Florida Board of Nursing Approved IV Education

This course has been designed to fulfill the Florida Board of Nursing’s education components required for the Licensed Practical Nurse to practice infusion therapy. The Florida Board of Nursing has delineated very specific content to be included in the LPN infusion curriculum and specifics may be viewed in the Florida BON Rules, Chapter: 64B9-12.005 Competency and Knowledge Requirements Necessary to Qualify the LPN to Administer IV Therapy. This comprehensive 30 hour online education program meets the Florida Board of Nursing IV Therapy requirements for LPN’s, as well as, provides an excellent refresher course for the Registered Nurse or as a primer for new RN’s. 

In early 2016, the Infusion Nurses Society (INS), recognized as the global authority in infusion therapy, released the updated Infusion Therapy Standards of Practice. The INS sets the accepted standards for infusion therapy practice for all healthcare settings. This course is based on the current best practices as defined by the Infusion Nursing Society and other governing agencies such as the CDC, and FDA.

This 30 hour online continuing education provides a low stress, convenient method of obtaining quality infusion education incorporating various educational techniques designed for the adult learner. The program is comprised of the 30 hour didactic portion completed on your time schedule. Upon successful completion of the course exam, with a score of 80% or greater, the student may instantly print a “Certificate of Completion” for the didactic portion of the course. Within the course content, Pedagogy Inc. provides a complete set of skill check-off lists for completion by a Florida licensed Registered Nurse preceptor or employer.

For a complete list of accreditations for this course, please see the accreditation information box below the author’s bio.  All states recognize our courses for accredited continuing nursing education, CNE, contact hours.

Objectives

Objectives for Section 1: Peripheral IV Therapy

Upon completion of this curriculum, the nurse will be able to:

1. List specific measures that will protect against malpractice.
2. Identify infusion related complications, causes and appropriate treatment.
3. Demonstrate the correct calculation of an IV flow rate.
4. Identify methods of infection control related to IV therapy.
5. List the components of accurate and complete documentation of IV procedures and complications.
6. Demonstrate IV and Infusion related procedures  .

Objectives for Section 2: Central Venous Access Devices (CVAD)

Upon completion of this curriculum, the nurse will be able to:

1. Describe protective measures to guard against malpractice suits.
2. List 3 reasons for use and advantages of central lines.
3. List 4 veins used for central venous device placement and proper tip position.
4. Identify the various types of central lines.
5. Identify symptoms and prevention of complications.
6. Describe assessment criteria and documentation required for patients with central venous catheters.

Objectives for Section 3: Catheter Related Blood Stream Infections (CRBSI)

Upon completion of this curriculum, the nurse will be able to:

1. Identify at least three negative effects of central line related bloodstream infections.
2. Identify at least two methods by which central lines become colonized.
3. Identify at least three strategies to reduce the risk of CRBSI at the time of catheter insertion.
4. Recognize the proper time intervals and procedures for dressing change, injection port change, and site    observation.
5. State the recommended methods for obtaining blood cultures for CRBSI diagnosis.
6. State the recommended methods for treating CRBSI. 

Objectives for Section 4: Hypodermoclysis (Clysis)

Upon completion of this curriculum, the nurse will be able to:

1. Identify at least 3 factors that contribute to dehydration in the elderly.
2. Define hypodermoclysis.
3. Describe the advantages, disadvantages, indications, and contraindications of hypodermoclysis.
4. Describe the appropriate sites, solutions, volumes and rates for hypodermoclysis.
5. Describe the procedure for hypodermoclysis administration.
6. State at least 3 potential complications of hypodermoclysis.

Objectives for Section 5: Total Parenteral Nutrition (TPN)

Upon completion of this curriculum, the nurse will be able to:

1. Identify at least three medical conditions that indicate the use of TPN.
2. Identify at least three components of TPN.
3. Demonstrate understanding of TPN administration by recognizing the steps involved in TPN preparation and infusion.
4. Recognize at least two potential complications of TPN.
5. State at least four TPN monitoring measurements.

