The Nursing Care Quality Assurance Commission determines it is beyond the scope of a licensed practical nurse to perform a vaginal examination. The nurse may also get a prescription in their own name from their health care practitioner. Functions of the registered nurse supervising the nursing technician. 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 these activities are within the nurse's legal and individual scope of practice. Out-of-state distance learning nursing program approval for practice experiences in Washington state. The licensed practical nurse should use theScope of Practice Decision Treeto determine if performing these activities is within the licensed practical nurse's regulatory and individual scope of practice. If you have a question related to nursing practice in the state of Washington, please contactnursingpractice@doh.wa.govorarnppractice@doh.wa.govfor questions about advanced nursing practice. In some settings (community-based and in-home care) only a registered nurse may delegate and is required to validate competency prior to nursing delegation. The licensed practical nurse may collect the data and then have the registered nurse review the data and complete the assessment to determine the patient' needs and developing the nursing care plan. See theWashington State Department of Health Patient Rights Guidelinesfor more information. The nursing laws and rules allow a competent and appropriately trained licensed practical nurse from performing laser therapy for cosmetic purposes under the direction of an authorized health care practitioner or under the direction and supervision of a registered nurse. The laws and rules do not prohibit the licensed practical nurse from calling in a medication ordered by an authorized health care provider order, or under the direction and supervision of the registered nurse, to a pharmacist. The Nursing Care Quality Assurance Commission determines it is beyond the scope of the licensed practical nurse to lead this activity due to the complexity of the procedure. 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. The registered nurse delegator, home care aide and nursing assistant are each accountable for their own individual actions in the delegation process. A pharmacist is not identified as an authorized health care practitioner that the licensed practical nurse may take orders or direction from. The licensed practical nurse may perform nursing care under the direction of an authorized health care practitioner or at the direction and under the supervision of the registered nurse. TheRCW 18.79 Nursing Careand theWAC 246-840 Practical and Registered Nursingallow nurses to employ their full scope of practice in multiple settings. For more information, go to theWashington State Department of Overdose Education and Naloxone Distribution Website. 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. Delegation is not required for the NA-R/NA-C or other UAP to follow the cardiopulmonary resuscitation (CPR)/DO NOT ATTEMPT RESUSCITATION (DNAR) POLST in Section A. The licensed practical nurse needs to be competent regarding the specific medication including the indications, contraindications, and side effects that is being delivered to the patient. Ongoing evaluation and approval of nursing education programs located in Washington state. Training and competency assessment for personal care services (non-nursing care) does not require the services of a Washington state licensed professional nurse. (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. False eyelashes and extensions, as well as their adhesives, must meet the safety and labeling requirements for cosmetics. The licensed practical nurse may assist an authorized health care practitioner or the registered nurse in reinsertion of a tracheostomy tube if the decannulation occurs before the tract is established. The registered nurse delegator determines the patient does not require frequent nursing presence and evaluation. The Nursing Care Quality Assurance Commission determines it is beyond the scope of the licensed practical nurse to perform pulmonary artery pressure monitoring procedures due to the complexity of the procedure. It is within the scope of an appropriately prepared and competent licensed practical nurse to apply or remove an external electronic fetal monitor under the direction of an authorized health care practitioner, or under the direction and supervision of the registered nurse, following clinical practice standards. WSR 13-15-063, 246-840-940, filed 7/15/13, effective 8/15/13. Nurses must follow the delegation process following the RCW 18.79.260. A licensed practical nurse must have direction from an authorized health care practitioner or a registered nurse to perform tests such as a human chorionic gonadotropin (hCG), urine dipstick, occult blood screening, blood glucose capillary tests or otherCLIAapproved waiver under the CLIA criteria. 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. 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. Medication reconciliation is a formal process for creating the most complete and accurate list possible of a patient's current medications and comparing the list to those in the patient record or medication orders. The licensed practical nurse may assist an authorized provider in replacing a suprapubic catheter in a non-established tract. Seeking mental health care is both safe and encouraged. The patient must be in a stable condition. It is within the scope of practice of an appropriately trained and competent licensed practical nurse assist with an authorized health care practitioner or registered nurse to insert a PEG tube, . The Revised Code of Washington (RCW) 18.79 and Washington Administrative Code (WAC) 246-840 provide the statutory and legal basis of nursing practice. A prescription or order from an authorized provider may be necessary if complications occur or if medical treatment is required. The Nursing Care Quality Assurance Commission'sStanding Orders and Verbal Orders Advisory Opinionprovides additional guidance and recommendations. It is within the scope of practice of an appropriately trained and competent licensed practical nurse to assist in performing an endoscopy, sigmoidoscopy, or colonoscopy. TheWAII Handbookidentifies a Medical Doctor (MD), Doctor of Osteopathy (DO), Advanced Registered Nurse Practitioner (ARNP), Physician' Assistant (PA), and Naturopathic Physician as a medical authority to perform a sports physical examination. The licensed practical nurse must be competent. Staff must meet the credentialing, training and competency requirements established in the state and federal laws and rules specific to the setting. A licensed practical nurse may provide direct patient care and perform functions within the nurse's legal and individual scope of practice under the direction of an authorized health care practitioner or under the direction and supervision of a registered nurse. 