The answer to your question about normal saline being a medication is determined by the board of pharmacy in each state. This has primarily been associated with home health nurses and their legal ability to carry saline syringes that are not labeled for a specific patient. I would not consider this to be a medication. Are you saying that if it is a considered to be a medication, then a UAP could not insert a peripheral catheter? I have looked at the literature on delegation and have not seen this listed an a criteria for any board of nursing. This task could be delegated by a nurse but that depends upon the regulations about delegation that have been written by your state board of nursing. INS has a position paper about delegation of tasks to nursing UAPs but specify that this does not apply to medical UAPs. A medical UAP will usually have an education that is very close to that of an LP/VN and these people do a lot of infusion therapy in doctors offices.
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Office Phone 770-358-7861
Bard Access Systems
Saline is no longer a medication as far as Medicare goes. It no longer has a pharmacy NDC billing code so therefore it is not a medication for billing purposes or reimbursement.
Technicians may and can start PIV's and use normal saline. Look to Minn, Alaska, Wyoming. It is the state that determines this. States will be opeing up to this idea as we go due to the economic pressures on healthcare in the next three years.
I was told today that CMS changed the rules and that saline is a medication and requires a doctor's order. We are working on a flush protocol for the medical executive committee to approve!! Are we talking about different things?
In Texas, our board of nursing considers saline to be a medication and to delegate to any UAP wouldn't be permitted.
I would want to see the CMS document stating that saline is a medication. They may consider it a medication for billing purposes. Someone can correct me if I am wrong, but I don' t think that CMS is involved in the scope of practice issues for any professional.
Delegation from any nurse to an unlicensed person is regulated by the board of nursing, however unlicensed people give this all day, along with other IV medications in doctors offices under the "supervision" of the physician.
I am still investigating this issue.