KANSAS STATE BOARD OF NURSING
LANDON STATE OFFICE BUILDING
900 SW JACKSON, SUITE 1051
TOPEKA, KS 66612-1230

LPN IV Therapy Course Provider Application

Individual organizations or agencies desiring to obtain approval to provide a course for LPNs in IV Therapy administration must complete and submit an application to the Kansas State Board of Nursing (KSBN). Please review the following rules and regulations related to IV Therapy for LPNs and continuing nursing education in the Nurse Practice Act (available on-line at www.ksbn.org):


IV Therapy:
65-1136
60-16-101
60-16-102
60-16-103
60-16-104

CNE:
60-9-107

Please review these instructions before completing the application.

  1. Applications are to be submitted thirty (30) days prior to the first course. 
  1. The cover page must be completed.
  1. The content should be typed and organized in the order of the application criteria listed under “Regulation Description” on the attached form and the pages should be numbered.  All items listed under “regulation description” must be addressed and “additional information” attached where noted.
  1. Examples submitted in support of narrative statements must be referenced by page or appendix number and name of applicant
  1. Photocopies must be readable.

  2. If you are a current LT CNE provider you may award at least 32 contact hours to each LPN who successfully completes the course. Each RN who successfully completes the course may be awarded 20 contact hours, one time only.

  3. If you are not a LT CNE provider you may apply by submitting a single offering provider application at no fee for initial application. If approved the program providership will be effective for 2 years and may be renewed by submitting new application and fee prior to expiration.

 

INSTRUCTIONS FOR KSBN LPN IV THERAPY COURSE PROVIDER APPLICATION

Approval of the Kansas State Board of Nursing (KSBN) LPN IV Therapy course application is based on an analysis of the submitted information to determine the applicant’s capacity to provide LPNs IV Therapy Education meeting the statutes and regulations outlined in the Nurse Practice Act.
The purpose of the intravenous fluid therapy course shall be to prepare licensed practical nurses to perform safely and competently the activities defined in K.A.R. 60-16-102. The course shall be based on the nursing process and current intravenous nursing standards of practice.

 

APPLICATION REVIEW PROCESS


The completed LPN IV Therapy providership application will be reviewed by the Education Specialist, for compliance with the LPN IV Therapy statutes and regulations.

If an application has been reviewed and found deficient, or has approval pending, the coordinator shall submit all materials required before the date of the offering. Following approval by the Education Specialist, written notification will be sent including an IV Therapy provider number.

If applying for single offering CNE approval for the LPN IV therapy course the single program application shall be completed. There shall be no cost to this provider for the initial single offering providership. KAR 60-16-103 b (7)(B)

The single program providership shall be effective for two years and may be renewed by submitting the single offering provider application and by paying the fee specified in K.A.R. 60-4-103(a)(5).

Each long-term provider shall submit the materials outlined in KAR 60-16-103 subsection (b) with the five year long-term provider renewal.

 

KANSAS STATE BOARD OF NURSING
IV THERAPY COURSE PROVIDER APPLICATION

Administration                                                                                                                                                       

Regulation

Regulation Description

Additional information

 

Name and address of organization

Add to cover page

 

Name and address of department or unit within the organization responsible for the IV Therapy providership

Add to cover page

60-16-103 b (1)

Name and qualification of the coordinator

The intravenous therapy course coordinator shall meet the following requirements: be licensed as a registered professional nurse; be responsible for the development and implementation of the intravenous fluid therapy course; and have experience in intravenous fluid therapy and knowledge of the intravenous fluid therapy standards. KAR 60-16-104 d (1)(2)&(3)

Add to cover page and Include resume/CV for coordinator

Program Management – Proposal

60-16-103 b (2)

Name and qualifications of each faculty member of the course:

Each primary faculty member shall meet the following requirements; be currently licensed to practice as  a registered professional nurse in Kansas; have clinical experience within the past 5 years that includes intravenous therapy; and maintain competency in intravenous fluid therapy. KAR 60-16-104 e (1) (A)(B)&(C)
Each guest lecturer shall have professional preparation and qualifications for the specific subject area in which the individual instructs. KAR 60-16-104 e (2)

Add to policy

Include faculty and guest lecturer resumes/CV’s

60-16-103 b (3)

The mechanism through which the provider will determine that the licensed practical nurse seeking to take the course meets the admission guidelines:

To be eligible to enroll in an intravenous fluid therapy course, the individual shall be a nurse with a current license.  KAR 60-16-104 c

 

Add to policy

60-16-103 b
(4)

Description of  the educational and clinical facilities  that will be utilized:

Each classroom shall contain sufficient space, equipment, and teaching aides to meet the course objectives.  60-16-104 f (1)
The facility in which the clinical practice and competency examinations are conducted shall allow the students and faculty access to the intravenous fluid therapy equipment and intravenous fluid therapy recipients, and to the pertinent records for the purpose of documentation. 60-16-104 f (2)
There shall be a signed, written agreement between the provider and the cooperating healthcare facility that specifies the roles, responsibilities, and liabilities of each party. This written agreement shall not be required if the only health care facility to be used is also the provider. 60-16-104 f (3)

Add to policy

 

Include description of where class room hours and clinical hours will take place.

