PA Nurses Allowed to Perform Skin Suturing and Catheter Removal... 43 Tasks Defined

Ministry of Health and Welfare Announces Draft Regulations on Medical Support Work by Nurses
Clinical Experience Recognized for PA Nurses with Over 18 Months of Prior Service

Going forward, Physician Assistant (PA) nurses will be able to legally draft preliminary medical, surgical, and anesthesia records and perform certain physician tasks, such as skin suturing and replacing medical tubes. However, procedures such as bone marrow aspiration or paracentesis will only be permitted for those with advanced practice nurse qualifications, and supporting or assisting with the operation of surgical equipment will not be allowed.

Yonhap News Agency

The Ministry of Health and Welfare announced on October 1 that it will open the draft of the "Regulations on the Performance of Medical Support Work by Nurses" for public comment until November 10, and simultaneously issue an administrative notice regarding the "List of Medical Support Work Performed by Nurses." This is to establish detailed standards and guidelines for the medical support work of nurses, which was legalized under the "Nursing Act" enacted in September last year.

The draft regulation limits the medical institutions where PA nurses can perform medical support work to hospitals, general hospitals, and long-term care hospitals. In addition, medical institutions wishing to have nurses perform medical support work must obtain certification, but a grace period will be granted until December 2029.

The scope of medical support work is divided into three categories: patient assessment and support for records and prescriptions, support for procedures and treatments, and support for surgery and extracorporeal circulation. A total of 43 specific tasks are defined. This is the result of clarifying and reorganizing the terms and tasks, excluding some of the more controversial items from the 45 tasks previously proposed in public hearings.

Park Hyerin, Director of the Nursing Policy Division at the Ministry of Health and Welfare, explained, "In response to concerns that some tasks could be interpreted too broadly, tasks related to surgical tests or equipment support have been excluded, and procedures such as drainage tube insertion have also been removed."

Specifically, under physician delegation, PA nurses will be allowed to: monitor patient transport for critical tests; monitor the anesthesia process; draft preliminary medical, surgical, and anesthesia records; draft preliminary reports for tests, interpretations, consultations, and patient transfers; draft preliminary surgical, procedural, and treatment consent forms; draft preliminary medical opinions and certificates; and draft preliminary prescriptions for tests and medications under protocols.

Additionally, they may insert and replace nasogastric tubes (L-Tube, NG-Tube); clean and remove medical tubes (Tube, Catheter) and related devices; remove tracheostomy tubes (T-Tube); replace medical tubes and related devices; administer contrast agents through central venous catheters (C-line, PICC); remove central venous catheters; perform complex dressings (catheters, tubes, surgical sites, etc.); dress gastrostomy, enterostomy, and cystostomy sites; perform stage 3 pressure ulcer dressings; perform suction dressings; provide respiratory therapy (excluding respiratory rehabilitation); set ventilators (pressure, oxygen concentration, positive pressure, etc.); perform arterial blood sampling; insert peripheral arterial lines (A-line); perform skin suturing, knotting, and suture removal; incise and drain subcutaneous tissue; apply casts (full cast) and splints (partial cast) after trauma; administer intravesical BCG; perform prostate massage; perform digital rectal examinations (for objective verification of bleeding, etc.); conduct vaginal examinations during labor; assist with chest massage; support operation of extracorporeal circulation equipment under protocols; perform bone marrow aspiration; perform paracentesis; replace tracheostomy tubes; and perform stage 4 pressure ulcer dressings.

Other permitted tasks include: pre- and post-operative patient identification and interviews; support for surgery, such as administering contrast agents during procedures; non-invasive and invasive surgical support; preparation and operation of heart-lung machines and cardiopulmonary support equipment; preparation and management of extracorporeal circulation support devices (ECMO, VAD, IABP, etc.); maintenance and management of extracorporeal circulation-related equipment and components; and perfusion of organ preservation solutions and operation of extracorporeal circulation during various organ transplants (heart, lung, liver, etc.). All of these are included in the work scope of PA nurses.

Dedicated nurses eligible to perform medical support work must have at least three years of clinical experience and are required to complete training specified by the Minister of Health and Welfare. The training program will consist of theoretical, practical, and on-site training, with specific subjects and hours for each field to be determined through expert consultation and stipulated in the forthcoming "Notice on Training Programs for the Performance of Medical Support Work by Nurses."

Institutions authorized to provide such training include the Korean Nurses Association, the Korean Medical Association, hospital organizations and their branches, general hospitals with more than 300 beds, advanced practice nurse training institutions, and public health education and training centers. Each medical institution must also establish and operate a "Nurse Medical Support Work Operations Committee" to deliberate on matters related to the management of medical support work. This committee must include at least five members, including one chairperson, composed of physicians and nurses affiliated with the institution. Job descriptions must be prepared reflecting the completion of training by nurses performing medical support work.

Special provisions have been made for nurses who have already been performing medical support work prior to the implementation of the new regulations. Nurses with less than three years of clinical experience who have continuously performed medical support work for at least one year and six months will be considered as having met the experience requirement. Nurses with at least three years of clinical experience who have performed medical support work for at least one year and six months will be recognized as having completed the required training program.

The Ministry of Health and Welfare plans to finalize the regulations after broadly collecting public opinions during the notice period. Related opinions can be submitted by mail or email to the Nursing Policy Division of the Ministry of Health and Welfare by November 10.

This content was produced with the assistance of AI translation services.