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Role of the Ohio LPN in IV Therapy

This independent study is designed for LPNs who have successfully completed an out-of-state IV Therapy course which meets the Ohio Board of Nursing (OBN) requirements with the exception of OBN mandated content regarding law / rules governing the role of the Ohio LPN in IV therapy. By successfully completing this program, learners acquire the additional rule-related information/knowledge required by the Ohio Board of Nursing. You will receive an email to confirm your purchase. Please note the last 4 digits of your order number. You will need to sign in from the LPNAO website (Independent Study) page to resume your studies, should you decide to finish at a later time.
 

OBJECTIVES
Upon completion of this independent study the learner will be able to:
1. Describe the LPN’s role in IV therapy according to Ohio law and rules.
2. List IV therapy procedures specific to LPN permitted by Ohio law.
3. List IV therapy procedures, specific to the LPN, that are prohibited by Ohio law.
 

This offering has been approved by the Ohio Board of Nursing for 1.9 Contact Hours through the OBN Approver Unit at the Licensed Practical Nurse Association of Ohio. (OBN-002-92) It takes an average of 96 minutes to complete this independent study which consists of reading the instructions and material, taking the post-test and completing an evaluation form.
NOTE: Do not be alarmed or concerned if you require a longer or shorter period of time for completion as completion time has no influence on the contact hours you will receive. Contact hours were determined from an average of the time required to complete the entire course through a pilot study.
 

COURSE INSTRUCTIONS
1. At your own pace, thoroughly read the enclosed material. Complete the registration form, post-test, evaluation form and only Section 1 of the Ohio Board of Nursing Application to Perform Limited Intravenous Therapy Procedures by a Licensed Practical Nurse in Ohio.
2. Submit your registration form,  post-test, and evaluation form directly to LPNAO, Inc by clicking the "Submit" button:

FOLLOW-UP
1. Upon receipt of the required items your post-test will be evaluated. If a score of 80% or better is achieved, LPNAO will mail you a certificate indicating satisfactory completion and 1.9 Contact Hours will be awarded in Category A (Ohio Law and Rule).
2. Your Application to Perform Limited Intravenous Therapy Procedures by a Licensed Practical Nurse in Ohio will be sent you, by mail, along with additional processing instructions.
3. If your score is below 80%, a certificate cannot be issued. However, an alternate posttest will be sent to you and it is strongly recommended that you review the independent study content prior to taking the second test. After achieving a score of 80% or higher on the alternate test, the certificate with 1.9 Contact Hours in Category A (Ohio Law and Rule) will be awarded to you, and LPNAO will follow the procedure outlined in #2 above.
4. Failure to successfully complete the post-test with a score of 80% or better on the second try will result in a recommendation that you complete a Board of Nursing approved LPN/IV Therapy course. Your $25.00 fee for the issuance of an IV Therapy Authorization (made payable to “Treasurer, State of Ohio) will be returned to you. The fees paid to LPNAO will not be refunded.
Should you have any questions or require assistance during the learning process, feel free to
contact LPNAO at 1-800-222-5762 or (937) 399-8920

REGISTRATION and FEES
Payment was made to LPNAO for this course. ($25.00 -Registration fee plus $3 to cover handling charges.These fees are non-refundable).

To have your records at the Board of Nursing changed:
LPNAO will send you an Application to be completed once you have passed this course. At that time, you will
be instructed return a separate check or money order, made payable to: “Treasurer, State of Ohio” in the
amount of $25.00 (required by Board of Nursing) and the completed application to LPNAO.



Course begins here:

ROLE OF THE OHIO LPN IN IV THERAPY
Due to evolving changes in the health care delivery system, the use of intravenous therapy is
becoming commonplace in all settings where health care delivery occurs. LPNs are increasingly
required to administer medications and fluids via the intravenous route. Recognizing this trend,
the Ohio Board of Nursing (OBN) adopted rules (Chapter 4723-17 Ohio Administrative Code)
governing the role of LPNs in IV therapy, which initially became effective April 1, 1993. In
addition, Ohio legislation (HB 87 and SB 178), further passed in 1999 and 2000 respectively,
further expanded that role.
 

In Ohio, a licensed practical nurse wishing to perform specified IV therapy procedures must
successfully complete an OBN approved IV therapy course. This course is in addition to the
LPN’s basic education program and its curriculum is mandated by Ohio law and rule. A
component of this mandated curriculum comprises content relating to current law and rules of
the OBN pertaining to IV therapy and the accountability/responsibility of the Ohio licensed
practical nurse in the performance of specified IV therapy procedures.
Nevertheless, the Ohio Board of Nursing recognizes and accepts IV courses approved by certain
other state boards of nursing as being equivalent to OBN requirements with one exception.
Since out-of-state courses obviously do not address Ohio laws and rules, the LPN who
successfully completed one of these out-of-state courses must also successfully complete an
independent study module on the law and rules relating to LPN IV therapy in the state of Ohio
prior to becoming eligible to perform certain IV procedures. This independent study meets the
OBN criteria for the said module and comprehensively describes the role of the Ohio LPN in IV
therapy.
 

