WAC 388-112-0260 Adult Family Homes and Assisted Living Facilitiesalso have specific requirements for CPR and first aid training. The LPN honoring those wishes would have legal protection under the Chapter 70.122 RCW: Natural Death Act if POLST reflects patients wishes stated in an advance directive. 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. The nursing law and rule does not prohibit the competent and appropriately trained licensed practical nurse from administering any medication legend or controlled substance (Schedule II-IV) or over-the-counter medications. The Nursing Care Quality Assurance Commission recommends the licensed practical nurse use theScope of Practice Decision Treeto determine if the administration of the off-label medication is within the nurse's regulatory and individual scope of practice. Any person or entity may lawfully possess, store, deliver, distribute, or administer an opioid overdose reversal medication with a prescription or standing order. The licensed practical nurse may follow standing orders or verbal orders to renew an existing medication. The LPN should not initiate CPR if valid POLST exists indicating Do Not Attempt Resuscitation (DNAR). The LPN should give comfort care and wait for help to arrive. Standards and evaluation of nursing education programs. 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. WebHealthcare Delivery Systems (HCM340) Abnormal Psychology (PSY215) Community Health Nursing (NU 420) Care Management 2 (NUR 3219C) Human Physiology Laboratory (BIOL 3120 ) StuDocu Summary Library EN ATI Medical-Surgical (101) Marketing Management (BUS 5112) Biology: Basic Concepts And Biodiversity (BIOL 110) Trending Chemical nurse practitioner. The nursing laws and rules do not prohibit the competent and appropriately trained licensed practical nurse from initiating the admission of a patient to a hospital or SNF. Closing of an approved nursing education program located in Washington state. The licensed practical nurse can use nursing judgment. MSE is beyond initial triage. (15) "Stable and predictable condition" means the registered nurse delegator determines the patient's clinical and behavioral status is nonfluctuating and consistent. The patient may want to refuse CPR under all circumstances including choking or accidents. A pharmacist is not identified as an authorized health care practitioner that the licensed practical nurse may take orders or direction from. Approval of initial (new) in-state nursing education programs. The Nursing Care Quality Assurance Commission determines it is beyond the scope of the licensed practical nurse to remove an IABP or temporary pacing wires due to the complexity of the procedure and concerns about the stability of the patient. (2) The nursing process is defined as a systematic problem solving approach to nursing care which has the goal of facilitating an optimal level of functioning and health for the client, recognizing diversity. RCW 28A.210.383(4)(b) provides: In the event a school nurse or other school employee administers epinephrine in substantial compliance with a student's prescription that has been prescribed by an authorized health care practitioner with prescriptive authority and written policies of the school district or private school, then the school employee, the school district or school of employment, and the members of the governing board and chief administrator are not liable in any criminal action or for civil damages as a result of administering epinephrine. (RCW 28A.210.383). The NCQAC suggests the following: It may be within the scope of practice of the competent and appropriately trained licensed practical nurse to administer and read the TB skin test under the direction of an authorized health care practitioner or under the direction and supervision of the registered nurse. Previous Next 1 of 3 There are no specific laws or rules prohibiting the delegation. The licensed practical nurse must practice within his or her legal scope of practice. Degree requirements for nursing faculty teaching in prelicensure registered nurse or for RN to BSN education programs. A prescription or order from an authorized health care practitioner is required. It is not acceptable for the licensed practical nurse to routinely withhold medications without any medication prior to dialysis without an order from an authorized provider. Licensed prescriber reviews the medications list and reconciles. The procedure may be performed in a home setting or an in-center setting. The Nursing Care Quality Assurance Commission'sStanding Orders and Verbal Orders Advisory Opinionprovides additional guidance and recommendations. The Nursing Care Quality Assurance Commission determines it is beyond the scope of the licensed practical nurse to insert a FSE or IUPC. The nurse should use theScope of Practice Decision Treeto determine if these activities are within the nurse's legal and individual scope of practice. If a patient is deemed potentially dangerous to others, the licensed practical nurse may need to consult with the registered nurse cases are considered more complex and are often deferred to the registered nurse or other professional team member who is trained to handle the needs and complexities of the patient. The Nursing Care Quality Assurance Commission (NCQAC) recommends all Washington nurses complete the telemedicine training as a demonstration of competence as soon as practical to provide an overview of the roles, responsibilities, liability, and legal requirements for providing telehealth services. Using synchronous and asynchronous VDOT for tuberculosis treatment adherence is occurring across the United States and in Washington State. The nursing commission provides advisory opinions and interpretive statements about specific areas of nursing practice. The licensed practical nurse may assist an authorized health care practitioner, or the registered nurse, in performing a sterile speculum examination, including obtaining cytology specimens, following clinical practice standards. The patient must be in a stable condition. 