LOUISIANA STATE BOARD OF PRACTICAL NURSE EXAMINERS

131 Airline Drive, Suite 301, Metairie, LA 70001          Phone 504-838-5791     FAX 504-838-5279

Practice opinions

This list is not inclusive of all of lpn practice and should not be used to define or limit practice.

Please contact our office if you need further clarification on any of the practice opinions listed here.

Be sure to also review the Scope of Practice.

The following are opinions issued by the board:

• 9/18/1981   The attending physician makes the decision on assigning the following procedures to selected lpns following appropriate training: Pap smears, GC cultures, IUD string checks, fundal heart tones, Leopolds maneuvers, history taking for medical records.

• 1/31/1986  Lpns may perform heparinization during hemodialysis.

• 1/31/1986  Lpns may serve as first surgical assistant but they may not suture.

• 5/29/1987  Lpns may not inject medications per epidural catheter.

• 1/22/1988  Lpns may maintain heparin locks and administer IVPB meds per same.

• 10/05/1990   Lpns may, with proper instruction and determined competency, insert a feeding tube in a neonate, reinsert tracheostomy tube in an established tract, remove sheaths and hold pressure in cardiac cath lab, and later pull the lines under the direction of the physician.

• 10/04/1991   Lpns, with demonstrated competency, may load and monitor PCA machines. With regard to external venous access catheters/devices, trained lpns may obtain blood specimens; start an IV line, hang and monitor IV fluids, hang and monitor IVPB medications, flush with heparin lock solution, provide site care including dressing change. With regard to internal venous access devices (ie, port-a-cath, life port, etc.), trained lpns may:draw blood, start and monitor IV fluids, provide site care including dressing change. Lpns, when serving as first surgical assistant, may not suture, dissect, or cauterize.

• 2/3/1995   Lpns may monitor clients who receive IV conscious sedation.

• 6/16/1995   Lpns may delegate the insertion of glycerin suppositories to certified nursing assistants.

• 10/13/1995   Lpns may delegate capillary blood glucose testing to unlicensed assistive personnel in the nursing home setting. Delegation of tasks to unlicensed assistive personnel always includes the provision that there is written documentation of skills and competency readily available for the lpn to review for each individual to whom the task is delegated, and the skills and competency are re-evaluated every six months.

• 6/20/1997   Licensed practical nurses may conduct esophageal motility studies provided he or she possesses the necessary knowledge, skills, and ability to perform the studies, the procedure is performed under the direction of a physician, and the protocol is approved by the facility.

• 3/4/1999; amended 10/23/2009    Lpns may accept verbal/telephone orders only from a licensed physician or other authorized prescriber (optometrist, dentist, psychologist, physician assistant, or advanced practice registered nurse).

• 6/18/2010   The administration of botox, for cosmetic purposes only, is within the scope of practice of licensed practical nurses in the state of Louisiana when the following conditions are met:

1. A physician licensed to practice medicine in the state of Louisiana has first examined the client and determined that the injection is appropriate.

2. The physician directs the licensed practical nurse to perform the procedure.

3. The physician ensures that the licensed practical nurse, acting under his/her supervision, is appropriately trained and qualified to perform the procedure. This training must include, at a minimum:  indications/contraindications, potential complications, and infectious disease control considerations related to the procedure.

4. After the appropriate training has been completed, the licensed practical nurse is certain that he/she possesses the knowledge, skill, and ability to perform the procedure.

5. The procedure must be performed under the licensed physician's direction and immediate personal supervision -- i.e., where the physician is physically present on the premises and immediately available.

6. The licensed practical nurse may not, under any circumstances, act independently or in the absence of a Louisiana licensed physician in implementing the procedure.

7. If at any time and for any reason, the licensed practical nurse does not feel certain that he/she possesses the knowledge, skill, and ability to perform the procedure, the licensed practical nurse must refrain from administering the botox and notify the physician.

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