Specifically, this independent study module consists of six additional sections entitled:
• What’s the Law?
• Ohio Board of Nursing Guidelines
• Chapter 4723-17 OAC - Role of Licensed Practical Nurses in Intravenous Therapy
• Can I? Or Can’t I? (Allowable Procedures and Prohibitions)
• Summary Information
• Appendix A (Standards Relating to Competent Practice as a Licensed Practical Nurse)
 

Regardless of your employment situation, knowledge of Ohio’s laws and rules relative to IV
therapy is imperative, as they will ultimately guide your nursing practice in the area of
intravenous therapy.
 

WHAT IS THE LAW?
HB 87 and SB 178, Ohio bills which became law. Together, these laws in September, 1999 and
July, 2000 respectively impact the practice of nursing in Ohio. Specifically, they affect the role
of the licensed practical nurse in relation to intravenous therapy.
 

The most significant part of this legislation involved expanding the LPN’s role and scope of
practice in the area of intravenous therapy. These desired legal changes have, subsequently,
become part of the Nurse Practice Act (4723 Ohio Revised Code), the law regulating the practice
of nursing in Ohio. While the laws are written by the state legislators in Ohio, the Board of
Nursing is the agency that can determine if an LPN has met the criteria to perform certain IV
therapy procedures.
 

Since the LPN in Ohio must function in accordance with the statutes, or laws, governing the
practice of nursing, acquiring an understanding and working knowledge of the law is essential in
terms of safety and liability. What follows is the text of Sections 4723.17 and 4723.171 ORC,
which addresses the role of the licensed practical nurse in intravenous therapy.
Section 4723.17 Ohio Revised Code (The Law)
Requirements for Administration of Intravenous Therapy by Licensed Practical Nurse:
 

(A) The Board of Nursing may authorize a licensed practical nurse to administer to an adult
intravenous therapy authorized by an individual who is authorized to practice in this state and is acting within the course of the individual’s professional practice, if the licensed practical nurse has a current, valid license issued under this chapter that includes authorization to administer medications and one of the following is the case:
 

(1) The nurse has successfully completed, within a practical nurse pre-licensure education program approved    by the Board or by another jurisdiction’s agency that regulates the practice of nursing, a course of study that prepares the nurse to safely perform the intravenous therapy procedures the Board may authorize under this section. To meet this requirement, the course of study must include all of the following:
(a) Both didactic and clinical components;
(b) Curriculum requirements established in rules the Board of Nursing shall adopt in accordance with Chapter 119. of the Revised Code;
(c) Standards that require the nurse to perform a successful demonstration of the intravenous procedures, including all skills needed to perform them safely.
 

(2) The nurse has successfully completed a minimum of forty hours of training that includes all of the following:
(a) The curriculum established by rules adopted by the Board and in effect on January 1, 1999;
(b) Training in the anatomy and physiology of the cardiovascular system, signs and symptoms of local and systemic complications in the administration of fluids and antibiotic additives, and guidelines for management of these complications;
(c) Any other training or instruction the Board considers appropriate.
(d) A testing component that requires the nurse to perform a successful demonstration of the intravenous
procedures, including all skills needed to perform them safely.
 

(B) Except as provided in section 4723.171 of the Revised Code, a licensed practical nurse may perform intravenous therapy only if authorized by the Board pursuant to division (A) of this section and only if it is performed in accordance with this section. A licensed practical nurse authorized by the Board to perform intravenous therapy may perform an intravenous therapy procedure only at the direction of one of the following:
(1) A licensed physician, dentist, optometrist, or podiatrist who, except as provided in division (C)(2) of this section, is present and readily available at the facility where the intravenous therapy procedure is performed;
(2) A registered nurse in accordance with division (C) of this section.

(C) (1) Except as provided in division (C)(2) of this section and section 4723.171 of the Revised Code, when a licensed practical nurse authorized by the Board to perform intravenous therapy performs an intravenous therapy procedure at the direction of a registered nurse, the registered nurse or another registered nurse shall be readily available at the site where the intravenous therapy is performed, and before the licensed practical nurse initiates the intravenous therapy, the registered nurse shall personally perform an onsite assessment of the individual who is to receive the intravenous therapy.
(2) When a licensed practical nurse authorized by the Board to perform intravenous therapy performs an intravenous therapy procedure in a home as defined in section 3721.10 of the Revised Code, or in an intermediate care facility for the mentally retarded as defined in section 5111.20 of the Revised Code, at
the direction of a registered nurse or licensed physician, dentist, optometrist, or podiatrist, a registered nurse shall be on the premises of the home or facility or accessible by some form of
telecommunication.
 

