TABLE OF CONTENTS

SECTION I - SKILLED SERVICES 1.00 Sterile Technique Procedure

1.01 Cast Care

1.01A Spica Casts and Body Casts

1.02 Bucks Traction

1.01 1.03 Catheterization—Care of Indwelling Urinary Catheter

1.02 1.04 Catheterization—Insertion of Indwelling Urinary Catheter

1.03 1.05 Catheterization—Removal of Indwelling Urinary Catheter

1.04 1.06 Catheterization—Straight Catheter

1.05 1.07 Diabetic Teaching

1.06 1.08 End Stage Disease Services

1.07 1.09 Home Nursing Assessment Newborn

1.08 1.10 Home Nursing of Post-Partum Mother and Infant

1.09 1.11 Hospital Evaluation and Discharge Planning

1.10 1.12 Nursing Bag Management

1.11 1.13 Nursing Supervisory Visit

1.12 1.14 PH Probe Study—Placement and Monitoring

1.13 1.15 Chest Physiotherapy and Postural Drainage

1.14 1.16 Suctioning—Bulb

1.15 1.17 Suctioning—Nasopharyngeal and Tracheal

1.16 1.18 Thermoregulation

1.17 1.19 Tracheostomy—Cleaning of Suction Catheters and Connecting Tubing

1.18 1.20 Tracheostomy Stoma Site Care

1.19 1.21 Tracheostomy Suctioning

1.20 1.22 Tracheostomy Tie Change

1.21 1.23 Tracheostomy Tube Change

1.22 1.24 Tracheostomy Transition to Home

1.23 1.25 Urine Specific Gravity Measurement

1.24 1.26 Wound Care—Assessment, Clarification, and Staging

1.25 1.27 Wound Care—Dressing Changes

SECTION II - LAB PROCEDURES 2.01 Central Line Catheter Blood Draw

2.02 Dorsal Venipuncture

2.03 Glucose Testing—Using Glucometer

2.04 Glucose Testing—Using Test Strips

2.05 Heel Stick Procedure

2.06 Implanted VAD Blood Draw

2.07 Peripheral Blood Draw

2.08 Peripherally Inserted Central Catheter (PICC) – Blood Draw

2.09 Sputum Culture Collection

2.10 Stool Testing—Culture & Sensitivity, Occult Blood, Ova & Parasites, pH, Reducing Substance

2.12 Tracheal Gastric pH & Gastric Occult Blood

2.13 Tracheal Aspirate Collection

2.14 Urine Testing

SECTION III - MEDICATION ADMINISTRATION

3.00 Administration of Medications: General Guidelines 3.01 Eye Drop/Ointment Administration 3.02 Inhaled Medication—Metered Dose Inhaler (MDI)

3.03 Intramuscular Medication Administration

3.04 Ceredase Injection (Alglucerase)

3.05 Synagis Administration

3.06 Albumin

3.07 Amphotericin B

3.08 Antibiotics (PIV) and (VAD) using a Syringe Pump

3.09 ARA-C

3.10 Chemotherapy Through VAD

3.11 Deferoxamine

3.12 Factor VIII

3.13 Ganciclovir (DHPG)

3.14 IV Flush Guidelines

3.14A Heparin Grid A: Use to Complete Plan of Care

3.14B Heparin Grid B: Dose to be Given

3.15 Administration of IV Immune Globulin

3.16 Nasal Medication Administration

3.17 DDAVP Administration

3.18 Oral Medication Administration

3.19 Digoxin Administration

3.20 Outer Ear Medication Administration

3.21 Rectal Medication Administration

3.22 Silver Nitrate Administration

3.23 Subcutaneous Medication

3.24 Epogen (Epoetin Alfa)

3.25 GCSF (Neurogenic)

3.26 Growth Hormone

3.27 Insulin Administration—Using Soft Pocket Technique

3.28 Topical Emla Cream Administration

3.29 Wydase Administration

SECTION IV – HIGH TECH POLICIES

4.01 Apnea Monitor

4.02 Enteral Infusion Pumps for Continuous Drip Feedings

4.03 Infusion Pumps

4.04 Mechanical Ventilation in the Home

4.05 Aerosol Therapy – Nebulizer

4.06 Care and Maintenance of Hand Held Nebulizer

4.07 Home Oxygen Therapy Via Nasal Cannula

4.08 Phototherapy

4.09 Central Line Catheter – Administration of IVP Medication

4.10 Central Line Catheter – Administration of Hydration Fluid

4.11 Central Line Catheter – Administration of TPN/IL

4.12 Central Line Catheter Cap Change / Anti Reflux Valve

4.13 Central Line Catheter Dressing Change

4.14 Central Line Catheter Heparinization

4.15 Central Line Catheter Repair – Permanent

4.16 Central Line Catheter Repair – Temporary

4.17 Central Line Catheter – Site and Line Culture

4.18 Central Line Catheter – Use of Urokinase

4.19 Extravasation – Treatment / Documentation

4.20 Implanted Vascular Access Device (VAD) – Administration of IV Hydration

4.21 Implanted Vascular Access Device (VAD) – Administration of IVP Medication

4.22 Implanted Vascular Access Device (VAD) – Administration of TPN /IL

4.23 Implanted Vascular Access Device (VAD) – Catheter Care and Maintenance

4.24 Implanted Vascular Access Device (VAD) – Heparinization

4.25 Implanted Vascular Access Device (VAD) – Insertion of Huber Needle

4.26 Implanted Vascular Access Device (VAD – Removal of Huber Needle

4.27 Implanted Vascular Access Device (VAD) – Site Line and Culture

4.28 Peripheral IV – Access and Insertion

4.29 Peripheral IV – Administration of IVP Medication

4.30 Peripheral IV – Administration of IV Hydration

4.31 Peripheral IV – Discontinuation

4.32 Peripheral IV – Heparinization

4.33 Peritoneal Dialysis Catheter – Exit Site Cleaning & Dressing Change

4.34 Peritoneal Dialysis Catheter – Exit Site Culture

4.35 PICC Line – Administration of IVP Medication

4.36 PICC Line – Administration of IV Hydration

4.37 PICC Line – Administration of IV TPN / IL

4.38 PICC Line – Cap Change / Anti Reflux Valve

4.39 PICC Line - Dressing Change

4.40 PICC Line – Heparinization

4.41 PICC Line – Insertion

4.42 PICC Line – Repair (Temporary)

4.43 PICC Line – Removal

4.44 PICC Line – Site and Line Culture

4.45 PICC Line – Use of Urokinase

4.46 Gastrostomy Care

4.47 Replacement of Gastrostomy Button

4.48 Replacement of Gastrostomy Tube

4.49 Administration of Tube Feeding – Bolus, Bag Method using Nasogastric Tube, Gastrostomy Tube,

Percutaneous Endoscopic Gastrostomy Tube, or Jejunostomy Tube

4.50 Administration of Tube Feeding – Bolus, Syringe Method Using Nasogastric Tube, Gastrostomy Tube,

Percutaneous Endoscopic Gastrostomy Tube, or Jejunostomy Tube

4.51 Administration of Medications through Nasogastric, Gastrostomy or Jejunostomy Feeding Tube

4.52 Assessment of Gastric Residual

4.53 Gavage Feeding – Intermittent Feeding via Orally / Nasally Placed Gavage Tube

4.54 Jejunostomy Care

4.55 Placement and Verification of Naso Gastric Feeding Tube for Continuous Feeding