%PDF-1.6 % 3 0 obj <>/Metadata 45 0 R/Pages 5 0 R/StructTreeRoot 46 0 R/Type/Catalog/ViewerPreferences<>>> endobj 34 0 obj [/CalGray<>] endobj 35 0 obj [/CalRGB<>] endobj 45 0 obj <>stream application/pdf ˮAV˵ State Education Department Clarification about Administering Immunizations and Anaphylactic Agents by Registered Professional Nurses using Non-Patient Specific Orders and Protocols Wednesday, October 10, 2001 10:45:24 AM Acrobat PDFWriter 3.02 for Windows Microsoft Word 2017-06-20T15:24:48-04:00 2017-06-20T15:24:48-04:00 2017-06-20T15:24:48-04:00 uuid:36519177-84e8-4794-8f36-5de20834e702 uuid:944c8409-72af-462d-b791-fe4703f7ce33 endstream endobj 5 0 obj <> endobj 46 0 obj <> endobj 47 0 obj <>/CM2<>/CM3<>/CM4<>/CM5<>>> endobj 56 0 obj <> endobj 57 0 obj <> endobj 58 0 obj [48 0 R 49 0 R 50 0 R 68 0 R 69 0 R 70 0 R 71 0 R 72 0 R 73 0 R 74 0 R 75 0 R 76 0 R 52 0 R 53 0 R 77 0 R 53 0 R 78 0 R 79 0 R 80 0 R 79 0 R 81 0 R 82 0 R 83 0 R 82 0 R] endobj 59 0 obj [84 0 R 85 0 R 86 0 R 85 0 R 87 0 R 88 0 R 89 0 R 88 0 R 90 0 R 91 0 R 92 0 R 64 0 R 92 0 R 93 0 R 65 0 R 93 0 R 66 0 R 93 0 R 67 0 R 94 0 R] endobj 60 0 obj <>11]/P 95 0 R/Pg 21 0 R/S/Link>> endobj 61 0 obj <>14]/P 96 0 R/Pg 21 0 R/S/Link>> endobj 62 0 obj <>16]/P 96 0 R/Pg 21 0 R/S/Link>> endobj 63 0 obj <>18]/P 96 0 R/Pg 21 0 R/S/Link>> endobj 64 0 obj <>11]/P 92 0 R/Pg 21 0 R/S/Link>> endobj 65 0 obj <>14]/P 93 0 R/Pg 21 0 R/S/Link>> endobj 66 0 obj <>16]/P 93 0 R/Pg 21 0 R/S/Link>> endobj 67 0 obj <>18]/P 93 0 R/Pg 21 0 R/S/Link>> endobj 93 0 obj <> endobj 21 0 obj <>/ProcSet[/PDF/Text]>>/StructParents 2/Tabs/S/Type/Page>> endobj 98 0 obj [36 0 R 37 0 R 38 0 R 39 0 R] endobj 99 0 obj <>stream BT /Artifact <>BDC 0 0 0 rg /TT0 1 Tf -0.0013 Tc 0.0509 Tw 3 Tr 11.04 0 0 11.04 145.5656 595.92 Tm ( )Tj EMC ET /Artifact <>BDC BT /TT1 1 Tf 0 Tc 0.6024 Tw 11.04 0 0 11.04 80.28 634.08 Tm ( )Tj ET 90 631.8 283.08 1.08 re f 85.8 555.96 419.76 1.08 re f 87 543.24 111.72 1.08 re f 72 340.68 54.72 1.08 re f BT /TT2 1 Tf 0.0435 Tw 11.04 0 0 11.04 443.52 330.24 Tm ( )Tj ET EMC BT /P <>BDC /TT0 1 Tf -0.0008 Tc 0.0595 Tw 0 Tr 11.04 0 0 11.04 90 697.08 Tm [(Guidance: )-308.7(For the purpose of administering the influenza vaccine to adults only, i\ t is acceptable )]TJ -0.0012 Tc 0.1338 Tw 0 -1.141 TD (to maintain a log of the names, addresses and phone numbers of all adult\ patients, immunized )Tj -0.0009 Tc 0.1606 Tw 0 -1.152 TD (with the influenza vaccine under non-patient specific orders in a dated \ file with a copy of the )Tj -0.001 Tc -0.0027 Tw 0 -1.12 TD (influenza order and the influenza protocol attached to the log)Tj /TT2 1 Tf 0 Tc 0 Tw (. )Tj EMC /Span <>BDC -1.63 -2.293 Td (4.)Tj /T1_0 1 Tf (\003 )Tj EMC /StyleSpan <>BDC /TT0 1 Tf -0.0012 Tc 0.1389 Tw 1.63 0 Td (Record Maintenance by the Registered Professional Nurse)Tj EMC /Span <>BDC /TT2 1 Tf -0.0004 Tc 0.1417 Tw (: The regulation requires the registered )Tj -0.0013 Tc 0.028 Tw 0 -1.141 TD (professional nurse who administers the immunizations to maintain the rec\ ords of all persons immunized )Tj -0.0011 Tc 0.0011 Tw 0 -1.152 TD (at clinics [section 64.7\(a\)\(4\)\(iii\)\(f\)]. )Tj EMC /P <>BDC /TT0 1 Tf -0.0013 Tc 0.0509 Tw 0 -1.163 TD [(Guidance: )-599.4(The sponsoring agency, with the agreement of the registered professional\ nurse, may )]TJ -0.0009 Tc -0.0045 Tw 0 -1.12 TD (take responsibility for record keeping and maintenance of the immunizati\ on record)Tj /TT2 1 Tf 0 Tc 0 Tw (. )Tj EMC /Span <>BDC -1.63 -2.293 Td (5. )Tj /T1_0 1 Tf (\003)Tj EMC /StyleSpan <>BDC /TT0 1 Tf -0.0014 Tc -0.0008 Tw (Licensed Practical Nurses Assisting the Registered Professional Nurses i\ n Executing Non-)Tj -0.0014 Tc 0.1101 Tw 1.359 -1.152 Td (Patient