WSR 15-12-090
[Filed June 2, 2015, 9:50 a.m.]
Original Notice.
Preproposal statement of inquiry was filed as WSR 10-15-101.
Title of Rule and Other Identifying Information: WAC 246-926-180, amending the parenteral procedure rule for radiologic technologists.
Hearing Location(s): Department of Health, Town Center 2 (TC2), 111 Israel Road S.E., Room 145, Tumwater, WA 98501, on July 24, 2014 [2015], at 9:30 a.m.
Date of Intended Adoption: August 7, 2015.
Submit Written Comments to: Susan Gragg, Program Manager, Department of Health, P.O. Box 47852, Olympia, WA 98504-7852, e-mail, fax (360) 236-2901, by July 24, 2015.
Assistance for Persons with Disabilities: Contact Susan Gragg, program manager, by July 20, 2015, TTY (800) 833-6388 or 711.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The department of health (department) received a rule petition asking for clarification as to whether accessing peripherally inserted central catheters (PICC) lines and ports for manual and power injections is within the existing statutory scope of practice for radiologic technologists (RT). In its present form, this rule is not clear on the subject of RTs accessing PICC lines and/or ports. The department has determined that current law regarding the RT scope of practice includes administering diagnostic and/or therapeutic agents, identified in statute as parenteral procedures. The statute does not specify, nor does it limit, the route(s) an RT may use. The administration of substances related to radiologic technology, whether through intravenous injection or by accessing PICC lines and/or power ports, is nationally recognized technique. For that reason, the department is proposing an amendment to the rule.
Reasons Supporting Proposal: Rules that implement chapter 18.84 RCW, RT scope of practice, need to clearly state permissible duties to ensure that imaging technology is safe and effectively administered to the people of this state by skilled and qualified health care providers. The proposed rule meets the statutory goals and objectives because it clearly identifies allowed actions under RT scope of practice. The proposed rule is also consistent with industry standards.
Statutory Authority for Adoption: RCW 18.84.040.
Statute Being Implemented: RCW 18.84.040, 18.84.020(6).
Rule is not necessitated by federal law, federal or state court decision.
Name of Proponent: Department of health, governmental.
Name of Agency Personnel Responsible for Drafting, Implementation, and Enforcement: Susan Gragg, Program Manager, 111 Israel Road S.E., Tumwater, WA 98501, (360) 236-4941.
No small business economic impact statement has been prepared under chapter 19.85 RCW. The proposed rule would not impose more than minor costs on businesses in an industry.
A cost-benefit analysis is not required under RCW 34.05.328. Under RCW 34.05.328, a cost-benefit analysis is required for "significant legislative rules." By definition, under RCW 34.05.328 (5)(c)(ii), the proposed rule is considered an "interpretive rule." A preliminary cost-benefit analysis may be obtained by contacting Susan Gragg, Program Manager, Department of Health, P.O. Box 47852, Olympia, WA 98504-7852, phone (360) 236-4941, fax (360) 236-2901, e-mail
June 2, 2015
Dennis E. Worsham
Deputy Secretary
for John Wiesman, DrPH, MPH
AMENDATORY SECTION (Amending WSR 12-10-094, filed 5/2/12, effective 5/3/12)
WAC 246-926-180 Parenteral procedures ((for a diagnostic or therapeutic radiologic technologist, or a cardiovascular invasive specialist)).
(1) For the purposes of this section, these terms shall have the following meaning:
(a) "Diagnostic agent" means a substance used in radiologic technology to reveal, pinpoint, and define the localization of a pathological process, such as contrast preparations, radioactive isotopes, and dyes.
(b) "Parenteral administration" means introducing a substance or medication into the body in a manner other than through the digestive canal or by topical application.
(c) "Therapeutic agent" means a medication or substance intended for medical treatment in the radiologic technology domain.
(d) "Venipuncture" means a procedure to puncture a vein to withdraw blood or to start intravenous infusion related to radiologic technology, but does not include the insertion of peripherally inserted central catheter (PICC) lines.
(2) A certified diagnostic or therapeutic radiologic technologist may administer diagnostic and therapeutic agents via intravenous, intramuscular, or subcutaneous injection, under the direct supervision of a physician licensed under chapter 18.71 or 18.57 RCW. ((Diagnostic and therapeutic agents may be administered via intravenous, intramuscular, or subcutaneous injection. In addition to direct supervision,)) This includes accessing PICC lines and ports for manual or power injections for procedures related to radiologic technology. PICC lines and injection ports must be of a type approved by the federal Food and Drug Administration for administering diagnostic or therapeutic agents in radiologic technology. This does not include intraosseous infusion or intrathecal administration.
(3) Before the radiologic technologist may administer diagnostic and therapeutic agents, the following ((guidelines)) must be met:
(a) The radiologic technologist has had the prerequisite training and thorough knowledge of the particular procedure to be performed;
(b) Appropriate facilities are available for coping with any complication of the procedure as well as for emergency treatment of severe reactions to the diagnostic or therapeutic agent itself, including readily available appropriate resuscitative drugs, equipment, and personnel; and
(c) After parenteral administration of a diagnostic or therapeutic agent, competent personnel and emergency facilities must be available to the patient for at least thirty minutes in case of a delayed reaction.
(((2))) (4) A cardiovascular invasive specialist may administer parenteral diagnostic and therapeutic agents during cardiac or vascular catheterization procedures under the personal supervision of a physician licensed under chapter 18.71 or 18.57 RCW. Parenteral administration includes, but is not limited to, catheterization procedures involving arteries and veins.
(((3))) (5) A certified radiologic technologist or cardiovascular invasive specialist may perform venipuncture under the direct supervision of a physician licensed under chapter 18.71 or 18.57 RCW.