The evolution of independent for-profit (stand-alone) clinics providing intravenous (IV) hydration therapy has prompted many calls to the CRNS. After completing environmental scanning and a review of best practices, the CRNS has determined that it is within the scope of practice of Registered Nurses (RN) to administer IV hydration therapy and medications, vitamins, and/or electrolytes (additives) while working in stand-alone clinics so long as the nursing process is implemented and appropriate policies and supports are in place to support safe, competent, and ethical care of this client population.
RNs and Nurse Practitioners (NP) are accountable to practice within their legislated scope of practice and personal competence and to adhere to their Practice Standards and Code of Ethics as they would in any other practice setting. Registrants must complete the Recognition of Practice process to use the title RN and/or NP and to count the practice hours they have worked in an IV hydration clinic towards licensure.
With the growing popularity of IV hydration therapy and individuals “self-selecting” treatments – for example, to relieve the effects of a hangover, there is an increasing trend of complaints related to unsafe practices and untoward events reported in Canada and the United States. It is essential for RNs and NPs engaged in this practice to understand that IV hydration is a medical treatment and, therefore, there must be a medical condition for the client to obtain the treatment. As with all treatments and interventions, the risks of accepting treatments should be disclosed to the client and informed consent obtained.
To provide safe, competent nursing care and to meet the requirements for Recognition of Practice, the following must be in place when performing IV hydration therapy treatments:
- Appropriate policies, procedures, and resources.
- A health history and physical examination must be performed and documented by the prescribing NP or physician to ascertain if underlying co-morbidities, such as congestive heart failure or kidney disease, might be a contraindication to the client receiving treatment.
- Provision for diagnostic testing, as indicated for co-morbidities, should be completed as part of the client assessment. Diagnostic testing should be considered to establish a baseline for ongoing treatment.
- The infusion must be prescribed to treat a diagnosed medical condition; clients must not “self-select” treatments.
- There must be an order from an NP or physician for the RN to initiate the IV and/or administer the IV solution and additives.
- There must be appropriate documentation, including the client assessment, client consent, treatment ordered and administered, and client response to that treatment.
- The supplies, including IV lines, solution, and additives, must be procured from a reputable source and stored and handled in alignment with current infection prevention and control (IPAC) best practices and principles.
- There must be an ability to manage untoward events, including having the necessary emergency equipment on site.
For more information or to inquire about recognition of practice, please contact a nursing practice advisor practiceadvice@crns.ca.