STATE BOARD OF NURSING [49 PA. CODE CH. 21] Epidural Medications in Intrapartal Practice [27 Pa.B. 6475] The State Board of Nursing (Board) proposes to amend § 21.413(b)(5) (relating to interpretations regarding the administration of drugs--statement of policy) by deleting the prohibition against a registered nurse administering medications by epidural catheter or other pain relief devices in intrapartal practice. The Board believes that nursing care practice in regard to intrapartal analgesia has sufficiently evolved so that an obstetric nurse should be permitted to administer epidural analgesia to provide timely pain relief for a woman in labor.
The Board's proposal is based on a review of the current policy and comments and correspondence received from the Pennsylvania Nurses Association, the Hospital Association of Pennsylvania, the Pennsylvania Association of Nurse Anesthetists and the Association of Women's Health, Obstetric, and Neonatal Nurses (AWHONN). AWHONN is the only group that does not support the change. AWHONN believes that epidural analgesia administered by a registered nurse to a pregnant woman poses a risk-management concern. The Board notes that in many health care facilities today the patient herself administers her own analgesia through a hand-held patient controlled pump. The Board believes that nurse administered epidural analgesia would be safer than patient administered epidural medications because the nurse would be able to better manage the administration and identify any untoward side effects.
Statutory Authority
This statement of policy is proposed under sections 2(l) and 2.1(k) of the Professional Nursing Law (63 P. S. §§ 212(l) and 212.1(k)) and § 21.401 (relating to interpretations: scope of practice).
Comments
Under § 21.401, the Board will allow 60 days for public comment from the date of publication in the Pennsylvania Bulletin of this notice.
M. CHRISTINE ALICHNIE, PhD, RN,
ChairpersonFiscal Note: 16A-518. No fiscal impact; (8) recommends adoption.
Annex A TITLE 49. PROFESSIONAL AND VOCATIONAL STANDARDS PART I. DEPARTMENT OF STATE Subpart A. PROFESSIONAL AND OCCUPATIONAL AFFAIRS CHAPTER 21. STATE BOARD OF NURSING § 21.413. Interpretations regarding the administration of drugs--statement of policy.
(b) The following nursing practices fall within the scope of registered nursing practice under §§ 21.11; 21.12 and 21.14 (relating to general functions; venipuncture; intravenous fluids; and administration of drugs):
* * * * * (5) Monitoring and[, in situations other than intrapartal practice,] administering medications by epidural catheter or other pain relief devices to be used as analgesia for pain control. Administration of medications as used in this paragraph does not include initiation of the medication.
[Pa.B. Doc. No. 97-1984. Filed for public inspection December 12, 1997, 9:00 a.m.]