Objectives for Section 6: Transfusion Therapies

Upon completion of this curriculum, the nurse will be able to:

1. Explain the blood grouping systems and their importance in transfusion therapy.
2. List available blood components and indications for each.
3. Describe the activities required in preparation for a transfusion.
4. Identify equipment used to administer a transfusion and it’s proper usage.
5. Describe the nursing management of a blood component infusion.
6. Describe signs and symptoms of transfusion reactions, and appropriate interventions for each.
7. Explain appropriate patient education related to transfusion therapy.
8. Identify the required documentation for a blood transfusion.

Objectives for Section 7: Chemotherapy

Upon completion of this curriculum, the nurse will be able to:

1. Define how chemotherapy is used in cancer management.
2. List the major chemotherapy drug classifications and their general mechanisms of action.
3. Identify the major side effects/toxicities of chemotherapeutic agents.
4. Describe safe chemotherapy handling techniques.
5. Describe appropriate chemotherapy administration.
6. Recognize common psychological effects in patients receiving chemotherapy.

Objectives for Section 8: Gamma Globulin (IgG)

Upon completion of this curriculum, the nurse will be able to:

1. Name at least three conditions for which gamma globulin is indicated.
2. Demonstrate understanding of gamma globulin administration by recognizing the steps involved in its preparation and infusion.
3. Recognize at least two side effects of gamma globulin infusion.

Curriculum

Section One - Peripheral IV Therapy

This section of the Florida I.V. Therapy curriculum has been written to provide basic conceptual and operational knowledge to healthcare clinicians who have had limited exposure to infusion therapy principals and practice.  As the science of infusion therapy advances and technology expands, it is imperative that all healthcare clinicians and nurses practicing infusion therapy remain current in their knowledge of infusion therapies, principles, techniques, equipment and the latest in infusion evidence based practices. 

Chapter 1: Legal Issues

• Regulatory Agencies and Governing Bodies 
• Components of a Complete Physicians Order 
• Legal Terms and Applications in Nursing
• Protective Measures for Guarding against Malpractice Lawsuits

Chapter 2: Anatomy and Physiology

• The Vascular System: Veins, Arteries and Bone Marrow 
• The Three Layers of the Vessels and Their Function 
• Differentiating Arteries from Veins
• Veins used in Peripheral Intravenous Therapy for Pediatrics and Adults
• Intraosseous
• Skin: Anatomy and Physiology

Chapter 3:  Psychological Needs of the IV Patient

• Age Specific Needs of Children
• Elderly Patient Needs 
• Cultural Aspects
• Patients with Sensory Deficits 
• Methods of Reducing Patient Anxiety 
• Patient Teaching/Education

Chapter 4: Fluid and Electrolyte Balance

• Water: The Primary Fluid of the Body
• Hypovolemia—Dehydration: Assessment, Causes, Treatments 
• Hypervolemia—Fluid Overload: Assessment, Causes, Treatments 
• Fluid Compartments
• Electrolyte Imbalances: Assessment, Causes, Treatments

Chapter 5: pH, Osmolality and Incompatibilities of Solutions and Medications

• pH of Intravenous Solutions and Medications
• Tonicity: Isotonic solutions, Hypotonic solutions and Hypertonic Solutions Incompatibilities

Chapter 6: Fluid Regulation

• Methods of Fluid Regulation
• Patient Considerations in Fluid Regulation
• External Factors that Affect the Rate of Flow 
• Calculation of IV flow rates

Chapter 7: Infection Prevention and Safety Compliance

• Hand Hygiene
• Sharps Management
• Medical Waste Disposal
• Durable Medical Equipment Disinfection
• Standard Precautions
• Transmission-Based Precautions

