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					            PROCEDURES Beyond Basic Education that have been approved
             following the requirements of the Standardized Procedure Rule

AIRWAY MANAGEMENT
         Chest Tube Removal by Advanced Practice Nurses (CRNPs & CNSs)
         Endotrachael Intubation of Newborn by RNs in December 2006
         Endotracheal Intubation by RNs
         Needle Cricothyrotomy by RNs
         Needle Decompression of Tension Pneumothorax by Aeromedical RNs
         Pleural Catheters, Aspiration of Air from, by RNs
         Tracheostomy Tubes, Emergency Reinsertion/Changing of, by RNs and LPNs

ASSESSMENT
        EMTALA: Medical Screening Exam by RNs in October 2003

ASSISTANT TO THE PHYSICIAN
         Assisting the MD with RSI in hospital & during transport in June 2009
         Gastrostomy, Percutaneous Endoscopic, Tube Insertion Assistance by RNs in
         August 2006
         Endoscope Manipulation by RNs and LPNs
         Intraoperative Wound Closure, Intraoperative Skin Incisions, Radical Artery
         Harvesting for use as conduit for Coronary Artery Bypass Grafting by RNFAs in July
         2004
         RN as Procedural Assistant with Percutaneous Endoscopic Gastrostomy Tube
         Insertion in August 2006
         RNFA by RNs in June 2006

CARDIAC PROCEDURES
         Arterial Punctures by RNs
         Arterial/Venous Catheter Sheath Removal by RNs
         Arterial-Venous Sheaths Suturing by RNs in September 2006
         Boomerang Catalyst Device Removal by RNs in MICU, SICU, CV Lab, & CVU with
         current ACLS in February 2009
         Bubble Study, Echocardiographic by RNs in MICU, SICU, CV Lab, & CVU with
         current ACLS in December 2008
         Cardiac Output Thermodilution by RNs
         Cardiac Pacing Techniques, Temporary, by RNs*
         Compression System: Application of in August 2006
         Extracorporeal Membrane Oxygenation (ECMO) at bedside by RNs in September
         2008
         Graded Exercise Testing (GXT), Treadmill/Thallium Scans, Dobutamine Stress
         Testing
         Permanently Implanted Pacemakers, Interrogation, Threshold Testing and
         Programming by RNs
         Pulmonary Artery Catheter Removal by RNs

            Pulmonary Artery Catheterization, Nursing Management of the Patient with, by RNs
            Temporary Transvenous Pacemaker Electrode Removal by RNs
            Ventricular Assist Device (VAD): Care of the patient with by RNs in July 2008
CASTING
            Cast Reapplication by RNs and LPNs

CATHETERS, DRAINS & TUBES
        Chronically Indwelling Suprapubic Catheters and Chronically Indwelling Nephrostomy
        Tubes Reinsertion by RNs and LPNs
        Delegation of Clean Intermittent Urinary Catheterization to Unlicensed Assistive
        Personnel
        Gastrostomy Tubes Reinsertion by RNs and LPNs
        Mediastinal Tube Removal by RNs
        Nasogastric Tube Insertion by LPNs
        Lap Band Adjustment by RN and LPN in January 2009
        Pleural/Peritoneal Drain System: Care and Draining of by RNs & LPNs in December
        2006

DERMATOLOGY
        Intense Pulsed Light (IPL) by RNs & LPNs in September 2007
        Laser Hair Removal, Photofacial, laser skin tightening, laser skin resurfacing (non-
        ablative) by RNs in September 2007
        Microdermabrasion by RNs & LPNs in November 2002
        Sclerotherapy with Saline by RNs in September 2008

DIAGNOSTIC
         Bone Marrow Aspiration limited to iliac crest by RNs in July 2008
         Laboratory Procedures by LPNs
         Lumbar Punctures by CRNPs
         Needle Aspiration, Random Fine, of Breast by CRNPS in January 2003
         Punch Biopsies by CRNPs
DIALYSIS
         Continuous Renal Replacement Therapy (CRRT) in March 2004
         Femoral Vein Cannulation (or Catheterization) by RNs in Hemodialysis Setting
         Hemodialysis, Chronic, by LPNs
         Peritoneal Dialysis Catheter Removal by RNs


