Scope of Practice
Expanded Role of Licensed Practical Nurses (LPNs) in Chronic Hemodialysis Outpatient Settings
Effective October 1, 2006, LPNs working in chronic hemodialysis outpatient settings who have completed the required training components will be permitted to access and provide care to patients with central venous catheters under the direction of a Registered Nurse. Formal training program components and competency evaluation requirements were developed by a Task Force facilitated by the NYS Department of Health (DOH) and have been distributed to all dialysis facilities.
Facilities that choose to participate in the program allowing LPNs to access central venous catheters must include the training and competency requirements in the facility’s policies and procedures. The delegation of these activities is based on the RN’s professional judgment, the competence of the LPN, policy and procedure of the facility, and standards of nursing practice. Regardless of degree of delegation, the RN retains the ultimate responsibility for the administration and clinical management of dialysis care, including assessment of patient signs and symptoms of a reaction. The RN is responsible for evaluating each central venous catheter patient within thirty (30) minutes (not to exceed 45 minutes) of initiation of the dialysis procedure.
This program allows for competent LPNs to access central venous catheters ONLY in chronic hemodialysis outpatient settings and does not apply to any other setting. Facility compliance with the training and competency program requirements and implementation of the LPN expanded role will be monitored through routine NYS DOH surveillance activities.
NYSNA has received permission from the NYS Department of Health to attach the following documents (.pdf format; Adobe Acrobat Reader required):
Letter to Administrators
A letter from the NYS Department of Health, mailed to all chronic outpatient hemodialysis administrators providing notification and guidance on this practice change.- Licensed Practice Nurse (LPN) Competency Checklist
A document for use by dialysis sites separately, or in conjunction with, their competency checklists, to prepare LPNs for this expanded function. LPN central line competency must be met prior to performing this function and re-evaluated annually.
For questions, contact Education, Practice and Research at 800.724.NYRN, ext. 282 or e-mail.