An Overview of Ohio LPN IV Changes from March 2013, to the end of 2014

As seen in the Consultant Connection February 2015 Issue
Erin McClure, BSN, RN, WCC, ICP Inc., Nurse Consultant, emcclure@icppharm.com
In March 2013, new LPN IV Therapy laws took effect that directly affect nursing practice under the Ohio Revised Code (Law), section 4723.18, http://codes.ohio.gov/orc/4723.18. Some of the highlights from house bill 303 included; Former section 4723.177, ORC, now renumbered as 4723.18, was amended to remove the prohibition of “aspirating any intravenous line to maintain patency.” Thus, LPNs who are IV therapy certified will no longer be prohibited from aspirating an intravenous line when such aspiration is indicated and performed in accordance within the LPN scope of practice and the applicable standards of safe nursing practice as contained in Chapter 4723-4 of the Ohio Administrative Code. IV-Certified LPN’s can now administer antibiotics through a central venous line, which include a Peripherally Inserted Central Catheter (PICC), Tunneled, Non-Tunneled, Implanted Port, all which terminate in a central vein. 
The Ohio Administrative Code, following suit, was updated in February 1, 2014, OAC 4723-17 can easily be found at the Ohio Board of Nursing website:  http://nursing.ohio.gov.  The rules, OAC 4723-17-03 (IV Therapy Procedures), were amended in accordance with the law changes made by House Bill 303 and to further clarify information by separation of permissive and prohibited activities.  In a nutshell, language was removed that limited secondary antibiotic administration to peripheral only, changing it to allowing IV administration through a central line. It also removed language prohibiting IV aspiration, allowing IV Certified LPNs to initiate Central Venous Access Devices (CVADs). 
After attending a public meeting regarding LPN IV Therapy Practice at the Ohio Board of Nursing in September 2014, some of the key issues brought to the board were. Regulatory Language revision to make it easier to interpret, training; both new LPN students and IV certified LPNs, Mandatory Internenship/Competencies for both RNs and LPNs pertaining to IV Skills, use of the same language pertaining to IV therapy, in accordance with the Infusion Nurses Society(INS) /Association of Vascular Access (AVA), and expansion of the IV-Certified LPN Role to include TPN/Blood infusion/transfusion.  All comments and suggestions were welcomed and encouraged from the OBN.  The paragraph below contains an excerpt from the September 18-19 2014 meeting minutes from the OBN Practice Committee.
Janet Arwood and Lisa Emrich reported on the Board Committee on Practice meeting held September 18, 2014. They reported that the Committee and stakeholders reviewed draft legislative language regarding the LPN IV therapy requirements and discussed potential changes. Stakeholder input and discussion was substantial. Board staff will review the comments and revise the legislative language to provide greater clarity. The Board agreed to re-convene the Committee on Practice at the January Board meeting for further review and discussion.
As you see, this is going to be a continued process, with additional meetings, involving the OBN and the public, so please make your voices heard and give input or ask questions, which is welcomed by the Ohio Board of Nursing.  The ICP Nursing Department is following the progress of these changes and will continue to report any new information. 

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