Coprescribing of opioids for patients receiving medication assisted treatment (MAT). The licensed practical nurse may assist an authorized provider in replacing a suprapubic catheter in a non-established tract. The LPN should call the nursing supervisor, 911, or hospice for emergency help, and stay with the patient. Commission action regarding refresher course programs. The procedure may be performed in a home setting or an in-center setting. WebSee WAC 246-827-0240 for MA-certified. It may be within the scope of practice of the licensed practical nurse to hand a patient a pre-packaged sample that is properly labeled by an authorized health care practitioner or pharmacist. Competent practice may require the administration of first aid and/or CPR. Mitomycin C), and Bacillus Calmette-Gurin (immunotherapy) drugs. There must be an order from an authorized provider. It may be within the scope of practice of the competent and appropriately trained licensed practical nurse to perform the following tasks related to a VAD or other infusion devices under the direction of an authorized health care practitioner or under the direction and supervision of a registered nurse: It is not within the scope of a licensed practical nurse to perform the following tasks: 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. Such supervision shall be adequate to prevent an unreasonable risk of harm to clients; (4)(a) Performing or attempting to perform nursing techniques and procedures for which the nurse lacks the appropriate knowledge, experience, and education and failing to obtain instruction, supervision and consultation for client safety; (b) Violating the confidentiality of information or knowledge concerning the client, except where required by law or for the protection of the client; or. Only a registered nurse may delegate nursing activities to a nursing assistant-certified (NA-C), nursing assistant-registered (NA-R), or home care aid-certified (HCA-C) in an ALF. The Nursing Care Quality Assurance Commission'sStanding Orders and Verbal Orders Advisory Opinionprovides additional guidance and recommendations. This allows an authorized health care practitioner to issue a prescription made out in the name of the authorized entity. Medication reconciliation is a formal process for creating the most complete and accurate list possible of a patient's current medications and comparing the list to those in the patient record or medication orders. The nurse should use theScope of Practice Decision Treeto determine if specific activities are within the nurse's legal and individual scope of practice. [Statutory Authority: RCW 18.79.110, 18.79.260, 2012 c 164, and 2012 c 10. The purpose of reconciliation is to avoid errors that include but are not limited to transcription, omissions, duplication, dosing errors, or drug interactions. However, theMedical Quality Assurance Commission WAC 246-919-605 Use of Laser, Light, Radiofrequency, and Plasma (LLRP) Devices as Applied to the Skinincludes language and requirements for physicians. An order is required from an authorized health care practitioner for laboratory tests involving puncturing of the skin. In an emergency it may be difficult to determine whether the family member is the legal surrogate. The nursing law and rule does not prohibit the licensed practical nurse in making a decision to crush or split medications without an order. The licensed practical nurse is always individually accountable and responsible for the nursing care the licensed practical nurse provides. Routine radiology tests (such as chest, extremity); Computerized axial tomography (CAT) scans; Fluoroscopy, including upper gastrointestinal and barium enema procedures; Magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA); Nuclear medicine such as bone scans, thyroid scans, and thallium cardiac stress tests; The nurse providing synchronous (real-time audio and video) VDOT is required to take the telemedicine training. The Nursing Care Quality Assurance Commission'sStanding Orders and Verbal Orders Advisory Opinionprovides additional guidance and recommendations. The patient must be in a stable condition. The licensed practical nurse may not use the title of respiratory therapist unless the nurse is dually licensed. The nursing laws and rules allow a competent and appropriately trained licensed practical nurse to apply superficial chemical peels or microdermabrasion 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 determines it is beyond the scope of the licensed practical to provide epidural care during labor and delivery. See the Nursing Care Quality Assurance Commission'sAdministration of Sedating, Analgesic, and Anesthetic Agents Advisory Opinionfor additional guidance and recommendations. Seeking mental health care is both safe and encouraged. Laser treatment requires a prescription from an authorized health care practitioner. The LPN should suggest a care planning conference to evaluate whether POLST is appropriate when the patient or resident is admitted to a long-term care facility without POLST. Nursing assistant (CNA or NAR) (chapter 18.88A RCW) May administer in community-based care settings or in-home care settings under nurse delegation. The medication must be stored properly and safely in a secured system. WebWashington state nursing care quality assurance commission community-based and in-home care setting delegation decision tree. 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. Clinical and practice experiences for students in approved nursing education programs. 