General information and definitions related to licensing information: The “practice of nursing” by a licensed practical nurse means the performance for compensation of services requiring basic knowledge of the biological, physical, behavioral, psychological and sociological sciences and of nursing procedures which do not require the substantial skill, judgment and knowledge required of a registered nurse. These services are performed under the direction of a registered nurse or a licensed physician or licensed dentist and utilize standardized procedures in the observation and care of the ill, injured and infirm; in the maintenance of health; in action to safeguard life and health; and in the administration of medications and treatments prescribed by any licensed physician or licensed dentist authorized by state law to prescribe. On a selected basis, and within safe limits, the role of the licensed practical nurse shall be expanded by the board under its rule-making authority to more complex procedures and settings commensurate with additional preparation and experience. A “license” means an authorization to practice nursing as a registered nurse or a licensed practical nurse. A “licensed practical nurse” is a person who is licensed or holds the privilege to practice under this article and who practices practical nursing as defined herein. “L.P.N.” is the abbreviation for the title of Licensed Practical Nurse. “Privilege to practice” means the authorization to practice nursing in the state as described in the Nurse Licensure Compact provided for in Section 73-15-22. “Licensee” is a person who has been issued a license to practice nursing in the state or who holds the privilege to practice nursing in the state. License Requirements: Expanded Role for the Licensed Practical Nurse in hemodialysis: A. Initial certification Prior to board certification allowing the LPN to practice in the expanded role of hemodialysis, the LPN must: 1) Be currently licensed as a LPN in Mississippi or hold a temporary permit to practice as a LPN in Mississippi; and 2) Submit required application and fees; and 3) Have graduated from an state approved practical nurse educational program or an equivalent state approved program; and 4) Have one (1) year of clinical experience as a LPN within the past three (3) years; 5) Submit official evidence of completion of an educational program of study and clinical experience in hemodialysis approved by the board; and 6) Be certified in the Expanded Role of IV Therapy. However, any licensed practical nurse certified in expanded role of hemodialysis on or before April 1, 2007, will not be required to be certified in expanded role of IV therapy, provided that said licensed practical nurse who is certified in expanded role of hemodialysis on or before April 1, 2007, is educated and competent in all applicable procedures, and that said education and competence is documented initially, and also documented on a continuing basis. B. Renewal of certification. Expanded role LPNs shall renew hemodialysis certification in conjunction with renewal of the LPN license and shall submit the following: 1) Renewal application and fee; and 2) Documentation of completion of a minimum of ten (10) contact hours of continuing education and/or in service education in hemodialysis within the previous two (2) year period. C. Reinstatement of lapsed certification. Expanded role LPNs may reinstate lapsed hemodialysis certification upon: 1) Documentation of a current, active LPN license; and 2) Submission of the LPN expanded role reinstatement application and fee; and 3) Submission of documentation of completion of a minimum of ten (10) contact hours of continuing education and/or inservice education in hemodialysis within the previous two (2) year period if lapsed for less than two (2) years; or 4) Submission of evidence of successful completion of a board-approved hemodialysis update if lapsed for more than two (2) years. This update must include both theory and clinical components. Disciplinary action: Any expanded role LPN who is in violation of the Mississippi Nursing Practice Law and/or Rules and Regulations shall be subject to disciplinary action by the board. Scope of Practice: A. The LPN certified in hemodialysis may: 1) Initiate and discontinue hemodialysis via fistula needles in the peripheral fistula or graft; 2) Inject intradermal lidocaine in preparation for dialysis and access; 3) Initiate and discontinue hemodialysis via catheter; 4) Administer heparin intravenously, including: (a) Draw up and administer heparin (1:1000 strength) for initial and continued administration; and (b) Loading and activating the constant infusion pump and/or intermittently injecting the prescribed dose. 5) Administer saline intravenously, including: (a) Administration of a saline bolus during a hypotensive episode (this must be in accordance with an agency protocol and with RN supervision and consultation); and (b) Administration and regulation of a normal saline solution for purpose of maintaining the fluid plan that is established by the RN. 6) Draw up and administer erythropoietins intravenously. 7) Draw up and administer synthetic vitamin Ds intravenously. 8) If dually certified in IV therapy the expanded role hemodialysis LPN may administer approved IV fluids and medications as indicated in Part 2840, Chapter 3, Rule 3.3 A. 1) (b). B. The LPN certified in hemodialysis may function in this role and scope of practice only under the direct supervision of a registered nurse. C. The LPN certified in hemodialysis may function in this role only in hemodialysis facilities which are certified by the Mississippi State Department of Health, Division of Licensure and Certification, or its successor agency. D. The LPN certified in hemodialysis may NOT: 1) Administer or add the following except as specified in 4.3a: (a) IV medications; or (b) Blood, blood components, plasma, plasma expanders; or (c) Hypertonic solutions; or 2) Determine or regulate the dosage of heparin; or 3) Perform hemodialysis in the home setting.
