Practice Opinion Summaries

When multiple inquiries are received on the same practice matter, the Board publishes an advisory opinion statement for wide dissemination.   Go to Index of Advisory Opinion Statements to view the list of published statements.  

In addition, KBN has addressed many individual practice related inquiries and issued advisory opinion responses/letters to these individual requests.  A summary of these opinions (listed by fiscal year) is provided below.   Should you have a practice related question that is not addressed in a published advisory opinion statement, send a message via the Practice Contact Form.

You can access the FY 2007-2008 AOS Summary Report [PDF Format - 58k] in its entirety by clicking on the link.  The information provided below was taken from this report.

• Role of ARNP in the Performance of Infant Circumcisions
• Administration of Insulin by Nurses in School Setting via Parent Communication
• Delegation of Disconnection and Reconnecting of Oxygen to Unlicensed Assistive Personnel
• Scope of RN Practice "Instillation of Methotrexate into an Ommaya Reservoir"
• Scope of RN Practice to "Assist an Anesthesiologist/physician, or the ARNP in the Performance of a Regional Nerve Block"
• Scope of LPN Practice in the Performance of Urgent PC Neuromodulation
• Scope of RN Practice in the Performance and Collection of Endocervical Swab Specimens for the Assessment of Sexually Transmitted Diseases
• Scope of Nursing Practice in the Performance of Ear Stapling for the Treatment of Obesity
• Scope of RN Practice in the Performance of the Department of Transportation (DOT) Commercial Motor Vehicle Drive Physical Examination and Completion of the Medical Examiner’s Certificate

You can access the FY 2006-2007 AOS Summary Report [PDF Format - 69k] in its entirety by clicking on the link.  The information provided below was taken from this report.

• Delegation to Unlicensed Assistive Personnel
• Scope of LPN Practice – Home Health Care
• Scope of LPN Practice – Doctor’s On Call Answering Service
• Emergency Use of Nursing Students in Avian Flu Pandemic
• Scope of RN Practice – Certification of False Labor
• Pre-Anesthesia Screening Evaluation by an ARNP and/or RN
• Scope of Nursing in Acute Care Hospital Settings
• Application of Suprapubic and Fundal Pressures by RNs in Obstetrical Nursing Practice
• Teaching Unlicensed Assistive Personnel Medication Administration Curriculum – Scope of LPN Practice
• Scope of RN Practice and the Placement of a Magnet Nasal Tube Retaining Device
• Scope of LPN Practice and the Completion of an “Inpatient Rehabilitation Facility – Patient Assessment Instrument” (IRF-PAI)
• Application of Deep Oscillation/Hivamat®200 by Nurses

You can access the FY 2005-2006 AOS Summary Report [PDF Format - 107k] in its entirety by clicking on the link.  The information provided below was taken from this report.

• Role of the RN in Assigning Medicare Patient Hospital Admission Status
• Role of the LPN in Initial Nursing Assessment of Patients in a Wound and Hyperbaric Outpatient Department
• Roles of Nurses in Businesses Offering Complementary/Alternative or Holistic Practices (Raindrop Therapy and in a Holistic Retail Store)
• Delegation to Unlicensed Assistive Personnel:  Spiking IV Fluids
• Role of the LPN in Intravenous Therapy Practice:  CAD Pump and PCA Bolus
• Role of the RN in the Administration of Fentanyl PCA to Intrapartum Patients in Labor
• Role of the RN in Withdrawing Cerebral Spinal Fluid Samples via a Lumbar Drain
• Nurses Use of Standing Orders/Protocol for the Administration, Prescribing, and Dispensing of Medications to Students in a College Health Setting
• Role of the LPN in Assisting with the Placement of Percutaneous Endoscopic Gastrostomy (PEG) Tube
• Administration of Cytotec to Induce Labor
• LPN Intravenous Therapy Scope of Practice:  Titration
• Performance of Aspiration Biopsy of Chronic Wounds by Nurses
• Low Level Laser Therapy to Eliminate Smoking Addictions
• Role of the LPN in Training Unlicensed School Personnel to Perform Delegated Acts
• Administration of Nasal Versed (Midazolam) via an Intranasal Route in School Settings
• Wound Care Treatment by RNs Using the Anodyne® Therapy Professional System 480
• Use of Cosmetic Lasers by Nurses
• Degree of Supervision Needed by Nurses Who Perform Cosmetic Laser Treatments
• Advisory Opinion Request on ARNP Scope of Practice:  Laser Technology
• Role of the Women’s Health ARNP in Male Urology Care
• Proposed Amendments to 907 KAR 1:145, Supports for Community Living Services for an Individual with Mental Retardation or a Developmental Disability
• Article:  The Good Samaritan Law—A Nurse’s Responsibility to Act in an Emergency, P. Pabon, JD, KBN Prosecuting Attorney (see the last page of this report for a copy of this article)

