10.27.20.02

.02 Definitions.

A. In this chapter, the following terms have the meanings indicated.

B. Terms Defined.

(1) "Administer" means to hang or give subsequent fluids and medications.

(2) "Antineoplastic" means:

(a) Chemical or biologic agents that have a toxic effect on the disease-causing agent or modify the host environment; or

(b) Drugs that are capable of destroying invading organisms or malignant tumor cells.

(3) "Arterial catheter" means a catheter or needle inserted into an artery.

(4) "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.

(5) "Central venous catheter (CVC)" means a catheter whose tip is located in a central vessel.

(6) "Chronic dialysis client" means a client with end stage renal disease who is receiving routine dialysis treatments in an outpatient facility.

(7) "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.

(8) "Comprehensive assessment" means a nursing assessment that includes:

(a) The specific individual patient's clinical status;

(b) Medical treatment regime; and

(c) Complexity of the infusion therapy treatment regime including:

(i) The purpose and effects of the specific infusate or medication;

(ii) Skills to access and de-access the infusion catheter access device; and

(iii) The potential harm to the patient should an error occur.

(9) Direct Supervision.

(a) "Direct supervision" means oversight exercised by a registered nurse who is present on the unit of care during the infusion therapy process.

(b) "Direct supervision" includes the actions of:

(i) Observation;

(ii) Assessment;

(iii) Evaluation; and

(iv) Direction.

(10) "First dose" has the meaning defined by the facility's policies and procedures.

(11) "Hypodermoclysis" means the infusion of fluids into subcutaneous tissue for hydration.

(12) Implanted Port.

(a) "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.

(b) "Implanted port" is often referred to as a medi-port, port-a-cath, infuse-a-port, infusion port, or a subcutaneous port.

(13) "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.

(14) "Infusion therapy" means the initiation and administration of medication, fluids, and nutrients via an intravenous access device.

(15) "Initiate" means to hang and administer the first dose of medications or fluids.

(16) "INS" means Infusion Nurses Society.

(17) "Intraventricular reservoir" means a catheter threaded through the dura into a ventricle of the brain.

(18) “Licensee” means a registered nurse or licensed practical nurse.

(19) “LPN” means an individual who:

(a) Is licensed by the Board to practice licensed practical nursing; or

(b) Has a multistate licensure privilege to practice licensed practical nursing.

(20) "Midclavicular catheter" means a peripherally inserted catheter with the distal tip located between the axilla and the vena cava.

(21) "Midline catheter" means a peripherally inserted catheter with the tip terminating below the axilla.

(22) "Multi-lumen catheter" means a venous access device that has more than one lumen.

(23) “Multistate licensure privilege” has the meaning set forth in COMAR 10.27.01.01B.

(24) "Non-tunneled catheter" means a percutaneously placed catheter inserted into the vein.

(25) "ONS" means Oncology Nursing Society.

(26) "On-site supervision" means oversight exercised by a supervising registered nurse who is:

(a) Present in the facility; and

(b) Quickly and easily available to the patient and the assigned nurse during the course of infusion therapy.

(27) "Peripheral catheter" means a catheter or needle inserted into a superficial vein with the tip residing outside of the central venous system.

(28) "Peripheral veins" means those veins in the superficial aspects of the body excluding the external jugular vein.

(29) "Peripherally inserted central catheter (PICC)" means a catheter, inserted with or without a guide wire, whose tip is located in the vena cava.

(30) "PPN" means partial parenteral nutrition.

(31) “Registered nurse (RN)” means an individual who:

(a) Is licensed by the Board to practice registered nursing; or

(b) Has a multistate licensure privilege to practice registered nursing.

(32) "Specialized catheter" means an epidural, intrathecal, intrapleural, or peripheral nerve catheter.

(33) "Subcutaneous infusion of medication" means a continuous or intermittent infusion of medication by an indwelling needle or catheter inserted into subcutaneous tissue.

(34) "TPN" means total parenteral nutrition administered into the central venous system.

(35) "Tunneled catheter" means a CVC designed to have a portion of the catheter lie in a subcutaneous passage before exiting the body.

(36) "Nonsurgically placed" means a catheter placed percutaneously.