PURPOSE: This rule sets forth the minimum requirements for establishing and conducting a course of instruction for qualified practical nurse participants to become IV-Certified in the state of Missouri.

PUBLISHER’S NOTE: The secretary of state has determined that the publication of the entire text of the material which is incorporated by reference as a portion of this rule would be unduly cumbersome or expensive. This material as incorporated by reference in this rule shall be maintained by the agency at its headquarters and shall be made available to the public for inspection and copying at no more than the actual cost of reproduction. This note applies only to the reference material. The entire text of the rule is printed here.

1. (1) A venous access and intravenous (IV) infusion treatment modalities course shall prepare the non IV-Certified qualified practical nurse to safely perform the functions and procedures inherent in selected intravenous infusion treatment modalities as set forth in this rule.

2. (2) Course providers shall only design and conduct a venous access and intravenous infusion treatment modalities course as specified in this rule. The course shall provide sufficient instruction for the following qualified practical nurse participants to become IV-Certified in Missouri:

   1. (A) A practical nurse currently licensed to practice in Missouri;
   2. (B) A practical nurse with a temporary permit to practice in Missouri;
   3. (C) A graduate practical nurse of a non- Missouri practical nursing education program seeking licensure in Missouri;
   4. (D) A graduate practical nurse completing a Missouri practical nursing education program prior to February 28, 1999 and seeking licensure in Missouri; or
   5. (E) A federal employee who possesses a current license as a practical nurse in another state who is enrolling in a course provided by a federal facility located in Missouri.

3. (3) Curriculum.

   1. (A) The curriculum of a venous access and intravenous infusion treatment modalities course shall include the following components:

      1. 1. Review of the Missouri Nursing Prac-

tice Act including the current venous access 20 CSR 2200-6

and intravenous infusion treatment modalities regulations;

1. 2. Review of the policies and proce-

dures of the clinical agency where practical experience is received;

1. 3. Structure of the circulatory system

including anatomical location and physiology of veins used for venous access;

1. 4. Relationship between parenteral fluid

treatment administration and the body’s homeostatic and regulatory function with attention to the clinical manifestation of fluid and electrolyte imbalance and cellular physiology;

1. 5. Principles of infection control in

venous access and parenteral fluid administration;

1. 6. Identification of various types of

equipment used in venous access and parenteral fluid administration, with content related to criteria for use of each, and means of troubleshooting for malfunctions;

1. 7. Principles and practices related to

intravenous drug and/or fluid administration across the life span;

1. 8. Nursing management of venous

access and parenteral fluid administration procedures that are commonly used in patient care settings;

1. 9. Procedure for obtaining venous

access including appropriate equipment selection, psychological preparation of the patient, site selection, aseptic skin preparation, insertion and stabilization of the venous access device, application of dressing to insertion site, and documentation of procedure;

1. 10. Maintenance of venous access site

and parenteral fluid administration system components according to established current practices;

1. 11. Monitoring venous access site for

evidence of local complications, parenteral fluid infusion flow rate, and response to treatment;

1. 12. Adjusting parenteral fluid flow rate

in various clinical situations;

1. 13. Procedure for removal of peripheral

venous access device upon completion of the prescribed treatment or if suspected or confirmed complications arise;

1. 14. Calculation of drug dosage and par-

enteral fluid administration flow rates; and

1. 15. Principles of phlebotomy.

2. (B) The curriculum to be offered must be approved by the board.

   1. 1. The board has approved the most cur-

rent edition of the Venous Access and Intravenous Infusion Treatment Modalities Manual, which is incorporated by reference herein, available from the University of Missouri Instructional Materials Laboratory (IML) as FINANCIAL INSTITUTIONS AND PROFESSIONAL REGISTRATION

a standard curriculum. Copies of instructor and student manuals may be obtained by contacting the Instructional Materials Laboratory, College of Education, University of Missouri-Columbia, 1400 Rock Quarry Center, Columbia, MO 65211 or by phone at (800) 669-2465. This rule does not include any subsequent amendments or additions.

