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LPN mixing vanco


I recently wittnessed an LPN mixing vanco and was wondering if this is within their scope of practice. When I asked the nurse she responded with " I don't know, but I have been doing it a long time". I understand that they cannot hang an initial antibiotic, but can hang subsequent infusions. With the subsequent infusions they mix the antibiotics with use of a vial adapter, but this is not always the case with vanco. Vanco doses vary based upon trough levels so we often have to reconstitute and then further dilute.  Our policy is not that specific.

Also I was wondering about LPN's and PICC line care. I was just informed that an LPN flushed a PICC line and I was under the understanding that they were not allowed to access PICC lines. Is there something new with IV certification that allows them the ability to access PICC lines?


Thank you for your input.


LPN Mixing Vanco

The scope of practice r/t to infusion therapy for LPNs (Licensed Vocational Nurse) and VPNs (Licensed Vocational Nurse)  varies and is dependant of what state the nurse is in. What state are you asking about?


Exactly. questions about

Exactly. questions about scope of practice for any level of nurse is determined by the state board of nursing. And there is great variation between states. Most states now use a scope of practice decision tree. Find that resouce for your state. Also, nothing has changed about competency validation when a skill, task, or intervention is within the scope of practice. That is defined in the INS Standards of Practice. BTW, skills competency is not the same as certification, although some state boards of nursing do use that word inappropriately. 

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



As Lyn wrote, it all depends on the State that they practice in.  For instance, in my home state, LPN's can't admix, but assembly and activation of the MINI BAG + system, the VIAL MATE system, the DUPLEX system or the ADVANTAGE system, is just that: assembly and activation.  They can do these aforementioned systems, because there is NO mixing, but rather these systems have a premeasured, premixed medications, which again, just need assembly and activation.  Also, in my state, an LPN who is IV certified, can also hang medications/solutions and administer them into any central line, including PICC's.  SO, go to your state's Nursing Practice Act, and read what they can or cannot do.  You as a RN are a supervisor to the LPN and absolutly must know what is in, or out of their scope of practice. 


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