Specific Orders)Tj EMC /Span <>BDC /TT2 1 Tf -0.0017 Tc 0.114 Tw [(: )-362.4(The law authorizing registered professional nurses [RNs] to execute a no\ n-)]TJ -0.0009 Tc 0.0196 Tw 0 -1.141 TD (patient specific order for immunizations is silent on the participation \ of licensed practical nurses [)Tj -0.0004 Tc 0 Tw (LPNs]. )Tj -0.001 Tc 0.001 Tw 0 -1.152 TD (A number of questions have been raised concerning the role of )Tj -0.0018 Tc 0.0126 Tw (LPNs and whether RNs can assign certain )Tj -0.0002 Tc 0.2328 Tw 0 -1.141 TD (tasks related to immunizations to )Tj -0.0018 Tc 0.2421 Tw (LPNs. Education Law authorizes RNs to direct the nursing care )Tj -0.0011 Tc 0.2403 Tw 0 -1.141 TD (provided by )Tj -0.0012 Tc 0.2454 Tw (LPNs. Thus, an RN may direct an LPN in administering immunizing agents, \ that is, )Tj -0.0011 Tc 0.2101 Tw 0 -1.152 TD [(injecting a recipient with a vaccine and administering anaphylactic agen\ ts, when appropriate. )-459.1(This )]TJ -0.0009 Tc 0.1103 Tw 0 -1.141 TD [(authorization is conditioned on the on-site direction by the RN. )-359.3(The RN is responsible for exercising )]TJ -0.0014 Tc 0.2049 Tw 0 -1.152 TD (professional judgment, with knowledge of State regulations and practice \ guidelines, when assigning )Tj -0.0008 Tc 0.1018 Tw 0 -1.141 TD (administration of the immunizing agent to the LPN, thereby retaining the\ traditional delineation in the )Tj -0.0013 Tc -0.0007 Tw 0 -1.141 TD (scopes of practice between the RN and dependent practice of the LPN. )Tj /TT0 1 Tf -0.0018 Tc 0 Tw 0 -1.152 TD (Guidance)Tj /TT2 1 Tf 0 Tc 0.2997 Tw (: )Tj /TT0 1 Tf -0.0009 Tc 0.3033 Tw 5.489 0 Td (An LPN can assist in administering immunizations \(give the injection, a\ ssist in )Tj -0.0013 Tc 0.0909 Tw -5.489 -1.163 Td (recordkeeping, and when appropriate, administer anaphylaxis agents\) as \ long as the RN assesses )Tj -0.0011 Tc 0.3365 Tw T* (the recipient, and is responsible for the on-site direction of the LPN i\ n administering the )Tj -0.0007 Tc 0.0183 Tw 0 -1.141 TD [(immunizations. )-267.8(It is expected that, in this setting, a ratio of no more than three )]TJ -0.0022 Tc 0.0348 Tw 34.207 0 Td (LPNs to one RN is )Tj -0.0007 Tc 0 Tw -34.207 -1.141 Td (maintained. )Tj EMC /StyleSpan <>BDC -0.0013 Tc 0.0665 Tw -1.359 -2.293 Td (Please Note)Tj EMC /P <>BDC -0.001 Tc 0.0677 Tw (: Nothing in this memo prevents a licensed practical nurse, in the absen\ ce of a registered )Tj -0.0009 Tc 0.0349 Tw 0 -1.152 TD (professional nurse, from administering epinephrine in an emergency situa\ tion. )Tj -0.0015 Tc 0.0414 Tw 34.239 0 Td (For example, an LPN )Tj -0.0009 Tc 0.0003 Tw -34.239 -1.141 Td (responding to an emergency in which an individual has an anaphylactic re\ action to a wasp sting or the )Tj -0.0012 Tc -0.001 Tw 0 -1.141 TD (ingestion of peanut butter can administer treatment such as an )Tj -0.0019 Tc 0 Tw 26.913 0 Td (epi-pen. )Tj EMC /P <>BDC /TT2 1 Tf -0.0012 Tc 0.236 Tw -26.913 -2.272 Td [(We hope this information is helpful. )-484.8(Please continue to check our web site [)]TJ EMC /Link <>BDC (www.op.nysed.gov)Tj EMC /P <>BDC (] for )Tj 0.2084 Tw 0 -1.152 TD [(additional information and updates on this important issue. )-457(If you have further questions or concerns )]TJ -0.0012 Tc 0.0658 Tw 0 -1.141 TD (regarding this regulation or the content of this memorandum, please cont\ act the ˮAV˵ State Board for )Tj -0.0013 Tc 0.017 Tw 0 -1.141 TD (Nursing at \(518\) 474-3817 Ext. 120, the ˮAV˵ State Board for Medic\ ine at \(518\) 474-3817 Ext. 560, or )Tj -0.0017 Tc 0.0017 Tw 0 -1.152 TD [(the ˮAV˵ State Board for Pharmacy at \(518\) 474-3817 ext. 130. )-250.2(You may also e-mail us at:)]TJ EMC /P <>BDC -0.0016 Tc 0.0016 Tw 8.772 -1.141 Td ( State Board for Nursing: )Tj EMC /Link <>BDC 0 0 1 rg -0.003 Tc 0 Tw 10.576 0 Td (NURSEBD@MAIL.