INTERPRETIVE STATEMENT
(1) Title: May a registered nurse remove chest tubes after cardiac surgery?
Subject: The commission issued an advisory opinion in response to the request from Barbara Godfrey, RN, MSN.
Effective Date: January 14, 2000.
(2) Title: Can a Licensed Practical Nurse perform the following duties?
1. Enter orders for patients as directed, including consult requests and ordering various tests.
2. Manages chest tubes including changing the PleurEvac, adjustment of suture holding chest tube in place and removal of chest tubes as directed.
3. Pacing wire removal when directed.
4. Suture and staple removal when directed.
5. Enter surgical scheduling information and submit preoperative orders as directed.
6. Performs appropriate diagnostic and therapeutic procedures.
7. Makes pre and postoperative contacts/arrangements.
8. Provides counseling and education to patients and their significant others pre and postoperatively.
9. Manages/coordinates surgical clinics.
10. Provide communication link between patients and providers/team.
11. Coordinate patient care between cardiology and cardiac surgery.
12. Act as liaison between surgical team and other facilities.
13. Coordinate discharge follow-ups with cardiac, thoracic and other consulted services.
14. Tracking and making x-ray films available.
Subject: The commission issued an advisory opinion in response to the request from Frankie T. Manning.
Effective Date: January 14, 2000.
(3) Title: Is it within the scope of practice for a registered nurse to place a fetal oximeter in the labor and delivery environment?
Subject: The commission issued an advisory opinion in response to the request from Martina Letco Porter, RNC, MS, MBA.
Effective Date: January 14, 2000.
(4) Title: Registered Nurses Performing Procedural Sedation.
Subject: The commission adopted a policy that it is within the scope of practice of a registered nurse to assist in the care of patients receiving procedural sedation (otherwise known as conscious sedation) during therapeutic and diagnostic procedures.
Effective Date: January 14, 2000.
(5) Title: May the nursing assistant perform the following procedures under the supervision of the registered nurse if the nursing assistant has received training in the procedure and competency has been verified? Specifically, the following procedures: Clean dressing change (nonsterile), oral suctioning, removal of foley catheter, assist with incentive spirometry, measure Sa02 using a pulse oximeter, 12 lead ECG, refilling a formula bag for gastrostomy feeding without changing the tubing or bag, wet to dry dressing, adjusting an oxygen face mask, applying a nasal cannula.
Subject: The commission issued and advisory opinion in response to the request from Sandy Pendland, RN, Med.
Effective Date: March 3, 2000.
(6) Title: Is it within the practice of nursing to pre-fill insulin syringes for self-administration by an individual at a later date?
Subject: The commission issued an advisory opinion in response to the request from Pat Bossert, RN and Kathy Woods, RN.
Effective Date: March 3, 2000.
(7) Title: May a RN administer and review "medical evaluations" used to determine an employee's ability to wear respiratory protection? Specifically, can a RN, according to their training and level of expertise,
1. Administer a medical screening questionnaire.
2. Review the medical questionnaire to distinguish normal from abnormal responses.
3. Follow up with employees to clarify any positive (i.e., abnormal) responses on the questionnaire.
4. Verify normal health status of an individual worker related to their medical fitness to wear respiratory protection by reviewing reports from medical examinations or laboratory/test results.
5. Refer for further evaluation if any abnormal or irregular findings remain unexplained.
6. And, more specifically, can a RN perform these functions independently, or be delegated the responsibility?
Subject: The commission issued an advisory opinion in response to the request from Michelle Kom Gochnour.
Effective Date: March 3, 2000.
Contact Person: Jeanne E. Vincent, RN, MS, Associate Nurse Practice Manager, Department of Health, Nursing Care Commission, P.O. Box 47864, Olympia, WA 98504-7864, (360) 236-4725.