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. No, the telemedicine training requirement doesn't apply to audio-only telephone (telephone triage), facsimile, or email. This includes initiating or discontinuing therapy using pre-mixed medicated peritoneal dialysis bags, collecting specimens, catheter site care, and performing tubing or adaptor changes. Assist an authorized health care practitioner or the registered nurse in changing bottles and/or disposable collection system. The SNF may allow the licensed practical nurse to initiate the admission assessment within licensed practical nurse's scope of practice including collecting information and data without a registered nurse on the premises with the intent that the registered nurse will complete the comprehensive assessment and care planning. It is within the scope of practice of an appropriately trained and competent licensed practical nurse to perform routine and non-complex tracheostomy care under the direction of an authorized health care practitioner, or under the direction and supervision of the registered nurse, following clinical practice standards including: The licensed practical nurse should use theScope of Practice Decision Treeto determine if the activity is within the nurse's legal and individual scope of practice. This section should not be construed as prohibiting delegation to family members and other caregivers exempted by RCW. The Nursing Care Quality Assurance Commission'sStanding Orders and Verbal Orders Advisory Opinionprovides guidance and recommendations. Distance-learning nursing education course or courses offered by approved nursing programs. WebTAB II- NURSE DELEGATION RULES: WAC 246-846-910 through 246-846-970 TAB III- MEDICATION ASSISTANCE RULES: WAC 246-945 REVIEW PRIOR TO CLASS: TAB I- NURSE DELGATION LAW: RCW 18.88B TAB II- SELF DIRECTED CARE: RCW 74.39.050 TAB III - EXEMPT HSC LTCW WACS: WAC 388-112A-0090 TAB IV - EXEMPT DDA The licensed practical nurse may provide data to assist in the development of a nursing diagnosis. ThePublic Health Nurses: Dispensing Medications/Devices for Prophylactic and Therapeutic Treatment of Communicable Diseases and Reproductive Health Advisory Opinionprovides guidelines and recommendations. The licensed practical nurse uses and applies nursing diagnosis (formulated by the registered nurse) as a foundation for implementing interventions. WebThe registered nurse delegator identifies and facilitates any additional training of the nursing assistant or home care aide needed prior to delegation. STATE OF WASHINGTON . See theWAC 246-865-060 Pharmaceutical Services-Extended Care Facilityfor more information. See theWashington State Department of Health Patient Rights Guidelinesfor more information. Curriculum for prelicensure registered nursing education programs. Submitted by Anonymous on Fri, 01/27/2023 - 07:56. A prescription or order from an authorized provider is required. RCW 28A.210.383(2)(b). The telemedicine training provides a valuable overview of the roles, responsibilities, liability, and legal requirements when providing telehealth services. The nurse providing asynchronous (store-and-forward) VDOT is not required to take the training, but NCQAC recommends all nurses take the training. WebLocation: Spokane, WASHINGTON. WebThe registered nurse delegator previously provided written instructions for the care and treatment of the patient. Web(a) The delegating nurse shall: (i) Determine the competency of the individual to perform the tasks; (ii) Evaluate the appropriateness of the delegation; (iii) Supervise the actions of the person performing the delegated task; and (iv) Delegate only those tasks that are within the registered nurse's scope of practice. In most circumstances, if the patients heartbeat stops during a witnessed choking incident or other accident, the LPN should perform first aid measures. Is the nursing assistant or home care aide trained in diabetes care and insulin injections when delegating insulin? The Nursing Care Quality Assurance Commission does not have authority to interpret the laws governing the provision of health care in K-12, public and private schools. The registered nurse delegator, home care aide and nursing assistant are each accountable for their own individual actions in the delegation process. Can the task be performed without repeated nursing assessments? The licensed practical nurse is a valuable member of the health care team and should contribute to the development of the nursing care plan. Does the patient reside in one of the following settings? See theNCQAC Standing and Verbal Orders Advisory Opinionfor guidelines and recommendations. OREGON STATE UNIVERSITY Open search box. Patients with chronic pain, including those on high doses, establishing a relationship with a new practitioner. However, theMedical