The licensed practical nurse should use theScope of Practice Decision Treeto determine if specific activities are within the licensed practical nurse's legal and individual scope of practice. Using synchronous and asynchronous VDOT for tuberculosis treatment adherence is occurring across the United States and in Washington State. The licensed practical nurse may administer naloxone or other opioid antagonist to anyone at risk for having or witnessing an opioid overdose. The licensed practical nurse should use theScope of Practice Decision Treeto determine if specific activities are within the licensed practical nurse's legal and individual scope of practice. A prescription or order from an authorized provider is required. Any person or entity may lawfully possess, store, deliver, distribute, or administer an opioid overdose reversal medication with a prescription or standing order. The Nursing Care Quality Assurance Commission (NCQAC) recommends telemedicine training be completed as soon as possible as a demonstration of competency. An order is required from an authorized health care practitioner. Authorized prescriptions by ARNP with prescriptive authority. The licensed practical nurse practices in an interdependent role when carrying out nursing care and a dependent role when carrying out medical regimens. 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. Application requirements for ARNP prescriptive authority. 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. The nurse may get a prescription from a pharmacist with a Collaborative Drug Therapy Agreement (CDTA) or use the Washington State Department of HealthStatewide Standing Order to Dispense Naloxoneto get a prescription from a pharmacy. Although a nursing care assessment may include elements of a non-skilled personal care assessment, it is a comprehensive nursing care evaluation and must be performed by the registered nurse. VDOT is the use of a videophone or other video/computer equipment to observe clients taking their medications remotely. 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 specific activities are within the registered nurse's legal and individual scope of practice. Medical regimens require a prescription or order from an authorized health care practitioner. Continuing competency audit process and compliance. 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 is always individually accountable and responsible for the nursing care the licensed practical nurse provides. The full name of the medication being ordered; The total amount of medication to be given in a specified time period; The order should state if the dose can be given in divided doses; The order should state if the dose can be repeated; If repeated, the order should indicate how frequently, and in what time frame; and, The order should include what action should be taken if pain is unrelieved. (1) "Authorized representative" means a person allowed to provide written consent for health care on behalf of a patient who is not competent to consent. Only the registered nurse may delegate to assistive personnel to perform asthma management tasks in this setting. Off-label use should be done with careful insight and understanding of the risks and benefits to the patient considering high-quality evidence supporting efficacy, effectiveness, and safety. It is not within the LPNs scope of practice to certify death. 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. These people will be responsible for the storage, maintenance, and general oversight of the epinephrine autoinjectors. The licensed practical nurse practices interdependently when providing nursing care and dependently when carrying out medical regimens. The licensed practical nurse cannot provide nursing care independently. 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 person giving the test results or diagnosis must be competent to answer the patient's questions. Purpose and outcomes for approved nursing education programs. 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. Discussions should include a review of the patient's or residents medical history and recommendations from treating providers. See the Washington State Department of Health'sEpinephrine Autoinjectors and Anaphylaxis Training and Reporting for Authorized Entities Frequently Asked Questionsand theSSB 6421 Status Update Documentfor more information. The Nursing Care Quality Assurance Commission recommends the nurse follow theWAC 246-919-605for physicians when carrying out laser treatment procedures under the direction of an authorized health care practitioner. Curriculum for LPN nurse refresher course. The authorized health care practitioner may provide treatment following an established treatment plan during temporary absences of the prescribing physician provided there is a local back-up physician who will be available by telephone and see the patient within sixty minutes. Follow the policies and procedures relative to the documentation (paper or electronic) system used by the organization. The licensed practical nurse is required to use critical thinking in clinical problem-solving and decision-making processes relative to scope of practice, knowledge, competency, and experience. The nursing law and rules do not prohibit the competent and appropriately trained licensed practical nurse from giving drugs, including antineoplastic drugs, under the direction of an authorized provider or under the direction and supervision of the registered nurse. (3) "Complex task" means that a nursing task may become more complicated because of: (c) The nursing care task(s) and involved risks; and. The nursing commission provides advisory opinions and interpretive statements about specific areas of nursing practice. A prescription or order from an authorized provider may be necessary if complications occur