Individual LPN IV Therapy Course Approval

Individuals desiring to obtain approval of an IV Therapy Administration course for the obtaining of a KS IV Therapy Certification must complete and submit this application to the KSBN. The course must meet the requirements of a KS approved IV Therapy course as outlined in: K.S.A. 65-1136, K.A.R. 60-16-103, & K.A.R. 60-16-104.

You should complete this form if:

• You have performed intravenous fluid therapy prior to July 1, 1995. You will attach verification of the scope of IV fluid therapy you have performed and will be required to successfully complete the Kansas approved IV therapy examination, or
• You have successfully completed an intravenous fluid therapy course and passed an intravenous fluid therapy examination that was either through your LPN curriculum or a course which was not administered by a Kansas approved provider.

The following documents are required for submitting an application for LPN IV Therapy Course Approval:

• Attach the syllabus for the course you completed:
• The syllabus must provide the breakdown of hours the course consisted of: the # of didactic hours & the # of clinical hours.
• The syllabus must provide details on the curriculum taught.
• The syllabus must include details on the methods of student evaluation. The requirements for passing the course and the clinical competency.
• Attach either a transcript showing the course completed and passed if taken through your LPN curriculum or a certificate of completion if the course was taken through a provider not pre-approved by the State of Kansas.

Your course information will be reviewed to evaluate if it meets or exceeds the standards required in Kansas.

To complete the application, do the following:

• • Complete the application in full.
  • Attach all required documents as listed above.