3920 INTRAVENOUS THERAPY SERVICES

3920.1 If intravenous therapy services are provided, they shall be provided in accordance with the patient's plan of care and administered by a registered nurse or licensed practical nurse who shall have training or experience in intravenous therapy.

3920.2 The intravenous therapy service plan shall include, at a minimum, the following:

1. (a) Type, amount, flow rate, duration, and mode of administration of nutritional formula or intravenous solution;
2. (b) Type, dosage, frequency, duration, and mode of administration of medication;
3. (c) Type and frequency of laboratory tests to be monitored;
4. (d) Information on use of an anticoagulant in connection with intermittent intravenous therapy; and
5. (e) Specific laboratory test limits.

3920.3 Each clinical record shall include, at a minimum, the following information related to intravenous therapy:

1. (a) The intravenous therapy service plan, as ordered by the patient's physician;
2. (b) A copy of the consent form for intravenous therapy executed by the provider of the intravenous therapy product, or a copy of the consent form for intravenous therapy executed by the home care agency, including risks, benefits and alternatives;
3. (c) Documentation of training provided to the patient, patient's caregiver, or other responsible person in intravenous therapy;
4. (d) Information on composition, amount, rate, mode, duration, date, and time of administration of nutrition, medication, and intravenous solution;
5. (e) History of drug allergies and adverse reaction to medication therapy;
6. (f) Date and time of venous access insertion, and type and gauge of needle or catheter used;
7. (g) Information on change of solution, intravenous fluid administration, filter, tubing, and dressings;

(h) Observation of the patient and the access site;

(i) Laboratory monitoring;

(j) Information on all medication administered, including type, dosage, frequency, duration, route of administration, and toxic or side effects;

(k) Progress notes at least every thirty (30) calendar days; and

(1) A summary report at least every sixty-two (62) calendar days.

3920.4 The first dosage of an antibiotic or chemotherapy shall not be administered by a home care agency, unless an anaphylactic kit is immediately available for administration.

3920.5 The home care agency shall have written policies and procedures concerning intravenous therapy that address the following:

(a) Patient selection criteria;

(b) Monitoring of patients and emergency care;

(c) Availability of care twenty-four (24) hours a day and continuity of care;

(d) Preparation and storage of intravenous solutions, special nutrition formulas, and medications;

(e) Infection control;

(f) Disposal of sharps, catheters, tubing and dressings;

(g) Equipment care and maintenance;

(h) Administration guidelines, including adverse reaction protocol;

(i) Obtaining medical supplies;

(j) Blood transfusions; and

(k) Adverse reactions.

SOURCE: Final Rulemaking published at 51 DCR 2876 (March 19, 2004).