You can access the FY 2004-2005 AOS Summary Report [PDF Format - 74k] in its entirety by clicking on the link.  The information provided below was taken from this report.

• ARNPs and Cardiac Rehabilitation Programs
• RNs Prescribing Medication via Established Protocol Following Telephone Triage
• Performance of Punch Biopsies and Small Skin Lesion Excisions by RNs
• Roles of Nurses in Surgical Site Markings
• Application of 201 KAR 20:400 to Delegation of Triage to Paramedics in a Hospital Emergency Room
• Midclavicular IV Catheter Placement (Reference AOS #25)
• Delegation of Medication (Solu-Cortef, Injectable) Administration by Unlicensed Personnel in School Settings
• Role of LPNs in Case Management and Chart Reviews
• Roles of Nurses in the Administration of Medication via a Continuous Infusion Catheter for Maintenance of a Peripheral Nerve Block
• Role of ARNP Designated Nurse Anesthetist in the Use of Fluoroscopy in the Performance of Pain Management

You can access the FY 2003-2004 AOS Summary Report [PDF Format - 76k] in its entirety by clicking on the link.  The information provided below was taken from this report.

• Insertion of a Bravo PH Capsule by RNs
• Roles of Nurses in Psychotherapy
• Roles of RNs and ARNP Designated Nurse Practitioners in the Administration of Propofol (Diprivan) for Procedural Sedation
• Administration of Etomidate During Rapid Sequence Intubation
• Roles of Nurses in Telephone Triage
• Procurement of Medications by Nurses in a Correctional Facility
• Administration of Medications via Various Injectable Routes by ARNPs
• Guidelines (Protocol/Standing Orders) for Ordering Preoperative Tests
• Administration of Medications via Gastrostomy Tubes by UAPs in Schools
• Roles and Responsibilities of Nurses in an Acute Care Unit
• Expansion of the Scope of LPN Practice
• Nurse Administration of Versed (Midazolam) Via a Physician-Prescribed Protocol for Treatment of Terminal Restlessness
• Administration of Medication in Life Threatening Situations Without a Medical Order
• Nurses Performing Laser Hair Removal
• Administration of Local Anesthesia to Dental Patients by RNs
• Review of Normal Diagnostic Test Result Reports by RNs
• Roles of RNs in Reading X-rays to Confirm Peripherally Inserted Central Catheter Placement

You can access the FY 2002-2003 AOS Summary Report [PDF Format - 55k] in its entirety by clicking on the link.  The information provided below was taken from this report.

• Administration of Medication to Children in School Settings
• Monitoring of Patients Receiving Ketamine Hydrochloride
• Initiation of Resuscitation Absent a "Do Not Resuscitate" Order
• Role of RN in Performance of Circulating Duties in the Operating Room
• Therapeutic Phlebotomy via a Central Venous Line Access by RNs
• Initial Pain Assessment by LPNs
• Aspiration of a Central Venous Catheter by LPNs
• Delegation of Oxygen Saturation Measurement and Documentation to Unlicensed Assistive Personnel
• Role of Nurses in the Delegation of "Fleet" (Fleet Bisacodyl or Fleet Phospho-Soda) Enema Administration to Unlicensed Assistive Personnel

INFORMATIONAL NOTES:

Massage Therapy – House Bill 126 (2002) created the Kentucky Board of Licensure for Massage Therapy and licensure of massage therapists.  The act does not preclude “…Practitioners of the following occupations and professions regulated by state law while engaging in the practices for which they are duly licensed and while not holding themselves out to be a massage therapist: …registered nurses and practical nurses regulated under KRS Chapter 314….”