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. You should contact your legal advisor to obtain advice with respect to any particular issue or problem. The licensed practical nurse implementing the order is required to see clarification of the order when the licensed practical nurse has any reason to believe any contraindications exists, and to take any other action necessary to assure the safety of the patient. 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. The patient may want to refuse CPR under all circumstances including choking or accidents. Symjepi (https://www.symjepi.com/) is not classified as an EAI. Delegating specific nursing tasks as outlined in the plan of care and consistent with nursing delegation laws and rules. The order or prescription may be for a specific patient or through the use of standing orders. The nurse should use theScope of Practice Decision Treeto determine if these activities are within the nurse's regulatory and individual scope of practice. These commonly asked questions and answers offer information and general guidance regarding the practice of professional nursing in the State of Washington and do not constitute legal advice. Other examples include post-fall and pre-transfer assessments. The nursing laws and rules allow the competent and appropriately trained licensed practical nurse to perform therapeutic phlebotomy for conditions, such as polycythemia vera, under the direction of an authorized health care practitioner or under the direction and supervision of a RN. Manipulate, advance, irrigate, milk, or remove a chest tube. This procedure requires a prescription from an authorized health care practitioner. The licensed practical nurse may assist in carrying out the assessment process and carrying out these plans. There are no specific laws or rules prohibiting the delegation. See theNCQAC's Administration of Sedating, Analgesic, and Anesthetic Agents Advisory Opinionfor more information. The registered nurse delegator makes independent professional decisions of the delegation of a nursing task. POLST is usually for persons with serious illness or frailty. The licensed practical nurse should use theScope of Practice Decision Treeto determine if crushing a medication is within the nurse's regulatory and individual scope of practice. School registered nurses or licensed practical nurse (LPN) may provide telehealth services to students during the COVID-19 emergency within their legal scope of practice. The licensed practical nurse may assist an authorized health care practitioner or the registered nurse, in inserting a FSE or IUPC, following clinical practice standards. The licensed practical nurse does not need an additional order from an authorized health care practitioner to restart an intravenous line that is no longer patent. RCW 69.41.095allows the Licensed Practical Nurse to have a prescription for an opioid antagonist in the nurse's name to carry and administer in the non-work setting. Itdoes notinclude the use of audio-only telephone, facsimile, or email.. No, the telemedicine training requirement doesn't apply to audio-only telephone (telephone triage), facsimile, or email. Faculty requirements for nursing education programs. The Nursing Care Quality Assurance Commission supports the use of medication organizers following standards of practice for medication administration. Inflation and deflation of cuff in a healed and established stoma. A prescription or order from an authorized provider is required as TB skin test formulations are legend drugs. The laws and rules require the licensed practical nurses to demonstrate competence and accountability in all areas of practice in which the nurse is engaged. 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. Provision for continuity of drug therapy for residents. The laws and rules do not require a special certificate to perform cosmetic procedures. Critical thinking is purposeful and reflective judgment in response to events, observations, experiences, and verbal or written expressions. Some settings may use the licensed practical nurse to manage calls after specialized training and under the supervision of the registered nurse or other authorized health care provider. The facility or employer may require a specific certification or training program. The employer may also decide whether they want to require an in-person course or on-line course and other parameters. Independently change out chest tube bottles; Independently change a disposable collection system; or. The licensed practical nurse may not use the title of respiratory therapist unless the nurse is dually licensed. The nursing commission provides advisory opinions and interpretive statements about specific areas of nursing practice. Facilities should develop policies to manage legal risk in such a situation. 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. The licensed practical nurse can use nursing judgment. A prescription or order from an authorized provider is required. Curriculum for prelicensure registered nursing education programs. The LPN and RN may provide telehealth nursing services within their scope of practice to patients in Washington state. For more information, go to theWashington State Department of Health Overdose Education and Naloxone Distribution Website. 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. It is impossible for the Nursing Care Quality Assurance Commission (NCQAC) to provide a comprehensive listing of the duties that licensed nurses are permitted to perform since nursing practice is reflective of the dynamic changes occurring in healthcare and society. (5) "Home care aide" means a person certified under chapter. The licensed practical nurse administering the medication is responsible for ensuring the medication is safe to crush or split before giving it. The LPN or RN may provide telehealth nursing services within their scope of practice to patients in Washington state following standing orders approved by an authorized practitioner. Common interventional radiology procedures include thrombolysis, needle biopsies, paracentesis, and thoracentesis. Application requirements for ARNP prescriptive authority. A prescription or order from an authorized provider is required. Standing orders may be an option to allow the nurse to start an intravenous line based on specific criteria (such as a high acuity patient), admission to a specific unit (such as intensive care), or for a specific condition. WebThe Revised Code of Washington (RCW) 18.79 and Washington Administrative Code (WAC) 246-840 provide the statutory and legal basis of nursing practice. Do assessment, then proceed with a consideration of delegation. Denial, statement of deficiencies, conditional approval or withdrawal of approval of nursing education programs located in Washington state. 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. 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