or if medical treatment is required. The licensed practical nurse may assist an authorized health care practitioner, or the registered nurse, in performing a vaginal examination, following clinical practice standards. The Nursing Care Quality Assurance Commission'sStanding Orders and Verbal Orders Advisory Opinionprovides guidance and recommendations. The Community Based Nurse Delegation Program is authorized through the written rules within the Nurse Practice Act (WAC) and through Washington State Law (RCW). The licensed practical nurse is a valuable member of the health care team and should contribute to the development of the nursing care plan. Examples of settings include (but not limited to): Hospitals, nursing homes, assisted living facilities, adult family homes, schools, camps, clinics, public health clinics, homes, hospice, community health centers, homeless shelters, insurance companies and other businesses, law offices, travel clinics, occupational health centers, private clinics, outpatient clinics, ambulatory surgery centers, dialysis centers, mental health centers, infusion centers, medical spas, nursing informatics programs, correctional centers/jails, county health departments, government offices, cruise ships, churches, casinos, and retail clinics. [ IX, filed 3/23/60.] An exception exists in the physician rules that require a physician to be on the immediate premises during the patient's initial treatment when a nurse is performing laser therapy:WAC 246-919-605 Use of Laser, Light, Radiofrequency, and Plasma (LLRP) Devices as Applied to the Skin. (c) Willfully abandoning clients by leaving a nursing assignment, when continued nursing care is required by the condition of the client(s), without transferring responsibilities to appropriate personnel or caregiver; (d) Conviction of a crime involving physical abuse or sexual abuse including convictions of any crime or plea of guilty, including crimes against persons as defined in RCW, (e) Failure to make mandatory reports to the Nursing Care Quality Assurance Commission concerning unsafe or unprofessional conduct as required in WAC. See theRCW 18.20 Assisted Living Facilities and WAC 388-78A Assisted Living Facility Licensing Rules for more information. POLST is usually for persons with serious illness or frailty. (3) The following standards apply to registered nurses and licensed practical nurses: (a) The registered nurse and licensed practical nurse shall communicate significant changes in the client's status to appropriate members of the health care team. Appropriate documentation of a focused patient assessment and evaluation must substantiate intervention. It is not within the scope of the licensed practical nurse to replace a suprapubic catheter in a non-established tract. The nurse would need to contact the other state(s) to see if they can practice in their state with a Washington state license during the pandemic. 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 U.S. Office of Health and Human Services-Office of Civil RightsFrequently Asked Questions on Telehealth and HIPAAprovides information on waivers and exceptions and guidance during the COVID-19 emergency about HIPAA and telehealth services. RCW 69.41.095provides an exception to the nursing delegation laws and rules and does not require delegation for a nursing assistant to administer an opioid overdose medication by intranasal spray or by injection. 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. See WAC 296-04-045. This may be appropriate for patients with advanced dementia at risk for aspiration, patients with osteoporosis, or other conditions and situations in which chest compressions or other CPR interventions may cause more harm than benefit to the patient. Any CLIA waived test involving puncturing the skin requires an order from an authorized health care practitioner. The nursing laws and rules allow the competent and appropriately trained licensed practical nurse performing venipuncture to obtain blood samples for laboratory testing in any setting. The registered nurse delegator previously provided written instructions for the care and treatment of the patient. In no case, may administration of medications by injection with the exception of insulin injections, sterile procedures and central line maintenance be delegated. RCW 28A.210.383(2)(a). The procedure may be performed in a home setting or an in-center setting. RCW 43.70.495 requires the nurse who provides clinical services through telemedicine independently or under the direction of anauthorized health care practitionerto complete telemedicine training. The general age of majority for health care is eighteen years old in Washington State as defined in . Accreditation requirements for all nursing education programs located in Washington state. See the Nursing Care Quality Assurance Commission'sNeonatal Intubation and Related Procedures Advisory Opinionfor additional information. Purposes of commission approval of nursing education programs. A nursing diagnosis is used to determine the appropriate nursing care plan for the patient. Is the nursing assistant or home care aide, registered or certified and properly trained in the nurse delegation for nursing assistants or home care aides? Episodic care of chronic opioid patients. It is within the scope of practice of an appropriately prepared and competent licensed practical nurse to replace a suprapubic in an established tract under the direction of an authorized health care practitioner, or under the direction and supervision of the registered nurse, following clinical practice standards. TheDrug Enforcement Administration (DEA)does state that, an individual (secretary or nurse) may be designated by the practitioner to prepare prescription for the practitioner's signature.. 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