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I need to hear from whomever is doing
it in Indiana please!! You can email me privately if you wish, at [EMAIL PROTECTED]
Thanks!!
a/
Ann Williams RN CRNI From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of MidWest Vascular Access Sent: Wednesday, December 21, 2005 7:56 PM To: 'Leigh Ann Bowe-geddes'; [EMAIL PROTECTED]; [EMAIL PROTECTED]; [EMAIL PROTECTED] Subject: RE: RNs verifying tip termination on CXR You can add
Michelle Followell, RN,
CNN, CRNI -----Original
Message----- Vickie: Arkansas California Georgia Indiana Kentucky Michigan Minnesota Missouri New
Jersey North
Carolina Oregon Texas Washington Most of these are states that
utilize a decision tree model for determination of scope of practice. We have
the decision tree, but our Board also issues opinion statements. Previously, the
opinion statement concerning PICCs mentioned that an x-ray must be done if the
tip passed the shoulder, and that a physician must read the x-ray prior to use.
We got them to change this, and the opinion statement now addresses RNs
verifying initial tip termination (NOT reading the x-ray). Go to kbn.ky.gov,
click on Practice Issues (or something like that - it is on the left hand side),
then click on Advisory Opinion Statements. It is AOS # 25.
To get the Board to approve this
change I sent them a letter, explaining our intention and request. In the letter
I also explained our plan for competency validation and maintenance, and
informed them of other states in which this was already being done. I included a
letter of support from one of our Radiology attendings, a copy of the Opinion
Statement (similar to our current one) from Oregon Board of Nursing, a copy of
the JVAD article that Tim Royer wrote on the subject. I directed all of this to
the Chair of the Practice Committee. She then invited us to make a formal
presentation to the committee, and asked that we send enough copies of all of
the above for each committee member to have one. With those copies we included
some policies for competency and process from other facilities throughout the
country that were already doing tip verification. The committee Chairperson
distributed all this information in advance to the committee members, so that
they were aware of the information before the meeting. My manager spoke to the
committee at the meeting, explaining that we want the right people to be doing
the right things, and how this benefits patient care. The long history of this
practice in states such as Texas and Georgia didn't hurt. The committee
unanimously agreed to recommend this to the full Board. It was approved at the
next Board meeting, and we were free to move forward with it.
I recommend having a solid plan for
training and competency in advance of approaching the Board. If you are in a
state where this is already being done, or one which has a decision tree and no
written limitation concerning this, you may not need to ask the Board for
permission. The purpose of the decision tree is to assist in determining scope
of practice. If you can follow the decision tree and clearly see that this is
within your scope of practice, you don't need extra endorsement from the Board.
If you do need to ask the Board,
point out that Kentucky, a contiguous state, is doing this with the Board's
blessing. I will point out that I called TN Board of Nursing when we were
researching this, to find out if they allowed it. They were unable to answer me
either way. Good
Luck! Leigh
Ann Leigh Ann Bowe-Geddes, RN,
CRNI
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