ˮAV˵.GOV)Tj /T1_0 1 Tf (\002)Tj EMC /P <>BDC 0 0 0 rg /TT2 1 Tf -0.0011 Tc -10.387 -1.152 Td ( State Board for Medicine: )Tj EMC /Link <>BDC 0 0 1 rg -0.0027 Tc 11.137 0 Td (MEDBD@MAIL.ˮAV˵.GOV)Tj /T1_0 1 Tf (\002)Tj EMC /P <>BDC 0 0 0 rg /TT2 1 Tf -0.0023 Tc 0.0017 Tw -11.866 -1.141 Td ( State Board for Pharmacy: )Tj EMC /Link <>BDC 0 0 1 rg -0.0023 Tc 0 Tw 11.334 0 Td (PHARMBD@MAIL.ˮAV˵.GOV)Tj /T1_0 1 Tf (\002 )Tj EMC /P <>BDC 0 0 0 rg /TT2 1 Tf -0.0013 Tc 0.1006 Tw -19.565 -2.293 Td (or, you may write to the appropriate professional board office at: New Y\ ork State Education Department, )Tj -0.0017 Tc 0.1067 Tw 0 -1.141 TD (Office of the Professions, Education Building-Second Floor, 89 Washingto\ n Avenue, Albany, NY 12234\255)Tj 0 Tc 0 Tw 0 -1.152 TD (1000. )Tj EMC ET endstream endobj 44 0 obj <> endobj 43 0 obj <> endobj 100 0 obj <> endobj 42 0 obj <> endobj 105 0 obj <>stream 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<>/ProcSet[/PDF/Text/ImageB]/XObject<>>>/StructParents 0/Tabs/S/Type/Page>> endobj 150 0 obj <>stream /Artifact <>BDC 0 0 0 RG 0.48 w 1 j 1 J q 1 0 0 1 151.2 710.76 cm 0 0 m 390.96 0.24 l S Q BT 0 0 0 rg /TT0 1 Tf 0.8742 Tw 3 Tr 11.04 0 0 11.04 80.28 391.68 Tm ( )Tj ET 93 389.4 88.92 1.08 re f 90 288.24 173.04 1.08 re f BT /TT1 1 Tf 0.6024 Tw 11.04 0 0 11.04 80.28 151.44 Tm ( )Tj ET 90 149.16 189.84 1.08 re f EMC /Figure <>BDC q 84.24 0 0 86.4 59.76 674.4 cm /Im0 Do Q EMC BT /P <>BDC /TT2 1 Tf -0.0014 Tc 0.0058 Tw 0 Tr 8.52 0 0 8.52 151.2 719.04 Tm (THE STATE EDUCATION DEPARTMENT )Tj /TT3 1 Tf -0.0006 Tc -0.0009 Tw (/ THE UNIVERSITY OF THE STATE OF NEW YORK / ALBANY, NY 12230 )Tj EMC /P <>BDC 0.0036 Tc -0.0048 Tw 6.96 0 0 6.96 151.2 698.76 Tm (DEPUTY COMMISSIONER FOR THE PROFESSIONS )Tj 0.0013 Tc 0.0019 Tw 0 -1.448 TD (Office of the Professions )Tj EMC /TH <>BDC /TT4 1 Tf -0.0008 Tc -0.0047 Tw 11.04 0 0 11.04 360 644.76 Tm ([Practice Memorandum 2001.6] )Tj EMC /TH <>BDC -0.0011 Tc 0.0011 Tw 0 -2.293 TD (October 3, 2001 )Tj EMC /TH <>BDC 0.0008 Tc -0.0008 Tw -26.087 -2.293 Td (To: )Tj EMC /TD <>BDC -0.0015 Tc 0.0015 Tw 6.522 0 Td (Registered Professional Nurses, Nurse Practitioners, Pharmacists and Phy\ sicians )Tj EMC /TH <>BDC -0.002 Tc 0.002 Tw -6.522 -2.293 Td (From: )Tj EMC /TD <>BDC -0.0015 Tc 0.0015 Tw 6.522 0 Td (Johanna Duncan Poitier, Deputy Commissioner, Office of the Professions )Tj EMC /TD <>BDC -0.0011 Tc 0.0011 Tw T* (Barbara Zitt)Tj -0.0018 Tc 0.0018 Tw (el, Executive Secretary, ˮAV˵ State Board for Nursing )Tj EMC /TH <>BDC -0.0008 Tc 0.0008 Tw -6.522 -2.293 Td (Subject: )Tj EMC /TD <>BDC -0.0015 Tc 0.0015 Tw 6.522 0 Td (Clarification about Administering Immunizations and Anaphylactic Agents \ )Tj -0.0015 Tc 0.0015 Tw 0 -1.141 TD (by Registered Professional Nurses using Non-Patient Specific Orders and \ )Tj -0.0007 Tc 0 Tw 0 -1.141 TD (Protocols )Tj EMC /P <>BDC -0.0017 Tc 0.2495 Tw -6.522 -2.293 Td (On February 27, 2001, the ˮAV˵ State Education Department sent you a\ guidance memo about )Tj -0.0013 Tc 0.119 Tw 0 -1.152 TD (regulations to implement a new law [Cha)Tj 0.1193 Tw (pter 573 of the Laws of 1999] )Tj -0.0016 Tc 0.1248 Tw (concerning the administration of )Tj -0.0016 Tc 0.1093 Tw 0 -1.141 TD (immunizations and anaphylactic agents by registered professional nurses \ using non-patient specific orders )Tj -0.0014 Tc 0.0183 Tw 0 -1.141 TD (and protocols. In response to a number of questions we received from the\ field, the Department is pleased to )Tj -0.0011 Tc -0.0022 Tw 0 -1.152 TD (provide this information to help clarify the implementation of those reg\ ulations in professional practice. )Tj