Can vs. Should


IV insertion

What am I talking about? I am referring to a very difficult and controversial topic in infusion therapy, the use of  medical assistants  (MA) in peripheral intravenous insertion and administration (infusion) of medications. Before I continue,  I would like to disclose that I have nothing against medical assistants and this discussion does not include nursing  “assistive personnel” because the Infusion Nurses Society (INS) has already addressed their role in a position paper entitled, ” The Use of Nursing Assistive Personnel in the Provision of Infusion Therapy.

Medical assistants as defined by the US Bureau of Labor Statistics, perform routine administrative and clinical tasks to keep the offices and clinics of physicians, podiatrists, chiropractors, and optometrists running smoothly. In many states, the classification of medical assistant is defined under the provisions of the Medical Practice Act. Thus, the responsibility for the appropriate use of medical assistants rests with the physician. With that in mind, the question is… can a medical assistant perform a peripheral intravenous insertion and administer (infusion) medications? The answer is …with or without proper training and experience in peripheral insertion techniques and the principles of infusion therapy, there are medical assistants who perform this function in clinics and physician’s offices across the United States. There are no federal regulations or state mandates that prohibit a medical assistant from performing these functions as long as the function is delegated and the medical assistants are supervised by the physician.  So if they can, should they? There is no clear and easy answer. Because the medical assistants are under the employment of the physician or the practice employing the medical assistants, the decision to use medical assistants for this function rest solely on them. My opinion as an infusion nurse is the use of medical assistants for the direct provision of infusion therapies  may result in potential adverse outcomes to the patient and the public, and may increase liability risks for the physician and the practice.

As I have mentioned in a previous blog, I provide training classes on biologic infusions attended by healthcare professionals including medical assistants. Often, I am asked, can a medical assistant start a peripheral intravenous  line and infuse biologic agents? A tough question to ask  an “infusion nurse” and I have to take a deep breath and sigh. To quote my grandfather, he would say..“just because you can rob a bank, doesn’t mean you should”.

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