Are nurses allowed to remove JP drains? Your comprehensive guide

September 25, 2025 •

4 min read

While Jackson-Pratt (JP) drains are a common feature of post-operative care, their removal involves specific protocols and regulations. The central question remains: are nurses allowed to remove JP drains, or is this task reserved for a physician? It’s a matter that depends on several critical factors, including the nurse's credentials, institutional policy, and state regulations.

Quick Summary

A nurse's authority to remove a Jackson-Pratt (JP) drain is determined by their professional scope of practice, specific state and institutional policies, and the existence of a physician's order for removal. It is not a universally permitted procedure for all nurses and requires documented competency and adherence to strict protocols.

Key Points

RN Scope: A Registered Nurse (RN) can typically remove a JP drain, provided they have a physician's order, specific training, and demonstrated competency, and follow facility protocols.
LPN Limitations: Licensed Practical Nurses (LPNs) are generally not permitted to remove JP drains; this task is typically outside their scope of practice, as defined by state boards and institutional policy.
Prerequisites for Removal: A physician's order is mandatory before any nurse can remove a JP drain, with the order often conditional on the volume of drainage.
Procedural Adherence: The removal process is a delicate procedure requiring sterile technique, patient comfort, and knowledge of how to handle potential complications like resistance.
Facility Policy is Key: A nurse's actions are always governed by their specific healthcare facility's policies, which may impose stricter rules than state regulations.
Patient Safety: Ensuring patient safety is the top priority, which means adhering to the correct scope of practice and knowing when to escalate an issue to a physician.

The legal and procedural framework for JP drain removal

Jackson-Pratt (JP) drains are small, flexible tubes used to remove excess fluid from surgical sites, promoting healing and preventing complications. The process of removing these drains requires careful consideration of a nurse's credentials and the specific policies of their workplace.

Registered Nurses (RNs) and drain removal

For a Registered Nurse (RN), the ability to remove a JP drain is generally considered to be within their scope of practice, provided they have the necessary training and a physician's order. The process is not automatically delegated and involves several prerequisites.

Prerequisites for RNs

Physician's Order: A clear, documented order from the attending physician is mandatory. The order will specify the conditions for removal, often based on the volume of drainage over a set period, such as less than 30 mL in 24 hours.
Training and Competency: The RN must have received specific training and demonstrated competency in the procedure. This is typically part of their orientation and ongoing skill validation at a healthcare facility.
Facility Policy: The RN must adhere strictly to their employing facility's policies and procedures regarding drain management and removal. Some institutions may have additional requirements or restrictions.

Licensed Practical Nurses (LPNs) and drain removal

The scope of practice for Licensed Practical Nurses (LPNs), also known as Licensed Vocational Nurses (LVNs) in some states, is more restrictive. In many jurisdictions, removing a JP drain is not within the LPN's scope of practice and cannot be delegated to them.

LPN scope limitations

Delegation: While LPNs can perform tasks related to drain care, such as emptying the bulb, measuring output, and maintaining suction, drain removal is often considered a higher-level task that is not delegable.
State Board of Nursing: Each state's Board of Nursing defines the legal scope of practice. Many state boards explicitly state that advanced procedures like drain removal are not within the LPN's purview. It is crucial for LPNs to be aware of the specific regulations in their state.

The process of JP drain removal

The removal of a JP drain is a multi-step process that prioritizes patient safety and comfort.

Steps for removal

Patient Education: Before the procedure, the nurse explains the process to the patient, ensuring they understand what will happen and how to cooperate.
Preparation: The nurse gathers the necessary supplies, including sterile gloves, a suture removal kit, gauze, and a sterile dressing.
Procedure: The nurse washes their hands, puts on gloves, and removes the old dressing. If sutures are holding the drain in place, the nurse carefully cuts them. The patient is asked to take a deep breath and hold it, which helps relax the muscles around the drain site. The nurse then pulls the drain out with a slow, steady motion.
Post-removal Care: Once the drain is out, the nurse applies pressure to the site with sterile gauze to control any oozing and then covers it with a new dressing.

Potential complications and what to watch for

While typically a straightforward procedure, complications can arise. These include resistance during removal, which could indicate the drain is snagged on internal sutures, and excessive drainage post-removal. Nurses are trained to recognize these issues and know when to stop and notify the physician.

Comparison of RN and LPN duties regarding JP drains


Task	Registered Nurse (RN)	Licensed Practical Nurse (LPN)
Drain Removal	Yes, with physician's order, demonstrated competency, and per facility policy.	No, generally outside the scope of practice and not delegable.
Patient Assessment	Yes, full nursing assessment of the drain site and patient's condition.	Yes, contributes to assessment by collecting data and monitoring the site.
Drainage Measurement	Yes, measures and documents fluid output.	Yes, measures and documents fluid output.
Bulb Maintenance	Yes, empties and re-compresses the bulb to maintain suction.	Yes, empties and re-compresses the bulb to maintain suction.
Site Care	Yes, cleans and dresses the insertion site according to protocol.	Yes, cleans and dresses the insertion site according to protocol.
Patient Teaching	Yes, provides education on drain care and signs of complications.	Yes, reinforces teaching and answers patient questions within their scope.

The importance of institutional and state-specific protocols

Every healthcare facility will have its own policies regarding nursing procedures, which may be more restrictive than state law. Furthermore, state laws governing the scope of nursing practice vary significantly. Therefore, a nurse must always consult their institutional policy and state regulations before performing any procedure, including drain removal.

For further information on the scope of nursing practice, consult your state's board of nursing guidelines.

Conclusion: The definitive answer

The question, Are nurses allowed to remove JP drains?, has a nuanced answer. While it falls within the scope of practice for a Registered Nurse with a physician's order and demonstrated competency, it is generally not permitted for Licensed Practical Nurses. Strict adherence to institutional policy, state regulations, and proper procedural technique is paramount to ensure patient safety and maintain professional standards. The responsibility lies with the individual nurse to understand their specific limitations and credentials before undertaking this task.

Frequently Asked Questions

No, even with training and competency, an LPN's ability to remove a JP drain is dictated by their state's Nurse Practice Act. In many states, this falls outside the legal scope of practice for an LPN, making it a prohibited task regardless of individual skill.

A physician's order is a mandatory prerequisite for JP drain removal by a nurse. The order authorizes the procedure and often specifies criteria for removal, such as a low drainage volume, which signals that the drain is ready to come out.

If a nurse encounters resistance during removal, they should immediately stop the procedure and notify the physician. Forcing the drain could cause patient injury or damage to internal tissues. The drain may be snagged on sutures or internal tissue.

Yes, a registered home care nurse can remove a JP drain, provided they have a physician's order and their home health agency's policy allows it. This is a common practice for patients who are discharged from the hospital with a drain still in place.

A JP drain removes fluid from a surgical site and is typically smaller. A chest tube is larger and drains air or fluid from the chest cavity (pleural space). Removing a chest tube is a more complex, high-risk procedure that is typically performed by a physician.

Hospital policies provide the specific rules and regulations that nurses must follow within that institution. They can be more restrictive than state law. A nurse must be trained and validated in a hospital's specific procedure before they can perform a JP drain removal there.

Common criteria include a consistently low drainage output (e.g., less than 30 mL in 24 hours), and the character of the drainage changing from bloody to serous (clear, watery). The patient's overall healing and condition are also considered.