EMC /Span <>BDC /TT5 1 Tf 0 Tc 0 Tw 0 -2.293 TD (1.)Tj /T1_0 1 Tf (\003 )Tj EMC /StyleSpan <>BDC /TT5 1 Tf -0.0012 Tc 0.3382 Tw 1.902 0 Td (CPR Certification)Tj EMC /Span <>BDC /TT4 1 Tf -0.0012 Tc 0.3457 Tw (: The Regulations of the Commissioner of Education require that register\ ed )Tj -0.0013 Tc 0.0847 Tw 0 -1.141 TD (professional nurses who administer immunizing agents using a non-patient\ specific order be currently )Tj -0.0014 Tc 0.2071 Tw 0 -1.141 TD (certified in cardiopulmonary resuscitation [CPR] by a program of the Ame\ rican Red Cross or the )Tj -0.0013 Tc 0.158 Tw 0 -1.152 TD [(American Heart Association or an equivalent organization acceptable to t\ he Education )-406.5(Department )]TJ -0.0007 Tc 0.0007 Tw 0 -1.141 TD ([section 64.7\(a\)\(3\)]. )Tj EMC /P <>BDC /TT5 1 Tf -0.0015 Tc 0.0776 Tw 0 -1.174 TD (Guidance: Staff development or )Tj 0.0872 Tw (inservice departments that train individuals in CPR but do not )Tj -0.0013 Tc -0.0011 Tw 0 -1.141 TD (necessarily provide \223certification,\224 are considered equivalent org\ anizations by the Department. )Tj EMC /Span <>BDC 0 Tc 0 Tw -1.902 -2.272 Td (2.)Tj /T1_0 1 Tf (\003 )Tj EMC /StyleSpan <>BDC /TT5 1 Tf -0.001 Tc 0.1387 Tw 1.63 0 Td (Primary Care Provider Notification)Tj EMC /Span <>BDC /TT4 1 Tf -0.0012 Tc 0.1479 Tw (: The regulation requires that the registered professional nurse, )Tj -0.0014 Tc 0.0224 Tw T* (with the consent of a patient or a person legally responsible, notify ea\ ch patient\222s primary care provider, )Tj -0.0009 Tc 0.3565 Tw 0 -1.152 TD (when there is one, when the patient is immunized under a non-patient spe\ cific order [section )Tj -0.0011 Tc 0.0772 Tw 0 -1.141 TD [(64.7\(a\)\(4\)\(iii\)\(d\)]. )-326.2(The intent of this requirement is to ensure that a best effort is made t\ o contact )-326.5(the )]TJ -0.0011 Tc -0.0025 Tw 0 -1.141 TD (patient\222s primary care provider about the immunization. )Tj EMC /P <>BDC /TT5 1 Tf -0.0008 Tc 0.1783 Tw 0 -1.174 TD (Guidance: For the administration of the influenza vaccine to adults only\ , acceptable practices )Tj -0.0011 Tc 0.0298 Tw 0 -1.141 TD [(include such examples as having a patient fill out a postcard )-278.3(that the nurse or agency can send to )]TJ -0.0012 Tc 0.3599 Tw 0 -1.152 TD (the primary care provider or having a patient sign a consent form on the\ certificate of )Tj -0.0009 Tc 0.0607 Tw 0 -1.141 TD (immunization agreeing to provide the primary care provider with a copy o\ f the certificate listing )Tj -0.0015 Tc 0.0015 Tw 0 -1.152 TD (the immunization provided. )Tj EMC /Span <>BDC /TT4 1 Tf 0 Tc 0 Tw -1.63 -2.261 Td (3.)Tj /T1_0 1 Tf (\003 )Tj EMC /StyleSpan <>BDC /TT5 1 Tf -0.0006 Tc 0.0387 Tw 1.63 0 Td (Information to be Kept with the Record)Tj EMC /Span <>BDC 0 Tc 0 Tw (:)Tj /TT4 1 Tf -0.0008 Tc 0.0443 Tw 17.543 0 Td ( The regulation requires that a registered professional nurse, )Tj -0.0012 Tc 0.03 Tw -17.543 -1.152 Td (administering immunizations under a non-patient specific order, attach a\ nd maintain a copy of the order )Tj -0.001 Tc 0.2228 Tw 0 -1.141 TD [(and protocol with the individual record for each patient [section 64.7\(\ a\)\(4\)]. )-471.4(The purpose of this )]TJ -0.0012 Tc 0.1759 Tw 0 -1.152 TD (requirement is to protect vulnerable populations, such as the aged and c\ hildren, from the effects of )Tj -0.0013 Tc 0.1272 Tw 0 -1.141 TD (multiple immunizations, and to track immunizations administered in order\ to properly treat untoward )Tj -0.0001 Tc 0 Tw 0 -1.141 TD (reactions. )Tj EMC ET endstream endobj 10 0 obj <>stream ???8???|??????????|????????x???????????~?<??>??????>??| ?0?~?ß?>??ß>??>?~p??>8~?<??>?>?ÿ?ğ?χø珏?8>?|?>??|<??>??????϶?><?|s??>??Ϗ??~?σ>?8|??? ?|?<?? >??yϟ<Ǐx>?{???y??