescription or order from an authorized provider is required as TB skin test formulations are legend drugs. The Revised Code of Washington (RCW) 18.79 and Washington Administrative Code (WAC) 246-840 provide the statutory and legal basis of nursing practice. It is within the scope of practice of an appropriately trained and competent licensed practical nurse assist with an authorized health care practitioner or registered nurse to insert a PEG tube, . The facility can be more restrictive. The nurse must follow clinical standards of care. Severity and duration of the withdrawal relate to the dose of naloxone and the degree and type of opioid dependency. Licensure as an esthetician to perform diabetes management tasks in this setting the practitioner.! 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