Section 4723-4-02 - Intravenous therapy procedures for licensed practical nurses(A) Except as provided in paragraph (B) of this rule, a licensed practical nurse shall not perform any of the following intravenous therapy procedures: (1) Initiate or maintain any of the following: (a) Blood or blood components;(b) Solutions for total parenteral nutrition;(c) Cancer therapeutic medications including, but not limited to, cancer chemotherapy or an anti-neoplastic agents;(d) Investigational or experimental medications;(e) Solutions administered through any central venous line or arterial line or any other line that does not terminate in a peripheral vein, except as provided in paragraph (B)(1) of this rule;(f) An intravenous piggyback infusion, except as provided in paragraph (B)(3) of this rule.(2) Discontinue a central venous, arterial, or any other line that does not terminate in a peripheral vein;(3) Initiate or discontinue a peripherally inserted central catheter, or any catheter that is longer than three inches;(4) Program or set any function of a patient controlled analgesic;(5) Mix, prepare or reconstitute any medication for intravenous therapy, except as provided in paragraph (B)(4) of this rule;(6) Administer medications by an intravenous route, except as provided in paragraph (B)(3) of this rule;(7) Inject medications by a direct intravenous route, except as provided in paragraph (B)(5) of this rule;(8) Change tubing on an arterial line, a central venous line, or on any line that does not terminate in a peripheral vein;(9) Change an intermittent infusion device, unless the tip of the connected intravenous catheter terminates in a peripheral vein.(B) A licensed practical nurse may perform the following procedures only for individuals aged eighteen or older and only when directed to do so by a licensed physician, physician assistant, dentist, optometrist, podiatrist, or registered nurse in accordance with section 4723.18 of the Revised Code:(1) Administer the following solutions, or combinations of the solutions, through a venous line: (a) Five per cent dextrose and water;(b) Five per cent dextrose and lactated ringers;(c) Five per cent dextrose and normal saline;(f) 0.45 per cent sodium chloride and water;(g) 0.2 per cent sodium chloride and water; or(h) 0.3 per cent sodium chloride and water.(2) Administer any of the solutions set forth in paragraph (B)(1) of this rule that contain vitamins or electrolytes after a registered nurse initiates the first infusion of the solution containing vitamins or electrolytes.(3) Initiate or maintain an intermittent or secondary intravenous infusion containing an antibiotic;(4) Prepare or reconstitute an antibiotic additive to be administered through an intravenous infusion;(5) Inject heparin or normal saline to flush an intermittent infusion device or heparin lock, including, but not limited to, bolus or push;(6) Change tubing on an intermittent infusion device and on an intravenous line if the line terminates in a peripheral vein;(7) Place a venous access catheter, no longer than three inches in length, in the hand, forearm or antecubital space, followed by the placement of a saline or heparin lock, either for purposes of intermittent infusions, or to initiate infusions of any of the solutions set forth in paragraph (B)(1) of this rule; or(8) Stop an infusion of blood or blood component, or turn off the function of a patient-controlled analgesic device when a complication arises.(C) A licensed practical nurse may perform the procedures set forth in paragraph (B) of this rule only if one of the following requirements are met: (1) The licensed practical nurse is directed to perform intravenous therapy by a licensed physician, physician assistant, dentist, optometrist, or podiatrist who is present and readily available at the facility where the intravenous therapy procedure is performed;(2) The licensed practical nurse is directed to perform intravenous therapy by a registered nurse who has personally performed an on-site assessment of the individual to receive intravenous therapy, and that registered nurse or another registered nurse is readily available at the site where the intravenous therapy procedure is performed; or(3) If the intravenous therapy procedures are performed in a home as defined in section 3721.01 of the Revised Code, or in an intermediate care facility for individuals with intellectual disabilities as defined in section 5124.01 of the Revised Code, a registered nurse who directs the authorized licensed practical nurse to perform intravenous therapy is either: (a) On the premises of the home or facility; or(b) Accessible by some form of telecommunication. Replaces: 4723-17-03
Ohio Admin. Code 4723-4-02
Effective: 2/1/2024
Five Year Review (FYR) Dates: 02/01/2029
Promulgated Under: 119.03
Statutory Authority: 4723.07
Rule Amplifies: 4723.18, 4723.181
Prior Effective Dates: 02/01/2005, 02/01/2010, 02/01/2014, 02/01/2015