1. 2. If the provider of a course chooses to

develop its own curriculum, it must contain all of the components listed in subsection (3)(A)1.–5. of this rule and be submitted to the board for approval.

1. (C) A course shall, at a minimum, consist of:

   1. 1. Thirty (30) hours of classroom and

skills laboratory instruction or its equivalent, (e.g., faculty-student interactive study); and

1. 2. Eight (8) hours of supervised clinical

practice, which must include at least one (1) successful performance of peripheral venous access and the initiation of an intravenous infusion treatment modality on an individual.

1. (D) There shall be written course outcomes that identify the expected competencies of the participant upon completion of the course.
2. (E) The course participant must complete a pretest(s) in pharmacology, anatomy and physiology, and asepsis to determine the participant’s level of knowledge at the beginning of the course.
3. (F) All classroom and clinical instruction and practice must be supervised by a registered professional nurse designated by the provider and who meets the faculty qualifications as stated in section (4) of this rule.

1. (4) Faculty Qualifications and Responsibilities.

   1. (A) Nursing faculty must hold a current undisciplined license or temporary permit to practice as a registered professional nurse in Missouri and have a minimum of two (2) years of clinical experience within the last five (5) years that included responsibility for performing venous access and intravenous infusion treatment modalities.
   2. (B) All non-nurse faculty shall possess the professional preparation and qualifications to teach the specific content for which they are responsible.
   3. (C) For the clinical component of the course, the maximum faculty to student ratio shall be one to three (1:3) for observational experiences and the performance of non-invasive procedures and functions. The faculty to student ratio must be one to one (1:1) during the performance of peripheral venous access and initiation of an intravenous infusion treatment modality on an individual.
   4. (D) The course provider shall designate a registered professional nurse to be the course coordinator who shall be responsible for all aspects of the course.

2. (5) Classroom and Clinical Facilities.

   1. (A) Classrooms shall be of sufficient size and contain the necessary equipment and teaching aids to implement the course.
   2. (B) The clinical facilities utilized shall be sufficient to allow for appropriate implementation of the course and may include, but are not limited to, acute care, long-term care, ambulatory care, and community agencies that provide intravenous infusion treatment modalities.
   3. (C) Faculty and course participants shall have access to the necessary intravenous treatment equipment and patients/clients receiving intravenous treatment modalities, including pertinent medical records.
   4. (D) There shall be a signed written agreement between the course provider of the course and each cooperating clinical facility that specifies the roles, responsibilities, and liabilities of each party. This written agreement will not be required if the only clinical facility to be used is also the provider of the course.

3. (6) To successfully complete a venous access and intravenous infusion treatment modalities course for the purpose of becoming IV-Certified, the qualified participant shall:

   1. (A) Achieve a minimum grade of eighty percent (80%) on a written final examination of no fewer than fifty (50) multiple choice items;
   2. (B) Demonstrate clinical competency in the mastery of the course objectives; and
   3. (C) Perform at least one (1) successful peripheral venous access and initiate an intravenous infusion treatment modality on an individual.

4. (7) Record Keeping.

   1. (A) The provider of an approved course shall maintain records documenting each participant’s attendance, scores, and competencies. These records shall be kept for a period of at least five (5) years. A copy of this record shall be provided to the course participant.
   2. (B) The provider of an approved course shall award a certificate, using a form provided by the board, to each participant who successfully completes the course.
   3. (C) Within thirty (30) days of a participant’s successful completion of an approved course, the designated course coordinator shall submit the required participant information to the board on a form provided by the board.

AUTHORITY: sections 335.017 and 335.036, RSMo 2000.* This rule originally filed as 4 CSR 200-6.040. Original rule filed Sept. 1, 2005, effective April 30, 2006. Moved to 20 CSR 2200-6.040, effective Aug. 28, 2006.

*Original authority: 335.017, RSMo 1983 and 335.036`, RSMo 1975, amended 1981, 1985, 1993, 1995, 1999.