2. WebContact Information Health Services Annie Hetzel 360-725-6040 The follow A-Z Index of health topics includes OSPI resources and external hyperlinks to resources produced by our partners. Is appropriate supervision available? Training and competency assessment for personal care services (non-nursing care) does not require the services of a Washington state licensed professional nurse. No color additives are approved by the FDA for permanent dyeing or tinting of eyelashes or eyebrows. It is within the scope of an appropriately prepared and competent licensed practical nurse to insert prostaglandin into the vagina for a cervical ripening or induction of labor with a viable fetus under the direction of an authorized health care practitioner, or under the direction and supervision, of the registered nurse, following clinical practice standards. POLST should not be written as part of routine admission paperwork without medical professional involvement and extensive discussion. (a) Failing to assess and evaluate a client's status or failing to institute nursing intervention as required by the client's condition; (b) Willfully or repeatedly failing to report or document a client's symptoms, responses, progress, medication, or other nursing care accurately and legibly; (c) Willfully or repeatedly failing to make entries, altering entries, destroying entries, making incorrect or illegible entries and making false entries in employer or employee records or client records pertaining to the giving of medication, treatments, or other nursing care; (d) Willfully or repeatedly failing to administer medications and treatments in accordance with nursing standards; (e) Willfully or repeatedly failing to follow the policy and procedure for the wastage of medications where the nurse is employed or working; (f) Nurses shall not sign any record attesting to the wastage of controlled substances unless the wastage was personally witnessed; (g) Willfully causing or contributing to physical or emotional abuse to the client; (h) Engaging in sexual misconduct with a client as defined in WAC. Not all medications may be split. RCW 69.41.095allows the Licensed Practical Nurse to carry and administer an opioid antagonist (such as naloxone) to a person suspected of experiencing an opioid overdose in any setting. Examples include instillation of dimethyl sulfoxide (DMSO), chemotherapy (e.g. The nursing laws and rules do not prohibit the competent and appropriately trained licensed practical nurse from initiating the admission of a patient to a hospital or SNF. 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 may administer medications by any route. See theFood and Drug Administration's website, Using Eye Cosmetics Safely, for more information. Employer: Washington Department of Labor & Industries - Insurance Services . Do assessment, then proceed with a consideration of delegation. For more information and resources on POLST, go to: The patient (or surrogate decision-maker) and the health care provider should discuss information to assure the POLST reflects the patient's wishes, as expressed in an advance directive or through communications with family or others. It is within the scope of the appropriately prepared and competent licensed practical nurse to assist an authorized health care practitioner, or the registered nurse, in performing the OSHA Respirator Medical Evaluation Questionnaire and perform a respiratory fit test, following clinical practice standards. To learn more about the different training options available and access additional resources, see theWashington State Telehealth Collaborative Training webpage. The LPN or RN may provide telehealth nursing services within their scope of practice to patients in Washington state following standing orders approved by an authorized practitioner. POLST is usually for persons with serious illness or frailty. Resources, facilities and services for approved nursing education programs. The standing orders are often used to renew medication prescriptions. The nursing laws and rules do not prohibit the competent and appropriately trained licensed practical nurse from collecting the information for a pre-anesthesia assessment. 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 any of the activities the licensed practical nurse is assisting with, is within the nurse's legal and individual scope of practice. These procedures require a prescription from an authorized health care practitioner. Naloxone has not been shown to produce tolerance or cause physical or psychological pain. Pharmacy Quality Assurance Commission . The POLST form must be signed by the advanced registered nurse practitioner (ARNP), physician, or physician assistant and the patient or surrogate decision-maker to be valid. Other laws may apply depending on the setting. WebMust meet all Washington Administrative Code (WAC) requirements related to this position Minimum of 3 years nursing experience preferred Ability to read, write, and speak in English Delegation process experience preferred Must possess strong organizational, time-management, and problem-solving skills 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. WebWhat Is Nurse Delegation? Some facility laws do address medication refusal. 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. If a comprehensive nursing assessment is contemplated as part of the care plan, the registered nurse must undertake that portion of the pre-admission assessment. The facility can be more restrictive. The focused assessment may include obtaining health care history information and physical assessment. The laws states, The system shall provide an audit trail of all prescriptions electronically transmitted that documents for retrieval all actions and persons who have acted on a prescription, including authorized delegation of transmission. The order must be authenticated. Facilities should develop policies to manage legal risk in such a situation. Functions of the registered nurse supervising the nursing technician. The licensed practical nurse needs to determine whether the medication can be safety split to ensure proper dosage. However, theMedical Quality Assurance Commission WAC 246-919-606 Nonsurgical Medical Cosmetic Proceduresapplies to nonsurgical medical cosmetic procedures that involve the injection of a medication or substance for cosmetic purposes, or use of a prescriptive device for cosmetic purposes (except for laser, light, radiofrequency and plasma devices). RCW 28A.210.383(4)(b) provides: In the event a school nurse or other school employee administers epinephrine in substantial compliance with a student's prescription that has been prescribed by an authorized health care practitioner with prescriptive authority and written policies of the school district or private school, then the school employee, the school district or school of employment, and the members of the governing board and chief administrator are not liable in any criminal action or for civil damages as a result of administering epinephrine. (RCW 28A.210.383). RCW 18.20 Assisted Living Facilities and WAC 388-78A Assisted Living Facility Licensing Rules for more information. This communication shall take place in a time period consistent with the client's need for care. 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. 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