Chapter 8: Vascular Visualization

• Trans-illuminator Technology
• Near Infrared Technology
• Ultrasound

Chapter 9: Site Selection and Device Placement

• Criteria For Peripheral Devices
• 3 Types Of Peripheral Access And Criteria For Placement
• Special Considerations Of The Specific Age Groups
• General Considerations Of Short Peripheral Access 
• Veins To Avoid

Chapter 10: Vascular Access Device Management

• Needleless Connectors
• Filtration
• Add-on Devices
• VAD Stabilization
• Joint Stabilization
• Site Protection
• Flushing and Locking
• Assessment, Care, and Dressing Changes
• Administration Set Changes

Chapter 11: Procedures Guides and Videos

• Pre-insertion Procedures
• Peripheral IV Insertion
• Primary and Secondary Administration set-up
• IV Push Administration
• Catheter Discontinuation

Chapter 12: Assessment and Documentation

• Catheter Insertion Documentation 
• Catheter Removal Documentation
• Assessment, Monitoring and Documentation by Therapy

Section 2 - Central Venous Access Devices

This section of the Florida I.V. Therapy curriculum has been written to provide current conceptual and operational knowledge to the licensed nurse responsible for the care of patients with central venous access devices. Ever changing technologies and the evolution of the licensed nurse’s role in the management of central lines requires up to date knowledge of changes in techniques, equipment and devices in use today. This course contains current practices for best patient outcomes and provides 5.0 contact hours of continuing education.

Chapter 13: Central Line Review

• Definition of a Central Line
• Reasons for use of a central line
• Advantages of a central line
• Overview of Central Venous Access Devices
• Lumens
• Non‐valved and valved catheters
• Non‐tunneled catheters
• Tunneled catheters
• Implanted ports
• PICC or Peripherally Inserted Central Catheter

Chapter 14: Anatomy

• Veins used for placement of central venous access devices
• Catheter tip placement

Chapter 15: Assessment and Preparations for Central Venous Catheterization

• Considerations for selection of the device
• Preparations for central venous catheterization

Chapter 16: Vascular Access Device Management

• Needleless Connectors
• Filtration
• Add-On Devices
• CVAD Stabilization
• Site Protection
• Flushing and Locking
• Assessment, Care, and Dressing Changes
• Administration Set Changes
• Blood Sampling from a CVAD

Chapter 17: Procedure Guides and Videos

• Central venous catheter dressing change
• Needleless access device change
• Central venous catheter flushing
• Blood Sampling from a CVAD

Chapter 18: Complications

• Catheter related complications
• Systemic complications
• Insertion related complications

Chapter 19: Discontinuation of Therapy

• Removal of devices
• Central venous access device removal procedure

Chapter 20: Assessment and Documentation and Patient Education

• Documentation of insertions, removal, infiltration or extravasations
• Assessment, monitoring, documentation by type of therapy

Section 3 - Catheter Related Blood Stream Infections (CRBSI)

This section of the Florida I.V. Therapy curriculum has been written to provide education to licensed clinicians regarding the national efforts in effect to reduce the number of central venous access device related blood stream infections. The Joint Commission has addressed this issue in its 2010 National Patient Safety Goals by requiring education of all medical personnel who are involved in managing central lines, both in hospitals and long term care facilities. This education is expected to be completed on hire, annually thereafter, and when involvement in these procedures is added to an individual's job responsibilities.

Chapter 21: Scope of Problem

• Morbidity / Mortality
• Cost
• Surveillance

Chapter 22: Catheter Insertion

• Site Selection
• Sterile Technique
• Antimicrobial Impregnated Catheters 

Chapter 23: Catheter Site Maintenance

• Dressing
• Needleless Connector
• Observation

 Chapter 24: Medication Administration

• Infusate
• Administration Set
• Flushing 

Chapter 25: Diagnosis and Treatment

• Clinical Findings
• Cultures
• Treatment

Section 4 - Hypodermoclysis (Clysis)