(D) No licensed practical nurse shall perform any of the following intravenous therapy procedures:
(1) Initiating or maintaining any of the
following:
(a) Blood or blood components;
(b) Solutions for total parenteral nutrition;
(c) Any cancer therapeutic medication including, but not limited to, cancer chemotherapy or an anti-neoplastic
agent;
(d) Solutions administered through any central venous line or arterial line or any other line that does not terminate in a peripheral vein, except that a licensed practical nurse authorized by the Board to perform intravenous therapy may maintain the solutions specified in division (D)(6)(a) of this section that are being administered through a central venous line or peripherally inserted central catheter;
(e) Any investigational or experimental medication.
(2) Initiating intravenous therapy in any vein, except that a licensed practical nurse authorized by the Board to perform intravenous therapy may initiate intravenous therapy in accordance with this section in avein of the hand, forearm, or antecubital fossa;
(3) Discontinuing a central venous, arterial, or any other line that does not terminate in a peripheral vein;
(4) Initiating or discontinuing a peripherally inserted central catheter;
(5) Mixing, preparing, or reconstituting any medication for intravenous therapy, except that a licensed practical nurse authorized by the Board to perform intravenous therapy may prepare or reconstitute an antibiotic additive;
(6) Administering medication via the intravenous route, including all of the following activities:
(a) Adding medication to an intravenous solution or to an existing infusion, except that a licensed practical nurse
authorized by the Board to perform intravenous therapy may do either of the following:
(i) Initiate an intravenous infusion containing one or more of the following elements: dextrose 5%; normal saline; lactated ringers; sodium chloride 0.45%; sodium chloride 0.2%; sterile water;
(ii) Hang subsequent containers of the intravenous solutions specified in division (D)(6)(a) of this section
that contain vitamins or electrolytes, if a registered nurse initiated the infusion of that same
 (b) Initiating or maintaining an intravenous piggyback infusion, except that a licensed practical nurse authorized by the Board to perform intravenous therapy may initiate or maintain an intravenous piggyback infusion
containing an antibiotic additive;
(c) Injecting medication via a direct intravenous route, except that a licensed practical nurse authorized by the Board to perform intravenous therapy may inject heparin or normal saline to flush an intermittent infusion devise or
heparin lock including, but not limited to, bolus or push;
(7) Aspirating any intravenous line to maintain patency;
(8) Changing tubing on any line including, but not limited to, an arterial line or a central venous line, except that a licensed practical nurse authorized by the Board to perform intravenous therapy may change tubing on an intravenous line that terminates in a peripheral vein;
(9) Programming or setting any function of a patient controlled infusion pump.
 

(E) Notwithstanding division (D) of this section, at the direction of a licensed physician or a registered nurse, a licensed practical nurse authorized by the Board to perform intravenous therapy may perform the following activities for the purpose of performing dialysis:
(1) The routine administration and regulation of saline solution for the purpose of maintaining an established fluid plan;
(2) The administration of a heparin dose intravenously;
(3) The administration of a heparin dose peripherally via a fistula needle;
(4) The loading and activation of a constant infusion pump or the intermittent injection of a dose of medication prescribed by a licensed physician for dialysis.
 

(F) No person shall employ or direct a licensed practical nurse to perform an intravenous therapy procedure without first verifying that the licensed practical nurse is authorized by the Board to perform intravenous therapy.
 

(G) The Board shall issue an intravenous therapy card to the licensed practical nurses authorized pursuant to division (A) of this section to perform intravenous therapy. A fee for issuing the card shall not be charged under section
4723.08 of the Revised Code if the licensed practical nurse receives the card by meeting the requirements of division (A)(1) of this section. The Board shall maintain a registry of the names of licensed practical nurses who hold intravenous therapy cards.
 

[Effective June 26, 2003]
Section 4723.171 Ohio Revised Code (The Law)
Intravenous Therapy Procedures Performed by a Licensed Practical Nurse
(A) A licensed practical nurse may perform on any person any of the intravenous therapy procedures specified in division (B) of this section without receiving authorization to perform intravenous therapy from the Board of Nursing under section 4723.17 of the Revised Code, if both of the following apply:
(1) The licensed practical nurse acts at the direction of a registered nurse or a licensed physician, dentist, optometrist, or podiatrist and the registered nurse, physician, dentist, optometrist, or podiatrist is on the premises
where the procedure is to be performed or accessible by some form of telecommunication.
(2) The licensed practical nurse can demonstrate the knowledge, skills, and ability to perform the procedure safely.
(B) The intravenous therapy procedures that a licensed practical nurse may perform pursuant to division (A) of this section are limited to the following:
(1) Verification of the type of peripheral intravenous solution being administered;
(2) Examination of a peripheral infusion site and the extremity for possible infiltration;
(3) Regulation of a peripheral intravenous infusion according to the prescribed flow rate;
(4) Discontinuation of a peripheral intravenous device at the appropriate time;
(5) Performance of routine dressing changes at the insertion site of a peripheral venous or arterial infusion, peripherally inserted central catheter infusion, or central venous pressure subclavian infusion.