||??7`>?7<~?<'>Ϗǟ?????|?? 1o?8"so|??sso~<??!`?o ?? o??<o߿oߟ??o??Ͽ??o???o8 o??/o?s8>8<=Oſoy8?|  oY?1$A<?c8^sO_d?>{:[7??{;|???κυ8G;??^Ý??qx?n߾@ ~?#?gab?m?뱭?w 1ßß߀{ _=EkzӼ;?jx1kZ޴Sl?ogCnx! s?iqw(Z{?^qp(@O{??x!G/g,?{"w? @y? 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00000 n 0000079650 00000 n 0000079302 00000 n 0000079205 00000 n 0000079704 00000 n 0000079800 00000 n trailer <]>> startxref 80265 %%EOF 4 0 obj <>/ProcSet[/PDF/Text/ImageB]/XObject<>>>/StructParents 0/Tabs/S/Type/Page>> endobj 21 0 obj <>/ProcSet[/PDF/Text]>>/StructParents 2/Tabs/S/Type/Page>> endobj 45 0 obj <>stream application/pdf ˮAV˵ State Education Department Clarification about Administering Immunizations and Anaphylactic Agents by Registered Professional Nurses using Non-Patient Specific Orders and Protocols Wednesday, October 10, 2001 10:45:24 AM Acrobat PDFWriter 3.02 for Windows Microsoft Word 2022-06-22T10:23:19-04:00 2017-06-20T15:24:48-04:00 2022-06-22T10:23:19-04:00 uuid:36519177-84e8-4794-8f36-5de20834e702 uuid:72f6e95d-5ccc-40ce-9243-1aab1644c79f endstream endobj 46 0 obj <> endobj 58 0 obj [48 0 R 49 0 R 50 0 R null 69 0 R 70 0 R 71 0 R 72 0 R 73 0 R 74 0 R 75 0 R 76 0 R 52 0 R 53 0 R 77 0 R 53 0 R 78 0 R 79 0 R 80 0 R 79 0 R 81 0 R 82 0 R 83 0 R 82 0 R null 203 0 R 204 0 R] endobj 70 0 obj <> endobj 72 0 obj <> endobj 74 0 obj <> endobj 75 0 obj <> endobj 78 0 obj <> endobj 87 0 obj <> endobj 193 0 obj <> endobj 194 0 obj <> endobj 195 0 obj <> endobj 197 0 obj <> endobj 200 0 obj <> endobj 201 0 obj <>stream BT /Artifact <>BDC 0 0 0 rg /TT0 1 Tf -0.0013 Tc 0.0509 Tw 3 Tr 11.04 0 0 11.04 145.5656 595.92 Tm ( )Tj EMC ET /Artifact <>BDC BT /TT1 1 Tf 0 Tc 0.6024 Tw 11.04 0 0 11.04 80.28 634.08 Tm ( )Tj ET 90 631.8 283.08 1.08 re f 85.8 555.96 419.76 1.08 re f 87 543.24 111.72 1.08 re f 72 340.68 54.72 1.08 re f BT /TT2 1 Tf 0.0435 Tw 11.04 0 0 11.04 443.52 330.24 Tm ( )Tj ET EMC BT /P <>BDC /TT0 1 Tf -0.0008 Tc 0.0595 Tw 0 Tr 11.04 0 0 11.04 90 697.08 Tm [(Guidance: )-308.7 (For the purpose of administering the influenza vaccine to adults only, i\ t is acceptable )]TJ -0.0012 Tc 0.1338 Tw 0 -1.141 TD (to maintain a log of the names, addresses and phone numbers of all adult\ patients, immunized )Tj -0.0009 Tc 0.1606 Tw 0 -1.152 TD (with the influenza vaccine under non-patient specific orders in a dated \ file with a copy of the )Tj -0.001 Tc -0.0027 Tw 0 -1.12 TD (influenza order and the influenza protocol attached to the log)Tj /TT2 1 Tf 0 Tc 0 Tw (. )Tj EMC /Span <>BDC -1.63 -2.293 Td (4.)Tj /T1_0 1 Tf (\003 )Tj EMC /StyleSpan <>BDC /TT0 1 Tf -0.0012 Tc 0.1389 Tw 1.63 0 Td (Record Maintenance by the Registered Professional Nurse)Tj EMC /Span <>BDC /TT2 1 Tf -0.0004 Tc 0.1417 Tw (: The regulation requires the registered )Tj -0.0013 Tc 0.028 Tw 0 -1.141 TD (professional nurse who administers the immunizations to maintain the rec\ ords of all persons immunized )Tj -0.0011 Tc 0.0011 Tw 0 -1.152 TD (at clinics [section 64.7\(a\)\(4\)\(iii\)\(f\)]. )Tj EMC /P <>BDC /TT0 1 Tf -0.0013 Tc 0.0509 Tw 0 -1.163 TD [(Guidance: )-599.4 (The sponsoring agency, with the agreement of the registered professional\ nurse, may )]TJ -0.0009 Tc -0.0045 Tw 0 -1.12 TD (take responsibility for record keeping and maintenance of the immunizati\ on record)Tj /TT2 1 Tf 0 Tc 0 Tw (. )Tj EMC /Span <>BDC -1.63 -2.293 Td (5. )Tj /T1_0 1 Tf (\003)Tj EMC /StyleSpan <>BDC /TT0 1 Tf -0.0014 Tc -0.0008 Tw (Licensed Practical Nurses Assisting the Registered Professional Nurses i\ n Executing Non-)Tj 0.1101 Tw 1.359 -1.152 Td (Patient Specific Orders)Tj EMC /Span <>BDC /TT2 1 Tf -0.0017 Tc 0.114 Tw [(: )-362.4 (The law authorizing registered professional nurses [RNs] to execute a no\ n-)]TJ -0.0009 