<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".06" citation="COMAR 10.27.20.06" title_num="10" subtitle_num="27" chapter_num="20" heading="Infusion Therapy Acts — RN.">
  <paragraph num="A.">
    <text>In addition to all previously identified procedures in Regulations .04 and .05A—C of this chapter, the RN may perform the following procedures:</text>
    <paragraph num="(1)">
      <text>Administer medication via IV “push”;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Initiate subcutaneous infusion of medication; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Provide care and manage arterial catheters and arterial ports by:</text>
      <paragraph num="(a)">
        <text>Changing IV administration set;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Flushing or aspirating;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Changing dressing;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Obtaining blood specimens;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Accessing and de-accessing; and</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Changing injection cap.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>The RN, upon completion of a second specialized educational program in infusion therapy which includes didactic content and a clinical practicum consistent with the standards established by the ONS or other bodies approved by the Board and with documented evidence of clinical competency, may perform the following additional infusion therapy activities:</text>
    <paragraph num="(1)">
      <text>Administer antineoplastic agents;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Aspirate fluid from an intraventricular reservoir;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Administer fluids and medications via an intraventricular reservoir;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Manage implantable pumps by programming and filling with fluids and medications;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Insert, repair, and remove PICC and midclavicular catheters;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Insert and remove midline catheters;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Manage specialized catheters for analgesia;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Remove nonsurgically placed central and arterial catheters;</text>
    </paragraph>
    <paragraph num="(9)">
      <text>Administer pharmacological agents to de-clot or restore blood return; and</text>
    </paragraph>
    <paragraph num="(10)">
      <text>Repair a catheter.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>The RN may not perform the following acts:</text>
    <paragraph num="(1)">
      <text>Administer the initial dose of any medication by intrathecal, epidural, intrapleural, or peripheral nerve catheter; or</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Remove any tunneled catheter.</text>
    </paragraph>
  </paragraph>
</regulation>