Nurse Reporter Winter 2007 - Wyoming State Board of Nursing

S COPE OF P RACTICE I SSUES
Cheryl Koski, MN, RN, Executive Director
The following Advisory Opinions were
issued at the October 9-12, 2006
Board Meeting.
STERILE SPECULUM EXAM
TO DETERMINE PREMATURE
RUPTURE OF MEMBRANES – RN
Advisory Opinion Number:
06 - 165
Board Meeting Date:
October 9-10, 2006
The Practice Committee reviewed a
request from Penny Blount, RNC,
Director of Obstetric Unit,
Memorial Hospital of Sweetwater
County, Rock Springs, WY. Ms.
Blount requested an Advisory
Opinion regarding whether or not a
Register Professional Nurse may perform
a sterile speculum examination
for the purpose of determining premature
rupture of membranes in a
pregnant patient.
The Practice Committee reviewed
the original request and the additional
materials you sent. Upon the
recommendation from the Practice
Committee, the Board voted after
discussion that it is within the
scope of the Registered Professional
Nurse to perform sterile speculum
exams to determine premature rupture
of membranes in a pregnant
patient with the guidelines listed
below and according to the protocol
in the facility.
• The nurse must have the proper
education and training and documented
demonstrated competency
in the performance of
sterile speculum procedures;
• There must be a follow-up by
the licensed independent
healthcare provider within
twelve (12) hours following
the speculum examination by
the nurse regardless of the outcome
of the test results.
Approved: October 10, 2006
Reviewed:
Revised:
USE OF MEDIPLANNERS IN
SCHOOLS – RN
Advisory Opinion Number:
06 - 166
Board Meeting Date:
October 9-10, 2006
The Practice Committee reviewed a
request from Susie Delger RN, FNP,
Nursing Coordinator at Natrona
Count School District 1, Casper,
WY. Ms. Delger requested an
Advisory Opinion regarding the use
of mediplanners in schools in place
of the current practice of administering
medications from the original
container marked with the correct
information (child name, dosage,
and physician/APRN/PA name).
Upon recommendation of the
Practice Committee the Board voted
that school nurses should follow the
existing state medication policy and
procedures and administer medications
from the original container.
Approved: October 10, 2006
Reviewed:
Revised:
CLARIFICATION OF PROPOFOL
ADVISORY OPINIONS - RN
Advisory Opinion Number:
06 - 167
Board Meeting Date:
October 9-10, 2006
The Practice Committee reviewed
a request for clarification of propofol
Advisory Opinions from
Baerbel Merrill, MS, RNC,
Campbell County Memorial
Hospital, Gillette, WY.
Upon recommendation of the
Practice Committee the Board
voted that the Advisory Opinion
06-163 (Administration of
Anesthetic Agents such as
Propofol, Etomindate and
Ketamine by RNs for IV Conscious
Sedation) does not negate 03-124
(Propofol - RN) or 00-102 (Rapid
Sequence Intubation - RN). In
those situations the RN should follow
those Advisory Opinions.
Approved: October 10, 2006
Reviewed:
Revised:
GASTROSTOMY TUBE
REINSERTION INTO A
MATURE SITE – RN
Advisory Opinion Number:
06 - 168
Board Meeting Date:
October 9-10, 2006
The Practice Committee reviewed a
request from Marilyn Connor, RN,
Central Wyoming Hospice Program,
Casper, WY 82601. Ms. Connor
requested an Advisory Opinion
regarding whether or not is it is
within the scope of practice to
change a Gastrostomy Tube in a
mature stoma site upon the order of
a qualified provider.
Upon recommendation of the
Practice Committee the Board
voted that it is within the scope of
nursing practice for an RN to
change a Gastrostomy Tube in a
mature stoma site upon the order
of a qualified provider. The nurse
must be educationally prepared
and clinically competent in the
performance of the procedure. If
the nurse has any questions as to
the safe performance of the procedure,
the nurse should consult
with the patient’s medical provider
prior to the reinsertion of the
Gastrostomy tube.
Approved: October 10, 2006
Reviewed:
Revised:
8 W Y O M I N G N U R S E R E P O R T E R