[Effective April 10, 2001]

CHAPTER 4723-17 OAC
ROLE OF LICENSED PRACTICAL NURSES IN INTRAVENOUS THERAPY
In light of the current Nurse Practice Act (4723 ORC), the Ohio Board of Nursing revised its
rules (Chapter 4723-17 OAC) governing the role of LPNs in IV therapy. These rules
(reproduced in their entirety on the following pages) coupled with Sections 4723.17 and
4723.171 ORC present a comprehensive picture of the LPN’s role, accountability and
responsibility relating to intravenous therapy.
Although your move to Ohio does not require you to take an entire OBN approved IV therapy
course, noting the curriculum / course content specified in rules 4723-17-07 and 4723-17-09 may
be helpful for personal / professional review purposes. These specific rules acquaint you with
the knowledge level expected of the licensed practical nurse engaged in IV therapy in the state of
Ohio.
Based on the law at sections 4723.17 and 4723.171 of the Ohio Revised Code (ORC) as well as
OBN rules outlined in Chapter 4527-17 of the Ohio Administrative Code (OAC), qualified LPNs
holding an OBN IV Therapy card may perform at the direction of a registered nurse, and
licensed physician, dentist, optometrist or pediatrist, the following tasks related to intravenous
therapy, on individuals over the age of eighteen (18).
NOTE: For the purposes of IV Therapy in Ohio, “peripheral IV”, means an intravenous access
device that terminates in a peripheral vein, unless otherwise stated.
CHAPTER 4723-17 Ohio Administrative Code (The Rules)
Role of Licensed Practical Nurses in Intravenous Therapy
4723-17-01 Definitions
For the purposes of this chapter, the following definitions shall apply:
(A) “Adult” means anyone who is eighteen years of age or older.
(B) “Direction” means communication of a plan of care, based upon assessment of the individual by the registered nurse, or licensed physician, dentist, optometrist, or podiatrist which establishes the parameters
for provision of care or for the performance of a procedure. Unless otherwise provided
by law, the registered nurse or licensed physician, dentist, optometrist, or podiatrist
shall be available on site to assess and evaluate the individual’s response to the plan of care.
(C) “Initiate” means to start or to begin.
(D) “Maintain” means to administer or regulate an intravenous infusion according to the prescribed flow rate.
(E) “Piggyback” means an intermittent intravenous infusion.
(F) “OBN Approver” has the same meaning as in paragraph (J) of rule 4723-14-01 of the
 

Administrative Code.
4723-17-02 LPN Eligibility
A licensed practical nurse who seeks authorization from the board of nursing to perform intravenous therapy procedures in accordance with division (A) of section 4723.17 of the Revised Code and this chapter must have previously received board authorization to administer medications as provided in division (D) of section 4723.15 of the Revised Code.
 

