In most circumstances, if the patients heartbeat stops during a witnessed choking incident or other accident, the LPN should perform first aid measures. 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. Only a registered nurse may delegate nursing activities to a nursing assistant-certified (NA-C), nursing assistant-registered (NA-R), or home care aid-certified (HCA-C) in an ALF. 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. 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. RCW 28A.210.383(2)(a). The registered nurse delegator previously provided written instructions for the care and treatment of the patient. Extended or satellite nursing campus of nursing education programs approved in Washington state. The nursing laws and rules do not prohibit the competent and appropriately trained licensed practical nurse from administering medications following standing orders. Follow the policies and procedures relative to the documentation (paper or electronic) system used by the organization. The licensed practical nurse must be competent to carry specific steps identified in the standing order or verbal order. TheInstitute for Safe Medication Practices (ISMP)is a good resource for determining whether a medication is safe to crush. Generally, a prescription from an authorized health care practitioner is required for reimbursement of medical supplies. 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. Purposes of commission approval of nursing education programs. 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. This includes preparing and monitoring the dialysis machine, accessing an arteriovenous (AV) fistula or graft or a central venous catheter, initiating or discontinuing hemodialysis, collecting specimens, catheter site care, and performing tubing or adaptor changes. It is within the scope of practice of an appropriately trained and competent licensed practical nurse to perform routine and non-complex respiratory therapy procedures under the direction of an authorized health care practitioner, or under the direction and supervision of the registered nurse, following clinical practice standards. (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. The nursing laws and rules allow a competent and appropriately trained licensed practical nurse to apply cold therapy (cryotherapy) or heat therapy for fat removal under the direction of an authorized health care practitioner or under the direction and supervision of a registered nurse. Standing orders may be used. The licensed practical nurse must be competent. Additional student requirements for prelicensure registered nurse nursing education programs located in the state of Washington. For more information, go to theWashington State Department of 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. There are no specific laws or rules prohibiting the 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 theDentist Scope of Practice - Use of Botulinum Toxin Injections/Dermal Fillers Interpretive Statementfor more information. The licensed practical nurse implements health care plans developed by the registered nurse or other authorized health care practitioner. The licensed practical nurse is always individually accountable and responsible for the nursing care the licensed practical nurse provides. It is within the scope of an appropriately prepared and competent licensed practical nurse to insert prostaglandin into the vagina for a chemical abortion under the direction of an authorized health care practitioner, or under the direction and supervision of the registered nurse, following clinical practice standards. (c) The registered nurse and licensed practical nurse act as client advocates in health maintenance and clinical care. The Nursing Care Quality Assurance Commission determines it is beyond the scope of the licensed practical nurse to perform sexual assault examinations and perform colposcopy to collect forensic evidence. Is the task within the registered nurse's scope of practice? The nursing law and rules do not prohibit the competent and appropriately trained licensed practical nurse from giving experimental drugs by any route under the direction of an authorized provider or under the direction and supervision of the registered nurse. The Nursing Care Quality Assurance Commission supports the use of medication organizers following standards of practice for medication administration. Web(a) Delegating nursing care function or responsibilities to a person the nurse knows or has reason to know lacks the ability or knowledge to perform the function or responsibility, or delegating to unlicensed persons those functions or responsibilities the nurse knows or has reason to know are to be performed only by licensed persons. Degree requirements for nursing faculty teaching in prelicensure registered nurse or for RN to BSN education programs. 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. The nursing laws and rules allow a competent and appropriately trained licensed practical nurse to obtain a blood specimen via a capillary or venous blood sample to perform lead screening, hepatitis B screening, or other employee health laboratory tests under the direction of an authorized health care provider or under the direction and supervision of a registered nurse. The licensed practical nurse must follow theWAC 246-878 Compounding Practicesand theUnited States Pharmacopeia (USP)compounding guidelines. RCW 28A.210.380and28A.210.383regulations stipulate the requirements for epinephrine autoinjector use in public and private schools including the option of having a school stock supply of epinephrine autoinjectors for nurses to give following standing orders approved by an authorized health care practitioner. 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 Nursing Care Quality Assurance Commission recommends the licensed practical nurse use theScope of Practice Decision Treeto determine if these activities are within the licensed practical nurse's legal and individual scope of practice. It is up to the nurse, using nursing judgment, to determine which patients and services are appropriate for telehealth. WebWhat Is Nurse Delegation? The nursing laws and rules allow a competent and appropriately trained licensed practical nurse to apply eyelash extensions under the direction of an authorized health care practitioner or under the direction and supervision of a registered nurse. This section has been decodified as it was omitted from "The rules and regulations of the Washington state apprenticeship council," filed 2/12/65 and 10/11/65. It involves determining the meaning and significance of what is observed or expressed to determine need for action. Yes, licensed nurses (RN, LPN, or ARNP) in Washington state are required to take telemedicine training if the nurse provides telemedicine services. The prescriber or the registered nurse does not need to be on onsite when the licensed practical nurse administers medications. Refer to theStanding Order Advisory Opinionfor more information on use of standing orders. Curriculum for registered nurse to bachelor's or master's in nursing education programs. The physician rules allow delegation to a properly trained and licensed professional and require a physician to be on the immediate premises during the patient's initial treatment. The Food and Drug Administration (FDA) approves cosmetics. The licensed practical nurse should use nursing judgment and determine whether additional verification or clarification is required. Nurse administrator qualification requirements in nursing education programs located in Washington state. 