Paramedics in Hospital Emergency Departments – In October 2002, the Board directed that a letter be sent to the Office of the Inspector General requesting that a registered nurse be included in the administrative regulations governing hospitals, operation and services, implementing KRS 311A.170(5)(a).   This regulation requires a hospital, in collaboration with the medical staff, to provide operating procedures and policies under which the paramedic shall operate consistent with the paramedic's scope of practice.  KBN requests that the administrative regulation implementing this section require the hospital to include the director of nursing, or the director’s designee, who shall be a registered nurse experienced in emergency department management, in the hospital-designated representatives that address this matter.

You can access the FY 2001-2002 AOS Summary Report [PDF Format - 63k] in its entirety by clicking on the link.  The information provided below was taken from this report.

• "Repeat and Verify" of Verbal Orders
• Orders for Restraints
• Dementia-Specific Training for Nursing Assistants and Entry-Level Workers in Healthcare Facilities
• University of Louisville Acute Care Nurse Aide Training Program
• Administration of Insulin in a School Setting
• Administration of Medications in School Settings
• Administration of Medications by Unlicensed Personnel
• Delegation of Tasks in the Care of Patients Post-Cardiac Catherization/Intervention
• Surgical/Incisional Removal of a Skin Lesion for Biopsy Purposes
• Bed Control Coordinator
• NCLEX for Nurses in an International Nursing Exchange Program
• Administration of Placebos
• Administration of Propofol/Diprivan
• Dental Varnishes
• "Do Not Resuscitate" and "Discontinuation of Tube Feedings" Orders

You can access the FY 2000-2001 AOS Summary Report [PDF Format - 53k] in its entirety by clicking on the link.  The information provided below was taken from this report.

• Performance of Bone Marrow Aspiration and Biopsy by RNs
• Teaching and Delegating Carbohydrate Counts and the Administration of Insulin via an External Pump in a School Setting
• Performance of Dermabrasion and Microdermabrasion by RNs
• Cerumen Removal by Nurses
• Administration of Sub-Anesthetic Dosages of Ketamine for Pain Management by RNs
• Insertion of an Intravascular Hemostasis Device, such as an "Angioseal" that is Deployed as the Femoral Sheath is Removed After a Cardiac Catherization, by RNs
• Role of the LPN in Dialysis Care
• Performance of Myelograms by an ARNP Designated Nurse Practitioner
• Prescribing of Controlled Substances by ARNPs for Patients Admitted to a Health Care Facility

INFORMATIONAL NOTES:

Credentialing of Dialysis Technicians – In response to the 2001 General Assembly action to enact legislation in KRS Chapter 314 to authorize the Board of Nursing to regulate the practice of dialysis technicians, an administrative regulation was promulgated.   201 KAR 20:470E was promulgated June 21, 2001 and established the parameters for the training, credentialing and practice of dialysis technicians in Kentucky.  Refer to 201 KAR 20:470.

Declaratory Rulings – In response to the 2000 General Assembly action to enact legislation in KRS Chapter 314 to authorize the Board of Nursing to issue declaratory rulings, an administrative regulation was promulgated.  201 KAR 20:460, Declaratory Rulings, became effective on June 8, 2001.

You can access the FY 1999-2000 AOS Summary Report [PDF Format - 216k] in its entirety by clicking on the link.  The information provided below was taken from this report.

• Administration of Brevital for Conscious Sedation by RNs
• Performance of Hair Insertion by RNs
• Application of Topical Adhesives for Wound Closure by Nurses
• Utilization of the Colposcope in the Performance of Forensic Examinations by RNs