Quality Assurance Commission WAC 246-919-606 Nonsurgical Medical Cosmetic Proceduresapplies to nonsurgical medical cosmetic procedures that involve the injection of a medication or substance for cosmetic purposes, or use of a prescriptive device for cosmetic purposes (except for laser, light, radiofrequency and plasma devices). The Licensed Practical Nurse, just as in all care the nurse provides, must be appropriately prepared and competent to perform the activity safely. Stable and predictable may include a patient with sliding scale insulin orders. It is also an expectation. Agency policy based on statutes and regulations, standards of care, accreditation standards, and reimbursement requirements may stipulate who can perform a specific assessment in different practice settings. It is within the scope of an appropriately prepared and competent licensed practical nurse to follow standing orders to provide routine birth control or to screen for and treat sexually transmitted diseases. It may be within the scope of practice of the competent and appropriately trained licensed practical nurse to perform the following tasks related to a VAD or other infusion devices under the direction of an authorized health care practitioner or under the direction and supervision of a registered nurse: It is not within the scope of a licensed practical nurse to perform the following tasks: 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. Is appropriate supervision available? The most important consideration is whether it is safe for the patient to perform the initial and ongoing assessment, evaluation, or supervision using telehealth services following the nursing and delegation laws and rules (RCW 18.79,WAC 246-840,RCW 18.88A,WAC 246-841). 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. It is not within the scope of practice of the licensed practical nurse to perform an assessment by proxy. These procedures require a prescription from an authorized health care practitioner. The Nursing Care Quality Assurance Commission determines that it is not within the scope of a licensed practical nurse to perform electrodessication and curettage due to the complexity of the procedure. 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. They may administer or provide an epinephrine autoinjector to people who are experiencing anaphylaxis. A licensed practical nurse may assist an authorized health care practitioner or registered nurse in performing the procedure, including administering the local anesthetic. The facility can be more restrictive. The laws and rules found in Aging and Adult Service Section ofWAC 388-78A(assisted living facilities) and388-76(adult family homes) define the qualifications required for an individual to perform the required pre-admission/resident assessment. Episodic care of chronic opioid patients. Continue CPR until licensed staff or emergency medical responders arrive. The broadly written laws and rules allow nurses to practice to their full scope of practice in any setting. Does the patient have a stable and predictable condition? The competent and appropriately trained licensed practical nurse may also perform specific assessments or screening activities, such as mental health status screening, suicidal risk screening, substance use screening, behavioral health screening, oral health screening, growth and developmental screening, neonatal abstinence syndrome scoring system, or nutritional health screening. Use and protection of professional titles. The Nursing Care Quality Assurance Commission'sStanding Orders and Verbal Orders Advisory Opinionprovides additional guidance and recommendations. These online courses are on-demand eLearning with virtual proctored final exams. A facility or employer may require a specific certification or training program. Curriculum for approved nursing education programs. Commission action following commission site visit, complaint investigation, or national accreditation visits of nursing education programs located in Washington state. (13) "Procedure" means a series of steps with a desired result; a particular course of action or way of doing something. It is within the scope of practice of an appropriately trained and competent licensed practical nurse to perform a routine and non-complex cardiac stress test under the direction of an authorized health care practitioner, or under the direction and supervision of a registered nurse, following clinical practice standards. 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. Abnormal test results should be communicated by someone who can provide supporting information about the test, implications, and follow-up care. This communication shall take place in a time period consistent with the client's need for care. Curriculum for practical nurse nursing education programs. These procedures require a prescription from an authorized health care practitioner. See theNCQAC Standing and Verbal Orders Advisory Opinionfor guidelines and recommendations. Internationally educated nurse program approval criteria for nursing education programs approved in Washington state. The nursing laws and rules do not require an authorized health care practitioner or RN to be on the premises when a LPN provides nursing care or performs medical regimens. 