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 LPN should begin CPR if a valid POLST does not exist and continue until help arrives. Does the patient reside in one of the following settings? (d) The registered nurse and the licensed practical nurse shall be responsible for maintaining current knowledge in their field of practice; and, (e) The registered nurse and the licensed practical nurse shall respect the client's right to privacy by protecting confidential information and shall not use confidential health care information for other than legitimate patient care purposes or as otherwise provided in the Health Care Information Act, chapter. The patient must be in a stable condition. Employer: Washington Department of Labor & Industries - Insurance Services . 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. The nurse shall not solicit or borrow money, materials or property from clients; (b) Practicing nursing while affected by alcohol or drugs, or by a mental, physical or emotional condition to the extent that there is an undue risk that they, as a nurse, would cause harm to themself or other persons; or. 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. [ IX, filed 3/23/60.] Licensure for ARNP applicants educated and licensed outside the United States. A dentist may prescribe neuromodulators (such as Botox) or dermal fillers when it is used to treat functional esthetic dental conditions and their direct esthetic consequences. These terms are often used by health care agencies to describe different types of assessment. Invasive procedures require an order from an authorized health care practitioner. Reinstatement of approval for nursing programs located in Washington state. 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. Provision for clean, intermittent catheterization in schools. Mail: P.O. The Washington state laws and rules do not require a specific training course or certification. 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. (10) The nurse shall not disclose the contents of any licensing examination or solicit, accept or compile information regarding the contents of any examination before, during or after its administration. The licensed practical nurse must have the training, knowledge, skills and abilities to perform triage competently(RCW) 18.79,(WAC) 245-840andAdvisory Opinion on Telenursing. CNA may administer in a nursing home setting with a medication assistant endorsement. These online courses are on-demand eLearning with virtual proctored final exams. WebWashington state nursing care quality assurance commission community-based and in-home care setting delegation decision tree. Nursing assessment may include a comprehensive nursing assessment and/or a focused nursing assessment. The LPN should begin CPR and continue until help arrives if a valid POLST indicating CPR/Attempt Resuscitation. A prescription or order from an authorized health care practitioner is required. Standing orders and verbal orders may include medical orders or nursing orders. 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. 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 Nursing Care Quality Assurance Commission determines it is beyond the scope of a licensed practical nurse to perform a vaginal examination. 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 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. There must be an order from an authorized provider. This pre-admission/resident assessment (screening tool) does not necessarily require the services of a professional licensed nurse or the use of the nursing process (WAC 246-840-700). The complexity and seriousness of the test results may also determine who gives the results and by what method test results should be given. Standard I Initiating the Nursing Process: Nursing Diagnosis/Problem Identification. The registered nurse delegator decides if the task is not delegable. Patients with chronic pain, including those on high doses, establishing a relationship with a new practitioner. 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. It is within the scope of practice of an appropriately trained and competent licensed practical nurse to insert a feeding tube in a neonate, infant, child, or adult under the direction of an authorized health care practitioner, or under the direction and supervision of the registered nurse, following clinical practice standards. Some facility laws do address medication refusal. Competent practice may require the administration of first aid and/or CPR. The LPN may follow POLST in any setting based on regulatory and individual scope of practice. These procedures require a prescription from an authorized health care practitioner. Is RN assessment of patient's nursing care needs completed? The Nursing Care Quality Assurance Commission'sStanding Orders and Verbal Orders Advisory Opinionprovides additional guidance and recommendations. 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 goal of the pre-admission/resident assessment is to determine the personal care services needs of a potential resident and at times, the nursing care needs of said resident. 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 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. 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. Staff must meet the credentialing, training and competency requirements established in the state and federal laws and rules specific to the setting. 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. Authorized entities that choose to acquire epinephrine autoinjectors must have people connected with the entity, such as employees, who have completed an anaphylaxis and epinephrine autoinjector training. Any CLIA waived test involving puncturing the skin requires an order from an authorized health care practitioner. 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