Rule 4723-4-02 | Intravenous therapy procedures for licensed practical nurses.
(A) Except as provided in paragraph (B) of this rule, a licensed practical nurse shall not perform any of the following intravenous therapy procedures:
(1) Initiate or maintain any of the following:
(a) Blood or blood components;
(b) Solutions for total parenteral nutrition;
(c) Cancer therapeutic medications including, but not limited to, cancer chemotherapy or an anti-neoplastic agents;
(d) Investigational or experimental medications;
(e) Solutions administered through any central venous line or arterial line or any other line that does not terminate in a peripheral vein, except as provided in paragraph (B)(1) of this rule;
(f) An intravenous piggyback infusion, except as provided in paragraph (B)(3) of this rule.
(2) Discontinue a central venous, arterial, or any other line that does not terminate in a peripheral vein;
(3) Initiate or discontinue a peripherally inserted central catheter, or any catheter that is longer than three inches;
(4) Program or set any function of a patient controlled analgesic;
(5) Mix, prepare or reconstitute any medication for intravenous therapy, except as provided in paragraph (B)(4) of this rule;
(6) Administer medications by an intravenous route, except as provided in paragraph (B)(3) of this rule;
(7) Inject medications by a direct intravenous route, except as provided in paragraph (B)(5) of this rule;
(8) Change tubing on an arterial line, a central venous line, or on any line that does not terminate in a peripheral vein;
(9) Change an intermittent infusion device, unless the tip of the connected intravenous catheter terminates in a peripheral vein.
(B) A licensed practical nurse may perform the following procedures only for individuals aged eighteen or older and only when directed to do so by a licensed physician, physician assistant, dentist, optometrist, podiatrist, or registered nurse in accordance with section 4723.18 of the Revised Code:
(1) Administer the following solutions, or combinations of the solutions, through a venous line:
(a) Five per cent dextrose and water;
(b) Five per cent dextrose and lactated ringers;
(c) Five per cent dextrose and normal saline;
(d) Normal saline;
(e) Lactated ringers;
(f) 0.45 per cent sodium chloride and water;
(g) 0.2 per cent sodium chloride and water; or
(h) 0.3 per cent sodium chloride and water.
(2) Administer any of the solutions set forth in paragraph (B)(1) of this rule that contain vitamins or electrolytes after a registered nurse initiates the first infusion of the solution containing vitamins or electrolytes.
(3) Initiate or maintain an intermittent or secondary intravenous infusion containing an antibiotic;
(4) Prepare or reconstitute an antibiotic additive to be administered through an intravenous infusion;
(5) Inject heparin or normal saline to flush an intermittent infusion device or heparin lock, including, but not limited to, bolus or push;
(6) Change tubing on an intermittent infusion device and on an intravenous line if the line terminates in a peripheral vein;
(7) Place a venous access catheter, no longer than three inches in length, in the hand, forearm or antecubital space, followed by the placement of a saline or heparin lock, either for purposes of intermittent infusions, or to initiate infusions of any of the solutions set forth in paragraph (B)(1) of this rule; or
(8) Stop an infusion of blood or blood component, or turn off the function of a patient-controlled analgesic device when a complication arises.
(C) A licensed practical nurse may perform the procedures set forth in paragraph (B) of this rule only if one of the following requirements are met:
(1) The licensed practical nurse is directed to perform intravenous therapy by a licensed physician, physician assistant, dentist, optometrist, or podiatrist who is present and readily available at the facility where the intravenous therapy procedure is performed;
(2) The licensed practical nurse is directed to perform intravenous therapy by a registered nurse who has personally performed an on-site assessment of the individual to receive intravenous therapy, and that registered nurse or another registered nurse is readily available at the site where the intravenous therapy procedure is performed; or
(3) If the intravenous therapy procedures are performed in a home as defined in section 3721.01 of the Revised Code, or in an intermediate care facility for individuals with intellectual disabilities as defined in section 5124.01 of the Revised Code, a registered nurse who directs the authorized licensed practical nurse to perform intravenous therapy is either:
(a) On the premises of the home or facility; or
(b) Accessible by some form of telecommunication.
Last updated February 1, 2024 at 9:29 AM
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