Tc 0.0196 Tw 0 -1.141 TD (patient specific order for immunizations is silent on the participation \ of licensed practical nurses [)Tj -0.0004 Tc 0 Tw (LPNs]. )Tj -0.001 Tc 0.001 Tw 0 -1.152 TD (A number of questions have been raised concerning the role of )Tj -0.0018 Tc 0.0126 Tw (LPNs and whether RNs can assign certain )Tj -0.0002 Tc 0.2328 Tw 0 -1.141 TD (tasks related to immunizations to )Tj -0.0018 Tc 0.2421 Tw (LPNs. Education Law authorizes RNs to direct the nursing care )Tj -0.0011 Tc 0.2403 Tw T* (provided by )Tj -0.0012 Tc 0.2454 Tw (LPNs. Thus, an RN may direct an LPN in administering immunizing agents, \ that is, )Tj -0.0011 Tc 0.2101 Tw 0 -1.152 TD [(injecting a recipient with a vaccine and administering anaphylactic agen\ ts, when appropriate. )-459.1 (This )]TJ -0.0009 Tc 0.1103 Tw 0 -1.141 TD [(authorization is conditioned on the on-site direction by the RN. )-359.3 (The RN is responsible for exercising )]TJ -0.0014 Tc 0.2049 Tw 0 -1.152 TD (professional judgment, with knowledge of State regulations and practice \ guidelines, when assigning )Tj -0.0008 Tc 0.1018 Tw 0 -1.141 TD (administration of the immunizing agent to the LPN, thereby retaining the\ traditional delineation in the )Tj -0.0013 Tc -0.0007 Tw T* (scopes of practice between the RN and dependent practice of the LPN. )Tj /TT0 1 Tf -0.0018 Tc 0 Tw 0 -1.152 TD (Guidance)Tj /TT2 1 Tf 0 Tc 0.2997 Tw (: )Tj /TT0 1 Tf -0.0009 Tc 0.3033 Tw 5.489 0 Td (An LPN can assist in administering immunizations \(give the injection, a\ ssist in )Tj -0.0013 Tc 0.0909 Tw -5.489 -1.163 Td (recordkeeping, and when appropriate, administer anaphylaxis agents\) as \ long as the RN assesses )Tj -0.0011 Tc 0.3365 Tw T* (the recipient, and is responsible for the on-site direction of the LPN i\ n administering the )Tj -0.0007 Tc 0.0183 Tw 0 -1.141 TD [(immunizations. )-267.8 (It is expected that, in this setting, a ratio of no more than three )]TJ -0.0022 Tc 0.0348 Tw 34.207 0 Td (LPNs to one RN is )Tj -0.0007 Tc 0 Tw -34.207 -1.141 Td (maintained. )Tj EMC /StyleSpan <>BDC -0.0013 Tc 0.0665 Tw -1.359 -2.293 Td (Please Note)Tj EMC /P <>BDC -0.001 Tc 0.0677 Tw (: Nothing in this memo prevents a licensed practical nurse, in the absen\ ce of a registered )Tj -0.0009 Tc 0.0349 Tw 0 -1.152 TD (professional nurse, from administering epinephrine in an emergency situa\ tion. )Tj -0.0015 Tc 0.0414 Tw 34.239 0 Td (For example, an LPN )Tj -0.0009 Tc 0.0003 Tw -34.239 -1.141 Td (responding to an emergency in which an individual has an anaphylactic re\ action to a wasp sting or the )Tj -0.0012 Tc -0.001 Tw 0 -1.141 TD (ingestion of peanut butter can administer treatment such as an )Tj -0.0019 Tc 0 Tw (epi-pen. )Tj EMC /P <>BDC /TT2 1 Tf -0.0012 Tc 0.236 Tw 0 -2.272 TD [(We hope this information is helpful. )-484.8 (Please continue to check our web site [)]TJ EMC /Link <>BDC (www.op.nysed.gov)Tj EMC /P <>BDC (] for )Tj 0.2084 Tw 0 -1.152 TD [(additional information and updates on this important issue. )-457 (If you have further questions or concerns )]TJ 0.0658 Tw 0 -1.141 TD (regarding this regulation or the content of this memorandum, please cont\ act the ˮAV˵ State Board for )Tj -0.0013 Tc 0.017 Tw T* (Nursing at \(518\) 474-3817 Ext. 120, the ˮAV˵ State Board for Medic\ ine at \(518\) 474-3817 Ext. 560, or )Tj -0.0017 Tc 0.0017 Tw 0 -1.152 TD [(the ˮAV˵ State Board for Pharmacy at \(518\) 474-3817 ext. 130. )-250.2 (You may also e-mail us at:)]TJ EMC /P <>BDC -0.0016 Tc 0.0016 Tw 8.772 -1.141 Td ( State Board for Nursing: )Tj EMC /Link <>BDC 0 0 1 rg -0.003 Tc 0 Tw 10.576 0 Td (NURSEBD@MAIL.ˮAV˵.GOV)Tj /T1_0 1 Tf (\002)Tj EMC /P <>BDC 0 0 0 rg /TT2 1 Tf -0.0011 Tc -10.387 -1.152 Td ( State Board for Medicine: )Tj EMC /Link <>BDC 0 0 1 rg -0.0027 Tc 11.137 0 Td (MEDBD@MAIL.