4723-17-03 Intravenous Therapy Procedures
(A) Except as provided in paragraph (B) of this rule, no licensed practical nurse shall perform any of the following intravenous therapy procedures:
(1) Initiate or maintain any of the following:
(a) Blood or blood components;
(b) Solutions for total parenteral nutrition;
(c) Cancer therapeutic medications including, but not limited to, cancer chemotherapy or an anti-neoplastic agents;
(d) Investigational or experimental medications;
(e) Solutions administered through any central venous line or arterial line or any other line that does not
terminate in a peripheral vein, except as provided in paragraph
(B)(1) of this rule;
(f) An intravenous piggyback infusion,
except as provided in paragraph
(B)(2) of this rule.
(2) Discontinue a central venous, arterial, or any other line that does not terminate in a peripheral vein;
(3) Initiate or discontinue a peripherally inserted central catheter;
(4) Aspirate any intravenous therapy line to maintain patency;
(5) Program or set any function of a patient controlled analgesic;
(6) Mix, prepare or reconstitute any medication for intravenous therapy, except as provided in paragraph (B)(3)
of this rule;
(7) Administer medications by an intravenous route, except as provided in paragraph (B)(2) of this rule;’
(8) Inject medications by a direct intravenous route, except as provided in paragraph (B)(4) of this rule;
(9) Change tubing on an arterial line, a central venous line, or on any line that does not terminate in a peripheral vein.
(B) A licensed practical nurse authorized by the board to perform intravenous therapy procedures, may perform the following procedures only for individuals aged eighteen or older and only when directed to do so by a
licensed physician, dentist, optometrist, podiatrist, or registered nurse in accordance with section 4723.17 of the
Revised Code:
(1) Administer through a central venous line or a peripherally inserted central catheter the following solutions only:
(a) An infusion containing one or more of the following elements:
(i) Dextrose 5%;
(ii) Normal saline;
(iii) Lactated ringers;
(iv) Sodium chloride 0.45%;
(v) Sodium chloride 0.2%; or
(vi) Sterile water;
(b) Subsequent containers of the intravenous therapy solutions specified in paragraph (B)(1)(a) of this rule that contain vitamins or electrolytes, provided a registered nurse initiated the infusion of that same intravenous
solution.
(2) Initiate or maintain a peripheral intravenous piggyback infusion containing an antibiotic
(3) Prepare or reconstitute only an antibiotic additive to be administered through a peripheral infusion;
(4) Inject heparin or normal saline to flush an intermittent infusion device or heparin lock, including, but not
limited to, bolus or push;
(5) Change tubing on an intravenous line only if the line terminates in a peripheral vein;
(6) Initiate intravenous therapy only in the hand, forearm or antecubital space for the administration of solutions
containing one or more of the following:
(a) An infusion containing one or more of the following elements:
(i) Dextrose 5%;
(ii) Normal saline;
(iii) Lactated ringers;
(iv) Sodium chloride 0.45%;
(v) Sodium chloride 0.2; or
(vi) Sterile water
(b) Subsequent containers of the intravenous therapy solutions specified in paragraph (B)(6)(a)
of this rule that contain vitamins or electrolytes, provided a registered nurse initiated the infusion of that same intravenous solution.
(C) A licensed practical nurse authorized by the board to perform intravenous therapy procedures may perform the procedures set forth in paragraph (B) of this rule only if one of the following requirements are satisfied:
(1) Except as provided in paragraph (C)(3) of this rule, the licensed practical nurse is directed to perform intravenous therapy by a licensed physician, dentist, optometrist, or podiatrist who is present and readily available at the facility where the intravenous therapy procedure is performed;
(2) Except as provided in paragraph (C)(3) of this rule, the licensed practical nurse is directed to perform intravenous therapy by a registered nurse who has personally performed an on-site assessment of the individual to receive intravenous therapy, and that registered nurse or another registered nurse is readily available at the site where the intravenous therapy procedure is performed;
(3) When the intravenous therapy procedures are performed in a home as defined in section 3721.10 of the
Revised Code, or in an intermediate care facility for the mentally retarded as defined in section 5111.20 of the
Revised Code, a registered nurse who directs the authorized licensed practical nurse to perform intravenous therapy is either:
(a) On the premises of the home or facility; or
(b) Accessible by some form of telecommunication;
(D) Any licensed practical nurse may perform any of the intravenous therapy procedures specified in paragraph (E) of this rule on any person without receiving authorization to perform intravenous therapy from the board
of nursing under section 4723.17 of the Revised Code, if both of the following apply:
(1) The licensed practical nurse acts at the direction of a registered nurse or a licensed physician, dentist, optometrist, or podiatrist and the registered nurse, physician, dentist, optometrist, or podiatrist is on the premises where the procedure is to be performed or accessible by some form of telecommunication; and
(2) The licensed practical nurse can demonstrate the knowledge, skills, and ability necessary to perform the
procedure safely
(E) The intravenous therapy procedures that a licensed practical nurse may perform in accordance with paragraph (D) of this rule are limited to the following:
(1) Verification of the type of peripheral intravenous solution being administered;
(2) Examination of a peripheral infusion site and the extremity for possible infiltration;
(3) Regulation of a peripheral intravenous infusion according to the prescribed flow rate;
(4) Discontinuation of a peripheral intravenous device at the appropriate time; and
(5) Performance of routine dressing changes at the insertion site of a peripheral venous or arterial infusion, peripherally inserted central catheter infusion, or central venous pressure subclavian infusion.
4723-17-04 Approval of An Intravenous Therapy Course
(A) Any person who desires to conduct a course in intravenous therapy for a licensed practical nurse shall submit the course individually for approval as a faculty directed continuing education activity to an Ohio board of nursing (OBN) approver in accordance with Chapter 4723-14 of the Administrative Code.
(B) Approval of a course in intravenous therapy for licensed practical nurses may be withdrawn or denied by the OBN approver if the course fails to meet the minimum requirements of the board as set forth in this
chapter and in Chapter 4723-14 of the Administrative Code.
(C) Each OBN approver shall publish and maintain a current list of approved courses in intravenous therapy for licensed practical nurses in Ohio. The board shall publish and maintain a current list of OBN approvers.
4723-17-05 Standards for Intravenous Therapy Course Personnel
(A) A person who is responsible for developing a licensed practical nurse intravenous therapy
course for submission to an OBN approver shall satisfy all of the following:
(1) Hold an active Ohio license as a registered nurse;
(2) Possess a baccalaureate degree with a major in nursing;
(3) Have a minimum of two years experience in the practice of nursing as a registered nurse; and
(4) Have formal education or practical experience in adult education.
(B) Except as provided in paragraph (C) of this rule, the course in intravenous therapy for a licensed practical nurse shall be taught by one or more registered nurses each of whom meet the qualifications set forth in
paragraphs (A)(1) to (A)(3) of this rule:
(1) Have completed an approved professional nursing education program;
(2) Hold an active Ohio license to practice nursing; and
(3) Have a minimum of two years experience in the practice of nursing as a registered nurse that includes
substantial direct clinical experience in intravenous therapy.
(4) It is recommended that a registered nurse engaged in the teaching of licensed practical nurse intravenous therapy courses hold a baccalaureate degree with a major in nursing.
(C) A licensed health care professional who is not a registered nurse may be utilized to conduct a portion of the intravenous therapy course provided:
(1) The licensed health care professional teaches only a portion of the course at the direction of a registered nurse instructor; and
(2) The licensed health care professional imparts information that is consistent with his or her professional educational preparation and within his or her statutory scope of practice. 4723-17-06 Minimum Curriculum Requirements In accordance with division (A)(2)(a) of section 4723.17 of the Revised Code, the minimum
curriculum for an intravenous therapy course for licensed practical nurses shall be that contained in administrative rules in effect on January 1, 1999, and restated in paragraphs (A)(1) to (A)(13), and
paragraph (C) of this rule.
 

