It is within the scope of practice of the appropriately prepared licensed practical nurse to perform the following tasks related to chest tube care:

1. Chest tube insertion site care/dressing change;
2. Clamp the tube in an emergency;
3. Monitor patency of the draining system;
4. Assist the physician, advanced practice registered nurse or registered nurse in changing bottles and/or disposable collection system.

The appropriately prepared licensed practical nurse may perform these tasks provided:

1. The licensed practical nurse is educated and competent in the procedure. This education and competence must be documented initially and on an ongoing basis;
2. There is a medical order for the procedure;
3. The patient must be assessed initially and on an ongoing basis as needed by the registered nurse to determine whether there are contraindications or changes which require additional resources or expertise;
4. The licensed practical nurse practices according to accepted standards of practice;
5. The procedure is performed and the patient is monitored according to accepted standards of practice;
6. All necessary resources including, but not limited to emergency resources/equipment are available; and
7. The facility/agency has policies and procedures in place to address all aspects of the issue.

It is not within the scope of practice of the licensed practical nurse to perform the following tasks:

     A. Independently change out chest tube bottles;

     B. Independently change a disposable collection system; or

     C. Manipulate, advance, irrigate, milk or remove a chest tube.