This section of the Florida I.V. Therapy curriculum has been written to provide information regarding the use of hypodermoclysis, also known simply as clysis, to achieve rehydration in patients who might otherwise require hospitalization. Dehydration is a common occurrence, especially in the older population. Clysis is an optimal means of administering non-emergent parenteral fluids in a familiar, comfortable environment. This intervention is cost-effective, easy to administer, and safer than intravenous rehydration, but many nurses are unfamiliar with the therapy. This course will prepare the licensed clinician to provide this valuable intervention, thereby decreasing the risk of hospitalization with its associated risks and costs. “Clysis” or subcutaneous rehydration intervention is cost-effective, easy to administer, and safer than intravenous rehydration, but many clinicians are unfamiliar with the therapy. This course will prepare the licensed clinician to provide this valuable intervention, thereby decreasing the risk of hospitalization with its associated risks and costs.

Chapter 26: Dehydration

• Scope of Problem
• Contributing Factors
• Signs and Symptoms
• Assessment

Chapter 27: Hypodermoclysis Introduction

• Advantages
• Disadvantage
• Indications
• Contraindications
• Use in Terminally Ill Patients

Chapter 28: Infusion Parameters

• Sites
• Solutions
• Volume and Rate
• Hyaluronidase

Chapter 29: Administration

• Equipment
• Procedures

Chapter 30: Complications

• Systemic Complications
• Local Complications

Chapter 31: Communication and Documentation

 
Section 5 - Total Parenteral Nutrition in the Adult Patient

This section of the Florida I.V. Therapy curriculum has been written to provide current conceptual and operational knowledge to nurses and other healthcare providers interested in the provision of parenteral nutrition therapy. The understanding and use of TPN has evolved since its entry into mainstream healthcare several decades ago. 

Chapter 32: Indications for Parenteral Nutrition

• Altered Absorption Capacity
• GI Disorders Requiring Complete Bowel Rest
• Intractable Vomiting or Diarrhea
• Hypermetabolic States
• Anorexia Nervosa

Chapter 33: Goals

• Maintenance of Normal Body Weight and Protein Status
• Restoration of Normal Body Weight and Protein Status
• Maintenance or Restoration of Normal Micronutritional Status

Chapter 34: Normal Nutritional Requirements

• Protein
• Carbohydrate
• Lipid
• Vitamins
• Minerals
• Trace elements

Chapter 35: Nutritional Assessment

• Anthropometrics
• Biochemical
• Clinical
• Dietary

Chapter 36: Composition of Parenteral Nutrition

• Dextrose
• Amino Acids
• Lipids
• Water
• Electrolytes
• Vitamins
• Trace Elements
• Other Additives

Chapter 37: Administration

• Central Venous Access Devices
• Electronic Infusion Devices
• TPN and Lipids
• Preparing the TPN for Infusion
• Initiating the Infusion

Chapter 38: Complications

• Metabolic Complications
• Vascular Access Device-Related Complications

Chapter 39: Monitoring and Documentation

• Vital Signs
• Glucose
• Weight
• Intake and Output
• Laboratory Values
• TPN Administration
• IV Catheter Care

Section 6 - Transfusion Therapy

This section of the Florida I.V. Therapy curriculum has been written to provide clinicians caring for the adult patient receiving transfusion therapy. There are various blood components infused for very specific purposes, and each component requires knowledge related to that specific product. This specialized type of therapy requires advanced clinical knowledge beyond that required for the provision of general infusion therapy. Therefore, education related specifically to the administration of blood products is crucial to the safe and effective use of these components. This course will provide information necessary for administering these life saving infusions.