(A) A course which prepares licensed practical nurses in limited intravenous therapy shall include a minimum of forty hours of instruction which shall be distributed appropriately to include the list of components below. Time shall be allocated for laboratory and supervised clinical practice. The components shall include, but are not limited to the following:
(1) Policies and procedures of both the Ohio board of nursing and the employing agency relating to intravenous therapy and accountability and responsibility of the licensed practical nurse in the performance of limited intravenous therapy procedures;
(2) Support and psychological preparation for the individual receiving intravenous therapy as well as the appropriate family members and significant others;
(3) Anatomy and physiology of the peripheral veins used for venipuncture;
(4) Procedure for venipuncture, collection of equipment, site selection, palpation of veins, and skin preparation;
(5) Procedures for adding intravenous solutions to existing infusions, hanging intravenous solutions, changing
intravenous tubing, performing intravenous dressing changes and flushing and converting peripheral intermittent infusion devices/heplocks;
(6) Relationships between intravenous therapy and the body's homeostatic and regulatory functions;
(7) Signs and symptoms of local and systemic complications in the administration of fluids and guidelines for management of these complications as well as preventive measures;
(8) Identification of various types of equipment used in administering intravenous therapy with content related
to criteria for use of each and means of troubleshooting for malfunction;
(9) Formulas used to calculate flow rate;
(10) Principles and practices of universal precautions as related to intravenous therapy;
(11) Glossary of common terminology pertinent to intravenous therapy;
(12) Documentation of intravenous therapy procedures; and
(13) Demonstration of successful application of knowledge and skills to clinical practice by skills testing at least all of the components included in paragraphs (A)(8) and (A)(9) of this rule. (B) In addition to the requirements set forth in paragraph (A) of this rule, an intravenous therapy course for licensed practical nurses shall also include the following:
 

(1) A review of Chapter 4723. of the Revised Code and the rules of the board with respect to the role, accountability, and responsibility of the licensed practical nurse in intravenous therapy;
(2) Anatomy and physiology of the cardiovascular system as related to homeostasis;
(3) Anatomy and physiology of the respiratory system as related to homeostasis;
(4) Signs and symptoms of local and systemic complications in the administration of antibiotics;
(5) Guidelines for the management of complications arising from the intravenous administration of antibiotics;
(6) Procedures for reconstituting and administering intravenous antibiotics via piggyback which shall include, but
not be limited to, pharmacology, compatibilities, and flow rates;
(7) Procedures for maintaining a central line for infusing only the solutions specified in section 4723.17 of the Revised Code;
(8) A review of prohibited practices as set forth in section 4723.17 of the Revised Code; and
(9) A review of the role of the registered nurse, licensed physician, dentist, optometrist, or podiatrist who is
directing the licensed practical nurse to perform an intravenous therapy procedure with reference to how the
role may differ depending upon the setting in which the intravenous therapy is being provided.
(C) The registered nurse instructor of the course in limited intravenous therapy for licensed practical nurses shall plan and implement a minimum of at least three individually supervised successful venipunctures
performed on clients in the healthcare setting, each of which includes the total implementation of intravenous therapy, by each student under the direct supervision of the registered nurse instructor. Opportunity shall be given to the nurses to develop proficiency in limited intravenous therapy procedures and related nursing care. Practice
of all skill components and skills testing shall be done in either supervised clinical practice or while supervised in the laboratory.
(D) The performance of the three venipunctures required in paragraph (C) of this rule shall comprise no more than eight hours of the intravenous therapy course. Supervision of the student venipunctures may be provided by either a registered nurse who is an instructor in the intravenous therapy course, or by a licensed physician. 4723-17-07 Proof of Completion of a Board- approved Course In Intravenous Therapy
(A) The provider of a board-approved course in intravenous therapy shall have specific policies in writing regarding the level of achievement that a licensed practical nurse must maintain in order to successfully
complete the course in intravenous therapy and to obtain proof of completion of the course. Periodic evaluation of the nurse’s progress in the course shall be made by an instructor of the course.
(1) Each board-approved course shall include a testing component by which a licensed practical nurse can demonstrate competency related to intravenous therapy.
(2) Upon a student’s successful completion of an approved intravenous therapy course, the provider shall issue a
certificate of successful completion.
(B) On a form provided by the board, each provider of a board-approved intravenous therapy course shall submit to the board, documentation of completion and the required twenty five dollar issuance fee for each licensed practical nurse who successfully completes the intravenous therapy program.
(C) Upon receiving satisfactory documentation that a licensed practical nurse has successfully completed a board-approved intravenous therapy course, the board shall approve such nurse as authorized to provide
intravenous therapy and shall issue evidence of this authorization in a manner to be determined by the board.
(D) When a licensed practical nurse who has been licensed by endorsement in Ohio provides documentation satisfactory to the board of having successfully completed an intravenous therapy course in another state
that substantially meets the requirements of this chapter, the board may approve such nurse as authorized to provide intravenous therapy and shall issue evidence of this authorization in a manner to be determined by the board. The board may condition issuance of evidence of this authorization on proof of the nurse’s successful completion of board-approved course content covering Chapter 4723. of the Revised Code and the rules of the board with respect to the role, accountability, and responsibility of the licensed practical nurse in intravenous
therapy.
(E) No card, certificate or other documentation of board authorization to provide intravenous therapy shall be photocopied, reproduced, duplicated, or imaged onto paper or any electronic media. This prohibition shall not prohibit the nurse to whom such authorization is granted copying or otherwise reproducing such evidence of
authorization provided that the copy or reproduction is immediately, clearly, and permanently labeled as a copy or reproduction, and such label is accompanied by the initials of the nurse. 4723-17-08 Training as Part of a Practical Nursing Program
Nothing in this chapter shall prohibit a pre-licensure practical nursing education program approved by the board from incorporating in its standard curriculum course work on intravenous therapy that meets the curriculum and other criteria set forth for licensed practical nurses in section 4723.17 of the Revised Code and this chapter.
4723-17-09 Training in Intravenous Therapy in Conjunction With Dialysis Training.

