Can a licensed practical nurse start an intravenous line without an order from an authorized health care practitioner in certain situations, such as for an unstable/high acuity patient or if a practitioner ordered a blood transfusion but did not order in

It is not within the scope of practice for a licensed practical nurse to start an intravenous line without an order from an authorized health care practitioner. The RCW 18.71.011 Definition of the Practice of Medicine stipulates the practice of medicine to include severing penetrating the tissues of human beings. Standing orders may be an option to allow the nurse to start an intravenous line based on specific criteria (such as a high acuity patient), admission to a specific unit (such as intensive care), or for a specific condition. Standing orders may also be used to allow a nurse to start more than one intravenous line based on specific criteria. The nurse should use the Scope of Practice Decision Tree to determine if specific activities are within the nurse's legal and individual scope of practice. The Nursing Care Quality Assurance Commission's Standing Orders and Verbal Orders Advisory Opinion provides additional guidance and recommendations.