Revised Advisory Rulings 1001 and 9301

March 12, 2015

To:                   Massachusetts Nursing and Professional Healthcare Organizations

From:              Laurie Talarico, MS, RN, CNP Nursing Practice Coordinator

Re:                  Revised Advisory Rulings 1001: Management of Patients Receiving

                        Analgesia by Catheter Technique and 9301: Peripherally Inserted Central

                        Catheters 

At the March 11, 2015 Board of Registration in Nursing (Board) meeting, the Board issued revisions to Advisory Ruling (AR) 1001: Management of Patients Receiving Analgesia by Catheter Technique and AR 9301: Peripherally Inserted Central Catheters to ensure compliance with current statutes, regulations and scope of practice standards.

AR 1001: Management of Patients Receiving Analgesia by Catheter Technique guides the practice of the Registered Nurse (RN) whose clinical responsibilities include the administration and management of analgesic medication by catheter technique in order to alleviate acute or chronic pain, regardless of patient age or setting, by epidural, intrathecal, intrapleural, peripheral nerve routes.

AR 1001: Management of Patients Receiving Analgesia by Catheter Technique revisions include:

• A statement defining the role of the nurse in a management role as one that must ensure the availability of sufficient resources to provide for safe implementation, including, but not limited to organizational policies that provide for:

o   Protocols for assessing and documenting the education and validation for RN initial and continued competency for each activity

o   Nursing care responsibilities, including, but not limited to patient assessment, monitoring, medication administration, potential complications, and documentation criteria

o   Emergency protocols including, but not limited to, immediate, on site availability of emergency equipment, medications and personnel

·         Technical revisions

·         Updated references

Please take a moment to review the entire Advisory Ruling 1001

AR 9301: Peripherally Inserted Central Catheters guides the practice of the Registered Nurse (RN) whose clinical responsibilities include the insertion, management, and withdrawal of a Peripherally Inserted Central Catheter (PICC).  It also guides the practice of the Licensed Practical Nurse (LPN) whose clinical responsibilities include PICC management. 

AR 9301: Peripherally Inserted Central Catheters revisions include:

• A statement that the use of a medical device designed to produce visual ECG waveforms for the purpose of determining PICC tip placement is within the scope of practice for a qualified RN
• A statement that clarifies the scope of a qualified LPN includes PICC maintenance (e.g., access, dressing changes, and administering solutions and medications) 

·         Technical revisions

·         Updated references

Please take a moment to review the entire Advisory Ruling 9301