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Prepared by: Jim McGovern, Esq. & Brennan Santa, Law Clerk

All Licensed Practical Nurses (LPNs) in Ohio must be aware of their scope of practice and stay within the established boundaries. For example, LPNs can perform some types of intravenous (IV) therapy in certain situations. LPNs should understand what kinds of situations they are allowed to provide IV therapy, as well as when they are to be working under the direction of another provider, such as a physician or RN. Understanding the different situations of IV therapy, and when LPNs can participate, can impact whether an Ohio LPN exceeds their scope of practice and violates the Nurse Practice Act.

LPNs can perform IV therapy if certain conditions are met. First, when providing IV therapy to an adult patient, it must be at the direction of: a physician, physician assistant, dentist, optometrist, or podiatrist authorized in the state who is directly available at the facility.¹ LPNs can also perform IV therapy on an adult patient under the direction of a registered nurse (RN); however, the RN must have first performed an on-site assessment of the adult patient. However, if it’s at an immediate care facility for individuals with intellectual disabilities, the RN need only be at the premises or accessible via telecommunication.²

Moving beyond adult patients, LPNs can perform IV therapy on any person if: (1) it is at the direction of a physician, physician assistant, dentist, optometrist, or podiatrist authorized in Ohio, who is available on the premises or accessible by some form of telecommunication; (2) the licensed practical nurse must demonstrate the knowledge, skills, and ability to perform the procedure safely.³ The procedures that LPNs can complete if these conditions are met are limited to: verification of the type of peripheral intravenous solution being administered; examination of a peripheral infusion site and the extremity for possible infiltration; regulation of a peripheral intravenous infusion according to the prescribed flow rate; discontinuation of a peripheral intravenous device at the appropriate time; performance of routine dressing changes at the insertion site of a peripheral venous or arterial infusion, peripherally inserted central catheter infusion, or central venous pressure subclavian infusion.⁴

LPNs cannot provide certain types of IV therapy. For example, for adult patients, they cannot imitate or maintain cancer therapeutic medication, including cancer chemotherapy or an anti-neoplastic agent (and more). For a complete list of what LPNs should avoid doing for adult patients’ IV therapy, see the Ohio Revised Code.⁵ LPNs can, however, perform certain activities for adult patients’ dialysis when under the direction of a physician or a registered nurse; see the Ohio Revised Code⁶ for more details.

For a complete list of what types of IV therapy LPNs can perform, with all ages addressed, see the Ohio Administrative Code.⁷

Further, LPNs must be adequately trained and educated in order to assist with IV therapy. They must demonstrate that they can perform the skills required, and keep records of their training and competence. For more information on LPN training, education, skills, and records, see the Ohio Administrative Code.⁸

The Ohio Board of Nursing has created a flowchart to assist RNs and LPNs to determine whether an activity is within their scope of practice and in adherence to the Nurse Practice Act. LPNs (and RNs) can view this flowchart online and consult it.⁹ LPN scope of practice is also explained online by the Ohio Board of Nursing.¹⁰

Ohio LPNs who participate in IV therapy beyond the scopes outlined in the Ohio Revised Code and the Ohio Administrative Code may be placing patients at risk. Further, they risk having their license sanctioned by the Ohio Board of Nursing. If you need guidance regarding IV therapy for LPNs, other scope of practice issues, as well as any licensure concerns, contact Graff and McGovern.

1. Ohio Revised Code 4723.18. Section 4723.18 – Ohio Revised Code | Ohio Laws ↩︎
2. Id. ↩︎
3. Ohio Revised Code 4723.181(A). Section 4723.181 – Ohio Revised Code | Ohio Laws ↩︎
4. Id at (B). ↩︎
5. Id at (C). ↩︎
6. Id at (D). ↩︎
7. Ohio Administrative Code 4723-4-02. Rule 4723-4-02 – Ohio Administrative Code | Ohio Laws ↩︎
8. Ohio Administrative Code 4723-4-04. Rule 4723-4-04 – Ohio Administrative Code | Ohio Laws ↩︎
9. RN & LPN Decision Making Model | Ohio Board of Nursing ↩︎
10. Nursing Practice and Scopes of Practice | Ohio Board of Nursing ↩︎