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Rhonda Wojtas
LPNs and PICC lines

We are a relatively new PICC team started in Dec. We now
place about 70 PICC lines per month. With this increase there has become
an issue of blood draws. We still have a few LPN's who work at our
hospital. Because of our policy LPN's can not hang meds on PICC lines
so they can't do the blood draws. This causes extra work for the RN who
must do the draws for the LPN's.

I am wondering if this policy we have is out dated? Are there facilities that
allow LPN's to use PICC lines for infusion and to do blood draws?

Thanks in advance for your help.

kokotis
Kathy Kokotis Bard Access

Kathy Kokotis

Bard Access Systems

Every state has a nursing board.  The most important thing to find out if this is within the LPN scope of practice in your state.  This is very state dependent.

If it is withing their scope of practice or there is a decision algorithm for what an LPN can do than set up a training / competency program.

I believe this group can safely do the blood draws.  The key is the liability for the action which is regulated by the state

Kathy Kokotis

Kathy Kokotis

Bard Access Systems

DENISE123
Dear Rhonda:  I started my
Dear Rhonda:  I started my career in IV nursing as an LPN.  Under the Massachusetts scope of practice I could: change dsg's & blood draw off all central lines & remove them with the exception of Picc lines (though I did have experiences when the MD's didn't know how to do it and I'd have to walk them through it), access VAD's, hang meds (with exceptions) but not blood.  Since nurses could draw labs & place IV's, I was the night IV/phelbotomy nurse for the facility.  This also included alot of teaching.  My suggestion would be to get a copy of your states LPN scope of practice and institute a competency exam with an RN mentorship untill everyone including the LPN's are comfortable and feel skilled to handle any scenerio that may come along.  They can be a valuable resource, and any nurse (LPN or RN) should know what abilities and limitations she has.  I just attended a seminar with personal from Oregon and their LPN scope of practice is wider than Massachusetts so the bottom line is it depends on your states Board of Nursing.  Good luck and let me know how things turn out.     Denise
Rhonda Wojtas
Thank you for your input.

Thank you for your input. You have atleast given me some ideas that it may indeed be with in the LPN scope of practice here in Massachussets. I did call the State Board of Nursing but missed the return call. I will call again next week.

 Of course it can be a no win situation. When our LPN's have been asked to learn advance skills such as startiing IV's they get mad because they are doing more work for the same pay, the RN should be doing it, or they just refuse to learn the skill. 

 Right now the RN's are upset because they have their own patients to take care of but must stop and do the LPN's line draws. I am hoping we can find a solution that will be accetpable to everyone.

I understand both sides.

 

Thanks for your comments and help.

 

Rhonda Wojtas, RN PICC Team

Lowell MA

Rhonda Wojtas, RN VA-BC

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