Nurse Reporter Winter 2007 - Wyoming State Board of Nursing

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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
TEACHING ADMINISTRATION OF GLUCAGON TO NON- LICENSED PERSONNEL IN AN EMERGENCY - RN Advisory Opinion Number: 06 - 169 Board Meeting Date: October 9-10, 2006 The Practice Committee reviewed a request for reconsideration of a previous Advisory Opinion (05-147) on administration of Rhogam by LPNs from Baerbel Merrill, MS, RNC, Campbell County Memorial Hospital, Gillette, WY. Upon review of additional research the Practice Committee recommended and the Board voted that it is within the scope of LPNs to administer Rhogam and other IM blood products. Approved: October 10, 2006 Reviewed: Revised: 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 whether or not school nurses can teach someone to administer glucagon in an emergency (as delegated by the principle to a willing person.) Upon recommendation of the Practice Committee the Board voted that it is not within the scope of practice for a school nurse to teach an unlicensed, third party to administer glucagon. In an emergency, the school personnel should activate the emergency response system. The American Nurses Association recommends that only routine care be taught to an unlicensed third party. It is the practice committee’s opinion that this teaching be done by a diabetic educator or physician involved in the patient’s care. Approved: October 10, 2006 Reviewed: Revised: ADMINISTRATION OF RHOGAM – LPN Advisory Opinion Number: 06 - 170 Board Meeting Date: October 9-10, 2006 Winter 2007 Nurse VOL. 2 NUMBER 4 WYOMING Compact Nursing— What Is It and What It Would Mean to You R E P O R T E R Koski Appointed to NCSBN Board of Directors For Advertising Information Greg Jones Publishing Concepts, Inc. 1.800.561.4686 gjones@pcipublishing.com Powell Valley Healthcare is seeking individuals committed to being part of an organization where customers come first. Compassionate, team players please apply! Competitive wages, excellent benefits. Powell, Wyoming is located in a beautiful valley just a short drive from the entrance to Yellowstone National Park. Wildlife and sunshine abound. A paradise for outdoor enthusiasts and those who love small town living yet still close enough to the bigger city. Only 90 miles from Billings, Montana. RN's, LPN's, and C.N.A.'s-Full and part time positions, flexible schedules. Call 754-2267 or 1-800-428-1398 ext. 728 for more information or an application. www.pvhc.org EQUAL OPPORTUNITY EMPLOYER W Y O M I N G N U R S E R E P O R T E R 9
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Nurse Reporter Winter 2007 - Wyoming State Board of Nursing

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