EQUIPMENT
         Radiographic Equipment Operation by RNs and LPNs

GYNECOLOGY, OBSTETRICS
        Colposcope, Flexible, Utilization by RNs and LPNs to Collect Photographic Evidence
        from Rape Victims
        Colposcopy by CRNPs and CNMs
        Electrical Biofeedback and Muscular Stimulation in Pelvic Floor Rehabilitation for
        Urinary Incontinence by RNs and LPNs
        Endometrial Sampling by Advanced Practice Nurses
        Fetal Fibronectin Specimen Collection by RNs in L&D in November 2008
        Fetal Monitoring Internal Electrode Placement by RNs
        Fetal Presentation Verification via Ultrasound by RNs in March 2009
        Intrauterine Insemination by RNs
        Intrauterine Pressure Catheter Insertion by RNs
           Norplant System, Insertion and Removal of, by CRNPs and CNMs
           Prostaglandin Suppository Administration by RNs
           Umbilical Catheter Discontinuation by RNs

INTRAVENOUS THERAPY AND MEDICATION
         Anesthetic Agents: Administration of Local by RNs & LPNs in November 2006
         Central Venous or Arterial Specimen Collection by LPNs
         Chemotherapeutic Agent Administration by RNs and LPNs
         Etomidate: Administration of by Transport RNs in March 2008
         Implantable Programmable Drug Infusion Pump Refilling by RNs under MD
         Supervision in November 2008
         Implantable Pump Refilling by RNs in November 2008
         Intraosseous Infusions, Initiation of, by RNs
         Intraosseous Needle Placement by RNs in July 2007
         Intraperitoneal Administration of Chemotherapy by RNs in February 2007
         Intrathecal and Epidural Administration of Analgesic, Antibiotic and/or
         Chemotherapeutic Agents and Administration of Chemotherapeutic Agents Directly
         into a Body Organ or Cavity by RNs
         Intrathecal Medication via Intraventricular Catheter by RNs in Neuroscience ICU in
         July 2007
         IV Push Administration of Defined Medications by LPNs in January 2007
         IV Therapy in the Neonate by RNs
         IV Therapy via External Jugular by RNs
         Neuromuscular Blockade Administration for assisting physicians with intubation by
         RNs in September 2006
         Repair of Long Term Central Venous Catheters by the RN
         Peripherally Inserted Central Catheters (PICC) Insertion and Removal by RNs in May
         2005
         Peripheral Nerve Stimulation to evaluate neuromuscular blockade by RNs in
         November 2002
         Radioisotope, Intravenous Administration of, for SPECT Scan by RNs in September
         2003
         Radiopaque Contrast Media/Agent Administration by RNs
         Rapid Sequence Intubation (RSI) and Drug Assisted Intubation (DAI) by Transport
         RNS in May 2007
         Sedation, moderate, by RNs in October 2006

           Non-Anesthetic Drug Administration Intravenous by RNs for Conscious Sedation
           Subcutaneous Infusion by RNs in May 2008

NEUROLOGIC
        Functional Independence Measurement (FIM) Rating by LPNs in March 2006
        Lumbar Drains, care of patients with by RNs in July 2008
        Priming, Calibration and Operation of CIPER System (Intracranial Pressure System)
        by RNs in Neuroscience ICU in July 2007
        Sphenoidal Electrode Removal by CRNPS in March 2003

RNFAs

           Intraoperative wound closure, intraoperative skin incisions, radical artery harvesting
           for use as conduit for coronary artery bypass grafting by RNFAs in July 2004
SUTURES, STAPLES, SKIN CLOSURE
          Sutures and Staples Removal by LPNs

           Suturing, Knot Tying and Subcutaneous Skin Closure with Staples by RNs and LPNs

WOUND CARE
        Compression System Application in August 2006
        Hyperbaric Oxygen Treatment by RNs and LPNs in July 2008
        Negative Pressure Wound Therapy (Wound Vac® Therapy) by RNs and LPNs in
        November 2006
        Pulsatile Lavage by RNs in July 2008
        Sharp Debridement by RNs in Wound Care Center in July 2008
        TcPO2 Measurement by RNs & LPNS in September 2008
        Staging of Pressure Ulcers and Differentiation of Common Wounds by RNs in
        December 2008

DENIED Applications for Procedures Beyond Basic Education.
           Debridement: Conservative Sharp Wound by LPNs in November 2004
           Infiltration of Tumescent Lidocaine for Liposuction by RNs in July 2005
           Intermittent Injection of Non-Anesthetic Medications via an Epidural Catheter by RNs
           in November 2008
           Intravenous Administration of H2 Blockers by LPNs in July 2004

           LPN as Surgical First Assistant with Skin Closure Privileges in September 2006
           Sclerotherapy using Sotradecol by RNs in November 2007

				
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