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. The LPN should begin CPR and continue until help arrives if a valid POLST indicating CPR/Attempt Resuscitation. It is beyond the scope of a licensed practical nurse to independently perform training, performance appraisals, or competency validation related to nursing practice of the registered nurse or advanced registered nurse practitioner. If the patient's wishes are not known, the POLST should direct care in the patient's best interest. The licensed practical nurse not analyze, synthesize, or evaluate the data or develop the nursing care plan. Triaging occurs in various setting such as managed care organization, primary and specialty care, emergency departments, and crisis lines. 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. TheRCW 18.79 Nursing Careand theWAC 246-840 Practical and Registered Nursingallow nurses to employ their full scope of practice in multiple settings. Examples of diagnostic imaging procedures include: While the licensed practical nurse may perform routine, diagnostic imaging procedures, because of the complexity, it is not within the scope of the licensed practical nurse to perform interventional radiology procedures. Facilities should develop policies to manage legal risk in these situations. (2) "Coercion" means to force or compel another, by authority, to do something that he/she would not otherwise choose to do. The LPN may determine and pronounce death. See theRCW 18.20 Assisted Living Facilities and WAC 388-78A Assisted Living Facility Licensing Rules for more information. It is not within the scope of a licensed practical nurse to practice 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 nursing diagnosis drives interventions and patient outcomes, enabling the registered nurse to develop the nursing care plan. See the Nursing Care Quality Assurance Commission's for additional information. The nurse should use theScope of Practice Decision Treeto determine if these activities are within the nurse's legal and individual scope of practice. All nurses in Washington State are required to complete a suicide prevention training course from an approved list. The Nursing Care Quality Assurance Commission recommends the licensed practical nurse use theScope of Practice Decision Treeto determine if the administration of the off-label medication is within the nurse's regulatory and individual scope of practice. A focused nursing assessment means recognizing patient characteristics that may affect the patient's health status, gathering and recording nursing assessment data and demonstrating attentiveness by observing, monitoring and reporting signs, symptoms, and changes in patient conditions in an ongoing manner to the registered nurse or other authorized medical provider. (b) Failure to supervise those to whom nursing activities have been delegated. The licensed practical nurse may enter medication prescriptions into an electronic health system under the direction of an authorized health care practitioner. Title: 107N-YN_CS_NPS - Program Coordinator. 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. Standing orders may also be followed to direct occupational health activities. An order from an authorized health care practitioner is required. Reporting and recordkeeping requirements for nursing education programs. 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 may initiate the evaluation and/or respiratory fit testing following standing orders. The nursing laws and rules do not prohibit the competent and appropriately trained licensed practical nurse from administering medications following standing orders. Section B may require nursing delegation for some tasks following the delegation process. This order may be written for an individual patient or through a standing order. (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. Nurses may carry and administer an opioid antagonist (such as naloxone) in a suspected opioid overdose whether the person is a family member, friend, stranger, or a patient. These rules allow delegation of these procedures to a properly trained licensed practical nurse. The Nursing Care Quality Assurance Commission determines it is beyond the scope of the licensed practical to perform IUI. (5) "Home care aide" means a person certified under chapter. Independently insert or remove a CVAD, arterial catheter, or intraspinal catheter; Insert a peripherally inserted midline catheter. (a) Failing to assess and evaluate a client's status or failing to institute nursing intervention as required by the client's condition; (b) Willfully or repeatedly failing to report or document a client's symptoms, responses, progress, medication, or other nursing care accurately and legibly; (c) Willfully or repeatedly failing to make entries, altering entries, destroying entries, making incorrect or illegible entries and making false entries in employer or employee records or client records pertaining to the giving of medication, treatments, or other nursing care; (d) Willfully or repeatedly failing to administer medications and treatments in accordance with nursing standards; (e) Willfully or repeatedly failing to follow the policy and procedure for the wastage of medications where the nurse is employed or working; (f) Nurses shall not sign any record attesting to the wastage of controlled substances unless the wastage was personally witnessed; (g) Willfully causing or contributing to physical or emotional abuse to the client; (h) Engaging in sexual misconduct with a client as defined in WAC. 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