Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 4 › Subtitle 27 - BOARD OF NURSING › Chapter 10.27.20 - Management of Infusion Therapy by the Registered Nurse and the Licensed Practical Nurse › Section 10.27.20.02 - Definitions

Current through Register Vol. 51, No. 14, July 12, 2024
A. In this chapter,
				  the following terms have the meanings indicated.
B. Terms Defined.
(1) "Administer" means to hang or give
				  subsequent fluids and medications.
(2) "Antineoplastic" means:
(a) Chemical or biologic agents that have a
				  toxic effect on the disease-causing agent or modify the host environment;
				  or
(b) Drugs that are capable of
				  destroying invading organisms or malignant tumor cells.
(3) "Arterial catheter" means a catheter or
				  needle inserted into an artery.
(4)
				  "Assign" means to designate another licensee to be responsible and accountable
				  to perform nursing acts that are within the licensee's scope of practice,
				  knowledge, judgment, and skill.
(5)
				  "Central venous catheter (CVC)" means a catheter whose tip is located in a
				  central vessel.
(6) "Chronic
				  dialysis client" means a client with end stage renal disease who is receiving
				  routine dialysis treatments in an outpatient facility.
(7) "Clinical competence" means the
				  demonstrated ability to perform the identified IV tasks consistent with the
				  standards established by the INS, ONS, or other bodies approved by the
				  Board.
(8) "Comprehensive
				  assessment" means a nursing assessment that includes:
(a) The specific individual patient's
				  clinical status;
(b) Medical
				  treatment regime; and
(c)
				  Complexity of the infusion therapy treatment regime including:
(i) The purpose and effects of the specific
				  infusate or medication,
(ii) Skills
				  to access and de-access the infusion catheter access device, and
(iii) The potential harm to the patient
				  should an error occur.
(9) Direct Supervision.
(a) "Direct supervision" means oversight
				  exercised by a registered nurse who is present on the unit of care during the
				  infusion therapy process.
(b)
				  "Direct supervision" includes the actions of:
(i) Observation;
(ii) Assessment;
(iii) Evaluation; and
(iv) Direction.
(10) "First dose" has the meaning
				  defined by the facility's policies and procedures.
(11) "Hypodermoclysis" means the infusion of
				  fluids into subcutaneous tissue for hydration.
(12) Implanted Port.
(a) "Implanted port" means a reservoir
				  surgically placed under the skin and attached to a catheter which is placed in
				  a vessel, body cavity, or organ.
(b) "Implanted port" is often referred to as
				  a medi-port, port-a-cath, infuse-a-port, infusion port, or a subcutaneous
				  port.
(13) "Implanted
				  pump" means a catheter surgically placed into a vessel, body cavity, or body
				  space, and attached to a reservoir placed under the skin, that contains a
				  pumping mechanism for continuous medication administration.
(14) "Infusion therapy" means the initiation
				  and administration of medication, fluids, and nutrients via an intravenous
				  access device.
(15) "Initiate"
				  means to hang and administer the first dose of medications or fluids.
(16) "INS" means Infusion Nurses
				  Society.
(17) "Intraventricular
				  reservoir" means a catheter threaded through the dura into a ventricle of the
				  brain.
(18) "Licensee" means a
				  registered nurse or licensed practical nurse.
(19) "LPN" means an
				  individual who:
(a) Is licensed by the Board
				  to practice licensed practical nursing; or
(b) Has a multistate licensure privilege to
				  practice licensed practical nursing.
(20) "Midclavicular catheter" means a
				  peripherally inserted catheter with the distal tip located between the axilla
				  and the vena cava.
(21) "Midline
				  catheter" means a peripherally inserted catheter with the tip terminating below
				  the axilla.
(22) "Multi-lumen
				  catheter" means a venous access device that has more than one lumen.
(23) "Multistate licensure privilege" has the
				  meaning set forth in COMAR
				  10.27.01.01B.
(24) "Non-tunneled catheter" means
				  a percutaneously placed catheter inserted into the vein.
(25) "ONS" means Oncology Nursing
				  Society.
(26) "On-site supervision"
				  means oversight exercised by a supervising registered nurse who is:
(a) Present in the facility; and
(b) Quickly and easily available to the
				  patient and the assigned nurse during the course of infusion therapy.
(27) "Peripheral catheter" means a
				  catheter or needle inserted into a superficial vein with the tip residing
				  outside of the central venous system.
(28) "Peripheral veins" means those veins in
				  the superficial aspects of the body excluding the external jugular
				  vein.
(29) "Peripherally inserted
				  central catheter (PICC)" means a catheter, inserted with or without a guide
				  wire, whose tip is located in the vena cava.
(30) "PPN" means partial parenteral
				  nutrition.
(31) "Registered nurse (RN)" means an individual who:
(a) Is licensed by the Board to practice
				  registered nursing; or
(b) Has a
				  multistate licensure privilege to practice registered nursing.
(32) "Specialized catheter" means
				  an epidural, intrathecal, intrapleural, or peripheral nerve catheter.
(33) "Subcutaneous infusion of medication"
				  means a continuous or intermittent infusion of medication by an indwelling
				  needle or catheter inserted into subcutaneous tissue.
(34) "TPN" means total parenteral nutrition
				  administered into the central venous system.
(35) "Tunneled catheter" means a CVC designed
				  to have a portion of the catheter lie in a subcutaneous passage before exiting
				  the body.
(36) "Nonsurgically
				  placed" means a catheter placed percutaneously.