ˮAV˵.GOV)Tj /T1_0 1 Tf (\002)Tj EMC /P <>BDC 0 0 0 rg /TT2 1 Tf -0.0023 Tc 0.0017 Tw -11.866 -1.141 Td ( State Board for Pharmacy: )Tj EMC /Link <>BDC 0 0 1 rg 0 Tw 11.334 0 Td (PHARMBD@MAIL.ˮAV˵.GOV)Tj /T1_0 1 Tf (\002 )Tj EMC /P <>BDC 0 0 0 rg /TT2 1 Tf -0.0013 Tc 0.1006 Tw -19.565 -2.293 Td (or, you may write to the appropriate professional board office at: New Y\ ork State Education Department, )Tj -0.0017 Tc 0.1067 Tw 0 -1.141 TD (Office of the Professions, Education Building-Second Floor, 89 Washingto\ n Avenue, Albany, NY 12234\255)Tj 0 Tc 0 Tw 0 -1.152 TD (1000. )Tj EMC ET endstream endobj 202 0 obj <>stream /Artifact <>BDC q 1 0 0 1 151.2 710.76 cm 0 0 0 RG 0.48 w 1 j 1 J 0 0 m 390.96 0.24 l S Q BT 0 0 0 rg /TT0 1 Tf 0.8742 Tw 3 Tr 11.04 0 0 11.04 80.28 391.68 Tm ( )Tj ET 93 389.4 88.92 1.08 re f 90 288.24 173.04 1.08 re f BT /TT1 1 Tf 0.6024 Tw 11.04 0 0 11.04 80.28 151.44 Tm ( )Tj ET 90 149.16 189.84 1.08 re f EMC /Figure <>BDC q 84.24 0 0 86.4 59.76 674.4 cm /Im0 Do Q EMC BT /P <>BDC /TT2 1 Tf -0.0014 Tc 0.0058 Tw 0 Tr 8.52 0 0 8.52 151.2 719.04 Tm (THE STATE EDUCATION DEPARTMENT )Tj /TT3 1 Tf -0.0006 Tc -0.0009 Tw (/ THE UNIVERSITY OF THE STATE OF NEW YORK / ALBANY, NY 12230 )Tj EMC /P <>BDC 0.0036 Tc -0.0048 Tw 6.96 0 0 6.96 151.2 698.76 Tm (DEPUTY COMMISSIONER FOR THE PROFESSIONS )Tj 0.0013 Tc 0.0019 Tw 0 -1.448 TD (Office of the Professions )Tj EMC ET BT /P <>BDC /TT4 1 Tf -0.0008 Tc -0.0047 Tw 11.04 0 0 11.04 360 644.76 Tm ([Practice Memorandum 2001.6] )Tj -0.0011 Tc 0.0011 Tw 0 -2.293 TD (October 3, 2001 )Tj 0.0008 Tc -0.0008 Tw -26.087 -2.293 Td (To: )Tj -0.0015 Tc 0.0015 Tw 6.522 0 Td (Registered Professional Nurses, Nurse Practitioners, Pharmacists and Phy\ sicians )Tj -0.002 Tc 0.002 Tw -6.522 -2.293 Td (From: )Tj -0.0015 Tc 0.0015 Tw 6.522 0 Td (Johanna Duncan Poitier, Deputy Commissioner, Office of the Professions )Tj -0.0011 Tc 0.0011 Tw 0 -2.293 TD (Barbara Zitt)Tj -0.0018 Tc 0.0018 Tw (el, Executive Secretary, ˮAV˵ State Board for Nursing )Tj EMC ET BT /H1 <>BDC -0.0008 Tc 0.0008 Tw 11.04 0 0 11.04 71.9995 518.1864 Tm (Subject: )Tj -0.0015 Tc 0.0015 Tw 6.522 0 Td (Clarification about Administering Immunizations and Anaphylactic Agents \ )Tj 0 -1.141 TD (by Registered Professional Nurses using Non-Patient Specific Orders and \ )Tj -0.0007 Tc 0 Tw T* (Protocols )Tj EMC /P <>BDC -0.0017 Tc 0.2495 Tw 11.04 0 0 11.04 71.9995 467.6784 Tm (On February 27, 2001, the ˮAV˵ State Education Department sent you a\ guidance memo about )Tj -0.0013 Tc 0.119 Tw 0 -1.152 TD (regulations to implement a new law [Cha)Tj 0.1193 Tw 11.04 0 0 11.04 360 644.76 Tm -8.926 -17.192 Td (pter 573 of the Laws of 1999] )Tj -0.0016 Tc 0.1248 Tw (concerning the administration of )Tj 0.1093 Tw -17.161 -1.141 Td (immunizations and anaphylactic agents by registered professional nurses \ using non-patient specific orders )Tj -0.0014 Tc 0.0183 Tw 0 -1.141 TD (and protocols. In response to a number of questions we received from the\ field, the Department is pleased to )Tj -0.0011 Tc -0.0022 Tw 0 -1.152 TD (provide this information to help clarify the implementation of those reg\ ulations in professional practice. )Tj EMC /Span <>BDC /TT5 1 Tf 0 Tc 0 Tw 0 -2.293 TD (1.)Tj /T1_0 1 Tf (\003 )Tj EMC /StyleSpan <>BDC /TT5 1 Tf -0.0012 Tc 0.3382 Tw 1.902 0 Td (CPR Certification)Tj EMC /Span <>BDC /TT4 1 Tf 0.3457 Tw (: The Regulations of the Commissioner of Education require that register\ ed )Tj -0.0013 Tc 0.0847 Tw 0 -1.141 TD (professional nurses who administer immunizing agents using a non-patient\ specific order be currently )Tj -0.0014 Tc 0.2071 Tw T* (certified in cardiopulmonary resuscitation [CPR] by a program of the Ame\ rican Red Cross or the )Tj -0.0013 Tc 0.158 Tw 0 -1.152 TD [(American Heart Association or an equivalent organization acceptable to t\ he Education )-406.5 (Department )]TJ -0.0007 Tc 0.0007 Tw 0 -1.141 TD ([section 64.7\(a\)\(3\)]. )Tj EMC /P <>BDC /TT5 1 Tf -0.0015 Tc 0.0776 Tw 11.04 0 0 11.04 92.9976 328.2653 Tm (Guidance: Staff development or )Tj 0.0872 Tw (inservice departments that train individuals in CPR but do not )Tj -0.0013 Tc -0.0011 Tw T* (necessarily provide \223certification,\224 are considered equivalent org\ anizations by the Department. )Tj EMC /Span <>BDC 0 Tc 0 Tw 11.04 0 0 11.04 71.9995 290.5858 Tm (2.)Tj /T1_0 1 Tf 11.04 0 0 11.04 360 644.76 Tm -25.337 -32.081 Td (\003 )Tj EMC /StyleSpan <>BDC /TT5 1 Tf -0.001 Tc 0.1387 Tw 0.88 0 Td (Primary Care Provider Notification)Tj EMC /Span <>BDC /TT4 1 Tf -0.0012 Tc 0.1479 Tw (: The regulation requires that the registered professional nurse, )Tj -0.0014 Tc 0.0224 Tw T* (with the consent of a patient or a person legally responsible, notify ea\ ch patient\222s primary care provider, )Tj -0.0009 Tc 0.3565 Tw 0 -1.152 TD (when there is one, when the patient is immunized under a non-patient spe\ cific order [section )Tj -0.0011 Tc 0.0772 Tw 0 -1.141 TD [(64.7\(a\)\(4\)\(iii\)\(d\)]. )-326.2 (The intent of this requirement is to ensure that a best effort is made t\ o contact )-326.5 (the )]TJ -0.0025 Tw T* (patient\222s primary care provider about the immunization. )Tj EMC /P <>BDC /TT5 1 Tf -0.0008 Tc 0.1783 Tw 0 -1.174 TD (Guidance: For the administration of the influenza vaccine to adults only\ , acceptable practices )Tj -0.0011 Tc 0.0298 Tw 0 -1.141 TD [(include such examples as having a patient fill out a postcard )-278.3 (that the nurse or agency can send to )]TJ -0.0012 Tc 0.3599 Tw 0 -1.152 TD (the primary care provider or having a patient sign a consent form on the\ certificate of )Tj -0.0009 Tc 0.0607 Tw 0 -1.141 TD (immunization agreeing to provide the primary care provider with a copy o\ f the certificate listing )Tj -0.0015 Tc 0.0015 Tw 0 -1.152 TD (the immunization provided. )Tj EMC /Span <>BDC /TT4 1 Tf 0 Tc 0 Tw -1.63 -2.261 Td (3.)Tj /T1_0 1 Tf (\003 )Tj EMC /StyleSpan <>BDC /TT5 1 Tf -0.0006 Tc 0.0387 Tw 1.63 0 Td (Information to be Kept with the Record)Tj EMC /Span <>BDC 0 Tc 0 Tw (:)Tj /TT4 1 Tf -0.0008 Tc 0.0443 Tw 17.543 0 Td ( The regulation requires that a registered professional nurse, )Tj -0.0012 Tc 0.03 Tw -17.543 -1.152 Td (administering immunizations under a non-patient specific order, attach a\ nd maintain a copy of the order )Tj -0.001 Tc 0.2228 Tw 0 -1.141 TD [(and protocol with the individual record for each patient [section 64.7\(\ a\)\(4\)]. )-471.4 (The purpose of this )]TJ -0.0012 Tc 0.1759 Tw 0 -1.152 TD (requirement is to protect vulnerable populations, such as the aged and c\ hildren, from the effects of )Tj -0.0013 Tc 0.1272 Tw 0 -1.141 TD (multiple immunizations, and to track immunizations administered in order\ to properly treat untoward )Tj -0.0001 Tc 0 Tw T* (reactions. )Tj EMC ET endstream endobj 203 0 obj <> endobj 204 0 obj <> endobj 205 0 obj <> endobj xref 0 1 0000000000 65535 f 4 1 0000084444 00000 n 21 1 0000084679 00000 n 45 2 0000084865 00000 n 0000088835 00000 n 58 1 0000089014 00000 n 70 1 0000089219 00000 n 72 1 0000089268 00000 n 74 2 0000089317 00000 n 0000089366 00000 n 78 1 0000089416 00000 n 87 1 0000089476 00000 n 193 3 0000089540 00000 n 0000089576 00000 n 0000089612 00000 n 197 1 0000089648 00000 n 200 6 0000089684 00000 n 0000090149 00000 n 0000097082 00000 n 0000103500 00000 n 0000103563 00000 n 0000103617 00000 n trailer <<66E9D5874F56C042ABAC1E9C00E40448>]/Prev 80265>> startxref 103721 %%EOF