Nothing in this chapter shall prohibit a licensed practical nurse employed in a dialysis setting from completing an approved intravenous therapy course concurrently with the licensed practical nurse's training in dialysis.
4723-17-10 Rescinded 2-1-05

ALLOWABLE PROCEDURES
Based upon the law and rules from the State of Ohio, the Licensed Practical Nurse Association of Ohio, Inc.
has put together a list of IV Therapy procedures that may be preformed by a qualified LPN in Ohio, once the
LPN has completed the necessary education and received authorization from the Ohio Board of Nursing to
perform specific intravenous therapy procedures.
A qualified and authorized Ohio LPN may perform the following procedures related to intravenous therapy.
1. Prepare an adult for IV therapy and select the peripheral intravenous site in the hand, forearm and / or
antecubital fossa area only. (Adult means anyone who has reached the age of majority, eighteen.)
2. Assemble and maintain equipment for:
a. Gravity drip infusion
b. Electronic controlling devices, excluding patient controlled devices.
3. Perform venipuncture with a needle or catheter into a peripheral vein of the hand, forearem and / or
antecubital fossa area.
4. Initiate (i.e.start or begin) the infusion of authorized IV solutions as directed by a licensed physician,
dentist, optometrist or podiatrist, using only the vein of the hand, forearem, antecubital fossa and
calculate infusion rate using standard formulas. Authorized solutions are IV infusions containing
one or a combination** of the following:
a. Dextrose 5%
b. Normal Saline
c. Lactated Ringers
d. Sodium Chloride 0.45%
e. Sodium Chloride 0.2%
f. Sterile water
(** For example, the LPN could start D5 / Water or D5 / LR. Note: “Water” must always be sterile
and used in conjunction with other fluids.)
5. Maintain an infusion of the authorized solutions, listed in #4 above, that being administered through a
pre-existing central venous or peripherally inserted central venous catheter (PICC) (Note: Maintain
means to administer or regulate IV infusions according to the prescribed flow rate.)
6. Verify the type of peripheral solution being administered. *
7. Regulate a peripheral IV infusion according to the prescribed flow rate. *
8. Perform routine IV administration set changes on a peripheral IV line.
9. Perform routine dressing changes at the insertion site of a peripheral venous or arterial infusion,
peripherally inserted central venous catheter or central venous pressure subclavian infusion. *
10. Initiate, convert and flush peripheral intermittent infusion devices / heparin lock (meaning a device
that ends in a peripheral vein.) The peripheral intermittent infusion devices may be flushed with
normal saline and / or heparin to maintain peripheral venous patency of an intermittent infusion
device when the heparin does not alter an individual’s clotting time and is a non-therapeutic strength.
The flushing technique includes, but is not limited to, bolus or push.
11. Prepare or reconstitute an antibiotic additive only.
12. Initiate or maintain an intermittent IV infusion (piggyback) containing only an antibiotic additive.
(No other additive may be administered via piggyback; the IV line being used must terminate in a
peripheral vein.)
13. Discontinue a peripheral IV device,* (meaning a device that ends in a peripheral vein.)
14. Examine a peripheral infusion site. (Implied is the reporting and recording of significant
observations.) *
15. Hang subsequent containers of specified solutions (dextrose, 5%; normal saline; lactated ringers;
sodium chloride.45%; sodium chloride.2%; or sterile water) that contain vitamins or electrolytes if a
registered nurse hung the first container of the same solution.
*NOTE: The law clearly does not require an LPN to successfully complete an IV therapy course in order to
perform on any person the IV therapy procedures indicated above by an asterisk (*) IF BOTH OF THE
FOLLOWING APPLY:
1. The LPN acts at the direction of a registered nurse or a licensed physician, dentist, optometrist or
podiatrist who is either on site or available by telecommunication; AND
2. The LPN can demonstrate the knowledge, skills and ability to perform the procedure safely.



