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Committee reviews IV therapy regulation revisions to clarify LPN roles and definitions
Summary
The committee discussed draft revisions to IV therapy rules that define 'initiating' and 'pausing' IV therapy, restate limits on LPN tasks (including TPN and blood products), and instructed staff and the task force to refine regulatory language for return to the committee.
The Continuing Nurse Education and IV Therapy Committee met to discuss draft revisions to state IV therapy rules and how those changes would clarify the licensed practical nurse (LPN) scope of practice. The Chair opened the discussion and staff summarized proposed language and references to existing statutes and regulations.
Staff told the committee the task force had started by reviewing regulations and identifying missing definitions. "Initiating shall include assessing the patient, selecting and preparing materials, calculating, and inserting and stabilizing the cannula," the staff member said, describing the portion of the draft that ties 'initiation' to an authorized order. The staff member also proposed a working definition of intravenous fluids as "liquids administered directly into a vein, typically through a needle or catheter." (Staff member)
The committee debated distinctions between 'pausing' and 'discontinuing' an infusion. "Pausing is a temporary interruption with the intent to resume the infusion, where discontinuation is a permanent stopping of the infusion," staff said, and members discussed whether the language should be expanded to clarify monitoring responsibilities after RN initiation.
Staff cited applicable authorities while explaining limits on LPN functions: under the draft regulatory discussion and existing regulation language, LPNs would not initiate total parenteral nutrition (TPN) or lipids and would not administer blood or blood products; those duties were described as outside the LPN scope and appropriate for RNs. The staff member referenced K.A.R. 60-16-102 and K.A.R. 60-16-101 when outlining those constraints and pointed to KSA 65-11-36 as the statutory basis for supervision requirements.
Committee members raised operational questions for rural hospitals, asking whether clearer protocol language and a facility competency checklist could allow LPNs to monitor vitals or ongoing infusions after an RN has initiated therapy. One committee member said a clarified, facility-level protocol could "help rural hospitals" that rely on LPN staffing to manage multiple patients.
The committee agreed staff and the IV task force should draft specific regulatory revisions, produce a competency/confidence checklist and bring revised text back for further review at a future meeting. No final rule was adopted at the meeting; the task force will continue work and report back to the committee.