Chapter 40: Introduction to Transfusion Therapy

• Blood Components
• ABO Blood Group System
• Rh Blood Group System
• Other Blood Group Antigens
• HLA System

Chapter 41: Whole Blood

• Description
• Indications

Chapter 42: Packed Red Blood Cells

• Description
• Indications
• Donation and Testing
• Red Blood Cell Subsets

Chapter 43: Platelets

• Description
• Indications
• Donation and Testing
• Platelet Subsets

Chapter 44: Plasma

• Description
• Indications
• Donation and Testing

Chapter 45: Granulocytes

• Description
• Indications
• Donation and Testing

Chapter 46: Clotting Factors

• Cryoprecipitate
• Factor Concentrates

Chapter 47: Pre-transfusion Activities

• Licensed Independent Prescriber Order
• Patient Consent
• Type and Crossmatch
• Vascular Access
• Baseline Vital Signs

Chapter 48: Transfusion Administration

• Component Transport and Storage
• Equipment
• Pre-medication
• Identification
• Administration
• Monitoring
• Patient Education
• Documentation

Chapter 49: Complications

• Immune Complications
• Hemolytic Reactions
• Non-Hemolytic Reactions
• Non-immune Complications
• Infectious Complications
• Transfusion Associated Fluid Overload (TACO)
• Complications of Massive Transfusion

Section 7 - Chemotherapy

This section of the Florida I.V. Therapy curriculum has been written to provide clinicians administering and/or caring for the patient receiving chemotherapy. Both clinicians involved in infusing chemotherapeutic agents and those caring for patients receiving these medications need a working knowledge of the diagnoses for which they are given, side effects of the drugs, appropriate nursing interventions, and the psychological implications of having these diseases and receiving treatment for them. These drugs are double-edged swords. They can both cure cancer and cause cancer. They are associated with more side effects and more serious side effects than most other medications clinicians administer. Therefore, education related specifically to chemotherapy is crucial to the safe and effective use of these drugs. 

Chapter 50: Introduction to Chemotherapy

• Definition
• Goals of Chemotherapy
• Cell Cycle
• Chemotherapy Approaches

Chapter 51: Chemotherapy Drug Classifications

• Cell-cycle Specificity
• Mechanism of Action
• Alkylating Agents
• Antimetabolites
• Antitumor Antibiotics
• Mitotic Inhibitors
• Topoisomerase Inhibitors
• Miscellaneous
• Cytoprotective Agents

Chapter 52: Chemotherapy Side Effects

• Myelosuppression
• Gastrointestinal
• Integumentary
• Cardiovascular
• Respiratory
• Renal
• Neurologic
• Reproductive

Chapter 53: Safe Handling

• Preparation
• Administration
• Disposal
• Bodily Discharges

Chapter 54: Administration

• Pre-administration Activities
• Routes of Administration

Chapter 55: Psychological Effects

• Grief
• Loss of Status
• Desirability
• Long-term Concerns

Section 8 - Gamma Globulin

This section of the Florida I.V. Therapy curriculum has been written to provide current conceptual and operational knowledge to the licensed clinician interested in the provision of gamma globulin therapy. The understanding and use of gamma globulin has evolved since its entry into mainstream healthcare. 

Chapter 56: Introduction to Gamma Globulin

• Definition
• Indications
• Products

Chapter 57: Administration

• Intravenous
• Subcutaneous

Chapter 58: Possible Adverse Events

• Common Side Effects
• Uncommon Side Effects
• Anaphylaxis

Chapter 59: Patient Education

• Nurse Administration
• Patient Administration

Chapter 60: Assessment and Documentation

Chapter 61: Resources and Skill Check-Off Lists

• Skill Check-Off Lists
  • Peripheral IV Insertion
  • Medication Administration
  • Large Volume Electronic Infusion Device Peripheral IV Catheter Insertion
  • IV Push
  • Accessing a Port
  • Administration of Infusate via an Ambulatory Infusion Pump 
  • Blood specimen collection from a CVAD
  • Deaccessing an Implanted Port 
  • IV Push
  • Large Volume Electronic Infusion Device 
  • Medication Administration
  • Midline or Central Line Dressing Change 
  • Needleless Connector Device Change