INTRAVENOUS THERAPY PROCEDURES
NOT PERMITTED TO BE PERFORMED BY ANY LPN IN OHIO
Based on the law in sections 4723.17 and 4723.171 Ohio Revised Code (ORC) and the Ohio Board of
Nursing Rules found in Chapter 4723-17 Ohio Administrative Code (OAC), NO LPN shall perform any of
the following IV therapy procedures.
PROHIBITIONS
(Including, but not limited to:)
1. Initiating or maintaining
a. Blood or blood components
b. Solutions for total parenteral nutrition
c. Any cancer therapeutic medication, including but not limited to, cancer chemotherapy or antineoplastic
agents;
d. Any investigational and/or experimental medication.
2. Initiating or maintaining solutions administered through any central venous line or arterial line or any
other line that does not terminate in a peripheral vein.
**(Note: However, maintaining authorized solutions through a central venous line or a peripherally
inserted central catheter is permitted. Refer to “allowable Procedures” #4 and #5.)
3. Initiating IV Therapy in any vein other than a vein of the hand, forearm, or anticubital fossa.
4. Initiating IV Therapy on an individual under the age of 18.
5. Discontinuing a central venous, arterial or any other line that does not terminate in a peripheral vein.
6. Initiating or discontinuing a peripherally inserted central catheter.
7. Mixing or preparing any medication for IV Therapy.
**(Except preparing or re-constituting an antibiotic additive is permitted. Refer to “
Allowable Procedures” #11).
8. Administering medications via the IV route including:
a) Adding medication to an IV solution or to an existing IV infusion;
b) Initiating an IV infusion containing one or more of the following elements is permitted by an
LPN who holds a valid IV Therapy card from the Ohio Board of Nursing:
Dextrose 5%
Normal Saline,
Lactated Ringers
Sodium Chloride 0.45%
Sodium Chloride 0.2%
Sterile Water;
(Refer to “Allowable Procedures “#4 and #5)
c) Initiating or maintaining an IV piggyback infusion (Except one containing an antibiotic
additive. Refer to “Allowable Procedures” #12)
d) Injecting medication via a direct IV route including, but not limited to bolus or push. (Except
injecting heparin or normal saline to flush an intermittent infusion or heparin lock. Refer to
“allowable Procedures” # 10)
e) Initiating IV solutions containing vitamins or electrolytes. (Except hanging subsequent
containers of specified solutions containing vitamins or electrolytes if an RN initiated the same
infusion. Refer to “Allowable Procedures” #15)
9. Aspirating any IV line to maintain patency.
10. Changing tubing on any line other than one that terminates in a peripheral vein.
11. Programming or setting any function on a patient controlled infusion pump.
*NOTE: this document was developed for the sole use of the LPN/IV Therapy Course. Providers approved
by the Ohio Board of Nursing through the OBN Approver Unit at the Licensed Practical Nurse Association
of Ohio, Inc. (OBN-002-092). Others may reproduce no part of it for use without prior written permission of
LPNAO.
 

SUMMARY INFORMATION
Whatever your employment situation, you now know what’s allowable and what’s not in relation to IV
therapy procedures as determined by Ohio statutes and Ohio Board of Nursing rules.
Still, patient care situations occasionally arise which generate additional questions or dilemmas. At such
times, answers frequently lie within what constitutes the standards of safe nursing practice as outlined in
4723-4-04, OAC. (Refer to Appendix A - Standards Relating to Competent Practice as a Licensed Practical
Nurse.)
Basically, a licensed practical nurse is required to maintain current knowledge; practice according to current
laws and rules; and demonstrate competence in the practice of nursing. Regardless of the nursing procedure
indicated, the general ‘rule of thumb’ – When in doubt, don’t – is a prudent guideline for all nurses to follow.
(In a court of law, proven adherence to the standards of safe nursing practice is the nurse’s primary defense.)
It’s also advisable to keep this information packet in a readily accessible place in the event you need a quick
reference source.
LPNAO will notify you and the Ohio Board of Nursing when you successfully complete this independent
study module and submit the required verification information outlined in the introduction to this course.  The OBN will subsequently issue you an IV therapy card in a timely manner.
NOTE: You are not authorized to perform the allowable IV therapy procedures specified by law until you
receive your IV Therapy card from the OBN.

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