Include contracts with clinical sites for clinical portion of course that denotes availability of supplies, patients, and charts. Also describe roles, responsibilities, and liabilities of parties within the clinical site.

60-16-103 b (5)

Outlines of the classroom curriculum and the clinical curriculum, including time segments. These curricula shall meet the requirements if K.A.R. 60-16-104 (g):

The course shall consist of at least 30 hours of instruction and require at least 8 hours of supervised clinical practice, which shall include at least one successful peripheral venous access procedure and the initiation of an intravenous infusion treatment modality on an individual. KAR 60-16-104 b (1) & (2)

The board-approved intravenous fluid therapy curriculum shall be the following standards of the infusion nurses society’s supplement titles “infusion nursing standards of practice,“ volume 34, number 1S, dated January/February 2011, which are herby adopted by reference. KAR 60-16-104 g (1)

Add to policy

Include course breakdown for classroom and clinical instruction

Include course syllabus of classroom and clinical instruction

Include course (time segment) agenda

Include details and description of resources to be used by the faculty and students

60-16-103 b (6)

Methods of student evaluation that will be used, including a copy of the final written competency examination and the final clinical competency examination:

The final written competency examination shall be constructed from the board-approved pool of test questions and shall be based on the board-approved test plan. KAR 60-16-104 h (1)(A)
The final written competency examination shall consist of at least 50 questions and shall require a passing grade of 80 percent or above. KAR 60-16-104 h (1)(B)

The final clinical competency examination shall require successful completion of the procedures on the board-approved competency checklist. KAR 60-16-104 h (2)

Add to policy

Include copies of final written competency exam and final clinical competency exam.

Provide written policy that includes that the test will be written according to the board-approved test plans and will include only board-approved test questions and will require passing grade of 80% or above. 

Provide written policy  that includes the use of only board-approved checklist for clinical competency and will require passing grade of 100%

60-16-103 b (7)

If applicable, send an application for continuing nursing education approval. OPTIONAL

For each long-term program provider, the IV therapy course provider number shall be printed on the certificates and the course roster, along with the long-term provider number. 60-16-103 b (7)(A)

For each single offering program provider, the single program application shall be completed. There shall be no cost to this provider for the initial single offering providership. 60-16-103 b (7)(B)

Add to policy

It is not required to offer CNE contact hours for course completion

Separate Single offering provider application will need to be completed for the offering of approved CNE

60-16-103 c

If applicable, continuing education providers shall award at least 32 contact hours to each LPN who completes the course. Continuing education providers may award 20 contact hours, one time only, to each RN who completes the course.

Add to policy

60-16-103 d

After initial approval , each change in the course shall be provided to the board for approval before the change is implemented

Add to policy

60-16-103 e

Each IV Fluid therapy course shall submit to the board an annual report for the period of July 1 through June 30 of the respective year that includes the total number of licensees taking the intravenous fluid therapy course, the number passing the course, and the number of courses held. 60-16-103 e (1)

Single program providers shall be effective for 2 years and may be renewed by submitting the single offering providership application and paying the fee. 60-16-103 e (2)

Long-term providers shall submit the materials included in the IV Therapy proposal with their 5 year long term providership renewal. 60-16-103 e (3)

Add to policy

60-16-104 i (1)

The faculty shall complete the final record sheet, which shall include competencies and scores

Add to policy

60-16-104 i (2)

The intravenous fluid therapy course coordinator shall perform the following:
Award a certificate to each licensed nurse documenting successful completion of both the final competency examination and the final clinical competency examination. 60-16-104 i (2)(A)

Submit to the board, within 15 days, a typed, alphabetized roster listing the name license number of each individual who has successfully completed the course and the date of completion. The coordinator shall ensure that each roster meets all requirements. 60-16-104 i (2)(B)

RN and LPN participants shall be listed on separate rosters; and the roster shall include the providers name and address, the single or long-term provider number, the IV therapy provider number, and the signature of the coordinator

Add to policy

Submit proposed certificate of completion

 

Use Board approved standardized roster

60-16-104 i (2) (C)

Maintain records of each individual who has successfully completed the course for a period of at least five years.

Add to policy

 

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