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<regulation prefix="Regulation" num=".02" citation="COMAR 10.27.20.02" title_num="10" subtitle_num="27" chapter_num="20" heading="Definitions.">
  <paragraph num="A.">
    <text>In this chapter, the following terms have the meanings indicated.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Terms Defined.</text>
    <paragraph num="(1)">
      <text>“Administer” means to hang or give subsequent fluids and medications.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>“Antineoplastic” means:</text>
      <paragraph num="(a)">
        <text>Chemical or biologic agents that have a toxic effect on the disease-causing agent or modify the host environment; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Drugs that are capable of destroying invading organisms or malignant tumor cells.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>“Arterial catheter” means a catheter or needle inserted into an artery.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>“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.</text>
    </paragraph>
    <paragraph num="(5)">
      <text>“Central venous catheter (CVC)” means a catheter whose tip is located in a central vessel.</text>
    </paragraph>
    <paragraph num="(6)">
      <text>“Chronic dialysis client” means a client with end stage renal disease who is receiving routine dialysis treatments in an outpatient facility.</text>
    </paragraph>
    <paragraph num="(7)">
      <text>“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.</text>
    </paragraph>
    <paragraph num="(8)">
      <text>“Comprehensive assessment” means a nursing assessment that includes:</text>
      <paragraph num="(a)">
        <text>The specific individual patient's clinical status;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Medical treatment regime; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Complexity of the infusion therapy treatment regime including:</text>
        <paragraph num="(i)">
          <text>The purpose and effects of the specific infusate or medication;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Skills to access and de-access the infusion catheter access device; and</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>The potential harm to the patient should an error occur.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(9)">
      <text>Direct Supervision.</text>
      <paragraph num="(a)">
        <text>“Direct supervision” means oversight exercised by a registered nurse who is present on the unit of care during the infusion therapy process.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>“Direct supervision” includes the actions of:</text>
        <paragraph num="(i)">
          <text>Observation;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Assessment;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Evaluation; and</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Direction.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(10)">
      <text>“First dose” has the meaning defined by the facility's policies and procedures.</text>
    </paragraph>
    <paragraph num="(11)">
      <text>“Hypodermoclysis” means the infusion of fluids into subcutaneous tissue for hydration.</text>
    </paragraph>
    <paragraph num="(12)">
      <text>Implanted Port.</text>
      <paragraph num="(a)">
        <text>“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.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>“Implanted port” is often referred to as a medi-port, port-a-cath, infuse-a-port, infusion port, or a subcutaneous port.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(13)">
      <text>“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.</text>
    </paragraph>
    <paragraph num="(14)">
      <text>“Infusion therapy” means the initiation and administration of medication, fluids, and nutrients via an intravenous access device.</text>
    </paragraph>
    <paragraph num="(15)">
      <text>“Initiate” means to hang and administer the first dose of medications or fluids.</text>
    </paragraph>
    <paragraph num="(16)">
      <text>“INS” means Infusion Nurses Society.</text>
    </paragraph>
    <paragraph num="(17)">
      <text>“Intraventricular reservoir” means a catheter threaded through the dura into a ventricle of the brain.</text>
    </paragraph>
    <paragraph num="(18)">
      <text>“Licensee” means a registered nurse or licensed practical nurse.</text>
    </paragraph>
    <paragraph num="(19)">
      <text>“LPN” means an individual who:</text>
      <paragraph num="(a)">
        <text>Is licensed by the Board to practice licensed practical nursing; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Has a multistate licensure privilege to practice licensed practical nursing.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(20)">
      <text>“Midclavicular catheter” means a peripherally inserted catheter with the distal tip located between the axilla and the vena cava.</text>
    </paragraph>
    <paragraph num="(21)">
      <text>“Midline catheter” means a peripherally inserted catheter with the tip terminating below the axilla.</text>
    </paragraph>
    <paragraph num="(22)">
      <text>“Multi-lumen catheter” means a venous access device that has more than one lumen.</text>
    </paragraph>
    <paragraph num="(23)">
      <text>“Multistate licensure privilege” has the meaning set forth in COMAR 10.27.01.01B.</text>
    </paragraph>
    <paragraph num="(24)">
      <text>“Non-tunneled catheter” means a percutaneously placed catheter inserted into the vein.</text>
    </paragraph>
    <paragraph num="(25)">
      <text>“ONS” means Oncology Nursing Society.</text>
    </paragraph>
    <paragraph num="(26)">
      <text>“On-site supervision” means oversight exercised by a supervising registered nurse who is:</text>
      <paragraph num="(a)">
        <text>Present in the facility; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Quickly and easily available to the patient and the assigned nurse during the course of infusion therapy.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(27)">
      <text>“Peripheral catheter” means a catheter or needle inserted into a superficial vein with the tip residing outside of the central venous system.</text>
    </paragraph>
    <paragraph num="(28)">
      <text>“Peripheral veins” means those veins in the superficial aspects of the body excluding the external jugular vein.</text>
    </paragraph>
    <paragraph num="(29)">
      <text>“Peripherally inserted central catheter (PICC)” means a catheter, inserted with or without a guide wire, whose tip is located in the vena cava.</text>
    </paragraph>
    <paragraph num="(30)">
      <text>“PPN” means partial parenteral nutrition.</text>
    </paragraph>
    <paragraph num="(31)">
      <text>“Registered nurse (RN)” means an individual who:</text>
      <paragraph num="(a)">
        <text>Is licensed by the Board to practice registered nursing; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Has a multistate licensure privilege to practice registered nursing.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(32)">
      <text>“Specialized catheter” means an epidural, intrathecal, intrapleural, or peripheral nerve catheter.</text>
    </paragraph>
    <paragraph num="(33)">
      <text>“Subcutaneous infusion of medication” means a continuous or intermittent infusion of medication by an indwelling needle or catheter inserted into subcutaneous tissue.</text>
    </paragraph>
    <paragraph num="(34)">
      <text>“TPN” means total parenteral nutrition administered into the central venous system.</text>
    </paragraph>
    <paragraph num="(35)">
      <text>“Tunneled catheter” means a CVC designed to have a portion of the catheter lie in a subcutaneous passage before exiting the body.</text>
    </paragraph>
    <paragraph num="(36)">
      <text>“Nonsurgically placed” means a catheter placed percutaneously.</text>
    </paragraph>
  </paragraph>
</regulation>