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maureen lawler
techs drawing off lines???
The only folks we allow to access central lines at this acute care facility for labs are RNs and LPNs.  One of the Docs wants to send his "techs" from hiis private practice office over to the IV Team to be taught how to do this.  I'm not going to do this for a no. of reasons but wondered if anyone has ever done this and what you're rational was?  I believe this is VERY BAD IDEA!
lynncrni
There are several things to

There are several things to consider. Start with the information from your state board of nursing about delegation to unlicensed assistive personnel. Also a key issue is delegation by a nurse vs delegation by a physician - vastly different. These office techs are probably medical assistants. I have been researching information about their scope of practice and will be putting together a course for them. Basically they can be taught to do venipunctures but should not be involved with medication preparation or administration. I have not found any information about drawing blood samples from CVCs by med. assistants. Medical assistants are different from nursing assistants also. See the new INS position statement about this at http://www.ins1.org/i4a/pages/index.cfm?pageid=3412. 

Lynn Hadaway, M.Ed., RN, BC, CRNI

www.hadawayassociates.com

Lynn Hadaway, M.Ed., NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

daylily
So Lynn, from what I'm

So Lynn, from what I'm understanding, we should not be allowing unlicensed personnel to administer topical anesthetics prior to venipuncture (even with a medically approved protocol)?  I ask because this was recently come under question.

lynncrni
According to what I have

According to what I have been reading, there is a difference between delegation by a nurse and delegation by a physician. If you are talking about a task delegated to a nursing assistant by a nurse, then you will need to be in compliance with what your state board of nursing has published about this. Medical assistants can take delegation from a physician in their office to do just about anything and I have never found anything that provides true direction on this issue. The bottom line for a nursing assistant seems to be the need for any decisions based on assessment and judgement during the procedure. If the procedure does not call for any decisions, it may be safe to delegate, but if it does require decisions to be made it can not be delegated. But again, check your state board of nursing statements on this. 

 

Lynn Hadaway, M.Ed., RN, BC, CRNI

www.hadawayassociates.com

Lynn Hadaway, M.Ed., NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

Leigh Ann Bowegeddes
What Lynn says about
What Lynn says about delegation is true, and the medical assistant is not under our direction at all. My answer to this would be, "NO." The physician may be able to delegate this task to the MA, but that does not make it my job to facilitate this practice. Our team would stand against this for two reasons - 1) We would not support this level of employee handling our CVCs, and 2) The MA works for the doc, not the hospital, and therefore has no authority to put hands on patients in the hospital. Only hospital employees can touch patients, and all hospital employees have determined job descriptions that answer this question in advance. An MA as an employee would not be qualified to do this in our facility, so certainly could not be taught to as a non-employee. (Not that we have cause to hire MAs in the acute setting.) We have a duty to protect our patients while they are under our care. I was recently an inpatient, and if an MA had accessed my IV in any way, I would have made serious trouble for the hospital and individual nurses involved.
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